Life Health Accident Practice Exam
Oct 18, 2017 Life and Health. Mandated Health Benefits; Exhibit A - Exclusions, Reductions and Limitations for Individual Health Provisions (.pdf format) HIV Consent Form; Federal HIPAA Information; Filings Intake. List of Form Filing Fees; Transmittal Checklist for Life/Health Rate and Form Filings; Transmittal Checklist for Life/Health Miscellaneous Documents. Life and Health Insurance License The Basics What Is A Life And Health License?Earning your life and health insurance license is your first step to selling life and/or health insurance in your respective state as an insurance agent.The license is granted upon the successful passing of your specific state's exam. Jan 16, 2018 Use this Life and Health Insurance License Test Prep video to get a head-start on your Insurance Exam. Our original research into the Life and Health Insurance License Exam, offered by the state.
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Life is so precious and beautiful but so limited too. Health is a primary key for a fair and peaceful life. Sometimes, there come unwanted situations in life when our health is compromised, so, you must have prior knowledge to health and protection schemes which are directly related to your finance. Take this quiz and test your understanding of life and health insurance policies.
Life is so precious and beautiful but so limited too. Health is a primary key for a fair and peaceful life. Sometimes, there come unwanted situations in life when our health is compromised, so, you must have prior knowledge to health and protection schemes which are directly related to your finance. Take this quiz and test your understanding of life and health insurance policies.
Accident And Health Study Guide
- A.
Pays benefits only if it turns out the insured is eligible for benefits from social insurance
Pays a benefit if the insured is injured on the job and qualifies for workers compensation benefits
Provides a payment only when the insured is totally disabled, but not receiving any social insurance benefit plans
Provides for a bonus payment that will match social security disability income benefits, if they are paid
- A.
- B.
- C.
- D.
- 3.
- A.
- B.
- C.
- D.
- 4.
- A.
Select a provider and submit claims to the insurance company
Select a provider at work and claims processor
Pre-select a physician and third-party claims administrator
Pre-select a clinic and submit claims to the insurance company
- A.
An irrevocable beneficiary may be changed by the policy owner without the beneficiary's consent
An irrevocable beneficiary has a vested right that neither the policy owner nor his creditors can impair without the beneficiary's consent
A revocable beneficiary can become the policy owner at any time by paying the premiums
An irrevocable beneficiary has the right to name a contingent beneficiary for the policy
- A.
A hearing by the insurance commissioner to determine the severity of the the misrepresentation and to determine an appropriate course of action
None, if the policy has been in force for ove 12 months
Rescission of the policy
A hearing by a court of law to determine an appropriate course of action an insurer may take
- A.
- B.
- C.
- D.
- 8.
- A.
The election is made by the policy owner at the time the application is submitted
When no settlement option is chosen, the proceeds are automatically paid to the policy owner's state
The policy owner may change the settlement option after it has been chosen
The election may be made by the beneficiary if no settlement option is in force at the time of death of the insured.
- A.
To provide health insurance benefits to key employees
To give a key employee the ability to purchase the business
To give retirement benefits to key employees
To cover decreased business earnings due to the death of a key employee
- A.
- B.
As long as it was not insurance related, the application will be granted
Approve only after a review by a panel of insurance professionals
Deny the application without a hearing
- A.
- B.
- C.
- D.
- 12.
- A.
None, due to the fact that the concealment was unintentional
$250 fine to be paid to the injured party
Possible imprisonment to the party who concealed the information
Rescission of the contract
- Loss retention is an effective risk management technique when all of the following conditions exist except
The probability of loss is unknown
The losses are highly predictable
The insured chooses to assume the losses involved
The worst possible loss is not serious
- A.
- B.
- C.
Reserves the right to change the premiums, but may not change any of its terms
May not renew the policy if the insured ceases to comply with certain conditions such as continued employment
- A.
- B.
- C.
- D.
- 16.
- A.
Insurers may offer only broad coverage plans that contain both core benefits and additional benefits
Insurers may freely offer whatever supplemental coverages they prefer to market
Insurers may offer policies that contain only the core benefits
Insurers may create insurance policies for approval by the CA Department of Insurance
- The guaranteed insurability option provides the ability to:
Waive premium payments in the event of disability
Access a portion of the death benefit in the event of serious illness
Double the amount of the death benefit in the event of accidental death
Purchase additional insurance regardless of insurability
- Which type of insurance guarantees the right to renew thepolicy each year, regardless of health but at an increased premium
Convertible term
Level term
Decreasing term
Renewable term
- A.
Employees no longer had any legal means of obtaining reimbursement for work injuries
Employees would have to sue their employers to obtain reimbursement for work injuries
Employers would be held responsible for the cost of their employee's work injuries regardless of fault
Employers were no longer responsible for work injuries to employees
- A.
RW and Associates who represent BLG Insurance Corporation
RW and Associates underwriting for BLG Insurance Corporation
RW and Associates placing business through BLG Insurance Corporation
RW and Associates using the services of BLG Insurance Corporation
- The probationary period in a group health policy is intended for people
Who joined the group after the policy effective date
Without health coverage after a qualifying event who declined to join the group at the time of eligibility
With a pre-existing condition when they joined the group
- Which provision will pay a portion of the death benefit prior to the insured's death due to a serious illness
Waiver of premium
Accelerated death benefit
Cost of living
Disability Income
- An individual with a low income and high insurance needs should buy
Whole life insurance
Universal life insurance
Endowment insurance
Term insurance
- A.
An agent's supervisor who takes part of his commission
An employee who handles self-insurance claims
An employee who is responsible for evaluating for relative quality of competing group health and welfare benefits offered to his employer by insurers
An outside organization that processes claims for an employers self-funded plans
- A form of rest or relief offered to family members who are caring for a person who requires continual care is
Hospice care
Hospital care
Respite care
Intermediate care
- A.
They receive remaining payments to be made under a settlement agreement upon the primary beneficiary's death
The contingent beneficiary shares death proceeds equally with the primary beneficiary
They receive the death proceeds if the primary beneficiary is deceased at the time of the insured's death
More than one contingent beneficiary may be named
- A.
The insurer will make the payments until the insured juvenile reaches the specified age
The insurer will lend money to keep the policy in force
The insured's estate will make the premium payments
The insurer will make all the of the policy payments
- A.
- B.
- C.
- D.
- 29.
- A.
The policy face amounts are usually more than $1,000,000
The policy face amount is paid out only upon the death of the first insured to die
It offers premiums that are quite low compared to what is charged on separate policies
It is particularly well suited to meet the needs of estate taxes
- If an insurer is not able to meet financial obligations when due, the insurer would be considered
Insolvent
Unauthorized
Impaired
Non-admitted
- A.
- B.
- C.
Authorize the agent with a certificate of convenience
Request a certificate of authority be issued immediately
- A.
The own-occupation definition used by the Social Security Administration
The typical definition of partial disabiity used by disability income policies
The total disability definition used by the Social Security Administration
The typical definition of temporary disability used by disability income polices
- People commonly purchase an annuity to protect against the rist of
Dying before their home mortgage is paid off
Becoming uninsurable
Outliving their financial resources
Dying too soon
- In the event of an accidental death, the principal sum in a disability policy will be paid
Over the course of a set period
On a sliding schedule
In one lump sum
As a monthly indemnity
- Which of the following statements about the HICAP program is false ?HICAP
Stands for Health Insurance Counseling Advocacy Program
Serves people needing information about Medicare
Does not sell or endorse any specific types of insurance
Provides assistance for a fee based upon ability to pay
- A.
The greater the number insured, the more premium is collected to offset fixed costs
The insurer increases its market share with every insured
The greater the number insured, the greater the amount of premiums collected to help cover losses
The greater the number insured, the more accurately the insurer can predict losses and set appropriate premiums
- A.
- B.
- C.
- D.
- 38.A measure for rating an individual's need for LTC benefits is called:
Case management
Activities of daily living
The gatekeeper mechanism
Co-insurance
- A.
- B.
- C.
- D.
- 40.Which of the following are commonly covered by medical expense policies ?
Elective cosmetic surgeries
Pre-existing conditions
Expenses covered by a workers compensation policy
Accidental injuries
- A.
The insured's payment for healthcare that is not considered a covered expense
The cost of a covered expense minus the office co-payment
The portion of insurance premium paid for coverage by the insured
The amount of covered expense that the insured pays before the insurer pays
- A.
- B.
- C.
- D.
- 43.Which of the following expenses is never covered by a LTC insurance policy ?
Home health care
Adult day care
Hospital acute care unit
Alzheimer's disease
- Which of the following is a hazard ?
A large number of similar exposure units
A peril
A condition that might increase the likelihoold of a loss occurring
A speculative risk
- A.
An indemnity to the insured for all expenses incurrred when the insured is confined to a hospital
The daily benefit coverage amount stated in the policy for each day the insured is confined in the hospital
100% of the covered medical expenses less the deductible and co-insurance percentage
The amount of the actual hospital expenses
- A.
The agent will be able to operate if a receipt for payment is returned prior to the license expiration date
The agent will be able to operate for up to 60 days after the specified expiration date
The agent will be able to operate if the agent goes in person to the insurance department to receive a temporary extension of the license
The agent will be able to continue to operate after a 30 day extension to operate without receipt if requested and approved
- A provision stating that health insured's and their insurers will share covered losses in an agreed proportion is called
The stop-loss provision
Comprehensive insurance
Percentage insuring
Co-insurance
- Common life insurance policy riders include all of the following, except:
Extended term
Guaranteed insurability
Accidental death
Waiver of premium
- Term insurance is typically characterized by
Low premiums and high cash value
High premiums and no cash value
High premiums and high cash value
Low premiums and no cash value
- A.
The policy owner begins to receive $200 monthly payments from the insurer that will continue for life
The policy is surrendered and the policy owner is paid $10,000 by the insurer
The cash value is used to purchase a $50,000 term policy that is paid-up for 10 years
The cash value is used to purchase a $20,000 paid-up policy
- What would we call a representation which fails to correspond with its stipulations or assertions ?
Fatal
Fraud
Frivolous
False
- A.
- B.
Providing free insurance coverage in connection with the sale of services as an inducement for completing the transaction is not legal
Life and health ratings may not be related to the age of the insured
A life solicitor's license has the same licensing requirements as a life agent's license
- A.
Subtract from mortality and general expense charges
Add the current interest
Substract the policy surrender charges
Add the current premium paid
- A.
- B.
- C.
- D.
- 55.Which of the following requires a reporting company to respond to a consumer's complaint that his file contains inaccurate information about them
Unfair Practices Act
Fair Credit Reporting Act
COBRA
Medical Information Act
- A.
- B.
- C.
- D.
- 57.
- A.
Benefits are based on the level of a worker's earnings up to the time of the disability
Benefits will continue only while the worker cannot work at all
Benefits are designed to replace the entire amount of a worker's earnings
Workers must be totally and permanently disabled for at least five months to be eligible for benefits
- Under COBRA, a qualifying event ensures that an employee who loses coverage can
Transfer coverage to another group
Convert to an individual policy
Elect to continue coverage
Request a waiver of premium
- Under social security, the definition of disability is the inability to engage in
An approved occupation
An activity with a given level of compensation
Any substantial gainful activity
The person's chosen career
- A.
In 1990, the average annual cost for a nursing care home was approximately $10,000 per year
The need for LTC coverage can arise only after age 50
Medi-Cal is one of the most commonly sold LTC policies. It is designed to protect the assets of middle-class californians
The very poor and the very rich probably do not need LTC coverage
- A.
The program provides only a minimum floor of income. Individuals are expected to supplement this with their own personal programs.
The actuarial value of each person's contributions are closely related to the actuarial value of each person's benefits
With only a few exceptions, this is a voluntary program
The program is fully funded
- The insured's policy has deductible that is applied between the exhaustion of basic plan limits and the commencement of excess coverage. This is called a:
Family deductible
Per cause deductible
Corridor deductible
Stop-loss limit
- What makes up the entire contract in a life insurance policy ?
The policy, and when attached, the application
The policy, and any sales literature presented by the agent of the policy holder
The policy, the application, and any verbal understandings
The policy by itself, but never the applicatin
- Each of the following terms is an important characteristic of a major medical policy, except
Deductible
Co-insurance
Maximum amounts
Capitation
- In California, the minimum participation requirement for a contributory large group health insurance plan is
50% of eligible employees
25% of eligible employees
75% of eligible employees
40% of eligible employees
- A.
Group life insurance is offered only to employees who provide evidence of insurability
The initial premium for term insurance is lower than the initial premium for whole life insurance
Limited payment whole life policies stay in effect only for as long as the premium is paid
Universal life policies have a structured premium payment schedule that must be followed during the entire contract period
- During the disability elimination period
Residual benefits are payable
Occupational claims are payable
No benefits are payable
All claims are payable
- A provision stating that the insured and the insurer will share covered losses in an agreed proportion is called
Percentage sharing
Co-insurance
Stop-loss provision
Comprehensive insurance
- While an insurer is paying the premium for a life insurance policy under the waiver of premium rider
The insurer is named as the primary beneficiary
The cash value does not increase
The dividend payments cease
The policy remains in full force in every respect
- A.
- B.
- C.
- D.
- 71.According to the CA Insurance Code, all insurers must maintain a department to investigate:
Possible abuses of rating laws
Possible arson
Possible fraudulent claims from insureds
Possible abuses of fiduciary responsibilities
- Which of the following is a type of deductible that charges the insured after basic medical benefits have been paid and before other medical coverage begins?
Out-of-pocket limit
Calendar deductible
Carry-over provision
Corridor deductible
- Which of these statements concerning Medicare is not true ?
Part A provides hospital care
Part B provides doctors and physicians services
Part C provides long-term care benefits
It is part of the Social Security program
- A.
- B.
It is paid entirely by FICA (social security) payroll taxes
An individual must sign a form rejecting Part B or they will be enrolled in it
It provides some coverage and benefits for most medical expenses not covered by Part A
- A.
A person who has been entitled to Social Security disability benefits for 24 months
A person who has reached 65, is willing to pay a premium but is not eligible for Social Security,
A person who has reached 65 and is eligible for Social Security.
All the above are eligible
- Hospice care provides services to patients who are:
In a hospital and expected to recover
Terminally ill
Receiving respite care through Medicare
None of the above
- In the Medicare system, the services provided by doctors and surgeons are covered by: 1. Part A2. Part B 3. There is no charge for coverage4. there is a charge for coverage
1 and 3
1 and 4
2 and 3
2 and 4
- A.
- B.
- 79.
- A.
They are required to issue all policies on either a guaranteed renewable or non-cancelable basis
If the policy has been is force for at least 6 months, the insurer is prohibited from excluding any preexisting conditions.
The insurers are prohibited from any exclusion for all preexisting conditions
- A.
- B.
- C.
Offer core plans as a stand-alone or offer core plans along with broader plans
Both A and B are not allowed
- Medicare covers which of the following in order to provide long-term care for elderly:
Very broad and substantial intermediate care benefits
A wide range of custodial care coverage
Very limited nursing home coverage
Medicare provides none of the above
- A.
Those who are very rich or very poor probably are not in need of long term care coverage
The annual cost of nursing home care was about $10,000 in 1990
One of the best-structured plans for long term care for those in the middle class is Medi-Cal
The need for long term care insurance begins only at middle age.
- There is a type of benefit that pays for the cost of relief given to the caregiver of a person who requires constant care and supervision. What is this type of care called ?
Custodial Care
Hospice care
Intermediate relief care
Respite care
- A.
- B.
As a part of a comprehensive homeowner umbrella policy
As part of a life insurance policy through the use of an endorsement
- Pick from the following choices the features of a long-term care policy that would have the highest premium. 1. Long benefit period2. Short benefit period3. Long elimination period4. Short elimination period
1 and 3
2 and 3
1 and 4
2 and 4
- Which of the following categories of benefits are not covered in a long-term care policy ?
Home care benefits
Custodial care benefits
Acute care coverage in a hospital
Community based care benefits
- Any long-term care policy sold in California must provide for certain benefits. Select the most correct answer describing these benefits from the choices below.
Home care only
Medicare supplement
Institutional care only
Institutional care and home care
- Long-term care policies that deliver benefits for community based or home care services must include which of the following: 1. Respite care2 Hospice Care3. Home health care services
1 and 3
1 and 2
1,2 and 3
None of the above
- A.
They can exclude degenerative conditions like Alzheimer's
They may require hospital stays of certain lengths be satisfied before benefits are provided
'Inflation guard' is a non-legal provision in LTC policies
All the above are false
- A.
- B.
- 91.When Workers compensation laws became mandatory, it meant:
HMOs were required to provide medical services to all employees
Employers could use common law defenses more to their advantage
Employers were financially responsible for employees on-the-job injuries, regardless of fault
Employees were required to provide employers fault to file legal action
- Who pays the premiums for a Workers Compensation policy for a retail store ?
Equally divided between the employees and the storeowner.
Because of the occupation classification, it is paid entirely by the employees.
It is always paid entirely by the employer
Retail stores are excluded from statutory workers compensation laws
- Mike drives a truck for a delivery company. In the course of making a delivery he is involved in a serious accident, and is taken to the hospital. The hospital and doctors bills will be paid by:
The company workers compensation policy
Medi-Cal, assuming he qualifies for coverage
Mike's private auto insurance policy
None of the above
- Benefits will be paid from a Worker's Compensation Subsequent Injury Fund only if both the first and second injury are the result of an on-the-job accident
True
False
- The Worker's compensation portion (Part I) of the Worker's Compensation policy covers payments the employer (insured) must pay:
Under Worker's compensation law
To bring the work environment up to state safety codes.
To cover common law exposures
To coordinate with HMO coverage
- 'The seamless delivery of medical and indemnity for both occupational and non-occupational injuries and illnesses' is the definition of:
Worker's compensation
24-hour coverage
All disability policies
- In California after January 1, 2002, the definition of health insurance includes all of the following types of coverages, except:
Group medical coverage
Accidental death and dismemberment coverage
Individual hospital coverage
Individual surgical benefits
- A group health plan third party administrator might do any of the following, except:
Receive employee payments
Pay policy owner premiums
Track insured eligibility
Handle member complaints
- Unintentional concealment entitles the injured party to which course of action ?
Possible imprisonment to the party who concealed the information
$250 fine to be paid to the injured party https://dorsaisatint1985.mystrikingly.com/blog/add-a-blog-post-title.
None, given the fact that the concealment was unintentional
Rescission of the contract
- When may a representation be withdrawn ?
Only before the insurance is in effect
At any time as long as both parties agree
It can never be withdrawn
Only after the policy is in effect
- A significant benefit to the insured in group underwriting verses individual is
There are no enrollment restrictions
Previous claims are not a consideration
The cost of coverage is lower
Members are eligible for the entire contract period
- What kind of insurance pays medical benefits only in the event the insured suffers from one stipulated disease ?
Critical illness
Group medical expense
Specified disease
Individual medical expense
- A.
- B.
- C.
- D.
- 104.
- A.
To protect the interests of life insurers and their agents
To establish penalties for failure to comply with replacement requirements
To assure the purchaser receives information to make an informed decision
To reduce the opportunity for misrepresentation and incomplete disclosures
- A.
Charging a higher rate based upon the information given on the insurance application
Failure of the agent to submit the application to an insurance company
Declination of insurance coverage
Termination of insurance coverage
- A.
A provision that provides medical coverage for the surgical expense of donating a body organ
A provision that considers the insured to be disabled if donating a body organ.
A provision that covers hospital expenses following the donation of a body organ
A provision that extends coverage for rehabilitation after the donation of a body organ
- In order to obtain group insurance without providing evidence of insurability, what do eligible individuals generally have to do ?
Submit an attending physician's statement with their group enrollment cards
Pay the first year premium in advance
Nothing
Enroll within a specified eligibility period
- What is the purpose of the rehabilitation provision in a disability income policy ?
To provide increases in disability benefits to keep pace with inflation
To compensate insured's who lose their sight in both eyes
To encourage disabled insureds to return to their original occupations
To pay a portion of a workers pre-disability income when the insured returns to work
- An agent who acts as an insurance agent, broker, solicitor, life agent, or bail agent, acts in which capacity when handling premiums or return premiums for an insured ?
Natural person
Fiduciary
Legal representative
Managing general agent
- A measure of rating an individual's need for long term care benefits is called
Activities of daily living
The gatekeeper mechanism
Case management
Coinsurance
- In order to determine the amount of premium an insured will pay, the insurer multiplies the rate by:
The number of insureds on the policy
The number of exposure units
The expense factor
The premium adjustment factor
- Viatical settlements are accomplished through the use of
Non-forfeiture provisions
Settlement options
Collateral assignment
Absolute assignment
- A.
- B.
They can terminate making premium payments until the claim is resolved
They can ask a Medicare carrier to review the decision
They can ask for a second opinion by the state medical examiner
- What is the tax treatment for individual disability income policies
Non-deductible premiums and tax-free benefits
Non-deductible premiums and taxable benefits
Deductible premiums and taxable benefits
Deductible premiums and tax-free benefits
- The conversion privilege allows a person to change coverage from
A life insurance policy to an annuity
A group policy to an individual policy
An individual policy to a group policy
An annuity to a life insurance policy
- A.
Employer contributions are taxable to employees in the year they are contributed
Investment earnings are exempt from income tax until distributed
Employer contributions are deductible from corporate income taxation
Employer contributions are taxable to employees in the years they are received as benefits
- What provision prevents a family from receiving benefits from two separate group policies with the same medical expense ?
Assignment of benefits
Conversion of benefits
Extension of benefits
Coordination of benefits
- Self-funding of employee benefit plans cannot be used for
Short-term disability benefits
Health benefits
Death benefits
Hospital benefits
- Which of the following coverages is NOT one of the three traditional benefits of a group basic medical expense plan ?
Surgical expense
Private nursing expense
Physicians visit expense
Hospital expense
- A.
- B.
- C.
- D.
Decreases the length of time that premiums are payable
- What is the written instrument called in which the insurance contract is set forth ?
The provisions
The warrantees
The policy
The risk
- Which non-forfeiture option uses cash surrender values to purchase paid-up term insurance for the full face amount of the policy ?
Extended paid-up insurance
Extended term insurance
Reduced term insurance
Reduced paid-up insurance
- A.
- B.
- C.
- D.
- 124.
- A.
All correspondence between the agent and the policy holder
Printed material in general use which has been distributed by the insurer
A copy of the outline of coverage
All policies sold by the agent
- A worker dies while he is credited with six quarters of the last 13 quarter period. What status does the worker have under social security ?
Partially insured
Disability insured
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Currently insured
Fully insured
- A.
Returns insurance premiums if the insured surrenders the policy at any time after the third policy year
Waives the policy premium while the inured is totally disabled
Provides for the periodic return of a percentage of the premiums that have been paid if the insured becomes and remains disabled
Permits the policy owner to receive a full refund of premium if the policy is returned during the first 90 days after deliver
- An agent's appointment with an insurer will be discontinued if all of the following circumstances exist, except:
The agent quits working for the insurer
The insurer files a notice to terminate the appointment
Another insurer submits an employment application
The agent's insurance license expires
- Social Security provides protection against the financial consequences of all of the following, except:
Premature death
Disability
Poor investments
Retirement
- Which retirement plan utilizes non-deductible contributions?
Simplified employee pension plan
Roth IRAs
Profit-sharing plan
Tax-sheltered annuity
- Wellness benefits under a Health Maintenance Organization (HMO) typically include all of the following, except:
Routine physicals
Immunizations
Flouride treatments
Vision checks
- A.
An insured suffers a financial loss in the state lottery
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A guest is injured by a fall from the insured's deck
An insured is sued for unintentional slander of another person
An insured is admitted to the hospital for delivery of a newborn
- The social security normal retirement age depends upon
The number of quarters of coverage
The number of years of employment
The worker's year of birth
The worker's average annual earnings
- The complete ransfer by the existing owner of all rights in an insurance policy to another person is
Absolute assignment
Endowment
Collateral assignment
Non-forfeiture
- Which retirement plan was designed for employees of public school systems ?
TSA
IRA
401(K)
Keogh
- Which settlement option allows only the death benefit earnings to be paid to the beneficiary
Interest option
Cash option
Fixed period option
Fixed amount option
- A.
A worker's medical plan includes a carryover deductible provision
A person working for two employers has health insurance through both
Spouses are both employed and eligible for group medical benefits
An executive has additional coverage through an association policy
- A.
There is an additional premium for the additional coverage
No evidence of insurability is required for the annual increases in coverage
The insured receives an automatic increase in the policy's death benefit when there is an increase in the cost of living index
The face value of the policy raises or lowers as the cost of living index increases or decreases
- The social security blackout period ends when the surviving spouse reaches the age of
55
60
62
65
- A.
- B.
- C.
- D.
- 140.In which plans do employers make specific contributions to an employee's retirement account?
Defined contribution plans
Individual retirement accounts
Defined benefit plans
Keogh plans
- Traditional comprehensive major medical plans include all of the following, except:
Deductibles
Out-of-pocket maximums
First-dollar coverage
Coinsurance
- In a 7 year vesting schedule, what percentage of employer contributions must be vested after 7 years of service ?
40%
60%
80%
100%
- A representation in an insurance contract qualifies as which of the following ?
An express warranty
An implied warranty
An amendment
A policy provision
- A.
The extended term coverage will stay in force for a specified period of time, and then coverage will cease
No further premium payments are required
The term policy will have the same loan value as the original policy
The extended term insurance will be for the same face amount as the 20-pay life policy
- Identify which of the following is not a principal factor used to determine group disability income rates
Average age of the insureds who make up the group
Maximum indemnity period
Length of the waiting/elimination period
Location of the insured entity
- Which non-forfeiture option uses an existing policy's cash value to purchase a paid-up policy with a lower face than the original policy?
Extended paid-up insurance option
Reduced paid-up insurance option
Cash surrender value option
Extended term option
- A.
The wife receives medical care. ABC group insurer is primary
To reduce the risk of over-insurance, neither insurer will pay any benefits on any claim that is totally or partially covered by the other insurer if the other insurer is the primary carrier
The primary carrier determines what they ow for a claim by finding out what the secondary carrier will not pay
The husband receives medical care. XYZ group insurer is secondary.
- A.
Amount paid by the insured before benefits are payable
Payable amount split by the insured and the insurer
Number of days for which no benefits are payable
Number of days in which benefit payments end.
- Each of the following terms is an imortant characteristic of a major medical policy, except
Capitation fee
Deductible
Co-insurance
Maximum amounts
- HMOs are involved in all of the following, except
Providing healthcare services
Emphasizing the use of specialty physicians
Controlling costs by encouraging preventive care
Providing healthcare financial coverage
