GuranteedExamLife Flashcards
(75 cards)
1
Q
Which of the following is the most common method to supplement Medicare coverage?
- Medicaid
- Group health insurance
- Employer Health Insurance
- Coverage offered by private insurers
A
4
Coverage offered by private insurers
2
Q
How do warranties differ from representations?
1. a warranty is guaranteed to be true, a representation is believed to be true to the best of one’s knowledge.
2. a representation is guaranteed to be true, a waranty is believed to be true to the best of one’s knowledge.
3. a warranty is issued by the insurer, a representation is a statement provided by the applicant.
4.
an incorrect representation automatically voids a contract, whereas an incorrect waranty must be proven.
A
1
a warranty is guaranteed to be true, a representation is believed to be true to the best of one’s knowledge.
3
Q
Whose responsibility is it to make sure that the company is notified of a death claim at the earliest possible opportunity (in most cases)?
- the producer
- the insured
- the insured’s estate
- the funeral director
A
1
the producer
4
Q
What procedure is used by an insurer to protect itself in the event a dispute arises and the applicant and the agent do not recall the changes that were made in a completed application?
- The applicant and possibly the agent initial any changes made.
- The applicant and the agent sign a document that outlines changes made.
- An arbitration agreement is signed at the time of the signing of the application.
- All changes must be approved by the underwriter prior to the submission of the application.
A
1
The applicant and possibly the agent initial any changes made.
5
Q
All of the following are characteristics of variable whole life EXCEPT
- the premium is level
- there is no guaranteed cash value
- there is no guaranteed minimum death benefit.
- the agent must be licensed in both insurance and securities.
A
3
there is no guaranteed minimum death benefit.
6
Q
Which of the following is covered by a dread disease policy?
- mental health and related psychiatric illnesses
- hospital stays that extend beyond the usual and customary time frame
- illnesses that do not occur frequently but incur significant costs when they do occur
- a newly acquired illness that is contracted by a person with a pre-existing condition
A
3
illnesses that do not occur frequently but incur significant costs when they do occur
7
Q
Which of the following is TRUE of the limited pay whole life policy?
- Coverage ends when the policy is paid-up.
- Coverage continues after the policy is paid-up.
- Premium payments increase as the insured ages.
- Premium payments are lower than continuous premium whole life.
A
2
Coverage continues after the policy is paid-up.
8
Q
Which of the following amends the Social Security Act to make Medicare secondary to group health plans?
- ADEA
- ERISA
- OBRA
- TEFRA
A
4
TEFRA
9
Q
If the insurer wishes to share an applicant’s HIV status, the applicant must be given full notice of all of the following EXCEPT
- insurer’s practices with respect to the treatment of this information.
- the applicant’s rights to maintain privacy.
- an opportunity to refuse the dissemination of the information.
- the treatment procedures that are covered by the policy.
A
4
the treatment procedures that are covered by the policy.
10
Q
When does insurable interest come into play in a life insurance policy?
- when the applicant for the policy is not the insured
- when a charity is named beneficiary of the policy
- when a beneficiary is irrevocable
- when the free look period ends
A
1
when the applicant for the policy is not the insured
11
Q
All of the following are TRUE regarding incomplete applications EXCEPT
- the underwriting department will return the application to the agent.
- the applicant will have to wait additional time before coverage begins.
- there will be a delay in the underwriting process.
- the incomplete application can be accepted with the missing information added later.
A
4
the incomplete application can be accepted with the missing information added later.
12
Q
In order for an insurer to increase the premium on a noncancelable policy, which of the following MUST be true?
- The premium increase must be in the contract at the time it is issued.
- The insured develops a medical condition that increases risk.
- The insured reaches the age of 65.
- The premium increase must be in line with current inflation rates.
A
1
The premium increase must be in the contract at the time it is issued.
13
Q
What is the return of premium rider?
- an increasing amount of term insurance that always equals the total of premiums paid up to the current point
- a provision that allows the insured to cancel the policy in the first two years and have premiums refunded
- an increasing amount of term insurance that equals the cash value of the policy at any point in time
- a provision that states the insurer must return any premiums paid during the free-look period
A
1
an increasing amount of term insurance that always equals the total of premiums paid up to the current point
14
Q
All of the following are classifications of risk EXCEPT
- substandard.
- preferred.
- declined.
- non-nicotine.
A
4
non-nicotine.
15
Q
Which of the following coverage types pays a monthly cash benefit following the elimination period for total disability due to accident or sickness?
- Disability income insurance
- Credit disability insurance
- Recurrent disability insurance
- Workers compensation disability insurance
A
1
Disability income insurance
16
Q
What happens with the lifetime maximum benefit limit has been reached?
- The insurer will pay all of the remaining medical costs for as long as the policy is in force.
- The insured will pay all of the remaining medical costs for as long as the policy is in force.
- The provider who has reached the limit will no longer receive payments from the insurer.
- A new policy is issued and the maximum benefit limit is reset to zero ($0).
A
2
The insured will pay all of the remaining medical costs for as long as the policy is in force.
17
Q
Which of the following refers to how often a premium is paid?
- level
- mode
- net
- ratio
A
2
mode
18
Q
States generally define a true “group” for insurance as requiring a minimum of how many participants?
- 5
- 10
- 50
- 100
A
2
10
19
Q
Which of the following is TRUE of an equity-indexed annuity?
- It is a variable annuity.
- It may decrease in value.
- It requires a securities license to sell.
- It has a guaranteed minimum interest rate.
A
4
It has a guaranteed minimum interest rate.
20
Q
What is an impairment rider?
- It indefinitely extends the time to provide the proof of loss until after an impairment is resolved.
- It allows the reinstatement of a policy when an impairment is deemed to have caused the policy lapse.
- It lists specific conditions in the contract that are excluded from the contract
- It states that a contract can be cancelled and premiums refunded if the policyholder was mentally impaired at time of issue.
A
3
It lists specific conditions in the contract that are excluded from the contract
21
Q
A basic vision care package includes all of the following EXCEPT
- safety glasses.
- the annual eye exam.
- lenses and frames.
- contact lenses.
A
1
safety glasses.
22
Q
Short term disability insurance generally only covers injuries due to which of the following?
- Occupational injuries
- Non-occupational injuries
- injuries covered during the enrollment period
- injuries not covered by other insurance
A
2
Non-occupational injuries
23
Q
Which is the major reason why long term care insurance is becoming increasingly important?
- It is easy to make a profit from investing in long term care
- As life expectancy increases, the chances of needing long term care also increase
- Nursing homes only accept Medicare as a secondary insurance source.
- Many younger people are developing life-threatening conditions and require hospice care.
A
2
As life expectancy increases, the chances of needing long term care also increase
24
Q
Which policy provision permits the policyowner to take a specified number of days to examine the contract, and allows for cancellation and a full refund if the policyowner rejects the terms or costs?
- Exclusions
- Free look
- Grace period
- Insuring Clause
A
2
Free look
25
Which of the following is TRUE of a point of service plan?
1. Patients must submit claim forms for all services received.
2. The difference in cost between in-network and out-of-network is relatively small.
3. A patient's care is coordinated by an in-network primary care physician.
4. A patient may see any provider for any condition for the same cost and does not need to consult a primary care physician.
3
| A patient's care is coordinated by an in-network primary care physician.
26
Managed care plans increase efficiency by all of the following means EXCEPT
1. increasing beneficiary cost sharing.
2. controlling inpatient admissions and length of stay.
3. selectively contracting with health care providers.
4. transferring the management of costs to the insureds.
4
| transferring the management of costs to the insureds.
27
All of the following are tax qualified retirement plans EXCEPT
1. 401(k)
2. 403(b)
3. Section 529 plan
4. SIMPLE IRA
3
| Section 529 plan
28
Which type of receipt makes the insurer liable for the risk from the date of application, regardless of the applicant's insurability?
1. binding receipt
2. conditional receipt
3. inspection receipt
4. temporary receipt
1
| binding receipt
29
Upon the issuance of a conditional receipt for a renewal when the premium is paid AFTER the time granted by the insurer, what is the maximum amount of time for reinstatement of the policy?
1. 10 days
2. 30 days
3. 45 days
4. 60 days
3
| 45 days
30
Which of the following must be given to the insurer within 20 days after occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible?
1. evidence of insurability
2. notice of claim
3. proof of loss
4. supporting evidence for the claim
2
| notice of claim
31
All of the following are requirements to qualify for Social Security disability benefits EXCEPT when
1. credited with the appropriate number of quarters of coverage.
2. total and permanent disabled for at least 5 months.
3. disability expected to last for 12 months or end in death.
4. unable to work in occupation in which the worker was trained or educated.
4
| unable to work in occupation in which the worker was trained or educated.
32
What is a MIB report?
1. credit information on an applicant used in the underwriting process
2. medical information on an applicant for assessing life or health insurance risk
3. information on an applicant's moral character collected from interviews of associates
4. information on an applicant's medical condition collected via a physician's physical examination.
2
| medical information on an applicant for assessing life or health insurance risk
33
All of the following statements define preexisting conditions EXCEPT
1. any health condition that existed before the effective date of the policy for which the insured sought treatment.
2. any symptom that would cause a reasonable and prudent person to seek diagnosis and medical treatment.
3. any chronic health condition disclosed on the application that coverage is excluded for.
4. any chronic health condition that presents symptoms and which was unknown at the time of application.
4
| any chronic health condition that presents symptoms and which was unknown at the time of application.
34
For an individual long-term care policy there is an annual dollar limit for tax deductions that is based on which of the following?
1. age
2. cost of care
3. policy value
4. premium cost
1
| age
35
How long after being entitled to disability benefits will an individual be eligible to receive Medicare benefits?
1. immediately
2. 1 year
3. 2 years
4. at age 65
3
| 2 years
36
A consumer report used to determine eligibility for insurance may include all of the following EXCEPT
1. character.
2. reputation.
3. credit information.
4. medical underwriting exam.
4
| medical underwriting exam.
37
Which of the following policy types is considered double indemnity?
1. accidental death
2. key employee
3. term life
4. whole life
1
| accidental death
38
Which of the following is defined as the dollar amount beyond which the insured no longer participates in payment of medical expenses?
1. Deductible
2. Stop Loss Limit
3. Maximum Benefit
4. Coinsurance
2
| Stop Loss Limit
39
All of the following are nonforfeiture options EXCEPT
1. Cash surrender value
2. Extended term insurance
3. Reduced paid-up insurance
4. Cash dividend option
4
| Cash dividend option
40
Compared to basic hospital, medical and surgical policies, which type of insurance provides broader coverage, fewer gaps, higher individual benefits, and higher policy maximums?
1. medicaid insurance
2. major medical insurance
3. supplemental medical insurance
4. long term care insurance
2
| major medical insurance
41
Which of the following occurs immediately after the application is submitted and the initial premium paid?
1. the underwriting process begins
2. the applicant's references are checked
3. the beneficiaries are selected
4. the insurance goes into effect.
1
| the underwriting process begins
42
In a case where an individual's health is insured by both their own policy and their spouse's policy, which policy pays in the event of an illness?
1. Only the individual's policy pays.
2. Both policies pay the full amount.
3. The individual's policy pays first, the spouse's policy pays the remaining up to coverage amount.
4. The policy that was purchased first pays first, the second policy pays the remaining up to coverage amount.
3
| The individual's policy pays first, the spouse's policy pays the remaining up to coverage amount.
43
Which insurance plans are commonly offered through the worksite (employer sponsored) EXCEPT?
1. Medicare
2. Dental Insurance
3. Long Term Care Insurance
4. Supplemental Disability Insurance
1
| Medicare
44
When can the premiums of an individually owned health insurance policy be deducted from the individual's income tax?
1. when the taxpayer's medical expenses exceed 5.0% of adjusted gross income during a taxable year
2. when the taxpayer's medical expenses exceed 7.5% of adjusted gross income during a taxable year
3. any taxpayer who itemizes deductions may deduct their health insurance premiums
4. never because only group owned health insurance premiums may be deducted.
2
| when the taxpayer's medical expenses exceed 7.5% of adjusted gross income during a taxable yea
45
All of the following are required signatures on a life insurance application EXCEPT
1. the agent.
2. the applicant.
3. the minor in a juvenile policy.
4. the proposed insured.
3
| the minor in a juvenile policy.
46
How are term riders used?
1. to substitute the term of the coverage
2. to extend the effective dates of coverage
3. to purchase insurance on a family member of the originally insured
4. to purchase term insurance attached to supplement another life insurance policy
3
| to purchase insurance on a family member of the originally insured
47
Why are insurance policies considered conditional contracts?
1. Certain conditions need to be met to make the contract legally enforceable.
2. The policy is conditional upon approval from the underwriting process.
3. There are conditions included that can make the policy invalid.
4. They can be deemed invalid at a future date if misrepresentations were made.
1
| Certain conditions need to be met to make the contract legally enforceable.
48
In noncontributory plans, which percentage of eligible members must participate?
1. 0%
2. 50%
3. 75%
4. 100%
4
| 100%
49
A group conversion option may be used in all the following instances EXCEPT
1. the termination of the master policy.
2. loss of coverage due to loss of employment.
3. loss of eligibility on the part of a class of insureds.
4. a life-changing event, such as marriage, divorce, or childbirth.
4
| a life-changing event, such as marriage, divorce, or childbirth.
50
What specific new procedures does the USA Patriot Act require of insurance companies?
1. Establish an anti-money laundering program
2. Investigate applicants for potential terrorist links
3. Report large transactions by charitable organizations
4. To take action against employees for failure to implement the Act.
1
| Establish an anti-money laundering program
51
Which is the difference between participating and non-participating policies?
1. Participating policies pay dividends while non-participating policies do not.
2. Participating policies have lower premiums than non-participating policies
3. Participating policy dividends are like stock dividends, non-participating dividends are not.
4. Participating policy owners do not share in the divisible surplus of a company while non-participating policies do share in this surplus
1
| Participating policies pay dividends while non-participating policies do not
52
Why is the accidental death benefit referred to as double indemnity?
1. It provides for both the actual death as well as other losses from the accident
2. It provides twice the face value in the policy for death due to accident.
3. The beneficiaries have twice the amount of time to provide proof of loss.
4. The beneficiaries must provide proof of death due to multiple causes.
2
| It provides twice the face value in the policy for death due to accident.
53
Which problem was universal life insurance designed to address?
1. low interest rates during periods of high inflation
2. high interest rates during periods of low inflation
3. increased risk of death due to aging
4. lack of a fixed death benefit
1
| low interest rates during periods of high inflation
54
Which of the following is characteristic of a nonqualified plan?
1. defined vesting schedule
2. plan established by the employer
3. plan does not meet federal guidelines for tax benefits
4. employer contributions are deductible business expenses
3
| plan does not meet federal guidelines for tax benefits
55
Which of the following is TRUE for a flexible premium annuity?
1. The actual amount of the annuity benefit is determined in advance.
2. A single set amount premium is paid by the annuitant on an annual basis.
3. The company promises to pay the annuitant an amount each period beginning after a single lump sum payment.
4. The purchaser has the option to vary the amount of each premium payment falling between a minimum and maximum amount.
4
| The purchaser has the option to vary the amount of each premium payment falling between a minimum and maximum amount.
56
Which of the following is a characteristic of Preferred Provider Organizations (PPOs)?
1. prearranged costs for services rendered
2. providers receive a flat monthly amount for each user
3. ability to receive care at the same cost from any provider
4. emergency treatment is restricted to pre-selected hospitals
1
| prearranged costs for services rendered
57
According to the time of payment of claims provision, the insurer must make the payment immediately after receiving proof of loss EXCEPT
1. for claims involving periodic payments.
2. if the death is a suicide or due to a pre-existing condition.
3. when the policy is in the incontestability period
4. if the insured is able to eventually return to work.
1
| for claims involving periodic payments.
58
How does a noncancelable policy differ from a guaranteed renewable policy?
1. With the noncancelable policy, the insurer may increase the premiums by classifications.
2. With the noncancelable policy the insurer may increase premiums only based on the terms of the policy.
3. With the noncancelable policy, the insured may never increase the premiums under any circumstances.
4. With a guaranteed renewable policy, the insured may renew annually, with the noncancelable the insured may not cancel the policy.
2
| With the noncancelable policy the insurer may increase premiums only based on the terms of the policy.
59
Which is the primary purpose of Health Reimbursement Accounts (HRAs)?
1. To assist covered employees with the payment of medical expenses on a high deductible plan funded through pre-tax contributions.
2. To assist covered employees on standard group health insurance plans by using post tax contributions to fund an account to pay medical expenses.
3. To assist employees who work for small companies to pay medical expenses on high coinsurance policies.
4. To reimburse employees who choose not to participate in the group health coverage provided by their employer.
1
To assist covered employees with the payment of medical expenses on a high deductible plan funded through pre-tax contributions.
60
When a policy or certificate containing an accelerated benefit provision is applied for or delivered, the producer is responsible for providing the applicant a summary of coverage that includes all of the following EXCEPT
1. a detailed and comprehensive summary of the accelerated benefit
2. definitions of the conditions or occurrences triggering payment of the benefit
3. an explanation of any effects an accelerated benefit on the cash value, death benefit, premium payments, and loans.
4. a statement that benefit payments may adversely affect eligibility for Medicaid
1
| a detailed and comprehensive summary of the accelerated benefit
61
What type of insurance should a company purchase if it wants to insure the life of its CEO?
1. key person insurance
2. BOE insurance
3. group life policy
4. industrial life insurance
1
| key person insurance
62
What is the purpose of Stranger-originated life insurance (STOLI)?
1. the policy is originated primarily or solely for the purpose of resale
2. the policy is written so as to avoid proof of insurable interest
3. it is a method of insuring a person who has been previously declined.
4. it is a fraudulent policy meant for financial gain of someone unknown to the insured.
1
| the policy is originated primarily or solely for the purpose of resale
63
What does it mean if a health policy is conditionally renewable?
1. Insurer may elect NOT to renew based on the health of the insured.
2. Insurer may elect NOT to renew for any reason only on the policy anniversary or premium due date.
3. Insurer may elect NOT to renew only under conditions specified in the policy.
4. Insurer may elect NOT to review if the insured exceeds the maximum number of claims.
3
| Insurer may elect NOT to renew only under conditions specified in the policy
64
All of the following are characteristics of COBRA EXCEPT
1. qualifying events.
2. notification statements.
3. continuation of coverage.
4. change in medical privacy procedures.
4
| change in medical privacy procedures.
65
Why is relying solely on employer group life insurance generally considered inadequate for most individual's needs?
1. It is financially insufficient to cover end of life expenses.
2. It is meant to cover funeral expenses only.
3. It does not pay off the insured's mortgage.
4. It is based on salary amounts that are too low.
1
| It is financially insufficient to cover end of life expenses.
66
Which type of life policy can be continued year after year without a required medical examination but rates are dependent on the insured's current age?
1. whole life
2. variable life
3. flexible term
4. renewable term
4
| renewable term
67
Why is rehabilitation considered worthy of federal help under workers' compensation?
1. it reduces insurance losses and helps regain the worker's dignity
2. the costs to states are prohibitive so federal funding is required
3. states do not have the means to provide rehabilitative services
4. because under the Americans with Disabilities Act it is required
1
| it reduces insurance losses and helps regain the worker's dignity
68
Which type of rider reimburses health and social service expenses incurred in a convalescent or nursing home facility?
1. accelerated benefits rider
2. assisted living rider
3. terminal illness rider
4. long term care rider
4
| long term care rider
69
During which period of a Disability Income Policy is coverage effective but during which no benefits will be paid under the policy?
1. benefit period
2. elimination period
3. grace period
4. probationary period
4
| probationary period
70
Under which situation must insurable interest exist between the applicant and insured at the time of application?
1. When a third-party applicant names themselves beneficiary.
2. When the applicant and the insured are the same person.
3. When the beneficiary is a member of the applicant's immediate family
4. When a third-party applicant names the insured's company as beneficiary.
1
| When a third-party applicant names themselves beneficiary.
71
The group conversion option is allowed for all of the following EXCEPT
1. termination of the master policy.
2. loss of group coverage due to termination of employment.
3. upon the loss of eligibility on the part of a class of insureds.
4. during the annual benefits enrollment period.
4
| during the annual benefits enrollment period.
72
In a home healthcare benefit, all of the following are eligible expenses EXCEPT
1. intermittent part-time nursing care;
2. physical, occupational, or speech therapy;
3. blood transfusions
4. medical social services;
3
| blood transfusions
73
Which of the following lists the three common types of permanent individual life insurance?
1. Variable Life, Whole Life, Universal Life
2. Whole Life, Incidental Life, Term Life
3. Universal Life, AD&D,Term Life
4. Group Life, Whole Life, Variable Life
1
| Variable Life, Whole Life, Universal Life
74
In which of the following does a covered employee agree to a reduction in compensation so the amount can be used to cover medical expenses?
1. Consumer Driven Health Plan (CDHP)
2. Health Reimbursement Account (HRA)
3. Flexible Spending Account (FSA)
4. Healthcare Savings Account (HSA)
2
| Flexible Spending Account (FSA)
75
Obtaining consumer information reports under false pretenses is prosecutable by which of the following?
1. USA Patriot Act
2. Fair Credit Reporting Act
3. State laws where the applicant resides
4. Securities and Exchange Commission
2
| Fair Credit Reporting Act
