MO Insurance practice test
what does the Missouri life and health insurance guaranty association provide?
Claim payments of admitted, insolvent insurance companies
M is insured under a basic Hospital/Surgical Expense policy. A physician performs surgery on M. What determines the claim M is eligible for?
Determined by the terms of the policy
An insurer may not transact insurance unless authorized by the ...
Director of Insurance
Which of the following does social security not provide benefits for?
Dismemberment
how are Roth IRA distributions normally taxed?
Distributions are received tax-free
What is the purpose of the Missouri Life and Health Insurance Guaranty Association?
Ensures that claims filed against insolvent insurance companies will be paid
Which of the following is an important underwriting principle of group life insurance?
Everyone must be covered in the group
Which federal law allows an insurer to obtain an inspection report on a potential insured?
Fair credit reporting act
What kind of insurance policy supplies an income stream over a set period of time that starts when the insured dies?
Family maintenance policy
______ of personal life insurance premiums is usually deductible for federal income tax purposes.
0%
In Missouri, an A&H policy that is paid on a monthly basis requires a grace period of at least...
10 days
Jay's application for a producers license has been denied. He may request a hearing within ____ days after receipt of the denial.
30
a producer must report any person felony charges within_____ days of pre-trial hearing.
30
how long is the typical free look period for long term care insurance policies?
30 days
continuing education (CE) providers must report to the director a licensee's earned credit hours within....
30 days of course completion
Prior to a universal life insurance policy being terminated, written notice must be given to the policy owner at least
30 days of termination date
N is a 40-year old applicant who would like to retire at age 70. He is looking to buy a life insurance policy with level premiums, permanent protection, and be paid-up at retirement. Which of these should N purchase?
30 pay life
an insured pays premiums on an annual basis for an individual health insurance policy. What is the minimum number of days for the Grace Period provison?
31
s is employed by a large corporation that provides group health coverage for its employees and their dependents. If s dies, the company must allow his surviving spouse and dependents to continue their group health coverage for a maximum of how many months under COBRA regulations?
36
M's insurance company denied a reinstatement application for her lapsed health insurance policy. The company did not notify M of this denial. How many days from the reinstatement application date does the insurance company have to notify M of the denial before the policy will automatically placed back in force?
45 days
One becomes eligible for Social Security disability benefits after having been disabled for....
5 months
When an insured receives chiropractic service, the copayment may not exceed ____ of the total cost of providing the service.
50%
health policies that contain coverage for low protein modified food products for treatment of PKU or any inherited disease of amino and organic acids require a coinsurance not to exceed ____ of the cost of the formula or food products.
50%
which provision is not a requirement in a group life policy?
Accidental
P is blinded in an industrial accident. Which provision of his life insurance policy will pay a stated benefit amount?
Accidental death and dismemberment clause
at what time must a policy owner have an insurable interest on the insured in order for the life policy to be valid?
At the time of the application
Medicare part C is:
Available to those who are enrolled in Medicare Part A and Part B
In Missouri, a health insurance policy that is not exempt from state-mandated benefits must cover childhood immunizations and shall not charge any deductible or copayment. The exception to this would be
HMO's that exclude coverage to subscribers who obtain services by a non-participating provider
Which of the following types of organizations are prepaid group health plans, where members pay in advance for the services of participating physicians and hospitals that have aggreements?
Health Maintenance Organization (HMO)
How does an indexed annuity differ from a fixed anuity?
Indexed annuity owners may receive credited interest tied to the fluctuations of the linked index fixed annuity owners have separate investment account?
Which of these arrangements allows one to bypass insurable interest laws?
Investor originated life insurance (IOLI) or stranger originated life insurance (STOLI)
Which of the following types of health coverage frequently uses a deductible?
Major medical policy
Z owns a disability income policy with a 30-day elimination period. Z contracts pneumonia that leaves him unable to work from January 1 to January 15. Z then becomes disabled from and accident on February 1 until the disability lasts until July 1 the same year. Z will become eligible to receive benefits starting on:
March 1
Health insurance coverage of autism spectrum disorder treatments may be limited in which way?
Medically necessary treatment in accordance with a treatment plan
T the producer is replacing a clients existing insurance policy with a new one. Prior to policy delivery, which form must the client be provided with?
Notice regarding replacement
what must a producer sign when an existing life insurance policy is being reissued with a reduction in cash value?
Notice regarding replacement
a foreign insurance company cannot conduct business in Missouri without
a certificate of authority to transact business in Missouri
What is medicare?
a hospital and medical expense program
which of these individuals may not be compensated from an insurance company?
a licensed produces not appointed by the company
all of these statements concerning a licensees responsibility for premiums received are true except
a licensee must hold them in separate account before transmitting them to the insurance company
Which statement is true regarding a variable whole life policy?
a minimum guaranteed death benefit is provided
When a group accident and health policy is issued to an employer,
a policy is issued to the employer and certificate is issued to each employee
which of the following is considered to be a misrepresentation?
a producer guaranteeing a policy's dividends
which of these is considered an unfair trade practice?
a producer stating that a policy's dividends are guaranteed
A statement made by an insured in an insurance application that must be true to the best of ones knowledge and which becomes a part of the contract is known as:
a representation
which of the following is not a required provision in a group life policy?
accidental death and dismemberment
B owns a Whole Life policy with a guaranteed insurability option that allows him to purchase, without evidence of insurability, stated amounts of
additional whole coverage at specified times
L takes out a life insurance policy and dies 10 years laters. During the claim process, the insurer discovers that L had understated her age on the application. Under the misstatement of age provision, the insurer will:
adjust the benefit to a reduced amount
When can a policy owner change a revocable beneficiary?
anytime
Any changes made on an insurance application requires the initials of whom?
applicant
a health insurance policy application may only be altered with the written consent of the....
applicant
An applicant's medical information received from the Medical Information Bureau (MIB) may be furnished to the
applicants physician
before a life insurance policy is issued, which of these components of the contract is required?
applicants signature on application
an incomplete life insurance application submitted to an insured will result in which of these actions?
application will be returned to the writing agent
A(n) ___________ of benefits of a health policy transfers payments to someone other than the policyowner.
assignment
Which of the following is a requirement to attain a Missouri resident producer license?
at least 18 years old
When is a group health policy required to provide coverage for a newborn child?
at the moment of birth
When must a producer deliver a notice regarding replacement of life insurance?
at the time of application
S has a Whole Life policy with a premium payment due soon. Which provision would keep the policy in force if S does not make the required payment and the policy has adequate cash value from which the premium payment can be made?
automatic policy loan
an applicant for a nonresident producer license must
be a producer in good standing in their home state
to be elgible for a group health policy, a group must comply with which of the following?
be formed for a purpose other than obtaining insurance
S would life to use dividends from her life insurance policy to purchase paid-up additions. All of these would be factors that determine how much coverage can be purchased except...
beneficiary's age
T is receiving $3,000/month from a Disability Income policy in which T's employer had paid the premiums. How are the $3,000 benefit payments taxable?
benefits are taxable to T
Accidental death coverage is provided to commercial airline passengers in which of the following types of polices?
blanket accident policy
which of these is not considered to be a cost connected with an individuals death?
business expenses
G is an accountant who has ten employees and is concerned about how the business would survive financially if G became disabled. the type of policy which best addresses this concern is:
business overhead expense
which type of policy would pay an employees salary if the employer was injured in a bicycle accident and out of work for six weeks?
business overhead expense
which of these circumstances is a business disability buy-sell policy designed to help in the sale of a business?
business owner becoming disabled
The guarantee of insurability option provides a long-term care policy owner the ability to:
buy additional coverage at a later date
Each life insurance applicant in missouri is expected to be provided with a(n)....
buyers guide and policy summary
Which statement about a whole life policy is true?
cash value may be borrowed against
Company XYZ offers a group term life insurance plan to its employees. What does each employee covered under this plan recieve?
certificate of insurance
When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?
change of occupation provision
Health coverage for the administration of general anesthesia and hospital charges for dental care must be provided to a(n)
child under the age of five
P is a major medical policy owner who is hospitalized as a result of injuries sustained from participating in a carjacking. How will the insurer most likely handle this claim?
claim will be denied
A disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years priors. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim?
claim will be paid and coverage will remain in force
in Missouri, which of the following is considered an Unfair Trade Practice?
coercion
On August 6, D submitted an application for $50,000 life insurance policy and did not pay the initial premium. On August 19, D went to his doctor complaining of chest pains and some tests were given by the doctor. The life policy was delivered by the procedure on August 20 and D explains what had recently taken place with the doctor. What action should the producer then take?
collect initial premium along with a signed health statement
Which of the following is considered a producers fiduciary responsibility?
collect premiums and remit to the insurance company as soon as a reasonably possible
Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures?
commercial insurer
Which of the following correctly explains the actions an agent should take if a customer wants to apply for an insurance policy?
complete the application and review the information with the customer prior to the obtaining the customers signature, then send the application off to the insurance company
chemical dependency coverage is required in which type of policy?
comprehensive major medical
Insurance contracts are knowns as _____ because certain future conditions or acts must occur before any claims can be paid.
conditional
T applies for a life insurance policy and is told by the producer that the insurer is bound to the coverage as of the date of the application or medical examination, whichever is later. Assuming that T is an acceptable risk, what item is given to T?
conditional receipt
An insurance company receives E's application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not insured. Which of the following clauses details the conditions that E did not meet?
consideration clause
Major Medical policies typically:
contain a deductible and coinsurance
Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers (and their families) whose employment has been terminated the right to:
continue group health benefits
Which type of the following consists of an offer, acceptance, and consideration?
contract
When an employee is requited to pay a portion of the premium for an employer/employee group health plan, the employee is covered under which of the following plans?
contributory
Any state regulated health insurance plan issued in Missouri must
cover childhood immunization services
Which of the following BEST describes a hospital Indemnity Policy?
coverage that pays a state amount per day of a covered hospitilization
for the treatment of PKU, a health plan must cover formula and low protein modified food products for...
covered children less than six years of age
What group term life feature permits an individual to depart from the group and continue to be covered without providing evidence of insurability?
coversion
Insurance issued on a debtor to cover outstanding balances on installment loans is called
credit
which of the following types of individual policies does not require a policy summary be given?
credit life
K has a life insurance policy where her husband is a beneficiary and her daughter is a contingent beneficiary. Under the Common Disaster clause, if K and her husband are both killed in an automobile accident, where would the death proceeds be directed?
daughter
A credit life insurance policy covers the life of the
debtor
The combination of a whole life and _____ term insurance is referred to as a family income policy
decreasing
Which of these types of policies may not have the automatic premium loan provision attached to it?
decreasing term
Additional coverage can be added to a whole life policy by adding...
decreasing term rider
Which unfair trade practice involves making false statements about the financial condition of another insurance company?
defamation
p, age 50, purchased an annuity that p will fund with $500/ month for 15 years. The annuity will then pay p retirement payments after the 15 years. Which type of annuity did p purchase?
deferred
An agent takes an individual Disability Income application, collects the appropriate premium, and issues the prospective insured a conditional receipt. The next step the insurance company will take is to
determine if the applicant is an acceptable risk my completing standard underwriting procedures
which contract permits the remaining partners to buy-out the interest of a disabled business partner?
disability buy-sell
A CEO's personal assistant suffered injuries at home and as a result, was unable to work for four months. Which type of policy will pay a monthly benefit to the personal assistant?
disability income
B is a teacher who was injured in a car accident and cannot work. She is now receiving monthly benefits as result of this accident. Which type of policy does B have?
disability income
K becomes ill after traveling overseas and is unable to work for 3 months. What kind of policy would cover her loss of income?
disability income
a characteristic of preferred provider organization (PPOs) would be:
discounted fees for the patient
in a disability income policy, which of these clauses acts as a deductible?
elimination period
"A producer does not have the authority to change a policy or waive any of its provisions." The health provision that best describes this statement is called
entire contract
Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract?
entire contract
which of the following policy provisions prohibits an insurance company from incorporating external documents into an insurance policy?
entire contract
when an insurance company sends a policy to the insured with an attached application, the element that makes the application part of the contract between the insured and the insured is called the
entire contract provision
with accidental death and dismemberment policies, what is the purpose of the grace period?
gives the policy owner additional time to pay overdue premiums
coverage for human leukocyte antigen testing for bone marrow transplantation is required to be provided in all
group comprehensive health policies
Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this?
guaranteed insurability rider
K has a health policy that must be renewed by the insurer and the premiums can only be increased if applied to the entire class of insureds. This type of policy is considered
guaranteed renewable
What is the required renewability status of all medicare supplement policies
guaranteed renewable
which type of renewability best describes a disability income policy that covers an individual until the age of 65, but the insurer has the right to change the premium rate for the overall risk class?
guaranteed renewable
A 66-year old is covered under a group health plan while employed with a business that has 40 employees. If she injures herself while walking in the park, what coverage would be considered primary?
her group health plan
Which of the following will a long term care plan typically provide benefits for?
home health care
in life insurance, the needs approach is used mostly to establish:
how much life insurance a client should apply for
Which of these is not a reason for purchasing a life insurance on the life of a minor?
if both parents were to die, it would provide death benefits to the child
in regards to representations or warranties, which of these statements is true?
if material to the risk, false representations will void a policy
How would a contingent beneficiary receive the policy proceeds in an accidental death and dismemberment (AD&D) policy?
if the primary beneficiary dies before the insured
W is a 39-year old female who just purchased an annuity to provide income for life starting at age 60. All of these would be acceptable annuity choices EXCEPT....
immediate annuity
T sends proof of loss to her insurer for an acceptable medical expense claim under her individual health insurance policy. Upon receipt, the insurer must pay the benefits
immediately
When determining the monthly benefit amount for a disability income policy the factor that limits the amount a prospective insured may purchase is:
income
in order for coverage on a non-medical insurance application to take effect the same day, the producer must collect a signed application and.....
initial premium
Medicare part B does not cover:
inpatient hospital services
Information obtained from a phone conversation to the proposed insured can be found in which of these reports?
inspection report
a life insurance policy would be considered a wagering contract without:
insurable interest
When third-party ownership is involved, applicants who also happen to be the stated primary beneficiary are required to have:
insurable interest in the proposed insured
Which entity issues medicare supplement insurance?
insurance companies
what is being delivered during a policy delivery?
insurance contract to the proposed insured
who has the option to renew a renewable term policy?
insured
who may assign benefits from a group life insurance policy?
insured
what is the initial requirement for an insured to become eligible for benefits under the Waiver of Premium Provision?
insured must be under a physicians care
Which of these needs is satisfied by adjustable life insurance?
insured's need for flexible premiums
an insurance company normally has 2 years to contest information provided on an accident and health application. This 2 year period begins on the date that the:
insurer dates the policy
The percentage of an individual's Primary Insurance Amount (PIA) determines the benefits paid in which of the following programs?
Social security disability income
jasmine is a salaried employee of an insurance company. Which of the following duties would require her to be licensed as an insurance producer?
Soliciting insurance policies
T was treated for an ailment 2 months prior to applying for health insurance policy. This condition was noted on the application and the policy was issued shortly afterwards. How will the insurer likely consider this condition?
insurer will likely treat as pre-existing condition which may not be covered for one year
The ______ clause identifies which losses resulting from an accident or sickness are insured by the policy.
insuring
The clause in an Accident and Health policy which defines the benefit amounts the insurer will pay is called the:
insuring clause
which of the following health insurance policy provisions specifies the health care services a policy will provide?
insuring clause
which of the following claims are typically excluded from medical expense policies?
intentionally self-inflicted injuries
Which type of life insurance beneficiary requires his/her own consent when a change of beneficiary is attempted by the policyowner?
irrevocable beneficiary
a policyowner's rights are limited under which beneficiary designation?
irrevovable
health insurance plans that cover physical therapy visits may not impose a copay that...
is greater than the copay for primary care office visits
The conversion provision in a group health insurance policy
is mandated by state requirements
Credit life insurance is
issued in an amount not to exceed the amount of indebtedness
what is the purpose of a policy summary?
it highlights the critical parts of the policy issued
The health insurance program which is administered by each state and funded by both the federal and state governments is called:
medicaid
Which medicare product requires use of specified hospitals and physicians for non-emergency care?
medicare select
Which of the following activities may not be granted as credit for continuing education units?
meeting sales quotas
_________ can be defined as "making an unfair comparison of two insurance policies."
misrepresentation
a producer is circulating incorrect information about the benefits of a policy. This producer may be found guilty of...
misrepresentation
Which of these is not considered to be a right given to a policyowner?
modify a provision in the insurance contract
According to the Time Payment of Claims provision, the insurer must pay disability income benefits no less frequently than which of the following options?
monthly
Which of the following best describes how a preferred provider organization (PPO) is less restrictive than a health maintenance organization (HMO)?
more physicians to choose from
Which of these statements concerning an individual straight life annuity is accurate?
payments are made to an annuitant for life
which life insurance rider typically appears on a Juvenile life insurance policy?
payor benefit rider
which of the following best describes a contingent beneficiary?
person designated by the insured to receive policy proceeds in the event that the primary beneficiary dies before the insured
What must the policy owner provide to the insurer for validation that a loss has occured?
proof of loss
The legal Actions provision of an insurance contract designed to do all of the following, except:
protect the producer
When an insured has the same disability within a specified time period and the insurance company provides the same benefits without a new waiting periods, the second disability is covered under which of the following benefits?
recurrent disability
Which of the following is considered an element of a variable life policy?
underlying equity investment
a variable annuity has which of the following characteristics?
underlying equity investments
All of these are considered to be a benefit under social security, except for:
unemployment
Insureds in the same risk classification are being charged different premiums by an insurance company. This insurer is committing the illegal act of
unfair discrimination
In an insurance contract, the insurer is the only party who makes a legally enforceable promise. What kind of contract is this?
unilateral
S, age 40, is looking to buy a life insurance policy that will allow for increases or decreases in coverage as his needs change. The policy best suited for S would be...
universal life
Which of the following best descirbes how pre admission certification is used?
used to prevent nonessential medical costs
A(n) _______ Life policy offers the owner investment in products such as money-market funds, long term bonds and equities
variable
Which of these types of life insurance allows the policy owner to have level premiums and to also choose from a selection of investment options?
variable life
which of the following types of life insurance policies involves an investment account that is separate from the insurers general account?
variable life
Which type of life policy contains a monthly mortality charge as well as self-directed investment choices?
variable universal life
What is the primary factor that determines the benefits paid under a disability income policy?
wages
X owns a disability income policy. X recently suffered a disability which was due to the same cause as a previous disability. These disabilities both occurred over a four month span. Which of the following provisions allows X's second disability to be covered without a new elimination period?
recurrent disability
K failed to pay a renewal premium within the time granted by the insurer. K then sends in a payment which the insurer subsequently accepts. Which policy provision specifies that coverage may be restored in this situation?
reinstatement
which of these provisions require proof of insurability after a policy has lapsed?
reinstatement
T has a term policy that allows him to continue the coverage after expiration of the initial policy period. What type of term coverage is this?
renewable
a producer has influenced an existing policy owner to covert an existing whole life policy to reduced paid up insurance. The producer then sells the policy owner a new universal life policy. This transaction is called...
replacement
T is covered by an Accidental Death and Dismemberment (AD&D) policy that has an irrevocable beneficiary. What action will the insurance company take if T requests a change of beneficiary?
request of the change will be refused
T is covered by an accidental death and dismemberment (AD&D) policy that has an irrevocable beneficiary. What action will the insurance company take if T requests a change of beneficiary?
request of the change will be refused
D is an architect receiving Disability Income benefits who is not able to return to work full time, but can work on a part-time basis. Which of these features would allow D to continue receiving benefits?
residual benefit clause
S buys a $10,000 Whole Life policy in 2003 and pays an annual premium of $100. S dies 5 years later in 2008 and the insurer pays the beneficiary $10,500. What kind of rider did S include on the policy?
return of premium rider
An example of rebating would be
returning a portion of premiums as inducement to purchase insurance
M purchased an accidental death and dismemberment (AD&D) policy and named his son as beneficiary. M has the right to change the beneficiary designation at anytime. What type of beneficiary is his son?
revocable
which of the following statements best describes dental care indemnity coverage?
services are reimbursed after insurer receives the invoice
The insuring clause
states the scope and limits of the coverage
the annuity that represents the largest possible monthly payment to an individual annuitant is a (n)
straight life annuity
what should an insured do if the insurer does not send claims forms within the time period set forth in a health policys claims forms provision?
submit the claim in any form
Which of the following is the reimbursement of the benefits for the treatment of a beneficiaries injuries caused by a third party?
subrogation
the suicide provision for life policies would apply to
subsequent increases in benefits
Which of the following statements about the classification of applicants is incorrect?
substandard applicants are never declined by underwriters
When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain
suitability information
Which of the following services is not included under hospitalization expense coverage?
surgical fees
Which of the following statements about accumulated interest earned on dividends from an insurance policy is true?
taxed as ordinary income
Which of these is a TRUE statement regarding how Missouri law recognizes an association eligible for group coverage?
the association must NOT have been organized for the purpose of obtaining insurance
which of these statements regarding health coverage for physically handicapped dependents is false?
the dependent must have been over ten years of age when the handicap was incurred
Michael the insurance producer is acting in a fiduciary capacity when conducting business with all of these principals except
the director
which of these is a true statement regarding the regulatory authority of the director?
the director may establish guidelines for continuing education
Whole life insurance is sometimes referred to as "straight life." What does the word "Straight" indicate when using this phrase?
the duration of premium payments
which of the following statements is correct regarding an employer/employee group health plan?
the employer receives a master policy and the employees receive certificates
T and S are named co-primary beneficiaries on a $500,000 accidental death and dismemberment policy insuring their father. Their mother was named contingent beneficiary. Five years later, S dies of natural causes and the father is killed in a scuba accident shortly afterwards. How much of the death benefit will the mother recieve?
$0 because T is still alive
Under the USA Patriot Act, Insurers are required to report receipt of cash payments in excess of:
$10,000
An insured owns an individual disability income policy with a 30-day elimination period for sickness and accidents and month indemnity benefit of $500. If the insured is disabled for 3.5 months, what is the maximum amount he would receive for an approved claim?
$1250 3.5 months - 1 month elimination period = 2.5months. 2.5months X $500 monthly indemnity=$1250
M has a Major Medical insurance policy with a $200 flat deductible and an 80% Coinsurance clause. If M incurs a $2,200 claim for an eligible medical expense, how much will M receive in payment for this claim?
$1600 $2200-$200 deductible X 80% = $1600
Q is hospitalized for 3 days and recieves a bill for $10,100. Q has a major medical policy with a $100 deductible and 80/20 coinsurance. How much will Q be responsible for paying on this claim?
$2,100 $10,000 X 20%coinsurance +$100 deductible = $2,100
an employee with $25,000 group term life coverage was recently fired. This employees group coverage may be converted to a:
$25,000 individual whole life policy
T took out a $50,000 life insurance policy with an Accidental Death and Dismemberment rider. Five years later, T commits suicide. How much will the insurer pay?
$50,000
s buys a $50,000 whole life policy with a $50,000 accidental death and dismemberment rider. S dies 1 year later of natural causes. How much will the insurer pay the beneficiary?
$50,000
P purchases a $50,000 whole life insurance policy in 2005. One of the questions on the application asks if P engages in scuba diving, to which P answers "No". The policy is then issued with no scuba exclusions. In 2010, P takes up scuba diving and dies in a scuba-related accident in 2011. What will the insurer pay to P's beneficiary?
$50,000 minus any outstanding policy loans
C was injured while deep sea diving and requires a hospital stay. C has a Major Medical policy with a 80/20 coinsurance clause and a $400 deductible. What is the MAXIMUM C will pay if the covered medical expenses are $2000?
$720 In this situation, $400 deductible + 20% of the remaining medical bill = $720
a group life insurance policy insured may assign up to _____ of the insureds coverage
100%
What is the minimum benefit period that must be offered by a long-term care policy?
12 months
an insurer must provide an insured with claim forms within ____ days after receiving notice of a loss.
15
A licensee must complete _____ hours of continuing education every two years
16
After a life insurance policy has been in force for maximum of ____ year(s), it becomes incontestable
2
an insured must notify an insurer of a medical claim within ________ days after an accident
20
Insurers may request a hearing within ______ if their policy is rejected
20 days
J is 35-years old and looking to purchase a whole life insurance policy. Which of the following types of policies will provide the most rapid growth of cash value?
20-pay life
what type of policy would offer a 40 year old the quickest accumulation of cash value?
20-pay life
The USA Patriot Act was enacted in
2001
An insurer may normally delay the payment of cash value loan or surrender value for up to
6 months
an insurer may exclude pre-existing conditions coverage on a medicare supplement policy for up to...
6 months
How many days must the insured wait to take legal action against a health insurer after submitting written proof of loss if the insurer refuses to pay?
60
how long does an individual have to "rollover" funders from IRA or qualified plan?
60 days
A nondisabled individual is first eligible for a medicare supplement policy at age
65
What is the maximum fixed interest rate for life insurance policy loans?
8%
C is a key employee at ABC Incorporated. If a Key employee life policy is purchased on her life, which of these statements would be true?
Abc is the policyowner, c is the insured, and ABC is the beneficiary
When a policy owner cash surrenders a universal life insurance policy in its early years, this may be considered a red flag for a (n):
Anti-money laundering violation
In Missouri, all health policies must address diabetes coverage in which way?
Apply the same deductible and copays to covered diabetic supplies as other medical condtions
traditional individual retirement annuity (IRA) distributions must start by:
April 1st of the year following the year the participant attains age 70.5
which of these actions should a producer take when submitting an insurance application to an insurer?
Inform insurer of relevant information not included on the application
which of the following is not allowed in regards to a medigap (medicare supplement) policy?
Issuing an additional medigap policy to ensure no out-of-pocket exposure for the insured
Which licensee faces possible license revocation by the director of insurance?
Licensee who commingles monies belonging to policy holders with personal funds
J is issued a life insurance policy with a death benefit of $100,000. She pays $600 per year in premium for the first 5 years. The premium then increases to $900 per years in the sixth year, and remains level thereafter. The policys death benefit also remains at $100,000. Which type of life insurance policy is this?
Modified premium life
K buys a policy where the premium stays fixed for the first 5 years. The premium then increases in year 6 and stays level thereafter, all the while the death benefit remains the same. What kind of policy is this?
Modified whole life
which statement is true regarding a minor beneficiary?
Normally, a guardian is required to be appointed in the beneficiary clause of the contract
Which tax would an IRA participate be subjected to on distributions received prior to age 59.5?
Ordinary income tax and a 10% tax penalty for early withdrawal
Which of these statements is INCORRECT regarding a preferred provider organization (PPO)
PPO's are NOT a type of managed care systems
What does medicare parts A and B cover?
Part A covers hospitalizations; Part B covers doctors services
Which of the following information is NOT required to be included in a Whole Life Policy?
Policy's guaranteed dividend table
Whose interest is being protected by the enachment of "The Replacement of Life Insurance and Annuities" regulation?
Policyowner
Which long term care insurance statement is true?
Pre-existing conditions must be covered after the coverage has been in force for six months
Under what system do a group of doctors and hospitals in a designated area contract with an insured to provide services at a prearranged cost to the insured?
Preferred Provider Organization (PPO)
which of the following are equity-indexed annuities typically invested in?
S&P 500
P is an employee who quits her job and wants to convert her group health coverage to an individual policy. After the expiration of COBRA laws, which of the following statements is TRUE?
She DOES need to provide evidence of insurability
what does a guaranteed insurability rider provide a disability income policy owner?
The ability to periodically increase the amount of coverage without evidence of insurability
J, an Accidental Death and Dismemberment (AD&D) policy holder, dies after injuries sustained in an accident. J's age as stated on the application five years ago was found to be understated by ten years. Which of the following actions will the insurance company take?
The insurer will adjust the benefit to what the premiums paid would have purchased at the insureds actual age
All of these statements about equity indexed life insurance are correct, except...
The premiums can be lowered or raised, based on investment performance
Which accident and health policy provision addresses preexisting conditions?
Time limit on certain defenses
Why is an applicants signature required on a life insurance application?
To attest that the statements on the application are accurate to the best of the applicants knowledge
K purchased a life insurance policy in 1986 which paid 10% interest in the early years of the policy. Twenty years after the purchase, she received a notice from the insurer stating that the policy will soon terminate unless a much-higher premium is paid because of falling interest rates. This type of policy is known as a(n) _______ life policy.
Universal
When is the face amount paid under a Joint Life and Survivor policy?
Upon death of the last insured
a return of premium life insurance policy is:
Whole Life and increasing term
which of the following statements describes what an accident and health policy owner may not do?
adjust the premium payments
In health insurance policies, a waiver of premium provision keeps the coverage in force without premium payments:
after an insured has become totally disabled as defined in the policy
When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain suitability information. Suitability information includes...
age, annual income, financial experience
Q purchases a $500,000 life insurance policy and pays $900 in premiums over the first six months. Q dies suddenly and the beneficiary is paid $500,000. This exchange of unequal values reflects which of the following insurance contract features?
aleatory
Which of the following would a medicare supplement policy cover?
allowable amounts under medicare part B
The consideration clause in a life insurance contract contains what pertinent information?
amount of premium payments and when they are over due
P is a forty year old woman and would like to purchase an an annuity that will provide a lifetime income stream beginning at age sixty, which of the following did she not buy?
an immediate annuity
all of the following statements regarding group health insurance is true, except:
an individual policy is given to each member
Which of the following statements best describes what the legal actions provision of an accident and health policy requires?
an insured must wait at least 60 days after proof of loss has been submitted before a lawsuit can be filed
which premium schedule results in the lowest cost to the policy owner
annual
The director of insurance is authorized
to enforce state laws relating to insurance
When an individual is planning to protect his family with life insurance, one method of doing so is called needs analysis. What exactly does needs analysis involve?
established the needs of the individual and his dependents
which of these statements about a guaranteed insurability option rider is NOT TRUE?
evidence of insurability is required when the option is exercised
D is the policyowner and insured for a $50,000 life insurance policy. The beneficiary is D's wife. D and his wife divorce and D remarries, transferring ownership of his policy to his new wife. If D dies without making any further changes, to whom will the policy proceeds be paid to?
ex-wife
Life insurance and annuity replacement can be best described as....
exchanging an existing policy for a new policy
In a life insurance policy, which feature states that the policy will not cover certain risks?
exclusion
N is a student pilot with a large life insurance policy. Which of these features would limit the insurer's obligation in the event N was killed while flying as a student pilot?
exclusion
the sections of an insurance contract which limit coverage are called:
exclusions
Long term care policies will usually pay for eligible benefits using which of the following methods?
expense incurred
D owns a whole life policy that was purchased 10 years ago. If the premium payments suddenly stop and D takes no additional action, which Nonforfeiture option will the insurer likely proceed with?
extended term
an underwriter determines that a life insurance applicant's risk should be reclassified due to a health issue. This policy may be issued with a(n):
extra premium
What does a face amount plus cash value policy pay upon the insured death?
face amount plus the policy's cash value
Taking receipt of premiums and holding them for the insurance company is an example of:
fiduciary responsibility
what action should a producer take if the initial premium is not submitted with the application?
forward the application to the insurer without the initial premium
K, age 45, and his wife, age 43, have three children. They purchase a Family Policy that covers K's wife to age 65. All of these situations will pay a death benefit except
k's wife dies at age 66
An architecture firm would stand to lose a lot of money in the event of the death its project manager. which type of policy should the firm purchase on its project manager?
key person life policy
stranger originated life insurance (STOLI) has been found to be in violation of which of the following contractual elements?
legal purpose (Insurable interest)
What kind of premium does a whole life policy have?
level
T has an annuity that guarantees an income payment for the rest of his life. The contract also guarantees that if T dies before receiving payments for 20 years, the remaining payments will be paid to his son for the balance of the 20 years. What type of annuity is this?
life annuity with period certain
The Accelerated Death Benefit provision in a life insurance policy is also known as....
living benefit
an individual who purchases a life annuity is given protection against:
living longer than expected
Nursing home benefits must be provided for at least 12 consecutive months in which of the following types of policies?
long-term care
Dental care coverage is designed to cover the costs of all of the following except:
loss of income
basic hospital and surgical policy benefits are:
lower than the actual expenses incurred
The individual health insurance policy that offers the broadest protection is a(n) _________ __________ policy
major medical
pre-hospitalization authorization is considered an example of:
managed care
Which type of plan normally includes hospice benefits?
managed care plans
Rick recently died and left behind an individual IRA account in his name. His widow was forwarded the balance of the IRA. The widow qualifies for the:
marital deduction
Which of these factors do NOT play a role in the underwriting of a life insurance policy?
marital status
A disability income policy that only the policy owner can terminate and which the rates will never go up is considered to be...
noncancellable
What type of renewability guarantees premium rates and renewability?
noncancellable
j has a disability income policy that does not provide benefits for losses occurring as the result of his employment. What kind of coverage is this?
nonoccupational coverage
which of the following best describes a short-term medical expense policy?
nonrenewable
What must a producer sign when an existing life insurance policy is being reissued with a reduction in cash value?
notice regarding replacement
The notice of claims provisions requires a policyowner to:
notify an insurer of a claim within a specified time
If the sale of a medicare supplement involves replacement, all of these actions must be performed by the producer except...
notify the replaced insurance company
At the time of application, major medical health plans (including HMOs) are required to
offer coverage for prosthetic devices
generally, how long is a benefit period for a major medical expense plan?
one year
all of these statements concerning settlement options are true, except:
only the beneficiary may select
When a medicare supplement policy is delivered, disclosure standards require that a(n) _______ of coverage be provided to the insured.
outline
K owns a whole life policy. If K wants an increasing death benefit to protect against inflation, which dividend option should she choose?
paid-up additional insurance
Which of the following is a requirement for obtaining a resident producer license in Missouri?
pay a $100 license fee
the provision that defines to whom the insurer will pay benefits to is called
payment of claims
which of these is considered a mandatory provision?
payment of claims
M has an insurance policy that also has an outstanding policy loan at the time of M's death. The insurer will deduct the outstanding loan balance from the
policy proceeds
The ________ is authorized to assign a life insurance policy as collateral for a loan.
policyowner
The __________ has the right to change a life insurance policy's beneficiary.
policyowner
a provision in a life insurance policy that pays the policyowner an amount that does not surpass the guaranteed cash value is called the:
policyowner loan provision
a policyowner is able to choose the frequency of premium payments through what policy feature?
premium mode
How does group insurance differ from individual insurance?
premiums are lower
Which of these statements accurately describes the waiver of premium provision in an accident and health policy?
premiums are waived after the insured has been totally disabled for a specified time period
What is considered to be a characteristic of a conditionally renewable health insurance policy?
premiums may increase at time of renewal
Which of the following statements about a guaranteed renewable health insurance policy is correct?
premiums normally increase at time of renewal
the coordination of benefits provision:
prevents an insured covered by two health plans from making a profit on a covered loss
what is the purpose of the time of payment of claims provision
prevents delayed claim payments made by the insurer
A medical information Report (MIB) report may disclose which of the following:
prior use of marjuana
A(n) _________ is an individual who is appointed by an insurance company to transact insurance.
producer
who signs a "notice regarding replacement" form when an application is taken for a new insurance policy that replaces an existing one?
producer and applicant
a retirement plan that sets aside part of the company's net income for distributions to qualified employees is called a:
profit sharing plan
a policy of adhesion can only be modified by whom?
the insurance company
Which statement regarding the change of beneficiary provision is true?
the policyowner can change the beneficiary
Which of the following statements is true about most blue cross/blueshield organizations?
they are nonprofit organizations
T files a claim on his Accident and Health policy after being treated for an illness. The insurance company believes that T misrepresented his actual health on the initial insurance application and is, therefore, disputing the claim's validity. The provision that limits the time period during which the company may dispute a claim's validity is called
time limit on certain defenses
an insured recently took out a cancer insurance policy. The time limit on certain defenses provision in this policy allows the insurer...
to deny the amount of a claim for misstatements on the application occurring prior to the expiration of the first two policy years
why would the director of insurance examine the records of an insurance company?
to determine the solvency of the company
ABC Insurance company has accepted a life insurance application which contains unanswered questions. The company then makes the application part of the life contract. In this situation, the insurer has:
waived one of its legal rights
A life insurance policy which ensures that the premium will be paid if the insured becomes disabled has what kind of rider attached?
waiver of premium
Which of the following may not be issued after the director of insurance finds an insurance code violation committed by a licensee?
warrant for arrest
The part of a life insurance policy guaranteed to be true is called..
warranty
which parts of a life insurance policy are guaranteed to be true?
warranty
under which circumstance must a health insurer have expedited grievance review procedure?
when the enrollee's life or health is jeopardized
when is the face amount of a whole life policy paid?
when the insured dies or at the policys maturity date, which ever happens first
If an individual is covered under an accidental death policy and dies, and autopsy can be performed in all these situations, except:
when the state prohibits this by law
a life insurance policy that provides a policy owner with cash value along with a level face amount is called:
whole life
Health insurance policies in Missouri are required to contain coverage for human leukocyte antigen testing for bone marrow transplant...
with each issued health policy
A hearing must be held before a producers license can be suspended or revoked. Prior to this hearing, the director is required to give.....
written notice to the producer
Prior to a producers license being revoked, a hearing must be held. prior to this hearing, the director of insurance is required to give
written notice to the producer
