Ready GO
(8) Which of the following would NOT be eligible for coverage under key person
1. The pharmacist in a drugstore 2. The manager of a small store 3. The owner of a shop 4. The executive officer of a company
(11) If an insured decides to reduce the coinsurance amount on her major medical insurance what can the insured expect
1. a lower lifetime benefit payout 2. stop loss increase 3. a higher monthly premium 4. A higher deductible
(5) Which of the following premium modes would result in the lowest overall premium?
1. quarterly 2. semi-annual 3. monthly 4. annual
To be eligible under HIPAA regulations, for how long should an individual converting to an individual health plan have been covered under the previous group plan?
18 months
How long does a licensee have to notify the Superintendent of a change of address?
30 days
What is the period of coverage for events such as death or divorce under COBRA?
36 months
Which of the following individuals will be eligible for coverage on the Health Insurance Marketplace?
A permanent resident lawfully present in the U.S.
An insured is involved in an accident that renders him permanently deaf, although he does not sustain any other major injuries. The insured is still able to perform his current job. To what extent will he receive Presumptive Disability benefits?
Full benefits
Which of the following expenses is NOT covered by a health insurance policy?
Funeral
In life insurance policies, cash value increases
Grow tax deferred.
A rider attached to a life insurance policy that provides coverage on the insured's family members is called the
Other-insured rider
An insured who had a life insurance policy for $1 million died. In filing the claim, his wife and children discovered that there was no beneficiary named on the policy. What will happen to the death benefit in this case?
it will go to the insured estate
An insured has a life insurance policy that requires him to only pay premiums for a specified number of years until the policy is paid up. What kind of policy is it?
limited pay life
Medicare part C
managed by private insurers; Medicare Advantage
In a POS plan, benefits for covered services when self-referring (without having your primary care physician arrange for the service) are generally
more expensive
An insured stops making payments on a loan taken from his cash value policy. What will most likely happen?
the policy will terminate when the loan amount with interest equals or exceeds the cash value.
Before he died, an annuitant had received $12,500 in monthly benefits from his $25,000 straight life annuity. He was also the insured under a $50,000 paid-up whole life policy that named his wife as primary beneficiary. Considering both contracts, how much will the annuitant's spouse receive in benefits?
$50,000
(16) In order to get a nonresident license in this state, an agent must
1. Apply and pay a fee to a non-resident state that reciprocates 2. Pass the nonresidence state exam and satisfy their continuing education requirements 3. Represent an agency located in the state 4. Surrender their license in their state of resident
(9) Which of the following indicates the person upon whose life the annuity income amount is determined
1. Owner 2. Insured 3. Annuitant 4. Beneficiary
(6) One of the most important concepts in the calculation of the amount to be paid for a life settlement contract is
1. Price-earnings ratio 2. Life expectancy 3. Inflation 4. Morbidity
(10) All the following are true regarding key person disability income Insurance EXCEPT
1. The employer receives the benefits if the key person is disabled 2. The employer pays the premiums 3. The employer is insured 4. Premiums are tax deductible as a business expense
(23) How are policy loans calculated?
1. The face amount if the policy minus investment fees 2. The policy's cash value minus unpaid loans and accrued interest 3. the face amount of the policy minus unpaid loans 4. premium contributions over the previous year minus unpaid loans
(7) J's Retirement plan meets all federal requirements and entitles him to certain tax benefits as the owner of the plan. What term best describes j's retirement plan?
1. Unqualified 2. Variable 3. Deferred 4. Qualified
what is the maximum fine for violating a cease and desist order
5,000
An applicant has a history of heart disease in his family, so he would like to buy a health insurance policy that strictly covers heart disease. What type of policy is this?
????
medicaid
A combination federal and state medical assistance program designed to provide comprehensive and quality medical care for low-income families with special emphasis on children, pregnant women, the elderly, the disabled, and parents with dependent children who have no other way to pay for healthcare. Coverage varies from state to state
A Straight Life policy has what type of premium?
A level annual premium for the life of the insured
Which of the following is NOT an allowable 1035 exchange?
A whole life insurance policy is exchanged for a term insurance policy
How can a new physician be added to the PPO's approved list?
Agree to follow the PPO standards and charge the appropriate fees.
Agent A offers a prospective client two tickets to a Yankees baseball game with the condition that the client will purchase a family life insurance policy. This practice is known as
Apply within 90 days of becoming a resident.
All of the following statements are correct regarding credit life insurance EXCEPT
Benefits are paid to the borrower's beneficiary
skilled nursing care
Care that can be performed only by or under the supervision of licensed nursing personnel.
An insured is admitted to the hospital for surgery on a herniated disk. The insurance company monitors the treatment and progress in order to make sure that everything proceeds according to the insurer's schedule. This is called
Concurrent review
Because of the history of cancer in her family, Julie purchased a policy that specifically covers the expense of treating cancer. Her policy would be classified as what type of policy
Dread Disease Policy
When a life insurance policy is cancelled and the insured has selected the extended term nonforfeiture option, the cash value will be used to purchase term insurance that has a face amount
Equal to the original policy for as long a period of time that the cash values will purchase.
Why is an equity indexed annuity considered to be a fixed annuity?
It has a guaranteed minimum interest rate.
Which of the following is INCORRECT concerning Medicaid?
It is solely a federally administered program.
acute care
Level of health care, generally provided in hospitals or emergency departments, for sudden, serious illnesses or trauma
Your client wants both protection and savings from the insurance, and is willing to pay premiums until retirement at age 65. What would be the right policy for this client?
Limited-pay whole life
which of the following riders added to a life insurance policy can pay part of the death benefit to the insured to cover expenses incurred in a nursing or convalescent home?
Long-term care
What is the other term for the cash payment settlement option?
Lump sum
Medicare Part B
Managed by the government
Medicare Part A
Managed by the government (Center for Medicare and Medicaid Service)
Which renewal provision(s) must be included in a long-term care policy issued to an individual?
Noncancellable and guaranteed renewable
In long-term care insurance, what type of care is provided with intermediate care?
Occasional nursing or rehabilitative care
Prior to purchasing a Medigap policy, a person must be enrolled in which of the following?
Parts A and B of Medicare
In which of the following instances would the premium be tax deductible?
Premiums paid by an employer on a $30,000 group term life insurance plan for employees
Medicare Advantage
Private health plans that receive payments from Medicare to provide Medicare-covered benefits to enrollees. 3 in 10 beneficiaries are enrolled in these plans. AKA Medicare Part C
Which two terms are associated directly with the way an annuity is funded?
Single payment or periodic payments
A person steps off a street car and trips and breaks his ankle. This type of injury can be described as
Sudden and unforeseen
All of the following would be different between qualified and nonqualified retirement plans EXCEPT
Taxation on accumulation
According to the Coordination of Benefits (COB) provision in health insurance in this state, if insurer overpaid on a claim, the insurer may recover the excess from all of the following EXCEPT
The Insurance Guaranty Association.
the annuity owner dies during the accumulation period without naming a beneficiary. Annuity's cash value exceeds premiums paid. Which of the following is TRUE?
The cash value will be paid to the annuitant's estate.
Who chooses a primary care physician in an HMO?
The individual member
Who is the beneficiary in a credit disability income policy?
The lending institution
Which of the following is true regarding health insurance underwriting for a person with HIV?
The person may not be declined for medical coverage solely based on HIV status
An insured owes his insurer a premium payment. Since then, he incurs medical expenses. The insurer deducts the unpaid premium amount from the claim amount and pays the insured the difference. What provision allows for this?
Unpaid premium
What does Medicare Part A cover?
covers inpatient care provided in hospitals and short-term stays in skilled nursing facilities, hospice care, post-acute home health care, and pints of blood received at a hospital or skilled nursing facility
What does Medicare Part B cover?
covers outpatient services such as outpatient hospital care, physician visits, and preventive services; ambulance services, clinical laboratory services, durable medical equipment (such as wheelchairs and oxygen), kidney supplies and services, outpatient mental health care, and diagnostic tests
Under the Privacy Rule for HIPAA, protected information includes all individually identifiable health information
held or transmitted in any form
what services does Medicaid pay for
hospital care, outpatient care, and laboratory and X-ray services.
Which of the following entities has the authority to make changes to an insurance policy?
insurer's executive officer
what is intermediate care
nursing and rehabilitative care provided by medical personnel for stable conditions that require assistance on a less frequent basis than skilled care.
An immediate annuity purchased with the face amount at death or with the cash value at surrender can be referred to as which of the following
settlement option
Hospital indemnity/hospital confinement indemnity policy will provide payment based on
the number of days confided in a hospital
what happens if a deferred annuity is surrendered before the annuitization period
the owner will receive the surrender value of the annuity
Life settlement contracts must be approved by which of the following?
the superintendent of insurance
which of the following is true regarding qualified plans
is has a tax benefit for both employees and employer
what is the benefit of choosing extended term as a nonforfeiture option?
it has the highest amount of insurance protection
(15) Life insurance can provide which of the following?
1. Survivor protection 2. Protection against outliving one's assets 3. Creation of a future liability 4. Liquidation of one's estate
(12) Which of the following is NOT true regarding a noncancellable policy?
1. The guarantee to renew coverage usually only applies until the insured reaches age 65 2. Insured has the unilateral right to renew the policy for the life of the contract and may discontinue paying premium to cancel it 3. Insurer can increase the premium able what is stated in the Policy if claims experience is greater than expected 4. insurer cannot cancel the policy
Under which of the following circumstances would an insurer pay accelerated benefits? A. A couple wants to build a house and would like to make a larger down payment B. An insured is diagnosed with cancer and needs help paying for her medical treatment C. A couple is nearing retirement and needs a steady stream of income D. An insured is looking for a way to put her daughter through college
*Accelerated benefits are paid when insureds endure financial hardship due to severe illness. They may request immediate payment of some portion of the policy's death benefit, usually 50-100%, depending on the insurer. Benefits are not taxable.
(13)An agent's first year commission cannot exceed what percentage of the renewal commission for servicing a Medicare supplement policy in its second year?
1. 200% 2. 10% 3. 100% 4. 50%
(25) Core benefits are included in all medicare supplemental policies. What percentage of Part B coinsurance is required?
1. 35% 2. 10% 3. 20% 4. 15%
(20) What is the tax penalty for withdrawing money from an annuity prior to age 59 1/2
1. 5% 2. 10% 3. 12% 4. 20%
(4) The Omnibus Budget Reconciliation Act of 1990 (OBRA) requires that large group health plans with 100 employees or more must provide primary coverage for non retired, disables individuals under what maximum age?
1. 50 2. 55 3. 60 4. 65
(17) The waiting period before a qualified person can receive social security disability benefits is
1. 60 days 2. 5 months 3. 6 months 4. 2 years
(22) Under normal circumstances, how long is a temporary license in this state valid for?
1. 90 days 2. 1 year 3. 18 months 4. Up to three 60-day terms
(1)The Guaranteed Insurability Rider allows the owner to purchase additional amounts of life insurance without proof of insurability at al of the following EXCEPT
1. Birth of a child 2. Marriage 3. purchase of a new home 4. approximately every 3 years between the ages of 25 and 40
(21) A dentist is off work for 4 months due to a disability. His dental assistant's salary would be covered by
1. Business overhead insurance 2. Disability income 3. Key employee disability 4. Partnership disability
New York law allows for which of the following groups to provide blanket accident and health insurance?
1. Children at a school2. Children at a camp3. Volunteer fire department4. All of the above
(19) What effect will the long-term care (LTC) rider have on the death benefit of a life insurance policy if LTC benefits were paid to the insured
1. Increase the death benefit by the amount paid into LTC 2. Not affect the amount payable to the beneficiary 3. Eliminate the death benefit 4. Reduce the death benefit
(18) Which statement is required to be printed on the first page of a health insurance policy which signals to the insured that the policies benefits are limited?
1. Limited Policy Notice 2. Benefit Notice 3. Statute of Limitations 4. Limited Benefit Statement
(24) For which of the following reasons may group coverage NOT be discontinued?
1. Movement outside the service area 2. Fraud 3. The company stock value lowers 4. Non payment of Premium
Because of an injury an insured has been unable to work for 9 months. He paid the policy premium for his life insurance for the first 6 months of disability, but didn't have to pay anything for the remaining 3 months, yet the policy remained enforced. The policy includes
1. Nonforfeiture options 2. Waiver of premium rider 3. Guaranteed insurability benefits 4. Facility of payment clause
(2) A core Medicare supplement policy (plan A) will cover all of the following expenses EXCEPT
1. Part A deductible 2. The first 3 pints of blood 3. 20% of Part B coinsurance amounts for Medicare approved services 4. Part A coinsurance
(14) Which of the following is not a crucial factor in health insurance underwriting?
1. Physical condition 2. Morale hazards 3. Occupation 4. Income
26. Who can request changes in premium payments, face value, loans, and policy plans?
1. Producer 2. Policyowner 3. Beneficiary 4. Contingent beneficiary
(3) In contrasting stock insurers with mutual insurers, which statement is true?
1. Stock insurers are owned by the shareholders and issue non participating policies 2. Stock dividends are tax-free while policy Dividends are taxable 3. Non participating policies can be paid out dividends to policy owners 4. Mutual insurers are owned by shareholders and issue participating policies
Which of the following riders would NOT cause the Death Benefit to increase? A. Accidental Death Rider B. Payor Benefit Rider C. Guaranteed Insurability Rider D. Cost of Living Rider
B. Payor Benefit Rider *Payor Benefit Rider does not increase the Death Benefit; it only pays the premium if the payor is disabled or dies. With Guaranteed Insurability Rider, the policyowner can increase DB at specified ages or events, i.e. marriage or birth of a child; Cost of Living Rider increases DB to keep pace with inflation; in Accident Death Rider, if the insured dies from an accident, DB is a multiple of the Face Amount.
An insured pays $1,200 annually for her life insurance premium. The insured applies this year's $300 worth of accumulated dividends to the next year's premium, thus reducing it to $900. What option does this describe?
accumulation at interest
under which nonforfeiture option does the company pay the surrender value and have no further obligations to the policyowner?
cash surrender
Which of the following provisions must be included on the first page of a Medicare supplement policy, which states the insurer's right to change premium amounts?
continuation provision
What does Medicare Part C cover?
covers all Medicare-covered benefits covered under other parts, but as private health plans can vary the benefit design as long as the core benefit package (excluding the value of supplemental benefits) is actuarially equivalent to traditional Medicare. May also include extra benefits, such as dental services, eyeglasses, or hearing exams; AKA "Medicare Advantage"
What does Medicare Part D cover?
covers an outpatient prescription drug benefit through private plans. Plans are required to provide a "standard" benefit or one that is actuarially equivalent, and may offer more generous benefits. Medicare Part D Managed by private insurers
Credit insurance is a special type of coverage written to insure the life of the debtor and pay off the balance of a loan in the event of the death of the debtor. It is usually written as
decreasing term
Which of the following types of insurance policies is most commonly used in credit life insurance?
decreasing term
An insured has medical insurance coverage through 2 different providers, both covering the same expenses on an expense-incurred basis. Neither company knows in advance that the insured has coverage through any other insurers. The insured submits a claim to both insurers. How should the claim be handled?
each insurer should pay a proportionate share of the claim
What type of group rating uses the actual experience of the group as a factor in developing the rates to be charged?
experience rating
the main difference between immediate and deferred annuities
when the income payments begin
