Insurance exam 2.0
Terms in this set (68)
50 or more
One of the differences between group underwriting and individual underwriting is that there is little or no medical information required regarding plan participants in groups of
A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is known as
They can be changed only with the written consent of that beneficiary.
Which of the following statements is most correct concerning the changing of an irrevocable beneficiary
Contracting with insurance companies
. Which of the following is NOT a characteristic or a service of an HMO plan?
Notice Regarding Replacement
. Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in th
To minimize the insured's level of liability in the event of loss
Which of the following is NOT a goal of risk retention?
If a court ordered payment for a loss that was not covered in the policy even if it was clearly worded, it would be an example of which legal concept
Which type of Medicare policy requires insureds to use specific healthcare providers and hospitals (network providers), EXCEPT in emergency
An agent accepts the premium payment 35 days after it is due, telling the insured that there will not be a problem keeping the policy in force. This is an example of what type of agent authority
)If paid by the individual, the premiums are tax deductible.
Which of the following is INCORRECT concerning taxation of disability income benefits
inviting prospective clients to the grand opening of the company's new office
State law specifically prohibits using illegal inducements in the marketing of insurance. All of the following would be considered illegal inducements EXCEPT
which type of a hospital policy pays a fixed amount each day that the insured is in a hospital
The pre-existing condition waiting period fulfilled in the old policy will be transferred to the new policy, the new one picking up where the old one left off.
An individual purchased a Medicare supplement policy in March and decided to replace it 2 months later. His history of coronary artery disease is considered a pre-existing condition. Which of the following is true
An insured must notify the insurer of a claim on forms prescribed by the insurer.
.Which of the following is NOT true regarding uniform mandatory provisions concerning claims
A statement that is sufficiently clear to identify the insured and the nature of the claim
. Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
. For how many days of skilled nursing facility care will Medicare pay benefits
The appointing insurer
. Who is responsible for paying producer appointment fees
Benefits are considered taxable income to the business
.All of the following are true of the Key Person disability income policy EXCEPT
. Which of the following entities must approve all continuing education courses in this state
Which of the following persons is required to hold a producer license?
A person who negotiates insurance contracts
When an insurer combines two periods of disability into one, the insured must have suffered
Having all employees complete continuing education courses once every 2 years
. All of the following are licensing requirements for a business entity, EXCEPTa
)To cover the expenses of retraining the insured to return to work
What is the purpose of the rehabilitation benefit in disability insurance
The expense for an autopsy covered under the physical exam and autopsy provision is paid by
An insured has a primary group health plan and an excess plan, each covering losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any copayments or deductibles, how much will the excess plan pay
. In major medical insurance policies, when the insured's share of coinsurance reaches a certain amount, the insured is no longer obligated to pay it. This feature is known as
What is the initial period of time specified in a disability income policy that must pass, after the policy is in force, before a loss can be covered?
Outline of Coverage
Which document helps ensure that full and fair disclosure is provided to the recipient of a policy?
Employer health plans must provide primary coverage for individuals with end-stage renal disease before Medicare becomes primary for how many months
Respond to the consumer's complaint.
Under the Fair Credit Reporting Act, if the consumer challenges the accuracy of the information contained in his or her report, the reporting agency must
Group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense
As it pertains to group health insurance, COBRA stipulates that
. According to the Time Limit on Certain Defenses provision, the insurer cannot void the policy for any misstatements on the application (except for fraud) if the policy was in force for what time period
Issue age policy premiums increase in response to which of the following factors
66 and 2/3
. If an employer provides long-term group disability insurance for its employees, what percentage of monthly wages are lower-paid employees eligible to collect
Visits by a registered nurse
What types of services may NOT be provided under the long-term care's assisted living care?
Under the Affordable Care Act, a special enrollment period allows an individual to enroll in a qualified health plan within how many days of a qualifying event
24 credit hours
Prior to license renewal, all insurance producers must successfully complete a minimum of
Low maximum limits
All of the following are characteristics of a Major Medical Expense policy EXCEPT
What is the duration of the free-look period for Medicare supplement policies?
To be eligible under HIPAA regulations, for how long should an individual converting to an individual health plan have been covered under the previous group plan?
Excessive benefits may be taxable.
Which of the following statements is correct concerning taxation of long-term care insurance?
Imprison the licensee.
After a hearing, if the Commissioner finds that a licensee is in violation of the state insurance laws, the Commissioner can do any of the following EXCEPT
The insured must be unable to perform some activities of daily living.
What is necessary in order to be eligible to receive benefits from a long-term care policy?
A nursing home or one's own homed
Where would Long-term care services be rendered
Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many
Which of the following does a producer NOT have the authority to do
Which type of dental care would cover the cost of fillings
The Medicare supplement renewal commissions paid in the third year must be as high as the commission of which year?
Any licensed person whose activities affect interstate commerce and who knowingly makes false material statements related to the business of insurance may be imprisoned for up toa
How long is an open enrollment period for Medicare supplement policies
errors and omission
. Why is it essential for an insurer to document all correspondence with an insured
Disputes regarding consumer report information.
According to the Fair Credit Reporting Act, all of the following would be considered negative information about a consumer EXCEPT
Benefits received that are attributable to employer contributions are fully taxable to the employee as income.
owns a medical expense policy that he purchased for his family. John's employer purchased a Group Disability Income policy for John and all eligible employees. John subsequently suffered an accident on the job that left him unable to work for four months. If John receives benefits from his disability income policy, which of the following would be true?
8 am to 9 pm
According to the telemarketing sales rules, what are the permissible calling hours for telemarketing calls?
In an institutional setting
In which of the following locations would skilled care most likely be provided?
Which of the following insurance options would be considered a risk-sharing arrangement?
All of the following are examples of risk retention EXCEPT
The most the Insurance Guaranty Association will pay for net cash surrender values is
Disability insurance can be written as occupational or nonoccupational.
Which of the following statements about occupational vs. nonoccupational coverage is TRUE?
In disability income insurance, another name for the waiting period is the
Benefits are considered taxable income to the business.
Which of the following is not true of Disability Buy-Sell coverage?
failing to report to the department a criminal prosecution taken against the agent in another jurisdiction.
All of the following violations may result in an agent's imprisonment EXCEPT
When the premium is paid at the time of the application
When is the insurability conditional receipt given?
Protect private customer information filed with a financial institution.
the Gramm-Leach-Bliley Act was passed to
at least 4 years
For how long must a company maintain a complete file of all advertisements used?
Relief for a major care giver
What type of care is Respite care?
In an individual long-term care insurance plan, the insured is able to deduct the premiums from taxes. What income taxation will be imposed on the benefits received?
payment of premium
With respect to the Consideration Clause, which of the following would be considered consideration on the part of the applicant for insurance?