Ohio Life and Health Practice Exam
An insured has a stop-loss limit of $5,000, a deductible of $500, and an 80/20 coinsurance. The insured incurs $25,000 of covered losses. How much will the insured have to pay? $500 $5,000 $5,400 $5,600
$5,000
A life insurance policyowner is allowed __ days upon policy delivery to return the policy for a full premium refund. 7 10 14 30
10
Kathy pays a monthly premium on her health insurance policy. How long is her grace period?
10 days
Sole proprietors are permitted tax deductions for health cost paid from their earnings in the amount of cost that exceed 7 1/2 % of AGI cost that exceed 10% of AGI 100% of cost no deduction permitted
100 % of cost
Tonya has replaced her whole life policy with an annuity without incurring a tax penalty. This transaction is called a(n) Modified Exchange Endowment Exchange 1040 Exchange 1035 Exchange
1035 Exchange
How many employees must an employer have for a terminated employee to be eligible for COBRA?
20
Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. 10 20 31 60
20
A life insurance applicant in Ohio may backdate the application for up to ___ month(s)
3
An employee has ___ days after the day of marriage to add a new spouse to a small group plan
30
An insurance company has just received a request for verification from a viatical settlement provider. The insurer is required to respond within __ calendar days to this request.
30
The first payment for newborn accident and health coverage is due __ days after the birth
31
The legal action provision in a health contract is limited to no more than __ years 2 3 4 5
5 years
As of January 1, 2014, an employer with up to 25 full time equivalent (FTE's) with average annual wages of less than $50,000 may be eligible for a tax credit of ___ of the premiums paid by the employer. 30% 40% 50% 60%
50%
An insurer can exclude coverage for a preexisting condition on a Medicare Supplement policy for up to
6 months
How much does Medicare Part B pay for physician fees?
80 %
What is the nonforfeiture value of an annuity before annuitization?
All premiums paid, plus interest, minus any withdrawals and surrender charges.
An insurance company advertises an accident and health insurance product in a local Ohio newspaper and refers to dollar amount benefits. This insurer must also disclose which of the following in the advertisement?
Any applicable benefit reduction
Bill requires some nursing care and supervision but NOT full-time care. Which of these nursing home options would best serve him? Nursing home Assisted living Congregate housing Custodial residence
Assisted living
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's benefits must
Be the same and the premium cannot exceed 102%.
Which of the following is a requirement for ANY change in an insurance application?
Change must be initialed by the applicant
Which of the following statements is NOT true regarding Critical Illness Plan
Coverage is limited to a single devastating disease
Which of these is NOT subject to income taxation under Modified Endowment Contract (MEC) Loan against the cash value Policy withdrawal Policy Dividend Death Benefit
Death benefit
In what part of an insurance policy are policy benefits found?
Declarations". Essentially, the insurance declaration page is like a quick guide to the insurance policy, providing all of the basic information the policyholder needs to know
A form of medical health insurance covering the treatment and care of gum disease is called
Dental expense insurance
All of these are responsibilities of the superintendent except
Endorsing Insurers
Which of these is NOT a qualifying event for Medicare - On Social Security disability for over 2 years- Kidney failure- Age 65 or older- Falling below the federal poverty level
Falling below the federal poverty level
A spouse and child can be added to the primary insured's coverage as what kind of rider? Dependent term Guaranteed insurability primary term family term
Family term
Elizabeth is the beneficiary of a life insurance policy. She is receiving the death benefit in payments of $10,000 per month until the principal and interest has been paid out. Which option was chosen? Fixed period Fixed amount Life income Interest only
Fixed amount
A group Disability Income plan that pays tax-free benefits to covered employees is considered
Fully contributory
Barbara's policy includes a rider which allows her to purchase additional insurance at specific dates or events without evidence of insurability. This rider is called a(n)
Guaranteed insurability rider
Which of these is a TRUE statement regarding HIC's?
HIC's operate on a prepayment basis
Which of the following is considered to be an event or condition that increases the probability of an insured's loss? Risk Hazard Indemnity Peril
Harzard
All of the following plans allow for employee contributions to be taken on a pre-tax basis EXCEPT
Health Reimbursement Arrangement Plan
Which type of long-term care benefit would be most appropriate for a stroke victim who requires speech therapy administered at her home
Home health care
What does the Consolidated Omnibus Budget Reconciliation Act (Cobra) of 1985 allow an employee to do?
In the event of employment termination, group health insurance can be kept if the employee pays the premiums
Which of the following statements regarding Group Disability Income insurance is TRUE?
It provides benefits for nonoccupational illnesses and injuries
All of the following are examples of pure risk EXCEPT
Losing money at a casino
Which of these would NOT be considered a presumptive disability
Loss of a leg or an arm
A beneficiary has just received a claim payment fora life insurance policy. Which of the following is TRUE regarding the federal income tax liability owed?
No federal income tax is owed on life insurance proceeds
Chris is an insured bricklayer who severed his left hand in an automobile accident. Although his primary duty cannot be performed, Chris is also a substitute high school teacher. He collects a full disability income check every month. How does his policy define total disability? Recurrent Any occupation Own occupation Presumptive
Own occupation
Variable life insurance and Universal life insurance are every similar. Which of these features are held exclusively by variable universal life insurance?
Policyowner has the right to select the investment which will provide the greatest return
All of the following are considered appropriate uses of life insurance for business purposes EXCEPT Attracting quality employees by offering a group life plan Funding an entity buy-sell agreement Protecting the business by covering key employees with life insurance Protecting the business by covering entry level employees with life insurance
Protecting the business by covering entry level employees with life insurance
Which market index is normally associated with an indexed annuity's rate of return?
S &P 500
Term insurance is appropriate for someone who Seeks living benefits for themselves Seeks a policy that builds cash value Seeks temporary protection and lower premiums Seeks permanent protection and higher premiums
Seeks temporary protection and lower premiums
Generally speaking, which three levels of care are long-term care policies provided with
Skilled nursing, intermediate, and custodial care
Jonas has disability insurance through his employer. The employer pays 75% of the premium, and Jonas pays the other 25%. What is Jonas's tax liability for any benefits paid from the disability plan?
Taxes must be paid on 75% of the benefits received
Which of the following decisions would a Health Savings Account (HSA) owner NOT be able to make? The amount contributed by the employer The amount contributed by the owner The underlying account investments used The medical expenses paid for by the HSA
The amount contributed by the employer
Signatures for an insurance application MUST be obtained by the producer from all of the following sources EXCEPT The producer The insured The policyowner The beneficiary
The beneficiary
Pat owns a 20-pay life policy with a paid-up dividend option. Which of the following statements is true?
The policy may be paid up early by using policy dividends
What is the purpose of the Medical Information Bureau (MIB) To accept or decline insurance applicants To set the premium rates for insurers To help underwriters evaluate risk To perform physical examinations on applicants
To help underwriters evaluate risk
A life insurance policy that is subject to a contract interest rate is referred to as
Universal Life
Craig submits a $500 claim for medical expenses. With a past due premium of $100, the insurer pays $400. Which of the Uniform Optional Provisions covers this situation?
Unpaid premium
All of these statements concerning whole life insurance are false EXCEPT
When a whole life policy is surrendered, income taxes may be owed
Upon policy delivery, which of the following must a producer have an applicant sign if no initial premium was collected with the life insurance application?
a good health statement
A medical provider that accepts medicare assignment must
accept payment based upon a defined medicare schedule as payment in full
A Renewable Term Life Insurance policy can be renewed
at a predetermined date or age, regardless of the insured's health
Which of these factors is NOT taken into account when determining an applicants life insurance needs
automobile( In the process of determining an applicant's life insurance needs, an insurance producer takes into account all of these factors EXCEPT an applicant's automobile.)
Which situation would qualify an individual for receiving benefits from a qualified long-term care policy
becoming cognitively impaired (mentally ill)
An insured has a health plan that pays established amounts in accordance with a lit of injuries, surgical procedures, or other losses. This list is called
benefit schedule
Coverage for newborns under an accident and health plan MUST include coverage for
birth abnormalities
An order issued by the superintendent that prohibits practice listed in the order is called a(n)
cease and desist order
Which of the following is required for an insurer to conduct business in this state
certificate of authority
A medicare supplement policy is
designed to fill in the gaps of Part A AND Part B medicare
Matt is applying for life insurance and requests a double indemnity rider. A double indemnity benefit will be payable to Matt's beneficiary if Matt
dies instantly from a car accident
Under group health insurance, a certificate of coverage is issued to the A) employer B) employee C) producer D) sponsor
employee
The limited period of time given to all members to sign up for a group health plan is called the
enrollment period
When the principal gives the agent authority in writing, it's referred to as
express authority
a minor may receive a life insurance policy's death benefit ONLY
if the minor has an appointed guardian
A common exclusion with Vision plans is
lasik surgery
The time limit for filing claim disputes is addressed in which provision of an accident and health policy
legal actions
When a decreasing term policy is purchased, it contains a decreasing death benefit and increasing premiums level premiums decreasing premiums variable premiums
level premiums
A limited payment whole life policy provides
lifetime protection
A dread disease policy is considered to be a type of
limited health insurance policy
Pete the agent recently had his license suspended because he was found to be in violation of state insurance law. Due to this suspension, Pete
may be assessed the administrative costs sustained by the department
If an agent is believed to be causing considerable harm, the superintendent may incarcerate the agent may suspend the agent's license without a hearing may issue a cease and desist order against the agent may take away the agent's appointment
may issue a cease and desist order against the agent
The focus of major medical insurance is providing coverage for
medical and hospitalization expenses
The suicide clause of a life insurance policy states that if an insured commits suicide within a stated period from the policy's inception, the insurer will only be liable for a return of premiums paid minus indebtedness and with interest during the last 12 months minus indebtedness and without interest during the last 6 months
minus indebtedness and without interest
An example of a health insuring corporation (HIC) specialty care provider is a(n)
neurologist
A beneficiary change can occur
normally at any time during the policy term
A provision that allows a policyowner to withdraw a policy's cash value interest free is a(n)
partial surrender
States that have "no loss no gain" laws require a replacing policy to
pay for ongoing claims under the policy replaces
Advertisements for accident and health policies that ONLY cover stated illness MUST display a statement that the A. The premium guarantee B. policy is limited C. A schedule of payments D. The policy exclusions
policy is limited
A rehabilitation benefit is intended to
prepare the insured to return to employment
Which of the following is a reinstatement condition
proof of insurability
The branch of dentistry which deals with the replacement of missing parts is called
prosthodontics
The two major actions required for a policyholder to comply with the Reinstatement Clause are provide evidence of insurability, agree to a new incontestable period provide evidence of insurability, pay past due premiums pay past due premiums, agree to a new incontestable period pay past due premiums, agree to a reduction in coverage
provide evidence of insurability, pay past due premiums
An indemnity plan Pays both the insured and health care provider Provides the insured a specific dollar amount for services Pays the health care provider directly for services rendered Is typically issued as a group plan
provides the insured a specific dollar amount for services
An insurance producer is often responsible for field underwriting during the application process. All of these are possible field underwriting roles EXCEPT
providing commission information to the applicant
Which of these is NOT a legal reason for an HIC to release a subscriber's confidential health information
public interest
Continuous 24-hour care provided by licenses medical professionals under the direct supervision of a physician is called
skilled nursing care
In an insurance contract, the applicant's "consideration" is the A) offer and acceptance B) premium only C) statements made in the application and the premium D) statements made in the application only
statements made in the application and the premium
In a Long-Term Care policy, activities of daily living (ADL's) can be each of the following except
talking
Respite care is able to provide: permanent relief to the patient's primary caregiver health care to the patient's primary caregiver weekly benefit payments to supplement the primary caregiver's income temporary relief to the patient's primary caregiver
temporary relief to the patient's primary caregiver
An agent's license has been suspended for non-renewal. The agent may apply for reinstatement
the 12 month period following the date when the license should have been renewed
An advertisement for an insurance product may contain
the insurer's name
An agent's renewal date for his/her license is on or before
the last day of the licensee's birth month
Bob and Tom start a business. Since each partner contributes an important element to the success of the business, they decide to take life insurance policies out on each other, and name each other as beneficiaries. Eventually, they retire and dissolve the business. Bob dies 12 months later. The policies continue in force with no change. Both partners are still married at the time of Bob's death. In this situation, who will receive Bob's policy proceeds?
tom
A partial surrender is allowed in which of the following life policies? adjustable whole life Universal life Decreasing term life Limited whole life
universal lifw
A policyowner can receive an immediate payment before the insured dies by using a(n) viatical settlement contract buy-sell arrangement adhesion agreement spendthrift plan
viatical settlement contract
What type of injury would NOT be covered under a health insurance policy
work related
