Northwestern Mutual
If paid by the individual, the premiums are tax deductiblë
Which of the following is INCORRECT concerning taxation of disability income benefits?
An insured is diagnosed with cancer and needs help paying for her medical treatment
Under which of the following circumstances would an insurer pay accelerated benefits?
Medicare Part A is automatically provided when an indivual qualifies for Social security benefits at age 65
Which of the following statements pertaining to Medicare Part A is correct?
Guaranteed renewable
A Medicare supplement plan must have at least which of the following renewal provisions?
Is renewable at the insured' option to a specified age.
A guaranteed renewable disability insurance policy
Claim is denied if his policy contains the Illegal Occupation provision.
A man is injured while robbing a convenience store. How does his major medical policy handle the payment of his claim?
The insurance through his company is primary. - The policy that covers the person filing the claim is considered the primary
A man works for Company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim,
It is a compulsory program
All of the following statements about Medicare Part B are correct EXCEPT
Benefits are paid to the borrower's beneficiary
All of the following statements are correct regarding Credit Life Insurance EXCEPT
A worker receives benefits only if the work related injury was not his/her fault
All of the following statements concerning workers compensation are correct EXCEPT
$102
An employee insured under a group health plan has been paying $25 monthly premium for his group health coverage. The employer has been contributing $75 for the total monthly cost of $100. If the employee leaves the company, what would be his maximum monthly premium for COBRA coverage?
The group plan WILL NOT pay because the employee was injured at work
An employee insured under a group health policy is injured in a car wreck while performing her duties for her employer. This results in a long hospitalization period. Which of the following is true?
They are tax deductible
An insured makes regular contributions to his Health Savings Account. How are these contributions treated in regards to taxation?
Small employer
Company Y had 20 employees on staff last year. Which of the following terms most precisely labels the company's group insurance classification
Any occupation - more restrictive than other definitions
Disability income coverage specifies that the policy covers the insured if he is unable to perform any job for which he is qualified. In this case, total disability is defined as
Evidence of coverage
Each HMO enrollee must be provided
Capitation basis
HMOs that contract with outside physicians to provide health care service to their subscribers compensate those providers on a
The terminally ill
Hospice care is intended for
5 days
If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?
Executive is the owner, and executive pays the premium. - Employer reimburses the executive for the cost
In the executive bonus plan, who is the owner of the policy, and who pays the premium?
ALL PLANS The benefits in Plan A are considered to be core benefits and must be included in the other types. Therefore, all types contain the core benefits offered by Plan A.
In which Medicare supplemental policies are the core benefits found?
Yes, advertisements must not mislead the public in terms of financial standing
Is it illegal for an insurance company to advertise that it is the leader of the financial industry and therefore pays the most claims each year?
Increased benefits
Issue age policy premiums increase in response to which of the following factors?
Income assistance for work-related injury
Medicaid provides all of the following benefits EXCEPT
Outpatient hospital treatment
Medicare Part A services do NOT include which of the following?
A group enrollment system either at their place of employment or as a member of association
Most HMOs operate through what type of system?
Attending physician
Occasional visits by which of the following medical professionals will NOT be covered under LTC's home health care?
Not taxable since the IRS treats them as a return of a portion of the premium paid
On a participating insurance policy issued by a mutual insurance company, dividends paid to policyholders are
Accident-only
The insured's health policy only pays for medical costs related to accidents. Which of the following types of policies does the insured have?
The method of premium payment
The insuring clause of a disability policy usually states all of the following EXCEPT
Subrogation
The legal process that gives the insurer, after payment of a loss, the right to seek recovery from a third party that was responsible for the loss is known as
Need
The primary eligibility requirement for Medicaid benefits is based upon
Integrated dental plan
The type of dental plan which is incorporated into major medical expense plan is a/an
FEderal goverment
The usage of words or symbols that are similar to what entity is prohibited in life insurance advertisements?
Between %100 and %400
To be eligible for tax credits under the ACA, individuals must have income that is what percent of the Federal Poverty Level?
Monthly
Under an individual disability policy, the MINIMUM schedule of time in which claim payments must be made to an insured is
The applicant's health condition
Under the ACA, health insurance can no longer be underwritten based on which of the following factors?
A statement that is sufficiently clear to identify the insured and the nature of the claim
Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
Signed waiver of premium
Upon policy delivery, the producer may be required to obtain any of the following EXCEPT:
Within 2 months
Upon the submission of a death claim under a life insurance policy, when should the insurer pay the policy benefit?
6 months
What is the waiting period on a waiver of premium rider in life insurance policies?
0% Benefits are not income taxable
What percentage of individually-owned disability income benefits is taxable?
Grace period
What provision in a life or health insurance policy extends coverage beyond the premium due date?
Any policy that has a death benefit must also have a Change of Beneficiary provision
Which statement accurately describes the Change of Beneficiary provision?
The individual must be at least 65 years old
Which statement regarding qualifications for Social Security disability benefits is NOT true?
Single payment or periodic payments
Which two terms are associated directly with the way an annuity is funded?
State government
Workers Compensation benefits are regulated by which entity
Physical examination and autopsy
which of the following provisions is mandatory for health insurance policies?
Insurer
Which of the following entities can legally bind coverage?
The individual insured
In a group policy, who is issued a certificate of insurance?
Unearned premiums are retained by the insurance company
According to the rights of renewability rider for cancellable policies, all of the following are correct about the cancellation of an individual insurance policy except
gatekeeper
In an HMO, a Primary Care Physician is called a
Annuitization period
In an annuity, the accumulated money is converted into a stream of income during which time period?
15
An insurer must acknowledge receipt of a Notice of Claim within how many days?
COBRA - Nancy will be eligible for benefits for up to 36 months due to their divorce policy
Kevin and Nancy are married; Kevin is the primary breadwinner and has a health insurance policy that covers both him and his wife. Nancy has an illness that requires significant medical attention. Kevin and Nancy decide to legally separate, which means that Nancy will no longer be eligible for health insurance coverage under Kevin. Which of the following options would be best for Nancy at this point?
Other insurance coverages
Part 2 of the application for life insurance provides questions regarding all of the following EXCEPT:
An annuity
Periodic payments of accumulated funds best describes
Not tax deductible
Premium payments for personally-owned disability income policies are
Parts A and B of medicare
Prior to purchasing a Medigap policy, a person must be enrolled in which of the following?
It is fully funded by Social Security Taxes (FICA) It is funded by monthly premiums frrom government
Question 7 of 15 Concerning Medicare Part B, which statement is INCORRECT?
The individual mandate
The Affordable Care Act requires all U.S. citizens and legal residents to have qualifying health care coverage. This is known as
Draft insurance laws
The Commissioner has full power and authority to do all of the following EXCEPT
When the income payments begin. Immediate annuities will begin payments within the first year, while deferred will not begin until sometime after the first year
The main difference between immediate and deferred annuities is
Interest only option With this option, the insurance company retains the policy proceeds and pays interest on the proceeds to the recipient (beneficiary) at regular intervals
The policyowner wants to make sure that upon his death, the life policy will pay a portion of the proceeds annually to his spouse, but that principle will be paid to their children when they reach a certain age. Which settlement option should the policyowner choose?
"Own occupation" - less descriptive than other definitions
A brain surgeon has an accident and develops tremors in her right arm. Which disability income policy definition of total disability will cover her for all losses?
The benefit is received tax free
A corporation is the owner and beneficiary of the key person life policy. If the corporation collects the policy benefit, then
Policyowner to renew the policy at a stated age, with the company having the right to increase premiums on the entire class
A guaranteed renewable health insurance policy allows the
A retired person age 50
All of the following individuals may qualify for Medicare health insurance benefits EXCEPT AA retired person age 50.
The insurance agent's name and license number
All of the following information must be included in the evidence of coverage for an HMO plan EXCEPT
Skilled Care Skilled care is almost always provided in an institutional setting
All of the following long-term care coverages would allow an insured to receive care at home EXCEPT
Immediately
An HMO subscriber no longer meets plan eligibility requirements. When can the insurer cancel coverage?
The hearing must be held within 10 days of receiving a request, unless both parties agree to a later date.
An agent receives an Emergency Cease and Desist Order for chronically misrepresenting his insurance policies. The agent knows that he did not commit the violations stated in the Emergency Cease and Desist Order. He wants to contest the charges in a court hearing. Which of the following is true?
$120 a day Most LTC policies will pay the benefit amount in a specific fixed dollar amount per day, regardless of the actual cost of care.
An insured's long-term care policy is scheduled to pay a fixed amount of coverage of 120 per day. The faculty only charged 100 per day. How much will the insurance company pay?
Attained age
An insured's premium increases as a result of her age. Which type of policy does she have
Illegal
An insurer devises an intimidation strategy in order to corner a large portion of the insurance market. Which of the following best describes this practice?
Rated
Another name for a substandard risk classification is
Group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense
As it pertains to group health insurance, COBRA stipulates that
20 days
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?
The employer plan is primary coverage, and Medicare is secondary coverage
For an individual who is eligible for Medicare at age 65, and who is still employed and covered under the employer's plan, which of the following is true?
100%
For group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense?
100 days
For how many days of skilled nursing facility care will Medicare pay benefits?
6 months
How long is an open enrollment period for Medicare supplement policies?
The first day of disability and the day the insured starts receiving benefits
In a disability policy, the elimination (or waiting) period refers to the period between
Join the group after the effective date
In a group health policy, a probationary period is intended for people who
The application is completed and submitted
In insurance, an offer is usually made when
Promising to pay in accordance with the contract terms
In respect to the consideration clause, which of the following is consideration on part of the insurer?
Waiver of premium rider
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
Medicare Part C
Medicare Advantage is also known as
An agent misrepresents policy benefits to convince a policy owner to replace policies. - this is misrepresentation
Rebating is an unfair trade practice and is regulated by law. All of the following would be considered to be rebating EXCEPT
100%
S is a sole business proprietor who owns a medical expense plan. What percentage of the cost of the plan may he deduct?
30 days
The Commissioner of Insurance issues a Cease and Desist Order to an agent. If the agent wishes to contest the charges in court, how many days after the order was issued does the agent have to make the request?
26
The Patient Protection and Affordable Care Act mandates that insurers provide coverage for dependent children up to age of
Nonoccupational coverage
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
The applicant has been shown to be a poor personal credit risk
The following are all causes for the Insurance Commissioner to suspend or impose conditions upon the continuance of an agent's license EXCEPT
The borrower's annual income
The initial amount of credit life insurance may NOT exceed
Legal benefits
Under workers compensation, which of the following benefits are NOT included?
Health Care Accounts and Dependent Care accounts
What are the 2 types of Flexible spending accounts?
Hospital, Surgical, medical
What are the three basic coverages for medical expense insurance?
20% penalty
What is a penalty tax for non-qualified distributions from a health savings account?
Copayment is a set dollar amount
What is the main difference between coinsurance and copayments?
to help customers make educated decisions in buying life insurance
What is the main purpose of the regulation on life insurance policy illustrations?
The insurer is considered to be notified since the notification to the agent equals notification to the insurer.
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 wouild be handled?
Alien insurer
When transacting business in this state an insurer formed under the laws of another country is known as a/an
If it is intentional and material
When would a misrepresentation on the insurance application be considered fraud?
On the first page
Where in the long-term care policy must the insurer state the renewal provision?
On the face page
Where in the policy must the HMO insurer provide information about the HMO's name, address, and toll-free number?
Benefits are offered by the insurer - the government offers benefits
Which of the following is NOT true regarding Workers Compensation?
Creditor is the policyowner
Which of the following is TRUE about credit life insurance?
It can only be issued once in any 6-month period
Which of the following is a TRUE statement about a temporary license issued in this state?
A lump-sum benefit payment option. Buyout plans usually allow for a lump-sum payment of the benefit
Which of the following is a feature of a disability buyout plan?
Telling a client that his first premium will be waived if he purchased the insurance policy today
Which of the following is an example of a producer being involved in an unfair trade practice of rebating?
It cannot exclude newborn children from coverage
Which of the following is correct about a group health insurance policy?
Premiums are tax deductible
Which of the following is correct regarding Business Overhead Expense insurance?
Premiums are tax deductible and benefits are not taxed
Which of the following is correct regarding the taxation of group medical expense premiums and benefits?
Admitted
Which of the following is the closest term to an authorized insurer?
They must be at least guaranteed renewable
Which of the following is true regarding Medicare supplement policies?
The longer the elimination period, the lower the cost of coverage
Which of the following is true regarding elimination periods and the cost of coverage?
Creditor can only insure the debtor for the amount owed
Which of the following is true regarding the insurance amount in a credit life policy?
Certificate of authority
Which of the following must an insurer obtain in order to transact insurance within a given state?
Excessive benefits may be taxable
Which of the following statements is correct concerning taxation of long-term care insurance?
Stop-loss limit
Which of the following terms describes the specified dollar amount beyond which the insured no longer participates in the sharing of expenses?
Whole life
Which of the following types of insurance policies would perform the function of cash accumulation?
Implying that the agent is the insurer
Which of the following would be considered false advertising?
Amount paid with the accelerated benefit, plus the earnings lost by the insurance company in interest income from the accelerated benefit.
Which of the following would be deducted from the death benefit paid to a beneficiary, if a partial accelerated death benefit had been paid while the insured was still alive?
The HMO
Which of the following would be required to obtain a Certificate of Authority?
Creditor
Which of the following would be the beneficiary in credit life insurance?
The extent of benefits determined by insured's income - usually 60%
Which statement accurately correlates with group disability income insurance?
The insurance company
Who bears all of the investment risk in a fixed annuity?
An individual not covered by an employer-sponsored plan who has earned income
Who can make a fully deductible contribution to a traditional IRA?
The insurance company
Who do agents represent?
Insurers
Who makes up the Medical Information Bureau?
31 days
Within how many days must an insured notify the insurer of a child's birth and pay any required fees?
Work-related disabilities
Workers compensation insurance covers a worker's medical expenses resulting from work related sickness or injuries and covers loss of income from
The insured's premiums will be waived until she is 21.
A father owns a life insurance policy on his 15-year-old daughter. The policy contains the optional payor benefit rider. If the father becomes disabled, what will happen to the life insurance premiums?
A benefit for each day the insured is in a hospital
A hospital indemnity policy will pay,
Immediate annuity
A lucky individual won the state lottery so the state will be sending him a check each month for the next 25 years. What type of annuity products are they likely to provide these benefits?
Immediate annuity
A lucky individual won the state lottery, so the state sends him a check each month for 25 years. What type of annuity products are they likely to use to provide these benefits?
Insurance
What do individuals use to transfer their risk of loss to a larger group?
A debtor has an insurable interest in the life of a lender. (a lender has an insurable interest in the life of a debtor to an extent)
Which of the following is NOT true concerning insurable interest as it applies to life insurance?
Automatic premium loan
A policyowner fails to pay the premium due on his whole life policy after the grace period passes, but the policy remains in force. This is due to what provision?
Survivorship protection
A producer is helping a married couple determine the financial needs of their children in the event that one or both should die prematurely. This is a personal use of life insurance known as
Other-insured rider
A rider attached to a life insurance policy that provides coverage on the insured's family members is called the
It allows the insured to reject the policy with a full refund
What is the purpose of a free-look period in insurance policies?
Executive bonus
When an employer offers to give an employee a wage increase in the amount of the premium on a new life insurance policy, this is called
Return of premium
When an insured under a life insurance policy died, the designated beneficiary received the face amount of the policy as well as a refund of all of the premiums paid. Which rider is attached to the policy?
Exchanged of unequal values
Which of the following best describes the aleatory nature of an insurance contract?
The period of time during which accumulated money is converted into income payments
Which of the following best describes what the annuity period is?
Funding against general company financial loss
All of the following are business uses of life insurance except
A: The cash value is not guaranteed B: Policyowners bear the investment risk C: The premiums are invested in the insurer's general account D: The minimum death benefit is guaranteed C, the premiums are invested
All of the following are true about variable products EXCEPT
The plan is funded by permanent insurance ONLY. - Key person can be funded by any type of life insurance
All of the following are true of key person insurance EXCEPT
The Guaranty Association
All of the following entities regulate variable life policies EXCEPT
Cash option
An insured receives an annual life insurance dividend check. What term best describes this arrangement?
Adhesion
An insurer has made all of the decisions regarding the provisions included in the insured's policy. the insured finds an objectionable provision and wants to negotiate it with the insurer but is not allowed to do so. Her only options are to reject the policy or accept it as is. Which contract feature does this describe?
Consideration
An insurer neglects to pay a legitimate claim that is covered under the terms of the policy. Which of the following insurance principles has the insurer violated?
Inspection report
An insurer receives a report regarding a potential insured that includes the insured's financial status, hobbies and habits. What type of report is this?
Application
An insurer wants to begin underwriting procedures for an applicant. What source will it consult for the majority of its underwriting information?
It requires the policyowner to pay all overdue premiums with interest before the policy is reinstated
What does the reinstatement policy require?
Its premium steadily decreases over time, in response to its growing cash value
What is not true regarding a Straight Life policy?
$2,500
What is the maximum penalty for habitual willful noncompliance with the Fair Credit Reporting Act?
Keogh
Which of the following is an IRS qualified retirement program for the self-employed?
Pay-in period
Which of the following is another term for the accumulation period of an annuity?
Survivorship life
Which of the following is called a "second-to-die" policy
Loss of two limbs
Which of the following is considered a presumptive disability under a disability income policy?
Premiums are not tax deductible as a business expense - The business cannot take a tax deduction for the expense of the premium. However, if they key employee dies, the benefits paid to the business are usually tax free
Which of the following is correct concerning the taxation of premiums in a key-person life insurance policy
Coverage is unlimited
Which of the following is not true regarding Basic Surgical Expense coverage?
It has a guaranteed minimum interest rate
Why is an equity indexed annuity considered to be a fixed annuity?
Education
All of the following information about the applicant is identified in the General information section of a life insurance application EXCEPT
Either the amount paid into the plan or the cash value of the plan, whichever is the greater amount
If an annuitant dies before annuitization occurs, what will the beneficiary receive?
The policy will terminate when the cash value is reduced to nothing - the premium gets automatically paid from the contract's guaranteed cash value, therefore decreases
If an insured continually uses the automatic premium loan option to pay the policy premium,
Special risk policy
Which of the following special policies covers unusual risks that are NOT normally included under Accidental Death and Dismemberment coverage?
Aleatory
An insured pays a $100 premium every month for his insurance coverage, yet the insurer promises to pay $10,000 for covered loss. What characteristic of an insurance contract does this describe?
The insured may renew the policy for another years, but at a higher premium rate.
An insured purchased a 10-year level term life policy that is guaranteed renewable and convertible. What happens at the end of the 10-year term?
Joint life policy
A married couple owns a permanent policy which covers both of their lives and pays the death benefit only upon the death of the first insured. Which policy is that?
The owner must be the party to receive benefits
All of the following are true of an annuity owner EXCEPT
Equity Indexed annuity
An annuity owner is funding an annuity that will supplement her retirement. Because she does not know what effect inflation may have on her retirement dollars, she would like a return that will equal the performance of the Standard and Poor's 500 Index. She would likely purchase A
Neither approved the application nor issued the policy
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 by this point?
Upon the last death
In the survivorship policy, when does the insurer pay the death benefit?
Gets higher
Regarding long-term care coverage, as the elimination period gets shorter, the premium
Consideration
Something of value exchanged between the insurer and the insured is considered an
An index like Standard & Poor's 500
The equity in an equity index annuity is linked to
Must be informed of the source of the report
Under the Fair Credit Reporting Act,individuals rejected for insurance due to information contained in a consumer report
Old age survivors disability insurance
What is the official name for the Social Security Program?
Indemnity
Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital?
Conditions
Because an insurance policy is a legal contract, it must conform to the state laws governing contracts which require all of the following elements EXCEPT:
Premiums paid by an employer on a $30,000 group term life insurance plan for employees
In which of the following instances would the premium be tax deductible?
Generally not taxed as income
Life insurance death proceeds are
Alzheimer's disease
Long-term care insurance policies cover which of these?
The customer's associates, friends, and neighbors provide the report's data
In comparison to consumer reports, which of the following describes a unique characteristic of investigative consumer reports?
Tax deductible by the employer
The premiums paid by the employer in a business life insurance policy are
Annuity
Which of the following products will protect an individual from outliving his or her money?
Consumer report
Which of the following reports will provide the underwriter with the information about an insurance applicant's credit?
Fair Credit reporting act
An applicant is denied because of information found on a consumer report. Which of the following requires that the insurance company supply the applicant with the name and address of the consumer reporting company?
Insurable interest and consent
A life insurance policy has a legal purpose if both of which of the following elements exist?
$8,000, 60 days
An employee quits her job where she has a balance of 10000 in her qualified plan. The balance was paid out directly to the employee in order for her to move the funds to a new account. if she decides to rollover her plan to a traditional IRA how much will she receive from the plan administrator and how long does she have to complete the tax-free rollover?
Issue the policy anyway and pay the face value to the beneficiary
When Y applied for insurance and paid the initial premium on August 14th, he was issued a conditional receipt. During the underwriting process, the insurance company found no reason to reject the risk or classify it other than as standard. Y was killed in an automobile accident on August 22, before the policy was issued. In this case, the insurance company will...
$200,000
An insured purchased a 15-year level term life insurance policy with a face amount of $100,000. The policy contained an accidental death rider, offering a double indemnity benefit. The insured was severely injured in an auto accident, and after 10 weeks of hospitalization, died from the injuries. What amount would his beneficiary receive as a settlement?
15 days A probationary period refers to the amount of time that coverage is not available for illness-related disabilities, so it would not apply to a broken leg. The elimination period, however, is the time that must elapse between the onset of the disability and when benefits will start being paid. In this case, the individual is considered disabled for 45 days, and the benefits will start to be paid after 30 days. So, the client will receive benefits for 15 days.
A client has a new individual disability income policy with a 20-day probationary period and a 30-day elimination period. Ten days later, the client breaks their leg and is off work for 45 days. How many days of disability benefits will the policy pay?
Immediately
A health insurance policy lapses but is reinstated within an acceptable timeframe. How soon from the reinstatement date will coverage for accidents become effective?
Critical illness
A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is known as
Usual, customary, and reasonable
A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as
$12,000, all of which is taxable
A noncontributory group disability income plan has a 30-day waiting period and offers benefits of $2,000 a month. If an employee is unable to work for 7 months due to a covered disability, the employee will receive
Subrogation
A provision found in insurance policies which prevents the insured from collecting twice for the same loss is called
Disability income
A waiver of premium provision may be included with which kind of health insurance policy?
Managed care
A woman's health insurance policy dictates which doctors she is allowed to see. Her health providers share an assumed risk for their patients and encourage preventive care. What best describes the health system that the woman is using?
Cervical cancer exams for all women starting at age 40
According to the provisions of the Patient Protection and Affordable Care Act, all of the following are required preventive care services EXCEPT
Unfair
After filing a claim, an insured tells the insurer that there is more than one insurance policy in force. That insurer sets aside the claim until it hears what the other company will pay. The insurer's action will be classified as
Insurer
All advertisements are the responsibility of the
Physician's and surgeon's services These are covered under Part B
All of the following are covered by Part A of Medicare EXCEPT
Misstatement of age on the application
All of the following are grounds for cancellation of an HMO plan EXCEPT
Records of previous insurers
All of the following are to be included in the application for a certificate of authority to act as an HMO EXCEPT
Continuation provision
Which of the following provisions states the insurer's right to change premium amounts?
Offer the supplement policy on a guarantee basis
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?
Unfair claims settlement practice
An applicant properly notifies her insurer of a straightforward claim, but the insurer waits an exceedingly long time to process it. Which of the below terms best describes the behavior of the insurer?
$102 The employer is permitted to collect a premium from the terminated employee at a rate of no more than 102% of the individual's group premium rate (in this scenario, 102% of $100 total premium is $102). The 2% charge is to cover the employer's administrative costs.
An employee insured under a group health plan has been paying $25 monthly premium for his group health coverage. The employer has been contributing $75 for the total monthly cost of $100. If the employee leaves the company, what would be his maximum monthly premium for COBRA coverage?
15-year level term - they can switch to any BUT term insurance
An individual covered under a group life insurance policy may convert the policy to any of the following EXCEPT
Benefits that are attributable to the employer contributions are fully taxable to the employee as income
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?
$5000
An insured has a primary group health plan and an excess plan, each covering losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any copayments or deductibles, how much will the excess plan pay?
Time payment of claims
An insured notifies the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss?
10 days The grace period is 7 days if the premium is paid weekly, 10 days if paid monthly, and 31 days for all other modes.
An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?
The insured was in compliance with the policy requirements regarding claims
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?
Revocable
An insured wants to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have her husband named as what type of beneficiary?
31
Conversion to an individual whole life policy is permitted without evidence of insurability within how many days of the termination of employment?
The number of days confined in a hospital
Hospital Indemnity/hospital confinement indemnity policy will provide payment based on?
31 days
How long is the grace period in group policies?
4 years
How long must producer maintain records of continuing education course completion?
12
How many consecutive months of coverage (other than in an acute care unit hospital) must LTC insurance provide in this state?
First 3
How many pints of blood will be paid for by Medicare Supplement core benefits?
Within 90 days or as soon as reasonably possible, but not to exceed 1 year
How soon following the occurence of a covered loss must an insured submit written proof of such lose to the insurance company?
Immediately
If HMO coverage is terminated for misconduct detrimental to the delivery of services, the termination is effective
Within 2 years
If a claimant is to bring a recovery action against an insurance company for a loss claimed under a policy, the action must be brought
Paid endorsement
If a person is compensated for a testimonial in an advertisement, which of the following statements should be included in the advertisement?
30 days
If an HMO policy is cancelled for nonpayment of the amounts due under the contract, how long of a notice must the insurer give the insured
Plan A
If an insurance company offers Medicare supplement policies, it must offer which of the following plans?
Decreases
If an insured changes his payment plan from monthly to annually, what happens to the total premium?
Authorized
If an insurer meets the state's financial requirements and is approved to transact business in the state, it is considered to be
Nothing
If one takes Social Security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare?
Guaranteed renewable
If the insured has the right to keep a long-term care insurance policy in force by making timely premium payments, and the insurer may not make any change to the policy or decline to renew it, the policy is
Appointed by the Governor for a term of 2 years
In Texas, how is the Commissioner of Insurance placed in office?
Occasional nursing or rehabilitative care
In long-term care insurance, what type of care is provided with intermediate care?
The insured must have been first hospitalized for 3 consecutive days
In order for an insured under Medicare Part A to receive benefits for care in a skilled nursing facility, which of the following conditions must be met?
A list of proposed subscribers
In order to establish or operate an HMO, a certificate of authority from the Commissioner is required. Which of the following does NOT need to be included in the certificate of authority?
All providers will have the same coverage options and conditions for each plan
In reference to the standard Medicare Supplement benefits plans, what does the term standard mean?
The individuals son gets a part-time job to help support the family
In which of the following situations would Social Security Disability benefits NOT cease?
Care can be provided outside of the service area
Inpatient hospital care for HMO members
The insured may carry over the amount of this year's expenses to next year, which will help satisfy next year's deductible
Insured Z's health insurance policy year begins January. His policy contains a carry-over provision. In November, he has a small claim which is less than his deductible. WHich of the following is true?
Rates by class
Insurers may change which of the following on a guaranteed renewable health insurance policy?
5 months
Once the person meets the stringent requirements for disability benefits under Social Security, how long is the waiting period before any benefits will be paid?
Replace income lost due to a disability
The primary purpose of disability income insurance is to
Coinsurance
The provision that provides for the sharing of expenses between the insured and the insurance company is
Legal actions
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
Ownership
What is the major difference between a stock company and a mutual company?
25%
What is the minimum percentage of a licensee's total volume of premiums in a calendar year that must come from business other than controlled business?
Social Security disability benefit
Which benefit is based on the person's Primary Insurance Amount (PIA)?
Unlimited access to providers
Which characteristic does NOT describe managed care?
Payment is limited to a certain period of time
Which of the following applies to partial disability benefits?
The insured is not required to pay a deductible
Which of the following best describes the "first-dollar coverage" principle in basic medical insurance?
Whether the premiums were tax deductible
Which of the following determines whether disability insurance benefits are taxed?
Insurer's executive officer
Which of the following entities has the authority to make changes to an insurance policy?
Stock
Which of the following insurers are owned by stockholders who have the usual rights of ownership, including the right of voting?
It is a solely a federally administered program
Which of the following is INCORRECT concerning Medicaid?
A fine up to $100,000 The max is $25,000
Which of the following is NOT a possible penalty for a violation of the Insurance Code?
Creditor requiring that a debtor buys insurance from a certain issuer
Which of the following is NOT allowed in credit life insurance?
Automatic enrollment
Which of the following is NOT an enrollment period for Medicare Part A applicants?
Cosmetic surgery
Which of the following is NOT covered by Medicare?
Basic information about supplementary policies
Which of the following is NOT required to be stated in the outline of coverage provided with a long-term care policy?
Cost comparison methods
Which of the following is used to compare the cost of one life insurance policy against another in order to guide prospective purchasers to policies that are competitively priced?
Identity of the actual insurer
Which of the following must be included in all life insurance advertisements?
Plan A
Which of the following must be present in all Medicare supplement plans?
20% covered charges above the deductible
Which of the following must the patient pay under Medicare Part B?
Monthly
Which of the following premium modes would result in the highest annual cost for an insurance policy?
Medicaid
Which of the following programs expands individual public assistance programs for people with insufficient income and resources?
Impairment rider
Which of the following riders would not increase the premium for a policyowner?
Disability insurance can be written as occupational or nonoccupational
Which of the following statements about occupational vs. nonoccupational coverage is TRUE?
Part B coverage is provided free of charge when an individual turns age 65
Which of the following statements is INCORRECT concerning Medicare Part B coverage?
Medicare Advantage must be provided through HMOs
Which of the following statements is NOT correct?
It consists of 3 parts: Part A: hospitalization, Part B: doctor's services, Part C: disability income Parts A-C are part of MediCARE
Which of the following statements is NOT true concerning Medicaid?
A person's ability to work is significantly reduced or eliminated for the rest of their life
Which of the following would best describe total disability?
Fully insured status
Which one of the following is an eligibility requirement for Social Security disability income benefits?
An independent examination as often as reasonably required
While a claim is pending, an insurance company may require
Immediate. With an immediate annuity, distribution starts within 1 year of purchase.
A man purchased a $90,000 annuity with a single premium and began receiving payments 2 months after that. What type of annuity is it?
The date of the medical exam
An individual applied for an insurance policy and paid the initial premium. The insurer issued a conditional receipt. Five days later the applicant had to submit to a medical exam. If the policy is issued, what would be the policy's effective date?
With the policy
IF a policy includes a free-look period of at least 10 days, the Buyer's Guide may be delivered to the applicant
Lump-sum
If a settlement option is not chosen by the beneficiary or policyowner, which option will be used?
Corridor
In a basic expense policy, after the limits of the basic policy are exhausted, the insured must pay what kind of deductible?
Entire contract
The provision which states that both the policy and a copy of the application form the contract between the policy owner and the insurer is called the
Convertible term policy
The type of policy that can be changed from one that does not accumulate cash value to the one that does, is a
For 20 years or until death, whichever occurs first
Under a 20-pay whole life policy, in order for the policy to pay the death benefit to a beneficiary, the premiums must be paid
The period of time during which accumulated money is converted into income payments
Which of the following describes what the annuity period is?
Policyowner
Which of the following individuals must have insurable interest in the insured?
Contracting with insurance companies
Which of the following is NOT a characteristic of a service of an HMO plan?
They earn lower interest rates than fixed annuities
Which of the following is NOT true regarding equity indexed annuities?
The annuitant assumes the risks on investment.
Which of the following is TRUE regarding variable annuities?
Benefit payment amounts are not guaranteed
Which of the following is a feature of a variable annuity?
