Final Exam Prep Flashcards
What four services do HMO and PPO plans cover that are not covered by Medicare or Medicare Supplement policies?
Prescriptions, eye exams, hearing aids or dental care
Under an extended term nonforfeiture option, the policy cash value is converted to a face amount that is what percentage of the whole life policy?
100%
Are there life contingencies with an annuity certain?
No
A life contingency in an annuity is an option that provides a death benefit if the annuitant dies during the accumulation stage
What is the purpose of a conditional receipt?
To provide coverage on a date prior to the policy issue
What does it mean to legally bind coverage?
It means that an insurance company has confirmed that coverage is in place for a policyholder
As a general rule, are premiums for life insurance tax deductible?
No
The exception would be when an employer buys group term life insurance for his employees since it is considered a business expense
What three conditions must be met for a life insurance policy to begin coverage?
- Policy delivery
- Collection of the initial premium
- Applicant completes an acceptable Statement of Good Health
Are physical examination and autopsy mandatory for health insurance policies?
Yes
How soon following the occurrence of a covered loss must the insured submit written proof of the loss to the insurance company?
Within 90 days or as soon as reasonable but not to exceed 1 year
Do HMOs provide financing as well as reimbursement?
They do provide financing, not reimbursement
Do group disability benefits apply to injuries incurred both on and off the job?
No, on the job injuries are covered by Workers Comp
Does coverage for illness start immediately upon the reinstatement of a health insurance policy?
No
Accidental injury is covered immediately but illness is not to protect the insurer against adverse selection. Illness is covered 10 days after reinstatement.
What document describes the insured’s medical history, including diagnoses and treatments?
The APS (Attending Physician’s Statement)
What are the three features of noncancellable policies?
- Insurer cannot cancel the policy
- Premiums cannot be increased for the term of the policy
- Apply only to a certain age, usually 65
If an individual already receives Social Security disability benefits, what do they need to do to qualify for Medicare when they turn 65?
Nothing, they’re already qualified for Medicare Parts A and B once they turn 65
What is the maximum age for qualifying for a catastrophic plan?
30
Which has a higher premium and why: joint life or survivorship life?
Joint because survivorship pays on the last rather than the first death so premiums are spread out over a longer period of time
After the deductible, what percent of covered expenses will Medicare Plan B pay?
80%
In the event a policy lapses due to outstanding premium, within how many days would the policy be automatically reinstated once the outstanding premium is paid?
45
What contract characteristic defines the requirement that both the insured and the insurer must meet certain conditions?
Conditional
Does AD&D insurance cover presumptive disabilities?
Yes
How are accelerated benefits paid to a chronically ill insured taxed?
A portion of the benefit to a certain limit is tax free; the rest is taxable income
What is the waiting period on a Waiver of Premium rider in life insurance policies?
6 months
Who examines the books and records of insurance companies in Florida and how often?
The CFO and the Office of Insurance Regulation every 5 years