Other Insurance Questions Flashcards
d. Health Maintenance Organization.
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HMOs provide the Health Care coverage, as well as the medical care itself. They also must cover prescription medication.
The correct answer is: Health Maintenance Organization.
Capitation is an HMO program in which service providers are paid a fixed monthly fee for each member.
Mark’s home state is California, but he also sells insurance in Arizona. What type of producer is he?
A nonresident producer is any producer whose home state is not Arizona.
Trevor’s wife Laura gave birth to their third child today. How many days do they have to notify their health insurer of the birth?
Select one:
Insurers must be given notification of the birth of a child within 30 days. Newborns are covered from birth to the same extent as other children are on the policy. Coverage includes injury, sickness, congenital defects, birth abnormalities, and any necessary transportation to the nearest tertiary care facility for newborns.
The correct answer is: 30 days
E bought a $25,000 term to age 65 life policy fourteen years ago, when she was 52. She misstated her age on the policy and said she was 48. E died last month. Her beneficiary will receive which of the following?
The policy was term insurance to age 65. E was 66 when she died so there is no coverage in force. If the policy was level term until age 70 or older, E’s beneficiary would receive the death benefit minus the difference in what would have been charged for E’s correct age and what she actually paid. The correct answer is: $0
T has an Accident policy. If he goes to the emergency room when he breaks a leg jumping from a tree and the company pays the claim, what type of policy does Trey have?
With an Accidental Results-type claim policy, the injury must be the result of something the insured did not intend to happen when they did something. Trey did intend to jump from the tree, he did not intend to break his leg. With an Accidental Means policy, the insurer would not pay, because Trey did intend to jump from the tree.
The correct answer is: Accidental Result
T has an Accident policy. If he goes to the emergency room when he breaks a leg jumping from a tree and the company pays the claim, what type of policy does Trey have?
With an Accidental Results-type claim policy, the injury must be the result of something the insured did not intend to happen when they did something. Trey did intend to jump from the tree, he did not intend to break his leg. With an Accidental Means policy, the insurer would not pay, because Trey did intend to jump from the tree.
The correct answer is: Accidental Result
In disability insurance, the maximum benefit period of a Business Overhead Expense policy is usually:
Business Overhead Expense covers the cost of overhead, not income. It usually has a maximum benefit period of one year, after which the insured want to have a Business Disability Buy Out program in place to provide a life income to the insured in place of selling the insured’s interest in the business to his partners. The correct answer is: 12 months.
In disability insurance, the maximum benefit period of a Business Overhead Expense policy is usually:
Business Overhead Expense covers the cost of overhead, not income. It usually has a maximum benefit period of one year, after which the insured want to have a Business Disability Buy Out program in place to provide a life income to the insured in place of selling the insured’s interest in the business to his partners. The correct answer is: 12 months.
Rhonda noticed an insurance ad that described the premium as a deposit. What does this mean?
Select one:
Premiums cannot be described as a deposit unless guaranteed to be returned in full upon the insured’s demand. The correct answer is: The premium will be returned in full upon the insured’s demand.
Which of the following is not one of the options under Standard Non-Forfeiture Law?
Standard Non-Forfeiture Law deals with cash values or their equivalents which must be made available to the policyholder under one of several options if he/she cancels the policy or wants to stop paying premiums. The correct answer is: Guaranteed Insurability Option
Which of the following is not an annuity?
Variable Universal Life is an interest sensitive insurance product, not an annuity. The correct answer is: Variable Universal Life
All of the following information must be included in a Whole Life policy EXCEPT the policy’s:
One of the things that is certain about dividends is that they are NOT guaranteed. Also, dividends are only offered on policies by mutual companies, not by stock companies, so stock companies couldn’t even show a projection of dividends to the policy owner.
The correct answer is: guaranteed dividend table
All of these statements regarding METs are true EXCEPT:
Multiple Employer Trusts are generally made up of small employers that are too small to receive group benefits individually. The employers are usually in the same industry. The organization in which employers pay into a common pool and share costs and expenses is a Multiple Employer Welfare Association (MEWA).
The correct answer is: Employers pay into a common pool and share costs and expenses.
Optional uniform policy provisions are to protect the rights of which of the following?
The correct answer is: the insurer
