Insurance Life and Health Exam FX
If a person is compensated for a testimonial in an advertisement, which of the following statements should be included in the advertisement.
"Paid Endorsement"
What percentage of a company's employees must take part in a noncontributory group life plan
100%
Group life insurance is a single policy written to provide coverage to members of a group. Which of the following statements concerning group life is correct?
100% participation of members is required in noncontributory plans.
An individual purchased a 100,000 Joint Life Policy on himself and his wife. Eight years later he died in an automobile accident. How much will his wife receive from the policy?
100,000
If a person is disabled at age 27 and meets Social Security's definition of total disability, how many work credits must he/she have earned to receive benefits?
12 credits
Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?
20 (medicare pays for all covered services during the first 20 days in a skilled nursing facility)
When a policy is replaced, replacing insurers must maintain a replacement register regarding the policy for
3 years
How long is the free look period for a Medicare Supplement policy?
30 days
If an insured cognitive impairment results in the lapse of a long term care policy, how long for the policy lapse may the insured request reinstatement.
5 months
Once the person meets the stringent requirements for disability benefits, how long is the waiting period under Social Security before any benefits will be paid?
5 months
Ray has an individual major medical policy that requires a coinsurance payment. Ray very rarely visits his physician and would prefer to pay the lowest premium possible. Which coinsurance arrangement would be best for Ray?
50/50*(premiums are lower) 75/25 80/20 90/10
Unreimbursed medical expenses paid for the insured may be claimed as deductions if the expenses exceed what percentage of the adjusted gross income?
7.5%
Which of the following of the named beneficiaries would not be able to receive the death benefit directly from the insurer in the event of the insured death.
A minor son of the insured
Disability income coverage specifies that the policy covers the insured if he is unable to preform any job for which he is qualified. In this case total disability is defined as
ANY Occupation - more restrictive than other definitions.
The insureds health policy only pays for medical costs related to accidents. Which of the following types of policies does the insured have?
Accident-Only
All of the following are examples of violations of replacement except
Advising an applicant to answer questions correctly* -any deceptive or misleading information -failing to ask the applicant questions regarding replacement. -Intentionally answering a question incorrectly
An insured pays 100 dollars premium every month for his insurance coverage, yet the insurer promises to pay 10,000 for a covered loss. What characteristic of an insurance contract does this describe.
Aleatory
When an insured purchased her disability income policy, she misstated her age to the agent. She told the agent that she was 30 years old, when in fact, she was 37. If the policy contains the optional misstatement of age provision.
Amounts payable under the policy will reflect the correct age
If an insurance company makes a statement that its policies are guaranteed by the existence of the Insurance Guaranty Association, that would be considered
An unfair trade practice
The least expensive first year premium is found in which of the following policies.
Annually renewable term
Partners in a business enter into a buy-sell agreement to purchase life insurance, which states that should one of them die prematurely, the other would be financially able to buy the interest of the deceased partner. What type of insurance policy may be used to fund this agreement?
Any form of Life Insurance
Which statements accurately describes the change of beneficiary provision
Any policy that has a death benefit must also have a Change of Beneficiary provision.
Medicare Supplement policies must have a notice prominently printed on the first page stating the applicant is entitlement to a 30-day free look period, which allows the applicant to return the policy for which of the following reasons.
Any reason
In a replacement situation, all of the following must be considered except?
Assets* Exclusions Benefits limitations
An insurer that holds a Certificate of Authority in the state in which it transacts business is considered a/an
Authorized User
What is The Consolidated Omnibus Budget Reconciliation Act
COBRA
The type of policy that can be changed from one that does not accumulate cash value to the one that does is a?
Convertible Term Policy.
An insured is involved in an accident that renders him permanently deaf, although he does not sustain any other major injuries. The insured is still able to perform his current job. To what extent will he receive Presumptive Disability benefits?
Full Benefits
Which of the following is an eligibility requirement for social security disability income benefits?
Fully insured status
At the time the insured purchased her life insurance policy, she added a rider that will allow her to purchase additional insurance in the future without having to prove insurability. The rider is called?
Guaranteed insurability
Under the privacy for HIPAA protected information includes all individually identifiable health information
Held or transmitted in any form
Which of the following would not be considered a purpose of life insurance solicitation regulations in Georgia?
Help buyers choose most qualified insurance producer* -Provide buyers with information about policies that would best suit their needs -Improve buyers understanding of policy features -Help buyers evaluate the relative costs of life insurance plans.
Which of the following statements pertaining to Medicare Part A are true.
Individuals who have ALS automatically qualify for Medicare Part A, regardless of age.
Which of the following policy components contains the company's promise to pay?
Insuring Clause
When a reduced paid up nonforfeiture option is chosen, what happens to the face amount of the policy?
It is the reduced to the mount of what the cash value would buy as a single premium.
Which of the following is true about a policy assignment?
It transfers rights of ownership from the owner to another person.
What type of health insurance policy provides an employer with funds to train a replacement if a valued employee becomes disabled?
Key Person Disability
Insurance is a contract by which one seeks to protect another from
Loss
An insured is covered under a medicare policy that provides a list of network healthcare providers that the insured must use to receive coverage. In exchange for this limitation, the insured is offered a lower premium. Which type of medicare policy does the insured own.
Medicare Select
If a life insurance policy develops cash value faster than a seven-pay whole life contract, it is a
Modified endowment Contract
Which of the following premium modes would result in higher annual cost for an insurance policy.
Monthly
The coverage provided by a disability income policy that does not pay benefits for losses occurring as the result of the insured employment is called?
NONoccupational coverage
An applicant for a health insurance policy returns a completed application to her agent, along with a check for the first premium. She receives a conditional receipt two weeks later. Which of the following has the insurer done at this point?
Neither approved the application nor issued the policy
How many pairs of glasses in a 12-month period will a vision expense insurance plan cover?
One
An agent License can be issued
Only to individuals
A participating insurance policy may do which of the following?
Pay dividends to the policy-owner.
Which of the following applies to partial disability benefits?
Payment limited to certain period of time
An insurers agents responsibility include all of the following EXCEPT?
Preform Professionally Preform Faithfully Represent the insurer Represent the client*
Which of the following are the main factors taken into account when calculating residual disability benefits?
Present earnings and earnings prior to disability.
An insured pays 1,200 annually for her life insurance premium. The insured applies this years300 worth of accumulated dividends to the next years premiums, this reducing it to 900. What option does this describe?
Reduction of premium
Which of the following is NOT an enrollment period for Medicare Part A applicants
Special Enrollment General Enrollment Initial Enrollment Automatic Enrollment
The duties of an agent where replacement is involved include all of the following except?
Splitting the commission with the agent who originally sold the policy being replaced
A provision found in insurance policies which prevents the insured from collecting twice for the same loss is called?
Subrogation
Medicare supplements specifically exclude all of the following EXCEPT?
Surgical expenses of persons eligible for medicare
If the commissioner is not able to serve due to disability, resignation, or death, which of the following will happen?
THe chief deputy commissioner will serve as the commissioner
Which of the following can legally bind coverage?
The Insurer
If an applicant does not receive a copy of the new insurance policy, who is held responsible?
The agent
On a health insurance application, a signature is required from all of the following except
The agent The proposed insured The policy owner (if policy owner is different) The spouse of the policy owner*
All of the following statements about medicare supplement insurance policies are correct EXCEPT?
The are issued by private insurers They cover medicare deductibles and copayments They supplement Medicare benefits They cover extended nursing home care*
The entire contract is made up of all the following except
The buyers guide* The insurance policy The policy application The riders and endorsements
If an insurance premium is paid by the policy owner to the agent, and the agent fails to remit the premium to the insurer, which of the following statements are true?
The policy will not lapse since payment to the agent is the same as the payment to the insurer.
If an insurance premium is paid by the policy owner to the agent, and the agent fails to remit the premium to the insure which of the following of the statements is true?
The policy will not lapse since the payment to the agent is the same as the payment to the insurer.
A policy owner renames his five children as primary beneficiaries and his wife as a contingent beneficiary. If the policy owner and one of children die who would receive the policy benefit.
The remaining four primary beneficiaries.
Which of the following is true regarding Medicare supplement policies
These policies may not contain limitations of coverage except for those permitted by the pre-existing condition.
Which of the following statements is most correct concerning the changing of an irrevocable beneficiary?
They can be changed only with the written consent of that beneficiary
Which of the following insurance arrangements will be appropriate for a parent buying a life insurance policy on a child where the parent is the policy owner?
Third-party owner
A nonresident agent is allowed to conduct insurance transactions in Georgia because his home state allows Georgia residents to transact insurance business in it.
This is known as an Reciprocity agreement
Which provision states that the insurance company must pay medical expenses immediately?
Time of payment Claims
Which of the following is the best reason to purchase life insurance rather than the annuities
To create an estate
Agents who persuade insureds to cancel a policy in favor of another one when it might not be in the insured's best interest are guilty of
Twisting
Which of the following is a key distinction between variable whole life and variable universal life?
Variable whole life has a guaranteed death benefit
Which of the following determines wether disability insurance benefits are taxed.
Whether the premiums were tax deductible
The premium charged for exercising the guaranteed insurability Rider is based upon the insured's?
attained age
Which of the following is NOT covered by medicare?
cosmetic surgery
Group disability income insurance premiums paid by the employer are?
deductible by the employer as an ordinary business expense.
At what point would an automatic premium loan be generated
following the grace period
Which of the following is not a medicaid qualifier
insurability* Income level Age Residency
Who may contribute to a Keogh (HR-10) plan?
self-employed plumber
What is the term used for an applicants written request to an insurer for the company to issue a contract based on the information provided?
Application
What is the maximum period of time during which an insurer may contest fraudulent misstatements made in a health insurance application.
As long as the policy is in force
An agent is ready to deliver a policy to an applicant but has not yet received payment. Upon delivery, the agent collects the applicant's premium check, answers any questions the applicant may have, and then leaves. What did he forget to do?
Ask her to sign a statement of goodhealth
Which rider, when attached to a permanent life insurance policy, provides an amount of insurance on every family member?
Family Term Rider
A father purchases a life insurance policy on his teenage daughter and adds the payor benefit rider. In which of the following scenarios will the rider waive the payment of the premium.
If the father is disable for more than 6 months..
The section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the
Insuring Clause
When a beneficiary receives payments consisting of both principal and interest portions, which parts are taxable as income?
Interest Only
Which statements best describes the free look provisions?
It allows the insureds to return the policy within 10 days for a full refund of premiums if dissatisfied for any reason.
Why is an equity indexed annuity considered to be a fixed annuity?
It has a guaranteed minimum interest rate.
Which of the following statements is TRUE concerning the accidental Death Rider?
It will Pay double or triple the face amount.
In a group health policy, a probationary period is intended for people who?
Join the group after the effective date
An insured has a life insurance policy that requires him to only pay premiums for a specified number of years until the policy is paid up. What kind of policy is it?
Limited-pay Life
If a settlement options is not chosen by the policy owner or the beneficiary, which option will be used.
Lump Sum
Which of the following programs expand individual public assistance programs for people with insufficient income and resources?
Medicaid
Which of the following policies would be classified as a traditional level premium contract?
Straight Life
Which of the following would an accident-only policy not cover
Surgery to repair a wrist damaged by tendonitis (sickness)
Children's riders attached to whole life policies are usually issued as what type of insurance?
Term
Which of the following would be a following event as it relates to COBRA
Termination of employment do too downsizing.
The president of a company is starting an annuity and decides that his corporation will be the annuitant. Which of the following statements is true?
The annuitant must be a natural person
An insurer is attempting to determine the insurability of an applicant and decides to obtain medical information from several different sources. Which entity must be notified of the investigation?
The applicant
An applicant signs an application for a $25,000 life insurance policy, pays the initial premium, and receives a conditional receipt. If the applicant is killed in an automobile accident the next day,
The beneficiary will receive the full death benefit if it is determined that the applicant qualified for the policy.
The annuity owner dies while the annuity is still in the accounting stage. Which of the following is true?
The beneficiary will receive the greater of the money paid into the annuity or the cash value.
A corporation is the owner and the beneficiary of the key person life policy. If the corporation collects the policy benefit, then
The benefit is received tax free
An insured pays her major medical insurance premium annually on March. Last March she forgot to mail her premium to the company. On march 19, she had an accident and broke her leg.
The insurance company would pay the claim.
An employee is insured under her employer's group life plan. If she terminates her group coverage, which of the following statements is INCORRECT?
The insured may choose to convert to term or permanent individual coverage.
Who must pay for the cost of a medical examination required in the process of underwriting?
The insurer
Manny has been injured in an accident. Although she is still receiving benefits from her policy, she does not have to pay premiums. Her policy includes
Waiver of premium Rider
All of the following benefits are available under Social Security EXCEPT
Welfare Benefits
The main difference between immediate and deferred annuities is?
When the income payment begins
Which of the following statements regarding the taxation of modified Endowment Contracts is false?
Withdrawals are not taxable
COBRA applies to employers with at least?
20 employees
Which of the following is not a characteristic or a service of an HMO plan?
Contracting with insurance companies* Providing annual free checkups Encouraging early treatment Providing care on an out patient basis
A guaranteed renewable health insurance policy allows the
Policyholder to renew the policy to the stated age, with the company having the right to increase premiums on the entire class.
Regarding a PPO, which of the following is correct when selecting a primary care physician?
-The insurer may choose medical providers not found on the preferred list and still retain coverage. -The insured is allowed to receive care from any provider, but if the insured selects the PPO provider, the insured will realize lower out-of-pocket costs. -If a non-network provider is used, the insureds out-of-pocket costs will be higher. All of the above*
All of the following are True statements regarding the accumulation at interest option.
-The policy holder has the right to withdraw the accumulations at anytime. -The annual dividend is retained by the company. -The interest is credited at the rate specified by the policy.
If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?
5 Days
If an employee terminates her employment, which of the following provisions would allow her to continue health coverage under and individual policy, if requested within 31 days?
Conversion
What characteristic makes whole life permanent protection?
Coverage until death or age 100
Which of the following statements about group life is correct?
The cost of coverage is based on the ration of men and women in the group
Which statement accurately describes group disability income insurance?
The extents of benefits is determined by the insureds income.
Which of the following is not a feature of a non cancellable policy
The insurer may terminate the contract only at renewal for certain conditions.* The premiums cannot be increased beyond the amounts stated in the policy. The guarantee to renew coverage usually applies until the insured reached a certain age. The insured had the right to renew the policy for the life of the contract.
An employe quits his job on May 15 and doesn't convert his group life policy to an individual policy for two weeks. He dies in a freak accident on June 1. Which of the following statements best describes what will happen?
The insurer will pay the full death benefit
Which of the following statements in correct regarding a whole life policy?
The policy owner is entitled to policy loans.
What is an important feature of a dental expense insurance plan that in NOT typically found in a medical expense insurance plan.
Diagnostic and preventive care
The insurance policy, together with the policy application and any added riders form what is known as
Entire Contract
What does level refer to in level term insurance.
Face Amount
What policy component decreases in decreasing term insurance?
Face Amount
A prospective insured receives a conditional receipt bit dies before the policy is issued. The insurer will
Pay the policy proceeds only if it would have issued the policy.
What type of care is Respite care?
Relief for a major care giver
A man decided to purchase a 100,000 annually renewable term life policy to to provide additional protection until his children finished college. He discovered that his policy
Required a premium increase each renewal
All of the following are requirements for life insurance illustrations
- They may only be used as approved - They must identify non-guaranateed values -They must differentiate between guaranteed and projected amounts.
Most vision expense insurance plans restrict benefits to one exam and one pair of glasses in what time period?
12 months
An agent makes a mistake on the application and then corrects his mistake by physically entering the necessary information. Who must initial that change.
Applicant
All of the following long-term care coverages would allow an insured to receive care at home EXCEPT
Respite Care Home Health Care Custodial care in insureds house Skilled care*
If a life insurance policy has an irrevocable beneficiary designation,
The beneficiary can only be changed with written permission of the beneficiary.
An insured submitted a notice of claim to the insurer, but never received claims forms. He later submits proof of loss, and explains the nature and extent of loss in a hand-written letter to the insurer. Which of the following would be true?
The insured was in compliance with the policy requirements regarding claims.
When a life insurance policy was issued, the policy owner designated a primary and a contingent beneficiary. Several years later, both the insured and the primary beneficiary died in the same car accident, and it was impossible to determine who died first, Which of the following would receive the death benefit?
The insureds contingent beneficiary.
Which of the following types of policies allows for a flexible premium and a variable investment component?
Variable Universal Life Insurance
All of the following are characteristics of group life insurance EXCEPT
Premiums are determined by the age, sex, and occupation of each individual certificate holder
Which of the following is the risk classification used by an underwriters for life insurance?
Standard.
What is the best way to change and application?
Start over with a fresh application
Which of the following is true regarding HIV exams?
The applicant must give prior informed written consent
L has a major medical policy with a $500 deductible and 80/20 coinsurance. L is hospitalized and sustains a $2,500 loss. What is the maximum amount that L will have to pay?
$900 (deductible + 20% of the bill after the deductible (20% of $2,000)
All of the following qualify for Medicare Part A EXCEPT
Anyone that qualifys through Social Security Anyone who is at the end stage of renal disease Anyone who is over 65, not covered by social security, and is willing to pay the premium Anyone who is willing to pay the premium*
Whenever agents submit applications to insurers, they must also submit statements disclosing whether or not replacement is involved. Who must sign these statements?
Applicant and Agent
Which of the following is not true concerning medicaid
It consists of three parts: Part A: hospitalization, Part B: Doctors services, PartC : Disability income* -It is a state program -It is funded by state and federal taxes -It is intended to provide medical assistance for certain categories who are needed.
Concerning Medicare Part B, which statement is INCORRECT?
It is fully funded by Social Security taxes (FICA)* -It is known as medical insurance -It offers limited prescription drug coverage It provides partial coverage for medical expenses not fully covered by Part A
Which of the following is incorrect concerning Medicaid?
It is solely a federally administered program* -It provides medical assistance to low income people who cannot otherwise provide for themselves. -It pays for hospital care, outpatient care. and laboratory and X-ray services. -The federal government provides about 56 cents for every medicaid dollar spent.
