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Life and health
Question | Answer |
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In which of the following health plans are benefit payments attributed to employer contributions taxable to the employee? | Group disability income |
A man is employed at the age 65 and is now eligible for Medicare. He wants to know what health insurance coverage he is eligible to receive. Which of the following options are available to him? | Continuation of group health |
Which provision states that the insurance company must pay medical expense claims immediately? | Time of payment claims |
As it pertains to group health insurance, COBRA stipulates that | Group coverage must be extended to terminated employees up to a certain period of time at the former employees expense |
An insured has a major medical policy with a $500 deductible and a coinsurance clause of 80/20. If he incurs medical expenses of $4,000, the insurer would pay | $2,800 |
Which of the following statements concerning a simplified employee pension plan (SEP) is INCORRECT? | SEPs are suitable for large companies |
According to the future increase option rider (FIO), which of the following is NOT a qualifying event to increase an insurers benefit level? | Death of a spouse |
An individual, who is and continues to be a resident of Alabama, and who has 18 months of prior continuous coverage, but is not longer able to obtain coverage, shall be eligible for health expense coverage under | Alabama health plan |
In the event of loss, business overhead insurance will pay for | Rent |
Which of the following policies typically combine insurance and savings with the date of maturity earlier than age 100 at great expense to the policyholder? | Endowment at age 65 |
An insured severely burns her hand, but is not classified as disabled. Which of the following types of coverage would cover at least a portion of the insurers medical expenses? | Medical reimbursement benefit |
The insured had his wife named as the beneficiary of his life insurance policy. To ensure that his wife had income for the life after the insurers death, he chose the life income settlement option. The amount of payments will be determined by taking into | The insureds age at death |
Which of the following is an example of apparent authority of an agent appointed by an insurer? | The agent accepts a premium payment after the end of the grace period |
what is the benefit of choosing extended term as a nonforfeiture option | It has the highest amount of insurance protection |
What Is the maximum period of time during which an insurer may contest fraudulent misstatements made in a health insurance application? | |
As long as the policy is in force | |
All of the following are requirements for life insurance illustrations EXCEPT | They must be a part of the contract |
What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan? | Diagnostic and preventive care |
A medical insurance plan in which the health care provider is paid a regular fixed amount for providing care to the insured and does not receive additional amounts of compensation dependent upon the procedure performed is called | Prepaid plan |
Which of the following would most directly affect the purchasing power of benefits paid on a fixed annuity | Economic inflation |
What is the purpose of the insurance guaranty association? | To protect policy owners against insurer insolvency |
When the insured initials the cancellation of a policy, the unearned premium will be refunded on a | Short rata basis |
HMOs that compensate their health care providers based upon a predetermined payment amount per enrollee for a specified period of time, in exchange for providing a defended set of covered health care services, regardless of the amount provided, are said t | Capitation |
An insured is scheduled to have two cavities filled. He knows in advance which benefits will be paid for the procedure. Which clause is responsible for the advanced notification? | Prior authorization |
Which of the following has the right to convert the existing term coverage to permanent insurance? | Policyowner |
What is the period of coverage for events such as death or divorce under COBRA? | 36 months |
Which of the following is considered a presumptive disability under disability income policy? | Loss of two limbs |
Which of the following is another term for the accumulation period of an annuity? | Pay-in period |
Which of the following is TRUE of a qualified plan? | It has a tax benefit for both employer and employee |
An insurer has made all the decisions regarding the provisions included in the insureds policy. The insured finds an objectionable provision and wants to negotiate it with the insurer but is not allowed to do so. Her only option are to reject the policy o | Adhesion |
Under a health insurance policy, benefits, others than death benefits, that have not otherwise been assigned, will be paid to | The insured |
A business entity acting as an insurance producer is required to do all of the following EXCEPT | Be a publically owned company |
Which of the following is NOT an enrollment period for Medicare part A applicants? | Automatic enrollment |
what is the benefit of choosing extended term as a nonforfeiture option | It has the highest amount of insurance protection |
What Is the maximum period of time during which an insurer may contest fraudulent misstatements made in a health insurance application? | |
All of the following are requirements for life insurance illustrations EXCEPT | They must be a part of the contract |
What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan? | Diagnostic and preventive care |
A medical insurance plan in which the health care provider is paid a regular fixed amount for providing care to the insured and does not receive additional amounts of compensation dependent upon the procedure performed is called | Prepaid plan |
Which of the following would most directly affect the purchasing power of benefits paid on a fixed annuity | Economic inflation |
What is the purpose of the insurance guaranty association? | To protect policy owners against insurer insolvency |
When the insured initials the cancellation of a policy, the unearned premium will be refunded on a | Short rate basis |
HMOs that compensate their health care providers based upon a predetermined payment amount per enrollee for a specified period of time, in exchange for providing a defended set of covered health care services, regardless of the amount provided, are said t | Capitation |
An insured is scheduled to have two cavities filled. He knows in advance which benefits will be paid for the procedure. Which clause is responsible for the advanced notification? | Prior authorization |
Which of the following has the right to convert the existing term coverage to permanent insurance? | Policyowner |
What is the period of coverage for events such as death or divorce under COBRA? | 36 months |
Which of the following is considered a presumptive disability under disability income policy? | Loss of two limbs |
Which of the following is another term for the accumulation period of an annuity? | Pay-in period |
Which of the following is TRUE of a qualified plan? | It has a tax benefit for both employer and employee |
An insurer has made all the decisions regarding the provisions included in the insureds policy. The insured finds an objectionable provision and wants to negotiate it with the insurer but is not allowed to do so. Her only option are to reject the policy o | Adhesion |
Under a health insurance policy, benefits, others than death benefits, that have not otherwise been assigned, will be paid to | The insured |
A business entity acting as an insurance producer is required to do all of the following EXCEPT | Be a publically owned company |
Which of the following is NOT an enrollment period for Medicare part A applicants? | Automatic enrollment |
Mortality - interest + Expense = | Gross premium |
Most insurers issue health insurance policies for delivery in many states. Because each state regulates and mandates the requirement for policies delivered to their residents, instead of having a policy from each state, the insurer attaches | Conformity and state statutes provisions |
Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in the | Notice regarding replacement |
Equality indexed annuities | Seek higher returns |
Which of the following is the most precise synonym for an "authorized" insurer? | Admitted |
Insurer X charges the premium from its insured customers, passing on operating expenses for the company. The operating expenses plus premium equals the "gross" premium. What is another name for the operating cost for insurer X? | Expense loading |
Which of the following best describes gross annual premium? | Annual cost of mortality plus expenses |
A guaranteed renewable health insurance policy allows | Policy holder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class |
Which of the following is NOT true regarding a flexible spending account? | It does not have limits on contributions |
An employee will be taxed on the cost of group life insurance paid by the employer if the amount of coverage exceeds | $50,000 |
The law that protects consumers against the circulation of inaccurate or obsolete information is known as | The fair credit reporting act |
Which universal life option has a gradually increasing cash value and a level death benefit? | Option A |
Which of the following is NOT a feature of a noncallable policy? | The insurer may terminate the contract only at renewal for certain conditions |
Which renewability provision are you most likely to see on a travel accident policy? | Period of time |
How long after receiving notice of claims does an insurer have to furnish proof of loss forms? | Within 15 days |
Which of the following are generally NOT considered when underwriting group insurance? | The insureds medical history |
In disability income insurance, the own occupation definition of disability applies | For the first 2 years of disability |
What type of insurance would be used for a return of premium rider? | Increasing term |
One of the differences between group underwriting and individual underwriting is that there is little or no medical information required regarding plan participants in groups of | 50 or more |
Which of the following is NOT true regarding partial disability? | This is a form of insurance that covers part-time workers |
Al of the following would be a reason that an insurance company's name could be disapproved for use in the state of Alabama EXCEPT | The name is too long to be printed on a single line of the policy in the required type size |
The rider that may be added to a disability income policy that allows for an increase in the benefit amount under certain conditions is called | Cost of living (COLA) |
What is the maximum penalty for habitual willful noncompliance with the unfair credit reporting act? | $2,500 |
Which of the following describes taxation of individual income insurance premiums and benefits? | Premiums are not tax deductible, and benefits are not tax deductible |
Which of the following is NOT true regarding the needs approach method determining the value of an individuals life? | Need is predicted using the number of years until insureds retirement |
When benefits are paid directly to an insured under a health insurance policy, the policy provides benefits on what type of basis? | Reimbursement |
When a group health insurance plan is terminated, how long is an extension of benefits provided for any totally disabled employee or dependent? | 12 months |
What is the maximum amount that can be contributed to an MSA of the high-deductible the plan for individuals? | 65% |
All of the following are characteristics of a major medical expense policy EXCEPT | Low maximum limits |
What is the waiting period on a waiver of premium rider in life insurance? | 6 months |
With respect to a variable annuity, when is the number of annuity units determined? | At the time of initial payout |
Which of the following statements is true concerning employer group dental plans? | The seldom contain a conversion privilege |
Which of the following is considered to be a morale hazard? | Driving recklessly |
An individual has just borrowed $10,000 from his bank on a 5-year installment loan requiring monthly payments. What type of life insurance policy would be best suited to this situation? | Decreasing term |
Which of the following is the most common time for errors and omissions to occur on the part of the insurer? | Policy delivery |
Roger writes his company and notifies them that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss? | Time of payment of claims |
An agent accepts the premium payment 35 days after it is due, telling the insured that there will be no problem keeping the policy in force. This is an example of what type of agent authority? | Appartent |
An insured was involved in an accident and could not preform her current job for 3 years. If the insured could reasonably preform another job utilizing similar skills after 2 month, for how long would she be receiving benefits under an "own occupation " d | 2 years |
What is the benefit of experience rating? | It allows employers with low claims experience to get lower premiums |
An insured loses her left arm in an accident that is covered by her accidental death and dismemberment policy. What kind of benefit will she most likely receive from this policy? | The capital amount in a lump sum |
What would a physician utilize if he/she wanted to know if a treatment is covered under an insureds plan and at what rate it will be paid? | Prospective review |
An insurer invests the money it receives from premiums paid by the insureds. Which of the following is TRUE regarding the interest earned on these investments? | It is used to lower premiums |
Which of the following employees insured under group life plan would be allowed to convert to individual of some coverage once the plan is terminated? | Those who have been insured under the plan for at least 5 years |
Which of the following is NOT covered under part B of Medicare policy? | Routine dental care |
As long as the policy is in force | |
The sole proprietor of a business makes a total salary of $50,000 a year. This year, his medical expenses have reached a total of $75,000. What amount may the dolls proprietor deduct in regards to his medical expenses? | $50,000 |
Long-term care policies MUST cover | Alzheimer's disease |
Rod wants to lay his initial life insurance premium in advance. Which of the following best describes his situation? | Rod can pay his premium as early as he wants, even with his application |
All of the following are general requirements of a qualified plan EXCEPT | The plans must provide an offset for social security benefits |
An employee is insured under her employers group life plan. If she terminated her group coverage, which of the following is statements is INCORRECT? | The insured may choose to convert to term or permanent coverage |
Which of the following is NOT true of basic medical expense plans? | Coverage for catastrophic medical expenses |
How long will the beneficiary receive payments under the single life settlement option? | Until the beneficiarys death |
Which of the following are main factors taken into account when calculating residual disability benefits? | Present earnings and earnings prior to disability |
The death protection component of universal life insurance is always | Annually renewable term |
An insureds disability income policy includes an additional monthly benefit rider. For how many years can the insured expect to receive payment from the insurer before social security benefits begin? | 1 |
An applicant for an individual health policy failed to complete the application properly. Before being able to complete the application and pay the initial premium, she is confided to a hospital. This will not be covered by the insurance because she has n | Consideration clause |
In an adjustable life policy all of the following can be changed by the policy owner EXCEPT | The type of investment |
The patient protection and affordable care act includes all of the following provisions EXCEPT | Individual tax deduction for premiums paid |
Which of the following allows the insurer to relieve a minor insured from premium payment s if the minors parents have died or become disabled? | Pay or benefit |
Which of the following is true regarding a term health policy? | It is nonrenewable |
An insurer wants to obtain information from investigators regarding an applicant for insurance. What must the insurer do in order to legally acquire this information? | Present the insured with a disclosure authorization notice |
The full premium was submitted with the application for life insurance, and the policy was issued two weeks later as requested. When does the policy coverage become effective? | As of the application date |
Which of the following is NOT required for a producer to tell a prospect? | What requirements the producer needed to meet to obtain the insurance license |
All of the following statements concerning the use of life insurance as an executive bonus are correct EXCEPT | The policy is owned by the company |
What is the penalty tax for non qualified distributions from a medical savings account? | 20% |
An insured pays a monthly premium of $100 for health insurance. What would the duration of the grace period under her policy? | 10 days |
Which of the following would NOT cause the death benefit to increase? | Payor benefit rider |
Which of the following do the standard and preferred risk categories share? | Premiums are not elevated |
Under SIMPLE plans, participating employees may defer up to a specified amount each year , and the employer then makes a matching contribution up to an amount equal to what percent of the employees annual wages? | 3% |
The waiver of cost of insurance rider is found in what type of policy? | Universal life |
All of the following statements concerning dividends are true EXCEPT | Dividend amounts are guaranteed in the policy |
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? | $5,000 |
What type of annuity guarantees to pay an income to the annuitant each year as long as he lives, upon death, the annuity will refund the remaining payments to a beneficiary? | Installment refund annuity |
Under uniform required provisions, proof of loss under a health insurance policy normally should be filed within | 90 days |
An insured owns a $50,000 whole life policy. At the age 47, the insured decides to cancel his policy and exercise the extended term option for the policy's cash value, which is currently $20,000. What would be the face amount of the new term policy? | $50,000 |
Can an individual who belongs to a POS plan use an out-of-network physician? | Yes, and they may use any preferred physician, even if not apart of the HMO |
The paid up addition option uses the dividend | To purchase a smaller amount of the same type of insurance as the original policy |
Which of the following is NOT the purpose of HIPAA? | To provide immediate coverage to new employees who had been previously covered for 18months |
Issue age policy premiums increase in response to which of the following factors? | Increased benefits |
How long will the beneficiary receive payments under the single life settlement option? | Until the beneficiarys death |
In long-term care insurance, what type of care is provided with intermediate care? | Occasional nursing or rehabilitation care |
How soon following the occurrence of a covered loss, or after the insurer became liable for periodic payments of income benefits, must an insured submit written proof of such loss to the insurance company? | Within 90 days or as soon as reasonably possible but not to exceed one year |
An underwriter may reject an application for health insurance if the rejection is based upon which of the following? | Prescription usage |
Which of the following statements is NOT correct concerning the COBRA act of 1985? | It requires all employers, regardless of the number of age or employees, to provide extended group health coverage |
How are contributions to a tax sheltered annuity treated with regards to taxation? | They are not included as income for the employee, but are taxable upon distribution |
What is a foreign insurer? | An insurer with a home office in another state |
Which of the following is NOT true regarding equality indexed annuities? | They earned lower interest rates than fixed annuities |
Susan owns an individual long-term care insurance plan and is able to deduct the premiums from her taxes. What income taxation will be imposed on the benefits she receives? | None |
A participant contributes more than the maximum amount to her Roth IRA. what kind of tax penalty will he or she have to pay | 6% |
What type of annuity promises to pay to a beneficiary, in lump sum , the difference between the amount paid into the contract and the benefits received prior to the annuitants death? | Cash refund annuity |
Which concept is associated with "exclusion ratio"? | Annuities payments |
When may an insurer require an insured to provide generic information? | Never |
Which type of Medicare policy requires insureds to use specific healthcare providers and hospitals (network providers), EXCEPT in emergency situations? | SELECT |
An insurance entity or licensee can not pay a commission or fee to a person if the persons license is classified as one of the following except | Temporary |
Disability income policies can provide coverage for loss of income when returning to work only part-time after recovering from total disability. What is the benefit that is based on the insureds loss of earnings after recovery from a disability? | Residual disability |
What is the free look period for Medicare supplement policies? | 30 days |
Which of the following is not true of the disability buy-sell coverage? | Benefits are considered taxable income to the business |
Which of the following dental insurance categories would cover the fillings of cavities? | Routine and restorative care |
Which component increases in the increasing term insurance? | Death benefit |
The type of dental plan which is incorporated into a major medical expense plan is a/an | Integrated dental plan |
All of the following are correct about the required provisions of a health insurance policy EXCEPT | A reinstated policy provides immediate coverage for an illness |
Which of the following is an example of liquidity in a life insurance contract? | The cash value available to the policy owner |
An insured receives an annual life insurance dividend check. What term best describes this arrangement? | Cash option |
To be eligible under HIPAA regulations, for how long should an individual converting to an individual health plan have been cover under the previous group plan? | 18 months |
An insurance producer who is late in filing an application for license renewal will be charged a fee of | $50 |
The market value adjustment in modified guaranteed annuities refers to which of the following? | The difference between the contracted interest rate and the rate at surrender |
When can a long-term care policy deny a claim for losses incurred because of a pre-existing condition? | Within 6 months of the effective date of coverage |
Which type of insurance policy allows the policyowner to pay more or less than the planned premium? | Universal life |
Which describes the features of a comprehensive major medical policy? | Basic medical expense benefits are provided in a single package |
When would a 20-pay whole life policy endow? | When the insured reaches age 100 |
In a noncontributory health insurance plan, what percentage of eligible employees must participate in the plan before the plan can become effective? | 100% |
Annually renewable term policies provide a level death benefit for a premium that | Increases annually |
According to the law of agency, a principal is represented by an | Agent |
What is the main purpose of the seven-pay test? | It determines if the insurance policy is an MEC |
in a survivorship life policy, when does the insurer pay the death benefit? | Upon the last death (Second to die) |
Which of the following is NOT covered under plan A medigap insurance? | The Medicare part A deductible |
Every small employer carrier must actively offer to small employers how many health benefit plans? | 2 plans |
Maximum benefits for a major medical plan are usually lifetime | Maximums |
Which of the following types of insurance policies is most commonly used in credit life insurance? | Decreasing term |
Which of the following determines the cash value of a variable life policy? | The performance of the policy portfolio |
A policyowner is reading on the first page of his health insurance policy , which says "this is a limited policy " what is the name of this statement? | Limited policy notice |
Under which nonforfeirture option does the company pay the surrender value and have no further obligations to the policyowner | Cash surrender |
when an insurer offers services like preadmission testing, second opinions regarding surgery, and preventative care, which term would best apply | Case management provision |
Events or conditions that increase the chances of an insured loss occurring are referred to as | Hazards |
An insurance policy that only requires a payment of premium at its inception, provides insurance protection for the life of the insured, and matures at the insureds age 100 is called | Single premium whole life |
A tax sheltered annuity is a special tax favored retirement plan available to | Certain groups of employees |