Life, Health, Variable Annuities License Exam (2-15)

Front 1

All of the following unreimbursed medical expenses may be considered and lumped together to determine their deductibility:

Back 1

Prescription drugs, Contributions to a group medical plan

Front 2

Alcoholism or drug addiction would be considered which of the following hazards?

Back 2

Moral, It is an individual tendency that may increase the chance of loss

Front 3

In a replacement transaction, which of the following must send an important notice regarding replacement of life insurance to the new insurance company?

Back 3

The replacing agent must send this notice..

Front 4

Stagmite purchases a major medical policy with a $100 annual deductible, 80/20 co-insurance and a stop loss of $5000. If Stagmite were to incur covered expenses of $10,100, how much would Stag be out of pocket?

Back 4

2100: $10,100 minus the $100 deductible equals $10,000. 20% of $10,000 equals $2000. The out of pocket never reached the $5000.

Front 5

Optional Provisions 1 and 2, addressing changes of occupation and misstatement of age, permit the insurer to do which of the following?

Back 5

pay indemnities equal to the benefits that correspond to the premiums that have been paid: If an insured changes occupations to a more hazardous one than was noted in the application, this provision allows the insurance company to adjust the benefits to what the premium would have purchased. Same if the age is incorrect.

Front 6

Medicare Part "B" does not provide coverage for

Back 6

Home Health Services would be covered under Part A

Front 7

When an application for health insurance is submitted without an initial premium, the earliest effective date is:

Back 7

The date the policy is delivered to the prospect by the agent and the premium is collected.

Front 8

An applicant for insurance may pay the initial premium and receive a document from the agent indicating that if the policy is issued as requested coverage begins on the date of the documents. What is this document called?

Back 8

Conditional Receipt

Front 9

What is the agreement between an HMO and subscriber or group?

Back 9

Health maintenance contract

Front 10

Which part of Medicare requires premium payment by most eligible participants?

Back 10

Part B, supplementary medical insurance

Front 11

The type of health insurance policy most likely to cover all students attending a large university is:

Back 11

A blanket policy

Front 12

With regard to group insurance, who has the responsibility to apply for coverage, provide information about the group, maintain the policy, and pay premiums?

Back 12

The master policy owner

Front 13

Rose Bud receives a hospital bill for $9,500 after being released from the hospital. Her Major Medical policy has a $500 deductible and an 80% - 20% continuous coinsurance feature. Of the total expense, how much will Rose have to pay?

Back 13

$2,300

Front 14

Which of the following are eligible for Medicare coverage?

Back 14

People age 65 and older who are eligible for Social Security, People age 65 and older not eligible for Social Security, but willing to pay a monthly premium, People of any age who have been entitled to S.S. Disability benefits

Front 15

Which of the statements below about Medicare Part B are true? I. There is an annual deductible II. The insured is required to pay 20% after the deductible is met

Back 15

BOTH!

Front 16

The time period specified in the Free Look provision begins:

Back 16

When the policy is delivered

Front 17

Under the Basic Hospital Expense policy, what would not be covered under the miscellaneous expense benefit? Anesthesia, anesthesiologist, use of the operating room, or drugs

Back 17

Anesthesiologist

Front 18

June terminated her employment with the Wynot agency. She is told she will have 31 days to convert her coverage to an individual health policy. What else about conversion is true?

Back 18

She is still covered under the group policy for 31 days, If she becomes uninsurable they might charge her a higher premium because of her health, She must have been active in the group's plan for the last three months

Front 19

Which of the following statements is true? "Grandfathered" plans meet the requirements of creditable coverage

"Grandfathered" plans do not meet the requirements of creditable coverage

"Grandfathered" plans have no effect on coverage when a participant moves from one plan to another

"Non-grandfathered" plans are those that fail to meet requirements regarding creditable coverage

Back 19

“Grandfathered" plans meet the requirements of creditable coverage

Front 20

Which of the following is Not a unique character of a life insurance contract? Aleatory, Adhesion, Conditional, Estoppel

Back 20

Estoppel

Front 21

1. What is the most favorable clause for the applicant?

Disabled, any occupation,

Disabled, own occupation

Disabled, trained occupation

Disabled, experienced occupation

Back 21

Disabled, own occupation

Front 22

Which of the following statements is not correct concerning Medicaid?

1. To be eligible, one must be poor or become poor.

2. Medicaid provides for custodial care in a nursing home.

3. It is a federally administered program.

4. It is available to people of all ages.

Back 22

3. Medicaid is mostly funded by the Federal Government, but it is administered at the state level. The goal is to offer medical assistance to the poor of all ages whose income resources are insufficient to meet the costs of medical care.

Front 23

Which of the following describes a representation?

Back 23

When a prospect's statement on an application is held to be substantially true.

Front 24

What is considered a moral hazard?

Back 24

Lifestyle

Front 25

For a risk to be insurable it must contain what characteristics:

Back 25

The loss must be definite and measurable.

The loss exposures to be insured must be large.

The loss must be predictable.

Front 26

Who can write health insurance in Florida?

Back 26

Career Agent

Captive Agent

General Agent

Front 27

All of the following statements concerning Social Security disability benefits are true except:

The impairment must be expected to last at least 12 months.

The waiting period is 5 months.

The waiting period may be waived in certain circumstances.

Benefits are retroactive to the time of disability.

Back 27

Benefits are retroactive to the time of disability. If you were receiving benefits, recover, and then are disabled within five years, there would be no new waiting period. Benefits are retroactive, but do not include the waiting period.

Front 28

A small group is defined as:

Back 28

50 or less

Front 29

Can an agent in charge be designated as the agent in charge for more than one location?

Back 29

Yes, as long as insurance activities requiring licensure as an agent do not occur at any location when the agent is not physically present

Front 30

A Guaranteed Insurability rider can be attached to which of the following types of health policies?

Back 30

Disability income policy This is for "young professionals" who are likely to make more money in the coming years. This allows the insured to purchase additional insurance as long as his/her income has increased. One of the conditions for this is that the insured not be currently disabled. It is the only health insurance policy to which this rider may be attached. This is contingent upon meeting an earnings test to prove the income has increased

Front 31

What will the insurer do if its Disability Income policy contains a Change of Occupation provision, and the insured changes to a more hazardous job than is subsequently injured?

Back 31

Policy benefits will be reduced to an amount the premium would have purchased originally, based on the more hazardous occupation.

Front 32

Which of the following are eligible for Medicare benefits?

1. folks aged 65 and over

2. folks under age 65 receiving social security disability benefits

3. folks with chronic liver problems

4. folks with chronic kidney problems

Back 32

1, 2, & 4, it won't cover for the liver

Front 33

There are how many standard Medicare supplement policies?

Back 33

Ten, The NAIC developed a standardized model Medicare Supplement policy which provides "core" benefits, plus other supplement policies that would provide increasingly more comprehensive benefits.

Front 34

The minimum grace period in a health insurance policy paid on a quarterly basis is:

Back 34

31 days, The grace period is not less than, 7 days for weekly premiums, 10 days for monthly premiums, and 31 days for all others.

Front 35

The probationary period in a disability policy usually excludes payment for disabilities caused by sickness for how many days?

Back 35

15 or 30 days. These begin at the time the policy is issued and applies to sickness, not accidents. It provides a guidepost in borderline cases when there is a question as to whether the insured became ill before or after the effective date of the policy

Front 36

Which of the following denotes an "element of chance"?

Back 36

Aleatory. Although Aleatory means "unequal", it also means there is an element of chance, meaning that the contract is conditioned upon the occurrence of an event. It may or may not happen.

Front 37

What type of agent represents a number of insurance companies under separate contractual agreements?

Back 37

Independent Agents.

Career agents work for the insurance company and the General agent is his boss and they are captive. Personal Producing General Agents work for one company. They produce (sell). The Independent Agent has many different contracts with many different companies.

Front 38

Josh, age 67, continues to work for his company who has 20 employees. He is covered under their group major medical policy. Josh is also covered under Medicare. Which of the following is true?

Medicare is his primary payor, his group plan is his secondary payor

His group plan is his primary payor, Medicare is his secondary payor

Each pays half of the benefits

Josh can not be covered under both Medicare and a group plan

Back 38

His group plan is his primary payor, Medicare is his secondary payor.

Anyone age 65 and over and works for a company which has 20 or more employees must be offered the same benefits as those offered to younger employees. But, His plan at work is his primary payor. Medicare pays what his group plan does not.

Front 39

Which of the policy provisions defines a specific period in which an insured who has not paid the premium due remains covered by the policy?

Back 39

Grace Period. The grace period is 7/10/31. 7 days for weekly premiums, 10 days for monthly, and 31 days for all other premium modes.

Front 40

If an insurance company has rejected an applicant for coverage on the basis of a Medical Information Bureau (MIB) report, the MIB will release medical information contained in the report to which of the following, if any?

Back 40

The applicant's physician

Front 41

What is Business Overhead Expense insurance designed to pay?

Back 41

Business expenses incurred when the business owner is disabled. Business Overhead expense policies pay the business in the event the owner becomes disabled. It DOES NOT cover the owner's salary but does cover the employee's.

Front 42

Which of the following about Health Reimbursement Accounts HRA's is correct?

Back 42

HRA's are established by the employer. Health Reimbursement Accounts are the most common employer type of plans for High Deductible Health Plans. The employer set aside pre-tax dollars for the employee to pay deductibles, co-insurance and co-pays. The employer owns this plan and any unused money at the end of the year rolls over to the next.

Front 43

Which of the following companies can sell health insurance?

I. Mono-Line

II. Home Service/Industrial

III. Property/Casualty

IV. Multi-Lines Company

Back 43

All the above. Just about all companies can sell health insurance, with the exception of a surety company. Surety companies bond those who deal in the handling of money against theft.

Front 44

Lloyd's of London:

Back 44

does not insure anything. Lloyd's of London is the arena where all this takes place. It does not sell anything. It provides the "place to go " for a test pilot or a football player,etc... It's purpose is to gather and disseminate information for the individual underwriters. It is not an insurance company.

Front 45

following statements about life insurance and the risk it covers are true:

Back 45

Life insurance is a mechanism for pooling and sharing risks.

As the number of separate risks of the same type increases, the amount of loss within a given group becomes more certain.

The probability of an individual insured's death increases each year until it becomes a certainty.

Front 46

Faye is hospitalized for a serious illness. After being dismissed she submits a claim to:

1. the agent

2. the company

Back 46

Either. She may submit the claim to either the agent or the company.

Front 47

Which type of coverage is least affected by an increase in medical costs?

Back 47

Hospital Indemnity. These are known also as Hospital Fixed-Rate Policies. They simply pay a $ (dollar) amount for each day the insured is in the hospital. Ex. If the policy states it will pay $200 a day for each day the insured is confined to the hospital, and the insured is in the hospital for three days, it would pay $600, no matter what the hospital charged. It is paid directly to the insured.