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CHFC 311 Study Center > HS 311 Review > Flashcards

HS 311 Review Flashcards

1
Q

“Restoration of benefits” provision restores benefits to their…

A

original level after the insured has not received long term care covered by the policy for a certain time period.

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2
Q

All Medicare Prescription Drug Plans must allow for walk in pharmacy and…

A

mail in pharmacy options.

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3
Q

HO3

A

designed for single family homes

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4
Q

HO4

A

designed for tenants/renters

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5
Q

HO5

A

designed for broadest coverage

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6
Q

HO6

A

designed for condominiums

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7
Q

Primary Goals of the ACA

is to…

A

make health care more affordable.

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8
Q

Flex Rating Laws Allow insurers to…

A

change rates with out pre- approval by as much as much 5-10%.

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9
Q

Typically, automobile insurance is…

A

optionally renewable.

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10
Q

This long-term care benifit pays nursing home costs if a patient must temporarily leave the nursing home because of hospitalization or a variety of other reasons.

A

bed reservation benefit

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11
Q

Employer contributions for an employee’s disability income insurance are fully deductible to the…

A

employer as an ordinary and necessary business expense.

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12
Q

The taking of property from one person by someone else who has either caused harm or threatened to cause harm is referred to as…

A

robbery

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13
Q

Ethics is concerned with how we should…

A

behave

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14
Q

The rate at which people suffer illness, sickness, and disease at each age is shown in a…

A

Morbidity Table.

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15
Q

The elimination period for disability income benefits is typically…

A

3-6 months.

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16
Q

The actual cost of any given life insurance policy can most accurately be determined after the contract expires by…

A

death, maturity or surrender.

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17
Q

Health savings accounts allow…

A

unused amounts to carry over from one year to following years.

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18
Q

The common accident provision in a group major medical plan state that if two or more members of the same family are injured in the same accident, the covered medical expenses for all family members will be subject to a…

A

single deductible.

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19
Q

Alien Insurer

A

Insurer incorporated in a foreign country selling in your state.

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20
Q

Foreign Insurer

A

An insurer incorporated in one state selling in a neighboring state.

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21
Q

Domestic Insurer

A

A Company incorporated in one state selling in their own state.

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22
Q

Pre-existing Condition Exclusions will no longer be allowed by the ACA effective…

A

01-01-2014

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23
Q

Internet Insurance Company sells insurance entirely through the Internet and does not use sales representatives. This is an example of a…

A

direct response marketing system.

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24
Q

Treaty (automatic) Reinsurance

A

provides for contracts to be negotiated in advanced, preapproving all contracts that fit an agreed upon template.

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25
Q

Facultative reinsurance

A

provides for case by case negotiation over each reinsurance contract.

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26
Q

The portion of an insurance rate that is designed to cover future loss costs is known as the…

A

pure rate.

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27
Q

PUL covers _____ family members living in the named insured’s household.

A

all

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28
Q

The most effective method of dealing with pure risks involving the possibility of high frequency, low severity losses.

A

Risk retention

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29
Q

refers to gossip, slander, invasion of privacy, etc.

A

Personal injury

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30
Q

refers to physical injury to a person, necessitating medical treatments.

A

Bodily Injury

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31
Q

Commercial General Liability policy written on an occurrence basis provides coverage for losses that occur…

A

during the policy period.

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32
Q

Recovery that depends on the amount specified in the policy.

A

valued contract

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33
Q

Medicare advantage plans include the benefits of Medicare Parts A & B, as well as…

A

additional coverages, making it broader than traditional Medicare.

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34
Q

Having a hereditary disease might cause a person to seek out an insurance policy providing protection against the disease. This is an example of…

A

adverse selection.

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35
Q

An insurer who is not approved to place business in a jurisdiction where a producer wants to sell insurance is known as…

A

Non-Admitted Carriers

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36
Q

Premiums paid by a self employed individual for business coverage are deductible as a…

A

business expense.

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37
Q

provisions requiring employers to provide letters of credible coverage to individuals losing group coverage.

A

HIPAA

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38
Q

Mary currently earns $3000 a month. She has an individual disability income policy that will pay $2,000 per month if she is totally disabled. The policy also provides residual disability benefits. If Mary becomes disabled and earns only $2,100 per month, how much would she collect each month under her disability income policy.

A

$2,100/$3,000 = 70%

Mary Lost 30% of her pre-disability income.
30% of Mary’s Disability Income

$2,000 X .30 = $600.

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39
Q

A worker who has 40 credits of coverage is…

A

fully insured for life.

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40
Q

A worker who has 6 credits of coverage out of the last 13 quarters is…

A

currently insured.

41
Q

A worker who has 40 credits and has adequate recent credits, is…

A

disability insured

42
Q

Incorporation by reference is prohibited by the…

A

entire contract clause.

43
Q

A personal with an Auto Policy will need to purchase an additional policy if they want to be covered while driving in…

A

Mexico. (No second policy required, however, for Canada.)

44
Q

3 Hazards

A

Moral Hazard
Physical Hazard
Attitudinal Hazard

45
Q

What are some things health insurance underwriters may consider when underwriting a health insurance policy?

A

Smoking Habits, Age, Gender, and Geographic Location

46
Q

Stakeholders in the decision making process of a financial services professional, include…

A

The Client, The Organization, and The Community.

47
Q

Examples of Social Insurance include

A

Unemployment Insurance, Social Security, and Worker’s Compensation.

48
Q

Elements of Negligence include

A

a certain standard of care owed to others, proximate cause, and injury or damge.

49
Q

Limited-Payment life insurance builds up cash values faster than..

A

ordinary life insurance.

50
Q

With Permanent Life Insurance the shorter the required premium payment period,

A

the faster the cash value in a policy grows.

51
Q

Annuitants do not select investments in

A

indexed annuities.

52
Q

Viatical cash settlements are not determined by insurance companies. They are negotiated by

A

settlement brokers.

53
Q

Title insurance policies cannot be assigned to a new buyer who purchases a property. New buyers are required to buy

A

a new title policy.

54
Q

Earthquake policies are available for purchase as separate polices, but they are ____ subject to deductibles that apply to other homeowner policy endorsements.

A

not

55
Q

Dependents of persons receiving social security retirement benefits include

A

dependent parents, if they reside with the retiree.

56
Q

3 Life insurance Non-Forfeiture Options include

A

cash surrender, extended term insurance, and reduced paid-up insurance.

57
Q

Essential health benefits under the ACA include

A

Hospitalization, Emergency services, Maternity and Newborn Care Services.

58
Q

Declarations of a typical insurance policy include

A

name of the insured, name of the insurer, effective date, type of insurance, beneficiaries.

59
Q

Insurance and Annuities share the following common features:

A

Protection against loss of income
Premiums based on probabilities of death & survival
Use of the pooling techniques

60
Q

The typical rider for waiver of premium requires that the disability last at least

A

6 months before premiums will be waived.

61
Q

Arguments favoring federal insurance regulation do not include

A

“reflection of local conditions.”

62
Q

Premiums for disability income insurance are generally level and do not

A

increase annually.

63
Q

Insurance Risks have the following characteristics:

A

Amount of loss must be definite
The amount of loss must be important
The loss must be of an accidental nature.

64
Q

All permanent policies are required to have

A

policy loan provisions.

65
Q

Denial of benefits may not be based on the existence of

A

other earnings available to other household members.

66
Q

Enforceable Property & Liability Contracts require the following elements:

A

Offer & acceptance
Competent parties
Legal purpose
Consideration

67
Q

Activities of Daily Living include:

A 
Eating
Bathing
Dressing
Transferring
Continence
Toileting
68
Q

Companies limit the use of “class beneficiaries” due to the difficulty of

A

identifying all appropriate beneficiaries.

69
Q

Medicare prescription drug coverage is a voluntary plan with monthly premiums that could be waived for

A

low income benficieries.

70
Q

Dependent coverage would be extended to

A

unmarried, stepchild, under age 19.

71
Q

A long term care insurance policy benefit designed to allow for the rest and recuperation of the caregiver is called

A

respite care.

72
Q

With a Whole Life Insurance the shorter the payment paying period the

A

faster the growth of the cash value in a life policy.

73
Q

One basic benefit that must be included in all Medicare supplement policies is the

A

365 days of hospitalization coverage after Medicare ends.

74
Q

assumes the monies for survivors will be liquidated within their lifetimes.

A

Financial Needs Analysis

75
Q

assumes the survivors will live off the income of the amassed wealth, preserving it for legacy.

A

Capital Needs Analysis

76
Q

Relying upon market forces to regulate rates is known as

A

open competition.

77
Q

are financed by syndicates who keep the profits when they are made or absorb the losses if they are incurred.

A

Fair Plans

78
Q

Most states pay regular Unemployment Benefits for a maximum of

A

26 weeks.

79
Q

State Health Exchanges are scheduled to go into full effect by

A

01-01-2014

80
Q

require offenders to file proof of financial responsibility, after they are convicted of serious offenses.

A

Financial responsibility laws

81
Q

require coverage before you can get a tag for your car.

A

Compulsory insurance laws

82
Q

provide the highest level of benefits, if care is received from network providers.

A

PPOs

83
Q

defined in insurance terminology to the cause of a loss.

A

A peril

84
Q

permits the policyowner to select the investments into which his cash values are invested.

A

Variable Insurance

85
Q

allows both investment choices and the flexibility of Universal Insurance.

A

Variable Universal Insurance

86
Q

P & C Insurance – at time of

A

claim

87
Q

Life Insurance – at time of

A

purchase

88
Q

Purchased by the organization to protect D & O from

A

stockholder suits.

89
Q

Insurance doctrine of “making you whole.” Recovering the amount of your loss, but not more than the amount of your loss.

A

Contracts of Indemnity

90
Q

Sell high volumes of business for a select number of carriers, with top contacts and they do not build organizations, they sell.

A

PPGAs

91
Q

Are “not” growing in number…sell primarily participating policies…pay dividends.

A

Mutual Companies

92
Q

Standard - Companies chose the language
Required - Review them in Text
Prohibited – Cannot be agent of Buyer & Seller
Optional – Beneficiaries, Suicide Clause

A

Life Insurance Policy Provisions

93
Q

Car pooling and cost sharing are not

A

business use of an automobile.

94
Q

“Age or Gender Error” does not

A

void a contract. Can be corrected during life or after death by adjusting the proceeds up or down, as needed.

95
Q

Jack is 40 when he is killed in a car accident. The Insurance Company discovers that his application misstated his age. He was actually 30 when he bought the policy, not 25. He has been paying $.90/$1000 of coverage, instead of $1.00/$1,000 of coverage. If Jack had originally purchase a $100,000 policy, what amount would his beneficiaries actually receive?

A

@$90,000

96
Q

hired by consumers to assist in their claims process.

A

Public adjusters

97
Q

Term Insurance Conversion

Current age, current forms and rates

A

Attained age

98
Q

Term Insurance Conversion

Original age, original rates and forms, payment of the difference in premium plus interest.

A

Retroactive age

99
Q

Intended to be medical care for the indigent, not middle class entitlement.

Social stigma still present.

Provides long term care for the indigent.

A

Medicaid

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