Missed Questions on Exam FX

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An insured who has an accidental death and dismemberment policy losses her left arm in an accident., what type of benefit will she most likely receive from this policy

the cattail amount in a lump sum

which of the following statements is correct concerning the relationship between Medicare and HMO

HMO may pay for services not covered by Medicare.

Which of the following authorities issues insurance producer licesnes

commisioner

Which of the following is not an example of insurable intrest

debtor in creditor

Which of the following is NOT a cost saving service in a medical plan

denial of coverage

If one takes Social Security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare?

nothing

The law that protects consumers against the circulation of inaccurate or obsolete information is known as

the fair credit reporting act

For how many days of skilled nursing facility care will Medicare pay benefits?

100

If an insurer believes that inaccurate or misleading information was provided in the policy application, it may contest a claim within how many years?

2 years

When a group disability insurance plan is paid entirely by the employer, benefits paid to disabled employees are

Taxable income to the employer

A policy with a 31 day grace period implies

The policy will not lapse for 31 days if the premium is not paid when due

which of the following best described gross annual premium

annual loading

A long term care shopper guise must be presented at what point

prior to the time of the application

For group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense?

100%

under the affordable care act what percentage of preventive care must be covered with cost sharing

100%

the license of forgetful frank has lapsed. how long from the due date of the renewal will frank be reinstated without having to retake a course or exam

12 months

The relation of earnings to insurance provision allows insurance company to limit the insureds benefits to his/her average income over the last

24 months

Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained

3 days

If a consumer request additional information concerning an investigative consumer report how long does the insurer or reporting agency have to comply

5 days

What is the maximum amount that can be contributed to an MSA of the high deductible plan for individuals

75%

When is the earliest a policy may go into effect?

When the application is signed and a check is given to the agent

Under the mandatory uniform provision notice of claim the first notice of injury or sickness covered under and accident and health policy must contain

a statement that is sufficiently clear to identify the insurers and nature of the claim

Which of the following long term care benefits would provide coverage for care for functionally impaired adults on a less than 24 hour basis

adult day care

in reference to the standard Medicare supplement benefits plans what does the term standard mean

all providers will have the same coverage options and conditions for each plan

Under HIPPA which of the following is incorrect regarding eligibility requirements for conversion to an individual policy

an individual who was previously covered by group health insurance for 6 months is eligible

Regarding uniform mandatory provision concerning claims all of the following are true except

an insured must notify the insurer of a claim on forms prescribed by the insurer

Regarding uniform mandatory provisions concerning claims all of the following are true except

an insured must notify the insurer of a claim on forms prescribed by the insurer

Which of the following is the basic source of information used by the company in the risk selection process

application

All of the following are true of the key person disability income policy except

benefits are considered taxable income to the business

HMO that compensate their health care providers based upon a predetermined payment amount per enrollee for a specified period of time, in exchange for providing a defined set of covered health care services regardless of the amount of services actually provided are said to be operating on which method

capitation

A banker is ready to close on a customer loan. the bank is prepared to offer the loan but only if the customer purchases a life insurance policy from the bank in the amount of the loan. this is an example of

coercion

If an employee terminates her employment which of the following provision would allow her to continue health coverage under an individual policy if requested within 31 days

conversion

An insured is receiving hospice care, his insurer will pay for painkiller but not for an operation to reduce the size of the tumor. what term best fits this arrangement

cost containment

Which of the following terms describes making false statements about the financial condition of any insurer that are intended to injure any person engaged in the business of insurance

defamation

In a disability policy the probationary period refers to the time

during which illness related disabilities are excluded from coverage

which of the following choices best described the blackout period

from the youngest child age 16 until the surviving spouse age 60

What of the following methods of calculating the amount of life insurance needed takes into account the insureds wages years until retirement and inflation

human life value approach

Which insurance principle states that if a policy allows for greater compensation than the financial loss incurred, the insured may only receive benefits for the amount lost?

indemnity

which of the following entities approve all Medicare supplement advertisements

insurance commissioner or director

Which of the following entities has the authority to make changes to an insurance policy

insurers executive officer

which of the following is incorrect concerning Medicaid

it is solely a federally admistatred program

The provision which prevents the insured from bringing any legal action against the company for at least 60 day after the proof of loss is known as

legal actions

All of the following are characteristic of a major medical expense policy except

low maximum limits

Under the Affordable Care Act (ACA): which classification apples to health plans based on the covered cost

metal level claaisfatcion

Which of the following is not true regarding the needs approach method of determine value of an individual life

need is predicated using the number of years until the insured retirement

Which of the following is not true regarding the needs approach method of determine the value of an induvial life

need is predicted using the number of years until the insurers retirement

The coverage provided by a disability income policy that does not pay benefits for losses occurring as the result of the insured's employment is called

nonoccupational coverage

A producer has become disabled in order to keep his business going, what may his designee do

obtain a temp licensee

In long term care insurance what type of care is provided with intermediate care

occasional nursing or rehabilitative care

An applicant is discussing his options for Medicare supplement coverage with his agent. The applicant is 65 years old and has just enrolled in Medicare Part A and Part B. What is the insurance company obligated to do?

offer the supplement policy on a guaranteed issue basis

in addition to obtaining an insurance producer license a business entity in order to tract insurance must have at least

one individual licensed insurance producer

in alalbama an insurance company certificate of asuthoritiew is issued for what period of time

perpetual

All of the following are covered by part A of Medicare except

physician and surgeon's services

what type of health care plan allows insureds to select a physicians or hospital from a list of providers without being required to submit claim forms

preferred provider organization

Which of the following statements is an accurate comparism between private and government insurers

private insurers may be authorized to transact insurance by state insurance departments

which services are assoicated with standard and poor and AM best

ratiing the finacial stegienth of insurance companies

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 of the following is an example of a producer being involved in an unfair trade practice of rebating?

telling a client that his first premium will be waived if he purchase the insurance policy today

which of the following is not covered under plan a in Medicap insurance

the Medicare part a deductible

Which of the following statements about HRA is true

the account allows rolls over of unused balances at the end of the year at the employers discretion

Which of the following does not have to be disclosed in a long term care policy

the aggerate amount of premiums due

In applying for an original certificate of authority an insurer must submit an application with the appropriate frees and the following information except

the amount of insurance it intends to write

All of the following are ways in which a major medical policy premium is determined except

the average age of the group

which of the following is not a characteristics of group long term disability plan

the benefit can be up to 50% of ones yearly income

in insurance policies the insured is not legally bound to any particular action in the insurance contract but the insurer is legally obligated to pay losses covered by the policy what contract element does this describe

unilateral

all of the following cases show when a small employer medical plan cannot be renewable except

when the employer chooses to renew the plan

which of the following types of insurance policies would perform the function of cash accumulation

whole life

How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company?

within 90 days or as soon as reasonably possible, but not exceed 1 year

All of the following are correct about the required provisions of a health insurance policy except

a reinstated policy provides immediate coverage for an illness

In insurance transaction fiduciary resposbinblity means

being liable with respect to payment of claims

Prior to issuance of a long term care policy to an applicant age 80 or older the insurer must obtain all of the following except

data of pervious doctor visits

what insurance concept is associated with the name wises and fitch

guides describing company financial integrity

The annual contribution limit of a Dependent Care Flexible Spending Account is set by

the IRS

which of the following is an example of liquidity in a life insurance contract

the cash value available to the policyowner

Regarding Medicare SELECT policies, what are restricted network provisions?

they condition the payment of benefits

An agent and an applicant for a life insurance policy fill out and sign the application. However, the applicant does not wish to give the agent the initial premium, and no conditional receipt is issued. When will coverage begin?

when the agent delivers the policy, collects the initial premium, and the applicant completes an accentuable statement of good health

When is the earliest a policy may go into effect

when the application is signed and a check is given to the agent

Which of the following determines whether disability insurance benefits are taxed

whether the premiums were tax deductible

how long is an open enrollment period for Medicare supplement policies

6 months

A long term care insurance shoppers guide must be provided in the format developed by which of the following

NAIC

Which of the following is not true of basic medical expense plans

coverage for cataphoric medical expenses

Which of the following is true regarding a term health policy

it is nonrenewable

all of the following are correct about the required provisions of a health insurance policy except

a reinstated policy provides immediate coverage for illness

Occasional visits by which of the following medical professionals will not be covered under LTC home health care

attending physicians

What type group rating uses the actual experience of the group as a factor in developing the rates to be charged

experience rating

Workers Compensation benefits are regulated by which entity

state govermenet

A man bought an individual health insurance policy for himself. Which of the following roles does he now legally have?

Both subscriber and insured

An applicant who receives a preferred risk classification qualifies for

Lower premiums than a person who receives a standard risk

Which of the following types of agent authority is also called perceived authority

apparent

Which of the following entities must approve all Medicare supplement advertisements

insurance commissioner or director

Medical savings accounts are only available to groups of how many employees

no more than 50

an employee group with which of the following number of employees would qualify for a medical savings account

23 employees

All of the following statements describe MEWA expect

MEWAs are groups of at least 3 employers

a hospital indemnity policy wil pay

a benefit for each day the insurer is in the hospital

The purpose of managed care health insurance plans is to

control health insurance claims expense

an insured long term care policy is scheduled to pay a fix amount of coverages of $120 per day. the long term care facility only changed $100 per day. how much will the insurance company pay

$120

The relation of earnings to insurance provision allows the insurance company to limit the insures benefits to his/her average income over what period of time

2 years

Who must sign the "Notice Regarding Replacement"?

Both the applicant and agent

Under which of the following disability income plans would benefit the subject to income tax

group

The limits of a health reimbursement account are set by

the employer

Who determines the eligibility and contribution limits in a HRA

the employers determines both

In a group policy, who is issued a certificate of insurance

the individual insured

an insured had $500 left in his health reimbursement account when he quits his job what happens to the money

the insured can have access to the $500 at his previous employers discretion

When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of the loss. However, her agent did not notify the insurance company until 60 days after the loss. Which of the following statements correctly explains how this claim would be handled?

the insurer is considered to be notified since the notification to agent equals notification tot he insurer

Which of the following is not a feature of a noncancelable policy

the insurer may terminate the contract only at renewal for certain conditions

Regarding the return of premium option for LTC policies, what happens to the premium if the policy lapses?

the insurer will return a percentage of the premiums paid

all of the folliwng would be a reason that the insurance company name could be disapprove for the use in the state of alabama ecxcept

the name is o long to be printed on a single lien

An HSA holder who is 65 years old decides to use the money in the account for non-health expense. WHich of the following is true?

there will be a tax

Which provision states that the insurance company must pay medical expenses claims immediately

time of payment of claims

All of the following cases show when a small employer medical plan cannot be renewable except

when the employer chooses to renew the plan


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