Final Exam Flashcards
The deeds and actions of a producer indicate what kind of authority?
A. Express
B. Apparent
C. Implied
D. Conditional
Apparent
Jonas has disability insurance through his employer. The employer pay 75% of the premium, and Jonas pays the other 25%. What is Jonas’s tax liability for any benefits paid from the disability plan?
A. Taxes must be paid an all benefits received.
B. No taxes are payable on any benefits received
C. Taxes must be paid on 25% of the benefits received
D. Taxes must be paid on 75% of the benefits received
Texas must be paid on 75% of the benefits received
Which of the following protects a policyowner from a misrepresentation caused by an innocent mistake?
A. Reinstatement clause
B. Entire Contract clause
C. Incontestable clause
D. Nonforfeiture clause
Incontestable clause
A spouse and child can be added to the primary insured’s coverage as what kind of rider?
A. Dependent term
B. Guaranteed insurability
C. Primary term
D. Family term
Family term
An insured dies from what appears to be accidental causes. When confirming the cause of death, which of these actions by the insurer takes precedence?
A. Autopsy
B. Eyewitness account
C. Police report
D. Physician notes
Autopsy
A policyowner can receive an immediate payment before the insured dies by using a(n)
A. Viatical settlement contract
B. Buy-sell arrangement
C. Adhesion agreement
D. Spendthrift plan
Viatical settlement contract
Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit options would he choose?
A. Accelerated lifetime benefit
B. Guaranteed lifetime withdrawal benefit
C. Right of income rider
D. Guaranteed minimum accumulation benefit
Guaranteed lifetime withdrawal benefit
A 70 year old insured individual has suffered from kidney failure for the past 24 months. She is covered by her spouse’s large-group employer plan. How will Medicare be utilized in this situation?
A. Will be the primary insurer and pay for 100% of covered expenses
B. Will be the secondary insurer and pay for claims not fully covered by the group plan
C. Will not pay for any of the covered expenses
D. Will be the primary insurer and the group plan will be secondary
Will be the secondary insurer and pay for claims not fully covered by the group plan
When does a life insurance policy typically become effective?
A. When the policy is issued
B. When initial premium is collected and policy is issued
C. When the application is completed and signed
D. When the completed application to sign and initial premium is collected
When initial premium is collected and policy is issued
HIPAA considers which of the following as “individually identifiable health information”?
A. A person’s employment history
B. A person’s net income
C. A person’s hire date
D. A person’s health claim information
A persons health claim information
Any change of address by a licensee requires notice within 30 days to which of the following?
A. Governor
B. Attorney General
C. Insurer
D. Commissioner
Commissioner
For individual health insurance, coverage for pre-existing conditions may be excluded for up to _____ months after issuance of the policy
A. 18
B. 12
C. 6
D. 3
12
An insured was injured as an innocent bystander when someone committed a felony. The insurer is
A. Likely to void the policy
B. Partially liable for the loss
C. Not liable for the loss
D. Liable for the loss
Liable for the loss
Which dividend option would an insurer invest the policyowner’s money and add any interest earnings as the dividends accrue?
A. Accumulation at Interest Option
B. Cash dividend option
C. Paid-up Additions Option
D. One-year Term Dividend Option
Accumulation at Interest Option
In which of the following situations would the insurer be liable for a loss?
A. The insured skipped a payment beyond the 31 day grace period
B. The insured was injured while participating in an illegal occupation
C. The insured was given a notice of cancellation from the insurer
D. The insured suffered an injury as an innocent bystander during a bank robbery
The insured suffered an injury as an innocent bystander during a bank robbery
A common exclusion with Vision plans is
A. Eyeglass frames
B. The examination
C. Contact lenses
D. Lasik surgery
Lasik surgery
Bill requires some nursing care and supervision but NOT full-time care. Which of these nursing home options would best serve him?
A. Nursing home
B. Assisted living
C. Congregate housing
D. Custodial residence
Assisted living
A provision in a whole life policy that allows the policyowner to terminate the policy in return for a reduced paid-up policy of the same type is called a(n)
A. Insuring clause
B. Payor provision
C. Reinstatement provision
D. Nonforfeiture provision
Nonforfeiture provision
What will the beneficiary receive if an annuitant dies during the accumulation period?
A. The greater of the accumulated cash value or the total premium paid
B. The lesser of the accumulated cash value or the total premium paid
C. The interest earned on the accumulated cash value
D. Nothing
The greater of the accumulated cash value or the total premium paid
An example of risk sharing would be
A. Adding more security to
a high-risk building
B. Choosing not to invest in the stock market
C. Doctors pooling their money to cover malpractice exposures
D. Buying an insurance policy to cover potential liabilities
Doctors pooling their money to cover malpractice exposures
What is the tax liability for employer contributions in Health Savings Accounts (HSA’s)?
A. Taxable as regular income to the employee
B. Tax-deductible expense to the employee
C. No tax payment needed
D. Taxable to the employee when they exceed 7 1/2% AGI
No tax payment needed
A Medicare Supplement policy must NOT contain benefits which
A. Charge additional premiums
B. Duplicate Medicare benefits
C. Cover more than Medicare coverage
D. Are covered by Worker’s Compensation
Duplicate Medicare benefits
Jonas is a whole life insurance policyowner and would like to add coverage for his two children. Which of the following products would allow him to accomplish this?
A. Child term rider
B. Payor rider
C. Family maintenance rider
D. Family income rider
Child term rider
Paul is an employee who caught a disease unique to the trade in which he was exposed to. Paul has a(n)
A. Genetic predisposition
B. Worksite Malady
C. Contagious disease
D. Occupational disease
Occupational disease
Which of the following describes a person who is NOT acceptable by an insurer at standard rates because of health history, occupation, or hobbies?
A. Standard risk
B. Preferred risk
C. Unacceptable risk
D. Substandard risk
Substandard risk
How do insurers predict the increase of individual risks?
A. Law of large numbers
B. U.S. Census
C. Average mortality incidence
D. Experience of morbidity
Law of large numbers
What is an insurance policy’s grace period?
A. Period of time after the initial premium is paid in before the policy is issued
B. Period of time it takes for a policy’s underwriting to complete
C. Period of time after a policy is issued, and before it is delivered to policyowner
D. Period of time after the premium is due, but the policy remains in force
Period of time after the premium is due but the policy remains in force
An example of a presumptive disability would be
A. A stroke
B. Deafness
C. Diabetes
D. Cancer
Deafness
The difference between pre-certification and concurrent review is that pre-certification
A. Costs more to the patient
B. Cost less to the patient
C. Is considered a cost containment measure
D. Occurs before the treatment is provided
Occurs before the treatment is provided
An individual covered under a Blue Cross Blue Shield plan is called a(n)
A. Participant
B. Subscriber
C. Policyowner
D. Insured
Subscriber
To be classified as a small employer in Michigan, an employer must employ
A. 1-10 employees
B. 2-50 employees
C. 1-25 employees
D. 2-100 employees
2-50 employees
Which clause defines total disability as being unable to perform the major duties of the insured’s regular occupation?
A. Own occupation clause
B. Any occupation clause
C. Residual clause
D. Presumptive clause
Own occupation clause
In the state of Michigan, a licensed producer
A. Represents the insurer
B. May modify insurance contracts
C. Approves insurance contracts
D Represents the insured
Represents the insurer
Which of the following does Coordination of Benefits allow?
A. Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid
B. Allows both a group health plan and individual health plan to coordinate their benefit payments
C. Allows the deductible to be spread out between all the health providers
D. Allows each health provider to pay 100% of the claim
Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid
Newborn coverage under health insurance policies MUST include coverage for
A. Private hospital room from mother
B. Delivery costs
C. Birth abnormalities
D. Mother’s lost income
Birth abnormalities
Continued coverage under COBRA would be provided to all of the following EXCEPT:
A. Former dependent of employee no longer of dependent status
B. Terminated employee
C. Divorced spouse of employee
D. A covered employee is terminated for gross misconduct
A covered employee is terminated for gross misconduct
A person who is a non-smoker, of average weight, and excellent health would most likely be in which risk classification?
A. Standard
B. Substandard
C. Acceptable
D. Preferred
Preferred
Which of these is NOT subject to false advertising regulations?
A. Gifts
B. Brochures
C. Billboards
D. Letters
GIFTS
Which of the following is an example of a producer’s fiduciary duty?
A. Recording receipt and remittance of premiums due to the insurance company
B. Determine the rate classification of the insured
C. Reviewing policy summary of benefits
D. Witnessing applicant’s signature
Recording receipt and remittance of premium is due to the insurance company
What is the purpose for having an accelerated death benefit on a life insurance policy?
A. It allows for a spouse to be added as a rider to a life insurance policy
B. It allows for policy loans to be advanced to the insured in the event of unemployment
C. It allows for cash advances to be paid against the death benefit if the insured becomes terminally ill
D. At allows for a third party to purchase a life insurance policy at a discounted rate and immediately advance a portion of the death benefit
It allows for cash advances to be paid against the death benefit if the insured becomes terminally ill
A long-term care policy typically provides all the following levels of care EXCEPT
A. Skilled care
B. Intermediate care
C. Acute care
D. Custodial care
Acute care
Which type of clause describes the following statement: “We have issued the policy in consideration of the representations and your application and payment of the first-term premium”.
A. Premium clause
B. Consideration clause
C. Adhesion clause
D. Contestability clause
Consideration clause
Intentional withholding of material facts that would affect an insurance policy’s validity is called a(n)
A. Estoppel
B. Concealment
C. Adhesion
D. Misrepresentation
Concealment
Medicare Part A covers
A. Outpatient services
B. Doctor’s fees
C. Inpatient hospital stay
D. Prescription drugs
Inpatient hospital stay
Which of the following statements is TRUE about Medicaid
A. It is health insurance for the elderly
B. It is administered by the Federal government
C. It is funded by federal, state, and local taxes
D. Coverage includes compulsory hospital voluntary supplementary medical insurance
It is funded by federal, state, and local taxes
An insurer is REQUIRED to offer which of the following to each long-term care applicant at the time of purchase?
A. Lifetime level premiums
B. Conditional renewability
C. Deflation protection
D. Inflation protection
Inflation protection
The Do Not Call Registry offers exemptions for calls placed from all of the following EXCEPT
A. Charities
B. Political organizations
C. Insurance sales calls
D. Surveys
Insurance sales calls
What is implied authority defined as?
A. Authority given in writing to an agent in the agency agreement
B. Authority that is not specifically given to an agent in the agency contract, but that an agent can reasonably assume to carry out his/her duties
C. Authority given to handle claims and process payments
D. Authority given to an agent to act outside the scope of the agency agreement
Authority that is not specifically given to an agent in the agency contract, but that an agent can reasonably assume to carry out his/her duties
A whole life insurance policy accumulate cash value that becomes
A. The policy loan value which the insured may borrow against
B. The death benefit
C. The source of funding for administration fees
D. A source of funding a term rider to the policy
The policy loan value which the insured me borrow against
What makes an insurance policy a unilateral contract?
A. Only the insured pays the premium
B. Only the insured can change the provisions
C. Only the insurer is legally bound
D. Only the insured is legally bound
Only the insurer is legally bound
Sonia applied for a health insurance policy on April 1. Her Agent submitted the information to the insurance company on April 6. She paid the premium on May 15 with the policy indicating the effective date being May 30. On which date with Sonya have coverage?
A. April 1
B. April 6
C. May 15
D. May 30
May 30
Nate’s dependent son is physically handicapped, but not eligible for Medicare. How long may the son remain on Nate’s health coverage after the age of 26?
A. Extension may be granted to age 30 with Medicare exemption form
B. Coverage remains with written proof of disability independency
C. Only while the son is in rolled in school
D. Coverage ends at age 26
Coverage remains with written proof of disability and dependency
Which type of coverage pays an amount per day for hospitalization directly to the insured regardless of the insured‘s other health insurance?
A. MEWA
B. Mutual
C. Group
D. Hospital indemnity
Hospital indemnity
A Modified Endowment Contract (MEC) is best described as
A. A life insurance contract which accumulates cash values higher than the IRS will allow
B. An annuity contract which was converted from a life insurance contract
C. A modified life contract which enjoys all the tax advantages of whole life, insurance
D. A life insurance contract where all withdrawals prior to age 65 are subject to a 10% penalty
A life insurance contract which accumulates cash values higher than the IRS will allow
Which requirement must be met by associations that seek group health coverage for its members?
A. Must have a board of directors
B. Members must be individually underwritten
C. Must have been formed for a legitimate purpose other than obtaining insurance
D. Must have been formed over the last 10 years
Must have been formed for a legitimate purpose other than obtaining insurance
What guarantees that the statements supplied by insurance applicant are true?
A. Assurance
B. Promise
C. Representation
D. Warranty
Warranty
When a preferred provider organization (PPO) insured goes out-of-network, which of the following actions occur?
A. The insured will pay a reduced amount
B. The benefits are taxable
C. The insured has lower out-of-pocket expenses
D. The insurer will pay a reduced amount
The insurer will pay a reduced amount
Pat is insured with a life insurance policy and Karen is his primary beneficiary. They are both involved in an automobile accident where Pat dies instantly and Karen dies 5 days later. Which policy provision will protect the rights of the contingent beneficiary to receive the policy benefits?
A. Nonforfeiture clause
B. Common disaster clause
C. Spendthrift clause
D. Accident indemnity clause
Common disaster clause
Which of the following BEST describes a conditional insurance contract?
A. A contract that requires certain conditions or acts by the insured individual
B. A contract that has the potential for the unequal exchange of consideration for both parties
C. A contract where one party “adheres” to the terms of the contract
D. A contract where only one party makes any kind of enforceable contract
A contract that requires certain conditions or ask by the insured individual
Which of the following is NOT included under a health benefit plan?
A. Major medical policy
B. Basic hospital policy
C. Hospital indemnity plan
D. Surgical expense policy
Hospital indemnity plan