prepare to pass Flashcards
B’s policy provides coverage on an in-hopsital basis only and contains a limited daily room and board benefit. which of these policies does B have
comprehensive major medical
basic hospital
critical illness
basic surgical
basic hospital
every 12 months after the initial enrollment period, an HMO must hold an open enrollement period of
10 days
31
45
60
31 days
the insuring clause
-specifies the additional time given to pay past due premiums
-states the scope and limits of the coverage
-states the amount of premium to be collected
-prohibits the insured from suing the insurer for at least 60 days after filing a written proof of loss
-states the scope and limits of the coverage
which of the following provisions guarantees that premiums will be waived if a juvenile life policy owner becomes disabled
-family maintenance clause
-payor clause
-assignment provision
-automatic premium loan provision
payor clause
what is old age and survivors health insurance (OASDHI) also known as
-medicare
-social security
-medicaid
-FICA
Social secuity
T purchased a 100K single premium straight life annuity 5 years ago. he has received monthly payments since the inception of the annuity. if T dies the insurance company
-does not have to make any further payments
-must make full payments to the beneficiary
-must make half payments to beneficiary
does not have to make any further payments
S recently received a 500K lump sum retirement buyout from her employer. she would like to buy an annuity that will immediately furnish her with a guaranteed income for life. what type of anuity is best suited for her situation
-403B plan
-deferred premium
-single premium
-period certian
single premium
will start providing income payments within the first year
all students attending a large university could be covered by
-a blanket policy
-franchise policy
-jumbo group
-commercial insurance
blanket policy
insurers may request a hearing with _______ if their policy is rejected
20
30
60
90 days
20 days
with optionally renewable health policies the insurer may
-renew the policy only if no claims have been filed the previous year
-renew the policy only with the insureds consent
-review the policy wheneer they please and determine whether or not renew it
-review the policy annually and determine whether or not to renew it
-review the policy annually and determine whether or not to renew it
T owns an accident and health policy and notifies her insurance company that she has chosen a less hazardous occupation. under the change of occupation provision, which of the following actions may her insurance company take
-allow her to take a tax deduction on unearned premiums
-increase her policy coverage amount
-decrease her policy coverage amount
-nothing
increase her policys coverage amount
on Aug 6, D submitted an application for 50K life insurance policy and did not pay the initial premium. on aug 18, D went to his doctor complaining of chest pains, and some tests were given by the doctor. the life policy was delivered by the producer on aug 20 and D explains what had recently taken place with the doctor. what action should the producer then take?
-collect initial premium
-collect the intial premium along with a signed health statment
-explainto the application the policy is no longer in effect due to the change in health condition
-collect the initial premium and leave. a binding receipt
-collect the intial premium along with a signed health statment
which of these factors does not influence an applicant’s need for life insurance
-lifestyle of the applicant
-number of dependents
-self maintenance expenses
-future educational costs of dependents
future educational costs
what type of policy would only provide coverage for specific typees of illnesses
(cancer stroke)
-MEWA
-blanekt insurance
dread disease
disability
dread disease
which of these is not an example of doing insurance business
-selling shares of stock
receiving an insurance application
collecting insurance premium
delivering insurance policy
XYZ company pays the entire premium for its group health plan. the minimum percentage of eligible employees that must be covered is
-25
-50
-75
-100
100
when an employee is required to pay a portion of the premium for an employer/employee group health plan, the employee is covered under which of the following plans
-joint
-noncontributory
-contributory
-participating
contributory
K failed to pay a renewal premium within the time granted by the insurer. K then sends in a payment which the insurer subsequently accepts. which policy provision specifies that coverage may be restored in this situation
-free look
-reinstatment
-grace period
-consideration
reinstatment
what is the initial source of underwriting for an insurance policy
-application containing statements from the insured
-mib report
-credit report
-medical exam
application containing statements from the insured
B an insurance agent tells his clients that their rights may be impaired if they fail to complete a release form within a given period of time. B may be found guilty of
-boycotting
-rebating
-coercion
-discrimination
coercion
which type of provider is known for stressing preventative medical care and routine physical examinations
HMO
PPO
MEWA
Major medical provider
HMO
a primary beneficiary has died before the insured in a life insurance policy. a contingent beneficiary is also named in the policy, which of the following will occur when the insured dies
-proceeds will go to the primary beneficiarys estate
-probate will decide who receives proceeds
-proceeds will go to the contingent beneficiary
-proceeds will to to the insured estate
-proceeds will go to the contingent beneficiary
in order to sell an ________ life policy, a producer is required to register with the financial industry regulatory authority (FINRA)
-variable
-adjustable
-striaght
-term
variable
which of the following statements about health reimbursement arrangements HRA is correct
-if the employee had a qualified medical leave from work, lost wages can be reimbursed
-if the employee paid for qualified medical expenses, the reimbursements may be tax free
-an unused amounts are added to employees gross income
-health insurance premiums can be reimbursed to the employee
-if the employee paid for qualified medical expenses, the reimbursements may be tax free
which of the following statments about health coverage for newborns is not true?
-coverage includes treatment of congenital defects
-coverage continues after the first 31 days upon payment of the first premium
-coverage is limited to only congenital defects
-coverage begins at moment of birth
-coverage is limited to only congenital defects
with whome may an agent legally share commissions
-the insured
-applicant
-beneficiary
-another agent with same line of insurance
-another agent with same line of insurance
The policy provision that entitles the insurer to establish conditions the insured must meet while a claim is pending is
-grace period
physical examination and autopsy
entire contract
time limit on certain defenses
t`ime limit on certain defenses
which of the following statements about the classification of applicants is incorrect
-substandard applicants are never declined by underwriters
-substandard applicants are occasionally declined by underwririters
-preferred risk applicants typically have better premiums rates than standard risk applicants
-applicant can be classified as substandard risk because hazardous job
-substandard applicants are never declined by underwriters
in a life insurance policy which provision states who may select policy options, designate and name a beneficiary, and be the recipient of any financial benefits from the policy
owners rights
which of the following best describes a warranty
statement guaranteed to be true
which premium schedule results in the lowest cost to the policy owner
annual
during a sales presentation for a participating life insurance policy, an agent must
make a prospect understand that dividends are not guaranteed
which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures
commercial
ppo
hmm
admin services only plan
commerical insurer
periodic health claim payments must be made at least
monthly
weekly
daily
annually
monthly
under a long term care policy, which benefit would be typically excluded or limited
intermediate nursing
skilled nursing
home health care
alcohol rehab
alcohol rehab
V is insured under and individual disability income policy with a 30-day elimination period. on july 1 he is involved in an accident and temporarily disabled. he returns to work on December 1. how many months of benefit are payable?
6
5
4
4.5 months
4 months
T is covered by two health insurance plans: a group plan through his employer and his spouses plan as a dependent. under the model group coordination of benefits provision, when T files a claim, his employers plan is considered the:
principal
surplus
primary
secondary
primary
medicare part c is
-government insurance
avialable to those who are enrolled in a medicare supplement plan with income under 12K per year
original part a and b medicare
available to those who are enrolled in medicare part a and b
available to those who are enrolled in medicare part a and b
which of these is not considered to be a right given to a policyowner
-surrendering the policys cash value
-modify a provision in the insurance contract
-assignment of ownership
-change the beneficiary if revocable
-modify a provision in the insurance contract
which of these life products is not considered interest sensitive
-modified whole life
variable universal life
interest sensitive whole life
variable life
modified whole life
which of these actions is taken when a policyowner uses a life insurance policy as collateral for a bank loan
-revocable assignment
-beneficiary change
-irrevocable assignmengt
-collateral assignment
-collateral assignment
the percentage of an individuals primary insurance amount. (PIA) determines the benefits paid in which of the following programs
-SS disability income
medicare supplements
medivaid
cobra
-SS disability income
M’s insurance company denied reinstatement application for her lapsed health insurance policy. the company did not notify M of this denial. how many days from the reinstatement application date does the insurance company have to notify M of the denial before the policy will be automatically placed back in force
-10 days
30 days
45 days
60 days
45 days
an evidence of coverage form may be issued by a health maintenance organization HMO after being approved by the
-attorny general
NAIC
commissioner
National HMO assoc
commissioner
a life insurance application must be signed by all of these except
-the policyowner
the agent
the insured
beneficiary
beneficiary
what type of life policy covers two people and pays upon the death of the last insured?
-shared
-survivorship
-adjustable
-joint
survivorship
who is liable when an insured suffers a loss on a policy sold by an agent through an insurer not authorized to conduct business in texas
-the insured
the agent and the insured
the agent
the commissioner of insurance
the agent
what is considered to be a characteristic of a conditionally renewable health insurance policy
-premiums may increase at time of renewal
premiums may increase at any time
policy may be renewed at the discretion of the insured
policy may be amended by the insurer at an time
-premiums may increase at time of renewal
which of the following consists of an offer, acceptance and consideration
warranty
estoppel
contract
representation
contract
what type of life insurance are credit policies issued as
whole
variable
term
universal
term
if an individual is covered under an accidental death policy and dies, an autopsy can be performed in all these situations except
when the cause of death is unknown
when the state prohibits this by law
when consent for the autopsy is not obtained
when foul play was a contributing factor
when the state prohibits this by law
_______ of continuing education MUST be completed in the classroom or classroom equivalent
20
50
80
100
50%
an insured must notify an insurer of a medical claim within ______days after an accident
10
20
3040
20
an insurer must provide an insured with claim forms within ______days after receiving notice of a loss
5
10
15
20
15
which of the following is an important underwritiing principal of group life insurance
physical examinations are required
everyone must be covered in the group
employer must pay for the entire premium
the group must be formed for the purpose of gettting affordable insurance
everyone must be covered in the group
upon policy delivery, a signed good health statment is requested from the applicant. why would this be necessary?
-the applicant chose an annual premium mode
-the applicant is suspected of making a material misrepresentation
-the initial premium was submited with the application
-the initial premium was not submitted with the app
-the initial premium was not submitted with the app
which of the following is not a required provision in group life policies
-free look
incontestable
conversion
right to loan
right to loan
additional coverage can be added to a whole life policy by adding an
payor rider
accelerated benefit rider
decreasing term rider
automatic premium loan rider
decreasing term rider
a student pilot can pay regular premium costs for her life insurance policy with the addition of which of the following
guaranteed insurability rider
aviation exclusion
impairment rider
accidental death benefit rider
aviation exclusion
ABC insurance company is actively engaging in boycott, coercion, and intimidation that results in the unreasonable restraint of trade. abc is comitting a prohibited act under texas insurance laws covering
twisting
flase advertising
rebating
unfair methods of competition
unfair methods of competition
what should an insured do if the insurer does not send claims forms within the time period set forth in a health policys claims forms provision
-file a lawsuit
submit the claim in any form
wiat for the claim form to arrive
resubmit the request for a claim form
submit the claim in any form
which of these are not an example of nonforfeiture option
extnded term
reduced paid up
cash surrender
life income
life income
whole life policies are guaranteed to provide all the following except
cash value that will ultimately replace the death benefit
nonforfeiture benefit options
fixed premiums
partial withdraw features beyond surrender of charge
partial withdraw features beyond surrender of charge
investment gains from a universa life policy go towards
the cash value
what is considered to be a characteristic of a conditionally renewable health insurance policy
premiums may increase at a time of renewal
premiums may increase at a time of renewal
A Policy that becomes a MEC
will loose many of its tax advantages
will loose many of its tax advantages
free look provision begins
upon receipt of the policy by policyowner
upon receipt of the policy by policyowner
which of these statements concerning an individual disability income policy is true
normally includes an elimination period
normally includes an elimination period
all of these statments about the waiver of premium provision are true except
individual must be eligible for SS disability for claim to be accepted
individual must be eligible for SS disability for claim to be accepted
which of the following statments is true about a acceleerated death benefit
must have a terminal illness to qualify
must have a terminal illness to qualify
who elects the governing body of mutual insurance company
policyholders
policyholders
who owns a stock insurance company
stockholders
stockholders
less hazardous occupation under change of occupation which would the insurance comapny take
increase policy coverage amount
increase policy coverage amount
which of these is not a reason to purchase life insurance on life of a minor
if both parents were to die it would provide death benefit to a child
if both parents were to die it would provide death benefit to a child
when a person returns to work after a period of total disability but cannot earn as much as they did before the disability this situation is called which of the following
residual disability
residual disability
what type of life insurance are credit policies issued as
term
term
What type of insurance includes flexible premiums and an adjustable death benefit
universal life
universal life
pre hospital authorization is considered an example of
managed care
managed care
situation in which a group of physicians are salaried employees and conduct business in a hmo facility is
closed panel
closed panel
