Texas Life And Health Flashcards by Alicia Maddox

An advertisement is required to accurately represent all insurance providers (3)

Assets
Corporate structure
Financial standing

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Group health insurance is characterized by all…

Master contract
Lower administration cost
Conversion privilege

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Group health insurance underwriting avoids

Adverse selection

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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

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nonforfeiture option with the highest amount of insurance protection is

Extended term

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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

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What are the 3 dividend options

Accumulated interest
Reduction of premium
Paid up addition

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Who assumes all the risk regarding variable annuities

Annuitant - invested with the insured on a separate account

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With medical claims which provision states the provider must pay medical expense claims immediately

Time of payment claims

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HMO that have a contract with outside physicians to deliver services to their subscribers pay those providers on a

Capitation basis

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The 3 nonforfeiture options are

Shortened benefit period
Reduced paid up
Extended term

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Which provision states the insurance providers right to change the premium amounts

Continuation provision

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You can discriminate on an insureds

Lifestyles and habits

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Decreasing term policies have a ——premium

Level premium

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Decreasing term policies death benefit———- every year

Decreases (loans)

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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

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In life insurance the death benefit proceeds must be paid with ——

2 month

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Two components of a universal policy is

Insurance and cash account

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What hospital policy pays specific amount per day the insured is in the hospital

Indemnity

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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

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In a disability income policy what is the name of the time after a policy is in force before claims are covered

Probationary

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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

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Practicing providers are compensated on a fee for service basis under which organization

PPO

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Under AD & D policy what benefit will pay the beneficiary in the event the accidental death of the insured

Principle sum

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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

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

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

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

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

Texas Life And Health Flashcards

(83 cards)