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Florida Health insurance > Exam Simulator 1 > Flashcards

Exam Simulator 1 Flashcards

1
Q

A life insurance policy would be considered a wagering contract WITHOUT:

A

Insurable interest

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2
Q

Which of the following features of a group Term Life policy enables an individual to leave the group and continue his or her insurance without providing evidence of insurability?

A

Conversion privileges

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3
Q

Basic Medical Expense insurance:

A

Has lower benefits limits than Major Medical insurance

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4
Q

If a contract of adhesion contains complicated language, to whom would the interpretation be in favor of?

A

Insured

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5
Q

Which two entities regulate variable annuities?

A

Department of Financial Services; and Securities Exchange Commission

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6
Q

What is required in the Florida Employee Health Care Access Act?

A

Small group benefit plans are to be issued on a “guarantee-issue” basis

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7
Q

Which of the following situations are NOT subject to Florida life insurance laws?

A

Insurance companies’ day-to-day operations

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8
Q

Which Long Term Care insurance statement is true?

A

Pre-existing conditions must be covered after the coverage has been in force for six months

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9
Q

According to Florida law, when must an agent deliver the Outline of Coverage to a Medicare supplement applicant?

A

At the time of application

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10
Q

All of the following statements regrading group health insurance os true:

A

Premiums are usually determined by the claims experience of the group, A master contract is issued for the group, and Group health insurance premiums are typically lower than individual health insurance premiums

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11
Q

An individual has a Major Medical policy with a $5,00 deductible and an 80/20 Coinsurance clause. How much will the INSURED have to pay if a total of $15,000 in covered medical expenses are incurred?

A

$7,000

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12
Q

In Florida, most life insurance policies have a contestability period of

A

2 years

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13
Q

Which of the following statements BEST defines usual, customary, and reasonable (UCR) changes?

A

The maximum amount considered eligible for reimbursement by an insurance company under a health plan

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14
Q

Periodic health claim payments MUST be made at least:

A

Monthly

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15
Q

The Federal income tax treatment of employee-provided group Medical Expense insurance can be accurately described as:

A

Employee’s premiums paid by the employer is tax-deductible to the employer as a business expenditure

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16
Q

Which of the following acts is an agent NOT authorized to do on behalf of an insurer?

A

Accept premiums for policyholders

Complete insurance applications

Authorize claim payments

Ask Health related questions

  • Authorize claim payments *
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17
Q

A life insurance application must be signed by all of these Except:

A

The policyowner

The agent

The insured(if an adult)

Beneficiary

  • Beneficiary *
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18
Q

A Business Disability Buyout plan policy is designed:

A

To pay benefits to the Corporation or other shareholders

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19
Q

The waiting period for pre-existing conditions under a Medicare Supplement policy may NOT go beyond

A

6 months

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20
Q

P completed an application for a $10,000 life policy, but does not give the producer the initial premium. P’s coverage becomes effective when:

A

P receives the policy and pays the premium

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21
Q

Which of the following combinations plans is designed to protect an insured from an unpaid mortgage balance upon premature death?

A

Joint Life

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22
Q

How long does the coverage normally on a limited-pay life policy?

A

Age 100

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23
Q

Under the USA PATRIOT ACT, insurers are required to report receipt of cash payments in excess of

A

$10,000

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24
Q

Which of the following is not requires in the Outline of coverage for health insurance policy?

A

Projection of the policy future costs

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25
Q

Taking receipt of premiums and holding them for the insurance company is an example of:

A

Fiduciary Responsibility

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26
Q

Which policy requires an agent to register with the National Association of Securities Dealers (NASD) before selling?

A

Variable Life

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27
Q

Which mode of payment is NOT used by health insurance policies?

A

Monthly premium

Annual premium

Single premium

Semi-annual premium

  • Single premium *
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28
Q

What is the MINIMUM number of activities of Daily Living (ADL) an insured must be unable to perform to qualify for Long Term Care benefits?

A

2

29
Q

Which of the following is the reimbursement of benefits for the treatment of a beneficiary ‘s injuries caused by a third party?

A

Subrogation

30
Q

The minimum age at which a person can sign a life insurance application

A

15 years

31
Q

Qis severely injured in an automobile accident and become totally disabled. How many months must Q be disabled before being able to apply for Social Security benefits?

A

5 months

32
Q

If a retiree on Medicare required five hospital stays in one year, which policy would provide the best insurance for excess hospital expenses?

A

Medicare Supplement

33
Q

A Student pilot can pay regular premium costs for her life insurance policy with the addition of which of the following?

A

Aviation exclusion

34
Q

T took out a $50,000 life insurance policy with an Accidental Death and Dismemberment rider. Five years later, T commits suicide. How much will the insurer pay?

A

$50,000

35
Q

Which of these terms accurately defines an underwriter’s assessment of information on life insurance application?

A

Risk classification

36
Q

noncontributory employee group life insurance must:

A

All eligible employees must be covered; No evidence of insurability required; Must have conversion rights

37
Q

Insurers/agents must, in Florida, offer and issue all small employer health plans on a

A

Guaranteed-issue

38
Q

In Florida, when agents recommend changes be made for existing coverage, the agent must follow established procedures. The name of this rule is called the

A

Florida Replacement rule

39
Q

According to the Time Payment of Claims provision, the insurer mist pay Disability Income benefits no less frequently than which of the following options?

A

Monthly

40
Q

Which type of renewability best describes a Disability Income policy that covers an individual until the age of 65, but the insurer has the right to change the premium rate for the overall risk class?

A

Guaranteed Renewable

41
Q

A variable whole Life policy

A

A minimum guaranteed Death benefit is provided

42
Q

The provision in a health insurance policy that suspends premiums being paid to the insurer while the insured is disabled is called

A

Wavier of Premium

43
Q

What is the initial requirement for an insured to become eligible for benefit under the waiver of premium provision?

A

Insured must be under a physician’s care

44
Q

Which of the following does Social security NOT provide benefits for?

A

Survivorship

Dismemberment

Disability

Retirement

  • Dismemberment *
45
Q

Which of the following policy provisions prohibits an insurance company from incorporating external documents into an insurance policy?

A

Incontestable

46
Q

An employee of 20 years recently retired at the age 59 1/2. This employee’s group life contract can be

A

Converted to an individual permanent policy at an individual rate

47
Q

An insurance company may NOT reject a prospective insured’s life application on the basis of which of the following factors?

A

Gender

48
Q

Which type of policy would pay an employee’s salary if the employer was injured in a bicycle accident and out of work for six weeks?

A

Business Overhead Expense

49
Q

Which action could result in a hearing being ordered by the Department of Financial Services

A

Performing insurance transactions without a license

50
Q

T is covered by an Accidental Death and Dismemberment (AD&D) policy that has an irrevocable beneficiary. What action will the insurance company take if T requests a change of beneficiary?

A

Request of the change will be refused

51
Q

When a policyowner cash surrenders a Universal Life insurance policy in it’s early years, this may be considered a red flag for an

A

Anti-Money Laundering violation

52
Q

D was actively serving in the Marines when he was killed in an automobile accident while on leave. His $100,000 whole life policy contains a War Exclusion clause. How much will D’s beneficiary receive?

A

The full face amount

53
Q

From what authority derives the requirement that an insurance application contains a disclosure stating that an investigative consumer report may be obtained on an applicant?

A

Fair Credit Reporting Act

54
Q

Which of these is NOT considered to be a right given to a policyowner?

A

Modify a provision in the insurance contract

55
Q

Which of the following statements is CORRECT regrading the tax treatment of a lump-sum payment paid to a life insurance policy’s primary beneficiary?

A

All proceeds are income tax free in the year they are received

56
Q

A disability elimination period is best described as a:

A

Time deductible

57
Q

The provision that can be used to put an insurance policy back in force after it has lapsed due to nonpayment is called:

A

Reinstatement

58
Q

Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract?

A

Entire Contract

59
Q

If an agent would like to sell Variable annuites, which state examination must the agent pass?

A

Life and Variable contract

60
Q

J is agent who has induced and insured through misrepresentation to surrender an existing insurance policy. What is J guilty of?

A

Twisting

61
Q

The coordination of benefits (COB) provision exists in order to

A

Avoid duplication of benefits payments

62
Q

Which of these factors do NOT play role in the underwriting of a life insurance policy?

A

Marital Status

63
Q

Which type of life insurance beneficiary requires his/her consent when a change of beneficiary attempted by the policyowner?

A

Irrevocable beneficiary

64
Q

All of the following are eligibility requirements for an association group

A

Group must have been in existence for two years; group must hold regular meetings at least on an annual basis; at least 100 members must participate if the premium is contributory; must have been organized for some reason other than to obtain group insurance

65
Q

Which product would best serve a retired individual looking to invest a lump-sum of money through an insurance company?

A

Annuity

66
Q

Which of the following provisions is NOt required in HMO contracts/ certificates?

A

Seven day grace period

67
Q

R had received full disability income benefits for 6 months. When he returns to work, he is only able to resume half his normal daily workload. Which provision pays reduced benefits to R while he is not working at full capacity?

A

Residual Disability

68
Q

Basic Hospital and Surgical policy benefits are

A

Lower than the actual expenses incurred

69
Q

Employers with less than 20 employees are affected by Florida’s health coverage continuation act (MiNi Cobra)

A

20 employees

Florida Health insurance (5 decks)

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