Texas Life And Health Flashcards
An advertisement is required to accurately represent all insurance providers (3)
Assets
Corporate structure
Financial standing
Group health insurance is characterized by all…
Master contract
Lower administration cost
Conversion privilege
Group health insurance underwriting avoids
Adverse selection
If a life policy allows the policy owner to make periodic additions to the face amount, at standard rates without proving insurability , it includes
Guaranteed insurability rider
nonforfeiture option with the highest amount of insurance protection is
Extended term
Which disability policy provisions describes certain conditions, such as total and permanent blindness or dismemberment, that automatically qualifies the insured for full disability benefits
Presumptive disability
What are the 3 dividend options
Accumulated interest
Reduction of premium
Paid up addition
Who assumes all the risk regarding variable annuities
Annuitant - invested with the insured on a separate account
With medical claims which provision states the provider must pay medical expense claims immediately
Time of payment claims
HMO that have a contract with outside physicians to deliver services to their subscribers pay those providers on a
Capitation basis
The 3 nonforfeiture options are
Shortened benefit period
Reduced paid up
Extended term
Which provision states the insurance providers right to change the premium amounts
Continuation provision
You can discriminate on an insureds
Lifestyles and habits
Decreasing term policies have a ——premium
Level premium
Decreasing term policies death benefit———- every year
Decreases (loans)
3 qualities of equity indexed annuities
Have guaranteed minimum rate of interest
Invest more aggressively to aim for higher returns
Index with the poors 500
In life insurance the death benefit proceeds must be paid with ——
2 month
Two components of a universal policy is
Insurance and cash account
What hospital policy pays specific amount per day the insured is in the hospital
Indemnity
A heart surgeon has an accident & develops tremors In his Right arm, which definition of total disability will cover him under his disability income policy
Own occupation
And is less restrictive than other definitions
In a disability income policy what is the name of the time after a policy is in force before claims are covered
Probationary
A lady buys 25k in life ins while this is lol she can afford at this time she wants additional coverage in the future. What options does she need
Guaranteed insurability option
Practicing providers are compensated on a fee for service basis under which organization
PPO
Under AD & D policy what benefit will pay the beneficiary in the event the accidental death of the insured
Principle sum
A provision of life ins policy states the ins providers duty to pay benefits upon the insureds death and to whom benefits will be paid
Insuring clause
Dividends in a paid up addition option is used to
Purchase a smaller amount of insurance as the original policy
Which group coverage has to be extended to terminated employees up to a certain period of time and the former employees expense
Cobra
Two things that equity indexed annuities do
Seek higher returns and uses the minimum rate of the poors 500
Which nonforfeiture option delivers coverage for the longest period of time
Reduced paid up
Which entities has the authorization to revise or make changes to an insurance policy
Insurer’s executive officer
Whose written consent does the insurer’s executive officer need to revise an ins policy
Insured
What is the annuity period
The length of time during which accumulated money is converted into income payments
What are the two mandatory provisions required by law for health insurance policies
Physical examination and autopsy
Which product has a securities license requirement
Variable annuity
You must have your securities license and life ins license to sell what annuity
Variable annuities
What is the purpose of managed care health insurance plans
To control health insurance claim expenses
Stmt that accurately describes group disability income , percent of payment to the insured
The extent of benefit is settled upon by the insured income
Usually 60%
When is the limited - pay life policy paid up at what age
age 65
Limited pay while life policies are all paid up by the insured turns
65
What policy components includes the insurer’s promise to pay
Insuring clause
Name 3 groups that have insurability interest
Self , family members and key employees (people)
Do debtors have insurance interest (loans)
No - only people
Self, family member and key person from employers
Who needs a certificate of authority
HMO
Total Amount payable per point in a relative value system of determining coverage for a given procedure
Conversion factor
What happens to the face amount of the policy when a reduced paid up nonforfeiture option is chosen
It’s lowered to the amount of what the cash value would purchase a single premium
Survivorship life policy premium compared with joint life ins policy premium would be —-
Lower
Survivorship pays the last death
I’m relations of earning to IPS provision, ins comp limits the insured benefits to their average income over the last ——
24 months
Premium for exercising the guaranteed insurability rider is based upon the policy owners
Attained age
Under life insurance policy, upon submission of a death claim, when must the insurance provider pay the policy benefit
Within 2 months
An insured wants to name his wife the beneficiary, he also wants to retain all the rights of ownership, what type of beneficiary if this
Revocable
A producer must receive ———- in order to sell variable life ins policies
FINRA registration
Medicaid is funded by who
Both federal and state funds
A corporation is the owner and beneficiary of a key person life ins policy, if the company receives the policy benefit then the benefit is received
Tax free
Who has to obtain a certificate of authority
The HMO
The commissioner has to give the certificate of authority to the
HMO
A sales rep intentionally make a misleading statement to the applicant, this describes
Misrepresentation
An insured committed suicide one year after the policy was issued. The insurer will receive
A refund of the premiums paid
Cobra applies to employers with at least —— employees
20
I’m an annuity during which time period is accumulated money converted into a steam of income
Annuitization period
What describes the specified amount beyond which the insured no longer has to participate in the sharing of exspenses
Stop loss limit
Which Medicare supplement policies include core benefits
All plans
An agent selling variable annuities is required to be registered with
Firna
Under accident death and dismemberment policy, the death benefit is paid if the accident death takes place with in —— days of the accident
90 days
Where is the renewed provision in an LTC contract
On the first page
What is the purpose of an agent providing a conditional receipt to an applicant
Its provided by the agent only if the applicant prepaid all premiums in advance of the policy issue
An insured had multiple surgeries during the summer, his ins provider no longer bills him for medical expenses. What’s this called
Stop loss limit
A husband & wife both incur medical expenses that are credited to a single major medical ins deductible, what type of policy do they have
Family - 2 or more people
Rob is trying to get the lowest premium on a coinsurance policy, which should he get 90/10 or 50/50
90/10
How many pints of blood does a Medicare supplement core benefit pay
The first 3
Am HMO subscriber no longer meets plan eligibility requirements, when can the ins provider cancel coverage
Immediately
Can a person who belongs to a POS plan use an out of network physician
Yes
What’s the advantage of reinstating a lapsed policy instead of applying for a new one
The original age is used for determining the premium
The life settlement broker represents whom in a life settlement contract
The owner
Most policies will pay accident death benefits as long as the death is caused by the accident and takes place within —- days
90
Who is responsible for bearing all the investment risk in a fixed annuity
The insurance company
An applicant for a license must include info about their place of business for a minimum of —— years
5
The section of health ins policy that specifies the causes of eligible loss under which an insured is assumed to be disabled is the
Insuring clause
What are the two types of assignment
Absolute and collateral
Polices provision which prevents the insured from bringing any legal action against the insurer for at least 60 days after proof of loss is known
Legal action
Which of the following terms describes making false stmts about the financial conditions of any ins provider that are intended to injure any individual engaged in the business of insurance
defamation
An insured stated on application for life ins he never had a heart attack and in fact he did, claim was denied due to
Material misrepresentation
An insured bought an ins policy 5 yes ago, last year he received a dividend check, this yr he didn’t, what type of ins provider did he purchase
Mutual
In a replacement situation the producer must compare the benefits, limitations & exclusions on which policy
The current and proposed replacement policy
