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CFP > Insurance > Flashcards

Insurance Flashcards

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1
Q

Risk

A

A condition where there is a possibility of loss (a situation where an exposure to loss exist)

Ex: starting a business or buying real estate

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2
Q

Peril

A

The cause of a possible loss

Ex: windstorm, fire, or theft

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3
Q

Hazard

A

A condition that may create or increase the chance of loss arising from a given peril

Ex: owning a home on an earthquake fault line or by a river

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4
Q

Elements of insurance

A
  1. Large number of homogeneous exposure units
  2. loss must be definite and measurable
  3. Must be fortuitous or accidental
  4. Must not be catastrophic (for the insurance company)
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5
Q

Methods to avoid/reduce loss

A
  1. Avoidance
  2. diversification
  3. Transference
  4. Retention
  5. Risk reduction
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6
Q

Avoidance

A

Don’t drive, don’t buy property but rent

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7
Q

Diversification

A

Duplication of assets or activities at different locations

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8
Q

Transference

A

Insurance

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9
Q

Retention

A

Voluntary- recognizes that the risk exists and assume losses (deductible, coinsurance)

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10
Q

Risk Reduction

A

Sprinkler system, safety programs

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11
Q

Property/casualty insurable interest

A

At inception and at time of claim

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12
Q

Life insurable interest

A

At inception but need not be at time of claim

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13
Q

Declarations page

A

Part of insurance contract

Factual statements that identify the specific person, property or activity being insured

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14
Q

Definitions

A

Part of the insurance contract

Explanation of key policy terms

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15
Q

Insuring Agreement

A

Part of the insurance contract

Spells out the basic promise of the insurance company

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16
Q

Conditions

A

Part of the insurance contract

Spells out in details the duties and rights of both parties

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17
Q

Exclusions

A

Part of the insurance contract

Circumstances when the insurer will not pay

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18
Q

Negligences

A
  • attractive nuisance
  • neglect per se
  • strict liability
  • absolute liability
  • vicarious liability
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19
Q

Attractive nuisance

A

Swimming pool or vacant lot

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20
Q

Negligence per se

A

Violate a statute

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21
Q

Strict liability

A

Product liability

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22
Q

Absolute liability

A

Workers compensation

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23
Q

Vicarious liability

A

Respondent superior (principals responsible for their agents)

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24
Q

Defenses

A
  • assumption of risk
  • contributory
  • comparative
  • last clear chance
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25
Q

Assumption of risk

A

Skiing, stock car races

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26
Q

Contributory

A

Jay walking, being drunk

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27
Q

Comparative

A

A is 20% negligent, B is 80%

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28
Q

Last clear chance

A

Road rage

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29
Q

Capital utilization approach

A

Calculating life insurance needs

Uses annuitization to provide needed income but leaves no money at end of planned for period

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30
Q

Capital needs approach

A

Calculating life insurance needs

Uses interest only, so the original capital is still left at the end of income period

Also called capital retention or interest only

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31
Q

Insurance rating service/category

A

A.M. Best: A++ to F

Standard and Poor: AAA to CCC

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32
Q

Section I of Homeowners Policy

A

Coverage: A B C D

A- dwelling and attached structures
B- structures separated from dwelling (detached garage, fences)
C- contents and personal property
D- loss of use

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33
Q

Section II of homeowner policy

A

Coverage: E F

E- liability
F- medical payments

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34
Q

Property excluded under personal property coverage

A
  • animals, birds, or fish
  • motorized land vehicles and aircraft
  • property of roomers, boarders and other tenants
  • property contained in an apartment regularly rented or held for rental to others by the insured (unless specifically endorsed)
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35
Q

Perils covered- basic form

A

WHARVES/FLT

Windstorm, hail, aircraft, riot, vandalism, vehicles, explosions, smoke, fire, lightning, theft

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36
Q

Perils covered- broad form

A

Basic plus RAF

rupture of a system, artificially generated electricity, falling objects, freezing of plumbing

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37
Q

HO-1 coverage

A

Basic for all (A B C D)

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38
Q

HO-2 coverage

A

Home

Broad for all (A B C D)

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39
Q

HO-3 coverage

A

Home

A- open
B- open 10% A
C- broad 50% A
DA- open 30% A

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40
Q

HO-3/15 HO-5 coverage

A

Home

A- open
B- open 10% A
C- open 50% A
D- open 30% A

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41
Q

HO-8 coverage

A

Older home

Basic for all (A B C D)

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42
Q

HO-4 coverage

A

Renters

None for A and B
C- broad
D- broad 30% C

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43
Q

HO-6 coverage

A

Condo owner

A and B can have some coverage
C- open
D- broad 50% C

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44
Q

HO-7

A

Mobile home

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45
Q

Homeowner policy exclusions

A

Earthquake
Flood
Neglect
Intentional loss
Ordinance/law
Power failure
War
Nuclear hazard
Sink hole is a covered peril for the exam

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46
Q

Insurance required

A

Replacement cost coverage

Replacement cost ✖️ coinsurance percentage

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47
Q

Amount paid by insurance

A

Replacement Cost coverage

(Insurance carried➗insurance required) ✖️ loss ➖ deductible

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48
Q

Automobile risk exposures requirements for a vehicle to be eligible for: insurance service office (ISO) and personal auto policy (PAP)

A
  • be owned by an individual or husband and wife living in the same household
  • be a private passenger automobile
  • not to be used as a public or livery conveyance
  • not be rented to others
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49
Q

Auto insurance policy parts

A

Part A- limited to third parties
Part B- medical payments
Part C- uninsured/ underinsured motorists
Part D- damage to the covered auto

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50
Q

“Covered auto” as used under the policy

A
  • any vehicle shown in the declaration page
  • any of the following you acquire during the policy period: private passenger auto, pickup truck, panel truck, van
    -no coverage for pickup truck or van or panel truck used in a business (need commercial policy)
  • any trailer you own listed on declaration page
  • any auto or trailer you do not own while used as a temporary substitute for any vehicle described above because of a breakdown, repair, servicing, loss or destruction
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51
Q

Persons insured under the medical payments coverage of the PAP

A

The named insured and any family member who:
- suffers bodily injury caused by accident while occupying the covered auto
- if while a pedestrian are struck by any motor vehicle designed for use on public roads, or by a trailer

Other persons while occupant of the insured’s auto (passengers)

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52
Q

Uninsured motorist coverage
(UM)

A

Promises to pay the amount an injured insured could have collected from the uninsured driver if the driver had carried auto liability insurance. Covered person includes:
- named insured and any family member
- any other person occupying the insured’s covered auto
- any person, for damages that person is entitled to recover because of injury to a person above

this is liability protection, not medical payments

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53
Q

Perils covered under the “other than collision” provision of the auto policy

A

breakage of glass
loss caused by:
- falling objects
- fire
- theft
- explosion
- earthquake
- windstorm
- hail
- water
- flood
- riot/civil commotion
- contact with birds or animals

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54
Q

Umbrella liability insurance

A
  • usually a correct answer
  • provides liability coverage (BI/PD) for catastrophic legal claims
  • requires policy owner to carry certain underlying coverage of specified minimum amounts
  • professional acts are specifically excluded
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55
Q

Malpractice

A

Professional liability

Bodily injury (doctors, dentist)

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56
Q

Errors and Omissions
(E and O)

A

Professional liability

Monetary damages (financial advisors, lawyers, accountants, insurance agents, etc.)

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57
Q

Workers compensation

A
  • unlimited medical expenses
  • disability income (tax free)
  • death benefits
  • rehab (medical and vocational)
  • absolute liability
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58
Q

Medicare does NOT cover

A
  • routine foot care, glasses, hearing aids and dental work
  • emergency care outside the US (some exceptions for Canada, Mexico, and the Caribbean)
59
Q

Medicare- long term care

A
  1. Benefits are limited- pays all of first 20 days of skilled care and everything over a specified amount per day for next 80 days of skilled care (max 100 days)
  2. This limited benefit is subject to substantial restrictions:
    - pays for skilled care only
    - admission to a nursing home must follow within 30 days of a hospital stay of 3 days or more
    - patient’s condition must be expected to improve
60
Q

HMO

A

Provider paid monthly fee regardless of services rendered (capitation)

Out of network care not covered at all

61
Q

PPO

A

Provider paid for actual services rendered

Out of network partially covered (usually 70%)

62
Q

COBRA Coverage Requirements

A

Must have 20 full/part time employees

  • Voluntary or involuntary termination- up to 18 months
  • Employee’s death, divorce, legal separation or eligibility for Medicare- up to 36 months
  • loss of dependent status- up to 36 months
63
Q

Health Savings Account
(HSA)

A
  • used in conjunction with HDHP
  • distributions tax free if used for health care
  • contributions not spent are carried forward in owner’s name and are portable
  • unused assets become property of named beneficiaries upon death
  • distributions for non-medical are ordinary income taxable plus 20% penalty if under 65
64
Q

Definitions of Disability

A
  1. Own occupation- best definition for insured
  2. Modified any occupation
  3. Split definition-own then modified
  4. Any occupation (social security definition)
  5. Loss of income
65
Q

Noncancellable
“Noncan”

A

Disability Income Policy Continuance Provision

Continuous term policy guaranteeing the insured’s right to maintain the policy at the stated premium

66
Q

Guaranteed Renewable

A

Disability Income Policy Continuance Provision

Continuous right to maintain the policy, but the insurer may increase the premium by class of insureds

67
Q

Taxation of disability polices:

The individual owns the contract and pays the premium

A
  • premiums are not deductible
  • benefits are tax free for the employee
68
Q

Taxation of disability policies:

The employee owns the contract and the employer pays the entire premium under a bonus arrangement like section 162 disability insurance

A
  • premiums are deductible by the employer as a bonus
  • benefits are tax free to the employee
69
Q

Taxation of disability policies:

The employee owns the contract and the employer pays the entire premium under a salary continuation plan (group plan)

A
  • premiums are deductible by the employer
  • benefits are taxable to the employee
70
Q

Permanent life insurance- low risk tolerance

A
  • low risk tolerance
  • insurance company controls investment return
  • assets part of general account
  1. Whole life
  2. Universal life
71
Q

Permanent life insurance- high risk tolerance

A
  • client controls investment return
  • assets part of separate account
  1. Variable life
  2. Variable universal life
72
Q

Dividend options

A

CRAPO

  • cash
  • reduced premiums
  • accumulate with interest
  • paid up additions
  • one year term/5th dividend
73
Q

Nonforfeiture options

A

CEP

  • cash
  • extended term
  • paid up reduced amount
74
Q

Settlement options

A
  • cash
  • pure life/single life
  • refund
  • period certain
  • specified income/period
  • interest only
75
Q

Modified Endowment Contract
(MEC)

A
  • entered into after June 21 1988
  • fails to meet the “seven pay test” (included all single premium policies)
  • distributions/withdraws are taxed LIFO (interest first)
  • distributions under 59.5 also subject to 10% federal penalty tax (if not disabled)
  • death benefit is tax free
76
Q

MEC grandfather life insurance rules

A

If the death benefit increases by $150k or less and the insured has guaranteed insurability (no proof of insurability), the policy will not lose its grandfather (non MEC) status

If the policy increases by any amount and the insured must provide insurability, the policy may lose its grandfather (non MEC) status

77
Q

Proceeds taxable due to transfer for value

A

If an interest in a life insurance policy is transferred for valuable consideration (not a gift), the proceeds in excess of the consideration paid for the policy, combined with any premiums paid by the owner, are taxable as ordinary income. Exceptions to the rule:
1. Sale or transfer to the insured
2. Sale or transfer to a partner or partnership in which the insured is a partner
3. Corporation where the insured is a shareholder or officer
4. Divorce

78
Q

1035 tax free exchange rules

A

Life to life= ok
Life to annuity = ok
Annuity to annuity= ok
Annuity to life= NO NO NO

79
Q

Buy sell- stock redemption

A

No step up in cost basis

Entity is owner and beneficiary

80
Q

Buy sell- cross purchase

A

Step up in basis

Individual owner is owner and beneficiary

81
Q

Split dollar insurance- endorsement method

A

Employer is the owner
Employee is not a shareholder

Deferred compensation

82
Q

Split dollar- collateral assignment method

A

Employee is the owner

Employee is a shareholder

Employee assigned the policy

Deferred compensation

83
Q

Annuity taxation- periodic payouts

A

Basis➗payout = tax free

84
Q

Annuity taxation- lump sum payout

A

LIFO- interest first value

Ordinary income + 10% penalty under 59.5

85
Q

Flexible Spending Account
(FSA)

A
  • must be used by March 15 or forfeited to company (use it or lose it-medical only. Depending care must use by 12/31)
  • not subject to income tax, FICA, FUTA
  • health FSA may not be used to reimburse an employee premiums paid for other health plans (MSA, HSA, LTC)
  • expenses for LTC services cannot be reimbursed under health FSA, but other medical expenses can be reimbursed
86
Q

Fringe benefits tax free
(Major ones)

A
  • health care premiums
  • insurance premiums on non-discriminatory group life policy up to $50,000
  • company car for working conditions only
  • employer provided transit passes ($300/month cap) or parking ($300/month cap)
  • occasional overtime meal money, cab fare, theater or sporting event ticket
  • discounts on services limited to 20% of selling price charged customers
87
Q

Fringe benefits taxable

A
  • health insurance premiums paid for self-employed, partners, and more than 2% owners of S corp are taxable income
  • 100% is deductible as an adjustment to income on the front of the 1040
  • this can include all types of health insurance programs
88
Q

Insurance calculation- how much insured owes

A

For figuring out how much the insured owes, make sure to subtract the deductible from the claim

Ex: claim is $5k, deductible is $1k, coinsurance is 80/20%
1. $5k - $1k = $4k
2. $4k x 20% = $800
3. $800 + $1k= $1,800 insured person pays

89
Q

SIS and social security benefit calculations

A

Base benefit + (SIS - social security)

90
Q

Medicare skilled nursing coverage

A

First 20 days- fully paid by Medicare

Days 21-100- copayment is required. Insured pays $200 per day and insurance pays above the $200 per day

After 100 days- insured (patient) pays the full cost

91
Q

Options to stop paying the premium on whole life policy

A
  • cash it in
  • take a reduced amount of paid up whole life
  • take a paid up term (extended term) insurance policy
  • use APL to cover the premium (if elected by the policyholder in the application)
  • annuitize the cash value
92
Q

Does whole life have possible policy loans?

A

Yes

93
Q

Surrender policy and taxation

A
  1. Net cash value + loan = total cash value
  2. Total cash value - premiums= ordinary income

OR

  1. Surrender value - (premiums - dividends) = amount taxable

A surrender policy is taxed as ordinary income

94
Q

When will the proceeds from a life insurance policy be subject to income tax?

A

When the client sells his policy to a viatical company

It is a transfer for value that will subject the beneficiary to income tax on the proceeds. The death benefit paid to the viatical company will be subject to income tax above basis

95
Q

Do you pay the premium or cash value when buying your own policy in cross purchase?

A

Premium

96
Q

Are life and disability premiums deductible in cross purchase or entity purchase agreements?

A

No they are not deductible

97
Q

How is the capital gain in an annuity owned by a corporation taxed?

A

As ordinary income in that year

98
Q

Disadvantage of single life annuity

A

Annuitant received fixed payments

99
Q

When are annuity premiums deductible?

A

When paid as a bonus to an employee (the employee owns the contract)

100
Q

Conversion features

A

Life insurance and health insurance have conversion features

Short term disability and long term disability do not have conversion features

101
Q

How much can a key employee in a discriminatory group term life insurance exclude of the taxable cost of coverage

A

$0

102
Q

FSA grace periods

A

2.5 months for a health FSA

No grace period for a dependent care FSA

103
Q

Limit on total medical expenses that can be covered under FSA

A

$3,050 for health FSA

$5,000 for dependent care FSA

104
Q

Health FSAs cannot pay for

A
  • health insurance premiums
  • cosmetic items
  • cosmetic surgery
  • items that can improve general health (too broad)
105
Q

First to die policy

A
  • expires when the first person dies
  • when the first person dies, the other person receives the benefit and the policy ceases
  • it is less expensive than buying 2 level premium policies
106
Q

Survivorship life

A
  • protection for estate tax liability
  • means second to die
  • premium is usually less than a premium for the healthy person alone
107
Q

Reinstate policy

A

For term policies

If the policy lapses, you can submit a policy reinstatement form

You will have to pay any premiums in arrears but will maintain the premium of the original policy

108
Q

Emergency fund and insurance

A

It is always smart to have an emergency fund to hold you over for a long waiting period especially if you are a spender

109
Q

Keys words for term insurance

A

If it seems the client likely can’t afford higher premiums (like whole life), term is suitable
- key words can be financial edge

If they have to fund multiple other insurances (like disability or fund retirement) finding all these dollars to fund everything will be difficult

110
Q

PAP medical payments

A

Relatively small costs for emergency room treatments are covered under medical payments

111
Q

PAP BI/PD

A

If being sued, the liability section would likely provide a benefit

112
Q

Building replacement/damage cost- insured pays

A
  1. Building value x 90% coinsurance= insurance required
  2. Insurance carried ➗ insurance required = 4 point decimal
  3. 4 point decimal ✖️ damage = insurance
  4. Insurance - deductible= insurance coverage
  5. Damage - insurance coverage = insured pay amount
113
Q

Appropriate insurance coverage calculation

A
  1. coinsurance ✖️replacement cost
  2. If answer 1 Is below the coverage then you do: damage - deductible
114
Q

Intentional loss

A

Excluded from homeowner policies

115
Q

Sufficient coinsurance coverage calculation for home

A
  1. Purchase price - land = actual home value
  2. Actual home value ✖️coinsurance = insured amount

If insured amount is less than insurance coverage then it is sufficient coverage
- if more than insurance coverage then it is not enough

116
Q

Contact with a bird or animal

A

Covered under “other than collision”

117
Q

Benefits covered under workers compensation laws

A
  • total permanent disability benefits
  • rehabilitation benefits
  • occupational disease benefits
118
Q

Benefit of using a variable universal life policy for a cross purchase type buy sell

A

Wise investment choice can help reduce the premium rating (out of pocket cost)

119
Q

Selling price of a split dollar policy

A

The greater of the cash value or the premiums paid by the employer

120
Q

Life insurance policies on children

A

If the parent buys the policy and is the owner it does not expire when the kid turns 18. The parent will always be the owner and have control

121
Q

Whole life death benefit

A

death benefit + paid up additions

Cash value ceases at insured’s death

122
Q

Insurance company paying claims calculation

A

(Claim - deductible) ✖️ coinsurance

Make sure to check what the maximum deductible is- sometimes it’s only for 2 deductibles

123
Q

Insurance conversions

A
  • group health can be converted to an individual policy
  • group life can only be converted to a permanent policy, not term
  • group disability is not convertible
124
Q

Animal under “other than collision”

A

The actual animal itself is not covered but any economic loss related to the animal is covered

125
Q

Split dollar policy is not for who?

A

Not a key person policy

It’s an employee-benefit type policy application of life insurance

126
Q

If a company pays disability premiums in the form of a bonus

A

The disability benefits will be excluded from the employee’s income

The bonus is taxable so the benefits are tax free

127
Q

Owner under collateral assignment method for split dollar insurance

A

Employee

128
Q

Not a tax free benefit

A

Employer paid sick pay benefit

129
Q

Taxation of worker’s compensation disability income benefits

A

Tax free

130
Q

Inland marine floater

A

Covers property that moves from location to location

131
Q

Part of Medicare that covers drugs that can’t be self administered

A

Medicare part B

132
Q

Guaranteed renewable policy

A

Continuous right to maintain policy but insurer may increase premium

Less expensive than a non-can policy

133
Q

Conditionally renewable

A

Keep disability policy in force after age 65 and still working

134
Q

Maximum disability insurance coverage

A

60%

135
Q

Human life value approach

A

Based on purchasing an amount of life insurance equal to individual’s future income-earning ability

136
Q

First to die/joint life

A

Allows you to buy 1 policy and cover 2 people

Less expense than buying 2 term polcies

137
Q

Age 60+

A

Term insurance isn’t practical

138
Q

Group disability

A

Company pays premiums and benefits are taxable

139
Q

Negligence per se

A

Violating a statue

140
Q

Assumption of risk

A

Signing a waiver

141
Q

Viatical company basis and taxation

A

Basis = viatical purchase price + premiums paid

New basis is tax free to the viatical company

Death benefit - new basis = taxed at ordinary income

142
Q

Insurer payment calculation

A

Insurer = insurance company

(Medical expenses - deductible) x coinsurance

Do not add back deductible for the insurer

143
Q

Comparative Negligence

A

A is 20% and B is 80%

144
Q

Incontestable provision

A
  • included in life insurance contract
  • insurer will not contest policy after its in force for a specific period- usually 2 years

Exceptions:
- no insurable interest at inception of policy
- intent to murder
- healthy person impersonating applicant in the medical policy

CFP (6 decks)

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