Life and Health license
An insured's long-term care policy is scheduled to pay a fixed amount of coverage of $120 per day. The long-term care facility only charged $100 per day. how much will the insurance company pay?
$120
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 deducible [20% of $2000])
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
how many consecutive months of coverage (other than in an acute care unit of a hospital) must LTC insurance provide in this state?
12
Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within
90 days of loss
Most HMOs operate through what type of system?
A group enrollment system either at their place of employment or as a member of an association
which of the following is not covered under a long-term care policy?
Acute care in a hospital
insurance policies are not drawn up through negotiations and an insured has little to say about its provisions. what contract characteristic does this describe?
Adhesion
which of the following best describes the concept that the insured pays a small amount of premium for a large amount of risk on the part of the insurance company?
Aleatory(small premium/large risk)
what is the term used for an applicant's written request to an insurer for the company to issue a contract, based on the information provided?
Application
an individual is insured under his employer's group Disability Income policy. The insured suffered an accident while on vacation that left him unable to work for 4 months. if the disability income policy pays the benefit, which of the following would be true?
Benefits that are attributable to employer contributions are fully taxable to the employee as income
A small business owner is the insured under a disability policy that finds a buy-sell agreement. if the owner dies or becomes disabled, the policy would provide which of the following?
cash to the owner's business partner to accomplish a buyout
When twin brothers applied for life insurance from Company A, the company found that while neither of them smoked and both had a very similar lifestyle, one of the twins was in a much stronger financial position than the other. Because of this, the company charged him a higher rate for his insurance. This practice is considered
discrimination
which is true about the cash surrender nonforfeiture option?
funds exceeding the premium paid are taxable as ordinary income
life income joint and survivor settlement option guarantees
income for 2 or more recipients until they die
When a reduced-paid up nonforfeiture option is chosen, what happens to the face amount of the policy?
it is reduced to the amount of what the cash value would buy as a single premium.
which of the following is True regarding the annuity period?
it may last for the lifetime of the annuitant
what is the major difference between a stock company and a mutual company?
ownership
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 policyowner?
third-party ownership
If a policy includes a free-look period of at least 10 days, the Buyer's Guide must be delivered to the applicant
with the policy
what is the goal of the HMO?
Early detection through regular checkups
Long-term care coverage may be available as any of the following options EXCEPT
Endorsement to a health policy
items stipulated in the contract that the insurer will not provide coverage for are found in the
Exclusions
An agent selling variable annuities must be registered with
FINRA
when possible, what should insurers strive to eliminate from illustrations?
Footnotes and caveats
what are the 2 types of Flexible Spending Accounts?
Health Care Accounts and Dependent Care Accounts
under the privacy rule for HIPAA protected information includes all individually identifiable health information
Held or transmitted in any form
which of the following types of LTC is NOT provided in an institutional setting?
Home health care
Concerning Medicare Part B, which statement is INCORRECT?
IT is fully funded by Social Security taxes (FICA)
The provision which prevents the insured from bringing any legal action against the company for at least 60 days after proof of loss is known as
Legal actions
which of the following settlement options in life insurance is known as straight life?
Life income
which of the following is an example of limited-pay life policy?
Life paid-up at age 65
underwriting is a major consideration when an insured wishes to replace her current policy for all of the following reasons EXCEPT
Premiums always stay the same
a man decided to purchase a $100,000 Annually Renewable Term Life policy to provide additional protection until his children finished college. He discovered that his policy
Required a premium increase each renewal
a policyowner who is also the insured wants to name her husband as the beneficiary of her life policy. She also wishes to retain all of the rights of ownership. The policyowner should have her husband name as the
Revocable beneficiary
A producer is helping a married couple determine the financial needs of their children in the event one or both should die prematurely. This is a personal use of life insurance known as
Survivor protection
which statement is not true regarding underwriting group health insurance?
The group is assessed individually for insurability
which of the following best describes what the annuity period is?
The period of time during which accumulated money is converted into income payments
in terms of parties to a contract, which of the following does NOT describe a competent party?
The person must have at least completed secondary education
An insured has chosen joint and 2/3 survivor as the settlement option. What does this mean to the beneficiaries?
The surviving beneficiary will continue receiving 2/3 of benefit paid when both beneficiaries were alive
which of the following is a statement that is guaranteed to be true and if untrue may breach an insurance contract?
Warranty
When an insured makes truthful statements on the application for insurance and pays the required premium, it is known as which of the following?
Consideration
Contracts that are prepared by one party and submitted to the other party on a take-it-or-leave-it basis are classified as
Contracts of adhesion
According to the entire contract provision, what document must be made part of the insurance policy?
Copy of the original application
