Life and Health Certification Exam

in noncontributory group health plans, how many eligible employees must be covered by the plan?

100%

At what point after the effective date of an accident and health insurance policy does it become incontestable?

2 years

Damon purchased a 10-pay life policy at age 35. He can expect it to be paid up by age

45

a qualified retirement plan distribution is considered to be premature if made before the participant is age

59.5

susan is receiving continuing disability benefits and will for years to come. Her insurer according to the notice of claims provision can require her to give notice that the claim is continuing as ofter as every

6 months

when a health maintenance organization chooses a limited number of health care providers to provide services to its subscribers, this is known as

A Gatekeeper system

An admitted insurer must have which of the following before transacting insurance in the state?

A certificate of authority

beneficiaries of life policy designated as all my children or all my sisters and brothers still living are called

A class designation

A person in a position of financial trust is

A fiduciary

an insurer that distributes dividends to its policyholders is

A mutual company

Most people likely to experience a loss are also most likely to want insurance. This is known as

Adverse selection

The tendency for poor risks to seek and be covered for insurance more than average risks is known as

Adverse selection

Who investigates claims on behalf of the insurer or the insured?

An Adjuster

an agent who performs tasks that are not covered by the employment contract but which are necessary to maintain the agency relationship with the insurer acts with

Apparent authority

Leroy wants to buy a policy insuring the life of his wife loretta. What is the limit on how much insurance he can buy?

As much as the insurance company is willing to issue and leroy can afford

all of the following are required provisions in health care insurance policies EXCEPT

Change of occupation

what term describes a situation where a policy owner transfers a portion of her rights in an insurance policy to another party in order to secure a debt to that party?

Collateral assignment

under a long-term care insurance policy, the level of care that is mainly necessary for the purpose of meeting daily living requirements is called:

Custodial care

An insurer that is incorporated and operates in the same state with which it is organized is called

Domestic

All of the following groups may contract with PPOs exctpt

Government programs

laura names her daughter samantha as an irrevocable beneficiary on her life policy. Which of the following is true?

If laura wants to change the beneficiary, samantha must consent

Under which of the following circumstances will the payor rider waive premiums and allow a life policy to remain in force?

If the policyowner dies or becomes disabled prior to the insured reaching either age 18 or 21

paul and eleanor have a disability income policy that includes a rider that excludes coverage for Paul's existing diabetes. What rider is attached to this policy

Impairment rider

When a policyowner cannot exercise rights of ownership without the policy beneficiary's consent, the beneficiary is designated

Irrevocable

Which of the following correctly describes Medicaid?

It provides medical benefits for certain low-income people

When a convertible term life policy is converted to a permanent policy, the insured

Life only annuity

A person purchases a temporary annuity with a life with period certain of 10 years but he dies well before the 10 year certain period has elapsed. In abiding with this annuity contract, the company would

Make the stipulated payments to the annuitant's beneficiary for the rest of the certain period

A federal-state program designed to help needy persons, regardless of age, with medical coverage is called

Medicaid

Which of the following medicare advantage plans focus on the particular needs of defined groups of patients

Medicare managed plans

All of the following are elements that go into the calculation of premiums EXCEPT

Morbidity

When an insured can receive more from loss of time benefits than earnings from staying on the job, or can receive more for reimbursement of medical expenses than those expenses actually cost

Overinsurance occurs

The person on whose behalf he acts is called the

Principal

Restoration of a lapsed policy as it was originally purchased is known as

Reinstatement

Statements made by an insurance applicant on an application are considered to be what?

Representations

Which of the following sales of insurance is subject to replacement regulations?

Sale of new individual life insurance policy that causes an existing life insurance policy to be surrendered.

Money taken out of a modified endowment contract (MEC).

Subject to unfavorable tax rules

susan is 40 years old Her insurance application she started that she was 39. According to the misstatement of age provision, which of the following is true

Susans benefits will be reduced

according to the entire contract provision, what constitutes the entire contract of insurance in a health policy

THe policy and its endorsements

in a disability income policy, there is a period of time an insured must be disabled before benefits begin. The term that describes this interim is

The Probationary period

The insurance industry, human life value refers to which of the following?

The consideration in a life insurance contract

A standard medigap policy must provide which of the following?

The core benefits standardized by the Centers for Medicare and Medicaid services

If the insurance company accepts a Special Class Risk

The premium will be higher than for a normal risk

Many major medical policies include a provision whereby when expenses reach a certain dollar amount, the insured no longer shares in the cost of expenses; the insurer pays 100% of remaining covered charges. This is referred to as the ...

The stop-loss limit

When either the fixed period or fixed amount option is selected for a life policy

Total amount paid over the years will be greater than the face amount of the policy

Risk

Uncertainty of loss

Which of the following types of insurance riders is not based on term life insurance?

Waiver of premium

statements made by an applicant for life insurance that are guaranteed to be true are

Warranties

which of the following has a death benefit that expires?

Whole life insurance

Which of the following is not a dividend option?

Whole live insurance

if desdemona is insured by a life policy with a face amount of $250,000 but which has an outstanding policy loan of $10,000 at her death, the insurer

Will pay $240,000 to beneficiary

a lapsed life insurance policy may be reinstated

Within 30 days after the grace period expires

a nontaxable transaction where a cash value life insurance policy is converted into an annuity is known as

a 1035 exchange

Which of the following must be given to an insured when a replacement occurs

a Notice regarding replacement

all of the following are considered service providers except

a commercial insurance company

Gavin and Guinevere have a joint life policy. Gavin dies and the policy pays nothing. Later on, Guinevere dies and the policy death benefit is paid to the beneficiary. This is called

a survivorship or second-to-die policy

the key factor in rating long-term care policies is

ability to preform activities of daily living

All of the following would likely be eligible for group health insurance EXCEPT

all the uninsured residents of a nursing home

A health insurance policy that the insurer may choose NOT to renew only on the premium due date is called

an optionally renewable policy

Jane age 35 has just purchased a 20-pay whole life policy. When she turns 55 she will

cease paying premiums

a life insurance buyer's guide can be used for all of the following uses except

comparison of the cost of similar policies

jason neglected to mention on his application or a health policy that he had suffered a heart condition as a child. In order for the company to cancel jason's policy it must be determined that this omission was

deliberate and fraudulent

A disability policy that is nonoccupational

does not cover job-related disabilities

2 major phases of an annuity are

fixed and variable

when underwriting group life insurance, the underwriter generally quizlet

focuses on the group as a whole rather than on individual members

fixed annuities are supported by an insurer's

general account

Dread disease policies

generally covers illnesses that occur frequently, but do not incur significant costs when they do occur

HMO

health maintenance organization (cheaper - less options)

the premium for renewable term life insurance policy

increase each time it is renewed

the type of premium for term life insurance that remains the same throughout the policy period is

level premium

policies classified as non-occupational normally provide coverage for

losses due to sickness or accidents that are not work-related.

an agent attends a continuing education course offering 12 hours of credit before the course is approved by the commissioner. in this case, the agent will receive

no credit for the course, because courses must be approved before study begins

When an insured has a major medical plan with first dollar coverage, this means

no deductible applies

what part of the application includes medical information

part 1

Which part of medicare requires premium payment by most eligible participants?

part b, supplementary medical insurance

insurers do not have to offer every medicare supplement plan, but if they offer any, they must offer

plan A

PPO

preferred provider organization (

all of the following are benefits provided under part a of medicare except

private duty nursing

six months ago while leaving home from work, fell down a flight of stairs at her apartment buildning resulting in complete paralysis from which she is not expected to recover. Fifty-year-old carmelita will probably be able to collect disability benefits from

social security

A Universal Life Contract expires when

the cash value account becomes too small to pay the cost of insurance

social security defines disability as the inability to engage

the duties of any occupation

Exclusive or Captive Agents represent

the insurance company

The applicant for an insurance policy must sign all of the following EXCEPT?

the producers report

Which of the following is a common exclusion under dental expense insurance?

treatment of the pulp

The term "nonforfeiture values" refers to the fact that

when a policyowner stops paying premiums on a permanent policy, its cash value accumulation or equivalent must be made available to the policyowner

a guaranteed insurability rider normally provides that between ages 25 and 40, additional life insurance may be purchased without proof of insurability

whenever the policyowner wishes

Sherwood has no valid will but has named his estate as the beneficiary of his life insurance policy. As a result, he can expect that the policy proceeds

will be distributed after debt is paid off

All of the following are duties of the commissioner EXCEPT

writing the Washington insurance laws