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Life's Insurance > CA Accident and Health Insurance > Flashcards

CA Accident and Health Insurance Flashcards

1
Q

All of the following are covered under the Access for infants and Mothers Program. EXCEPT:

A

any mother who reside in the state of California whether or not she has applied

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2
Q

What happens under a misstatement of age clause on a disability policy?

A

all amounts payable under this policy shall be what the premium originally would have purchased and been paid at the correct age.

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3
Q

Which of the following is an INACCURATE statement regarding replacement for long-term care coverage?

A

Group long-term care policies have the same rules regarding replacement as individual long-term care policies

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4
Q

In which situation is a person or other entity that provides coverage for medical expenses Not subject to the jurisdiction of the insurance department?

A

When they are subject to the jurisdiction of another agency of this or another state or the federal government

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5
Q

Which is an INACCURATE statement regarding inflation protection for long-term care insurance?

A

The protection covers a specified percentage of actual or reasonable charges, and includes a maximum specified indemnity amount.

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6
Q

A policy with a life insurance benefit for a disabled employee includes an extension of benefits upon its discontinuance when all of the following are met EXCEPT

A

during a 30 day period in which to accept the terms of the new policy

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7
Q

Which of the following may be described as an “administrator” of life & health coverage or annuities?

A

the Insurance Commissioner who has access to the records for examination, audit, and inspection purposes

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8
Q

When does a license become inactive for a broker?

A

upon the termination of all appoinments, or all endorsements

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9
Q

Which is an ACCURATE statement regarding benefits of Medicare supplement and Medicare select plans?

A

There is no restriction for benefits after the coverage has been in effect for six months when involving a preexisting condition

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10
Q

All of the following may be eligible to qualify for enrollment in the Healthy Families Program EXCEPT

A

children who fail to meet citizenship or immigration rules

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11
Q

Who is the California Life and Health & Guarantee Association is regulated by?

A

The California Insurance Commissioner

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12
Q

All of the following are permitted to have blanket insurance policies with specific restrictions EXCEPT

A

any union with dues-paying members.

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13
Q

Which is an INACCURATE statement regarding standards to avoid unfair underwriting for applicants at risk for auto immune deficienct, human immunodeficiency virus, or AIDS related conditions?

A

Insurers are permitted to schedule AIDS and HIV testing without the specific consent of the individual applying for insurance

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14
Q

When shall an individual certificate be deemed to be “individualized” within the meaning of the CIC?

A

if it contains either the name of the person covered or some other means of identifying to the individual covered that it is his individual certificate

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15
Q

Can any life insurer issue group life insurance with premium rates less than the usual rates for such insurance?

A

yes, they may do so on any group plan, with or without annuities

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16
Q

Which is considered unnecessary replacement for long-term coverage unless as a means to consolidate policies with one insurer?

A

Issuing 3 or more policies within a 12 month period

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17
Q

under which situation would an individual enrolled in Medicare Part B be INELIGIBLE for open enrollment?

A

notice of end stage renal decease from the primary care physician

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18
Q

What do all long-term care insurers, agents and brokers owe to the policyholder or prospective policyholder?

A

a duty of honesty, good faith, and fair dealing

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19
Q

When is the practice of ‘post claims’ underwriting allowable on disability insurance covering hospital, medical or surgical expenses?

A

At no time

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20
Q

All of the following are types of licenses EXCEPT

A

accident and health solicitor

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21
Q

Life and Disability Insurance Analysts must provide an agreement with a statement that includes all of the following EXCEPT

A

that fees can be received for servicing a policy on which they were the selling agent

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22
Q

Which of the following BEST defines the general concept of the 24-hour care plan?

A

It integrates workers’ compensation medical care with the care provided by the group health insurance.

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23
Q

When is it allowable for a written application for any disability policy to be altered?

A

by the insurer, for administrative purposes only, when it is clear that the applicant has not made the insertions

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24
Q

Which is a requirement of an insurer who offers long-term care policies?

A

Provide the name, address and phone number for the local Health Insurance Counseling and Advocacy Program

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25
Q

What happens under a misstatement of age clause on a disability policy?

A

All amounts payable under this policy shall be what the premium originally would have purchased and been paid at the correct age.

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26
Q

Which is an INACCURATE statement regarding standards to avoid unfair underwriting for applicants at risk for auto immune deficiency, human immunodeficiency virus, or AIDS related conditions?

A

Insurers are permitted to schedule AIDS and HIV testing without the specific consent of the individual applying for insurance.

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27
Q

all of the following may be eligible to qualify for enrollment in the Healthy Families Program EXCEPT

A

Children who fail to meet citizenship or immigration rules.

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28
Q

When shall an individual certificate be deemed to be “individualized” within the meaning of the CIC?

A

If it contains either the name of the person covered or some other means of identifying to the individual covered that it is his individual certificate

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29
Q

Which is an INACCURATE statement regarding inflation protection for long-term care insurance?

A

The protection covers a specified percentage of actual or reasonable charges, and includes a maximum specified indemnity amount

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30
Q

Can any life insurer issue group life insurance with premium rates less than the usual rates for such insurance?

A

Yes, they may do so on any group plan, with or without annuities

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31
Q

Which is considered unnecessary replacement for long-term coverage unless as a means to consolidate policies with one insurer?

A

issuing 3 or more policies within a 12 month period

32
Q

Which of the following BEST defines the general concept of the 24-hours care plan?

A

It integrates worker’s compensation medical care with the care provided by group health insurance

33
Q

Life and Disability Insurance Analysts must provide an agreement with a statement that includes all of the following EXCEPT

A

that fees can be received for servicing a policy on which they were the selling agent

34
Q

Which is an ACCURATE statement regarding benefits of Medicare supplement and Medicare select plans?

A

There is no restriction for benefits after the coverage has been in effect for six months when involving a preexisting condition

35
Q

All of the following are requirements for an applicant to be licensed as a life & disability insurance analyst EXCEPT

A

having been employed by an insurance company

36
Q

Which of the following may be described as an “administrator” of life and health coverage or annuities

A

The insurance Commissioner who has access to the records for examination, audit, and inspection purposes

37
Q

Which of the following may insurers use in their underwriting?

A

family medical history

38
Q

Which is NOT a requirement of Medicare Supplement provider?

A

Displaying prominently on the first page of the policy disclosure that the policy “will cover all of the medical expenses”

39
Q

A policy with a life insurance benefit for a disabled employee includes an extension of benefits upon its discontinuance when all of the following are met EXCEPT

A

during a 30 day period in which to accept the terms of the new policy

40
Q

When may a licensee surrender for cancellation any license under which they are permitted to act?

A

at any time

41
Q

When is the practice of “post claims” underwriting allowable on disability insurance covering hospital, medical or surgical expenses?

A

at no time

42
Q

Which of the following is an INACCURATE statement regarding replacement for long-term care coverage?

A

Group long-term care policies have the same rules regarding replacement as individual long-term care policies

43
Q

Under which situation would an individual enrolled in Medicare Part B be INELIGIBLE for open enrollment?

A

notice of end stage renal decease from the primary care physician

44
Q

When does a disability policy become incontestable as to the statements contained in the application?

A

after this policy been in force for a period of two years during the lifetime of the insured

45
Q

Which coverage is a life insurance licensee NOT authorized to produce?

A

Coverage for major medical expenses

46
Q

In which situation is a person or other entity that provides coverage for medical expenses NOT subject to the jurisdiction of the insurance department?

A

When they are subject to the jurisdictions of another agency of this another state or federal government

47
Q

When is it allowable for a written application for any disability policy to be altered?

A

by the insurer for administrative purposes only, when it is clear that the applicant has not made the insertions

48
Q

Are dependents eligible for any premium refunds or dividends paid under any policy of group disability insurance?

A

Yes, insured employees are generally eligible as well as their dependents

49
Q

Under which situation would an individual enrolled in Medicare Part B be INELIGIBLE for open enrollment?

A

Notice of end stage renal decease from the primary care physician

50
Q

Which is an ACCURATE statement regarding long-term care advertisements and the “cold lead device” disclosure?

A

The fact that a cold lead device was used must be immediately announced to the customer

51
Q

Which coverage is a life insurance licensee NOT authorized to produce?

A

Coverage for major medical expenses

52
Q

Can any life insurer issue group life insurance with premium rates less than the usual rates for such insurance?

A

Yes, they may do so on any group plan with or without annuities

53
Q

All of the following may be eligible to qualify for enrollment in the Healthy Families Program EXCEPT

A

children who fail to meet citizenship or immigration rules

54
Q

Which is an INACCURATE statement regarding standards to avoid unfair underwriting for applicants at risk for auto immune deficiency, human immunodeficiency virus, or AIDS related conditions?

A

Insurers are permitted to schedule AIDS and HIV testing without the specific consent of the individual applying for insurance

55
Q

Who is the California Life and Health & Guarantee Association is regulated by?

A

The California Insurance Commisioner

56
Q

When shall an individual certificate be deemed to be “individualized” within the meaning of the CIC?

A

if it contains either the name of the person covered or some other means of identifying to the individual covered that it is his individual certificate

57
Q

Which is considered unnecessary replacement for long-term coverage unless as a means to consolidate policies with one insurer?

A

Issuing 3 or more policies within a 12 month period

58
Q

When may a licensee surrender for cancellation any license under which they are permitted to act?

A

at any time

59
Q

Which is NOT a requirement of a Medicare Supplement provider?

A

Displaying prominently on the first page of the policy the disclosure that the policy “will cover all of the medical expenses”

60
Q

Which of the following is an INACCURATE statement regarding replacement for long-term care coverage?

A

Group long-term care policies have the same rules regarding replacement as individual long-term care policies

61
Q

Which of the following BEST defines the general concept of the 24-hour care plan?

A

it integrates workers’ compensation medical care with the care provided by group health insurance

62
Q

When does the guaranteed issue period for Medicare Supplement end?

A

Sixty three days after the dis enrollment of the previous coverage

63
Q

What do all long-term care insurers, agents and brokers owe to the policyholder or prospective policyholder?

A

a duty of honesty, good faith, and fair dealing

64
Q

all of the following are permitted to have blanket insurance policies with specific restrictions EXCEPT

A

any union with dues paying members

65
Q

When does a license become inactive for a broker?

A

upon the termination of all appointments or all endorsements

66
Q

Which of the following may insurers use in their underwriting

A

family medical history

67
Q

What type of licensee can receive a fee from any person or source other than an insurer?

A

Life and Disability Insurance Analyst

68
Q

When is the practice of “post claims” underwriting allowable on disability insurance covering hospital, medical or surgical expenses?

A

at no time

69
Q

A policy with a life insurance benefit for a disabled employee includes an extension of benefits upon its discontinuance when all of the following are met EXCEPT

A

during a 30 day period in which to accept the terms of the new policy

70
Q

All of the following conditions provide a basis for group life insurance coverage EXCEPT

A

amounts of insurance may be selected as needed per individuals personal need

71
Q

Which is an INACCURATE statement regarding coverage for domestic partnerships?

A

A policyholder may not require that a domestic partnership be registered to qualify for coverage

72
Q

When a replacement policy is being considered, what is required from an insurer?

A

A list of existing policies, replacement notice signed by the applicant and the agent, and a notice sent to any existing insurers that replacement is possible are all requirements

73
Q

How long does an employee in a group insurance policy have to exercise the conversion privilege after employment is terminated?

A

31 days to use the conversion privilege and begin an individual life insurance policy

74
Q

What happens if an owner requests an immediate investment of monies in a variable annuity policy be returned during the 30 day cancellation period?

A

The owner shall receive the market value at the time of the cancellation

75
Q

All of the following are TRUE about the rules regarding the sale of life insurance and annuities to seniors age 65 or older EXCEPT

A

the agent, broker or insurer is required to show a copy of their insurance license with name, address, and phone number when conducting business in the senior’s home

76
Q

When is an ACCURATE statement regarding dependent coverage under a group insurance policy?

A

The coverage must not exceed mote than 100 percent of the coverage for the insured employee

77
Q

Losses arising from all of the following conditions may be excluded from group life policies EXCEPT

A

natural disasters

Life's Insurance (6 decks)

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