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Worksheetsfinal course exam part2
Total questions: 83
Worksheet time: 42mins
The frequency of premium payments is called the:
Premium commitment
Premium payment mode, aka Modal Premium
Electronic Funds Transaction
The frequency requirement
In order to advance part of the death benefit via the Accelerated Death benefit rider, the insured:
The insured needs an organ transplant
All of these qualify for an Accelerated Death benefit advance
The insured has been diagnosed with a terminal illness and has two years or less of life remaining
There has been a medical diagnosis that the insured's life span is drastically reduced due to a disease
A long-term care rider added to a life insurance policy can:
Will be paid in addition to the entire face amount of coverage in the event of the insured's death
Only be added if the insured is under age 40
Help cover the cost of long-term care if the insured needs help with two or more activities of daily living
Replace a long-term care insurance policy, as they are the same thing
The life insurance settlement option that is completely tax-free is the:
Interest only
Lump sum option
Fixed period installments
Fixed amount installments
An insured commits suicide 18 months after the policy was issued. What is paid to the beneficiaries?
A return of premium only
Interest on the death benefit from the date of death only
The full death benefit will be paid
Nothing will be paid as the suicide occurred within two years of the policy being issued
Can a minor be named as a beneficiary?
Yes, if the minor is considered a legally emancipated child
Yes, but minors cannot actually receive death benefits
No, all beneficiaries must be at least 18 years old
Only if the minor agrees in writing to have the death benefit paid to a trust
Statements that are made by the applicant are considered true to the best of knowledge. These statements are:
Representations
Statement of fact
Warranties
Considered fraudulent statements at all times
WHICH of these receipts provides coverage effective the date of application or the medical examination if the insured is a standard or better risk?
An approval receipt
A non-binding receipt
An insurability receipt
An unconditional receipt
How long does information remain on a person's credit report?
Ten years for personal bankruptcies, 20 years for business bankruptcies, and ten years for all other entries
Ten years for bankruptcies and seven years for other entries
Seven years for bankruptcies and ten years for other entries
Ten years for all entities on a credit report
Any ambiguities in a contract of adhesion are ruled against the party that drew up the contract. This is known as the:
Rule of Strict Construction
Rule of Valued Contracts
Law of Large Numbers
Rule of Indemnity
WHEN must an agent present and read a replacement notice to the applicant?
Only if requested by the applicant
Replacement notices are not required for life insurance policies, only for health insurance contracts
When the policy is issued
No later than the time of application
WHO is the only party that may change information on an application for insurance?
The applicant
The insurer
The agent without the applicant's consent
The insured
WHAT are the required elements of a legal and enforceable contract?
Consideration, Legal Purpose, Offer and Acceptance, and Competent Parties: CLOC
Coverage, Loss provisions, Occurrences, and Legal Benefit: CLOC
Contract terms, Lender approval, Office of the Commissioner acceptance, and Loyalty: CLOC
Contract, Legal Protection, Offer, and Consideration: CLOC
Insurance contracts are:
Semilateral
Multilateral
Unilateral
Bilateral
A contract that is missing a required element is automatically:
Enforceable
Voidable by going to court
Valid when approved by a court
Void
Internal replacement is known as:
Twisting
Inter-company issuance
Churning
Intra-company issuance
WHICH of the following would best describe the illegal practice of Twisting?
Twisting is the unfair trade practice of selling a person an additional life policy when it is not needed.
It is the agent convincing the applicant that another agent lied in order to obtain the insurance business
Twisting is the replacement of an existing policy with a different policy issued by the same insurance company
Twisting, also called External Replacement, involves a person illegally convincing another to drop their existing coverage to purchase similar coverage with another agent or insurance company.
If an employee joins his employer's group coverage during an open enrollment period, WHICH of these statements would be correct?
Only the dependents of the employee will have to prove health
All enrollees will have to prove health
There is no proof of health required for the employee or any dependents
The insurer can pick and choose which employees must prove health depending on age
WHAT type of IRA allows for a completely tax free distribution?
Traditional IRAs
ROTH IRAs
No IRA allows for a completely tax free distribution
SEP IRAs
A business has three partners. HOW many policies would be needed to fully insure a cross purchase buy-sell plan?
Six
Nine
One
Three
The maximum a person may contribute to an individual IRA is:
100% of earned income not to exceed a federal maximum per year
The only IRA that has a contribution limit is a ROTH IRA. Traditional IRAs do not have contribution limits
As much as the account holder wants to contribute
50% of the individual's earned income with no limit
A transfer occurs when a person transfers funds to the same type of account, but with a different institution. This type of transfer may occur:
Once per year
Twice per year
An unlimited number of times per year
Once during a person's lifetime
A qualified retirement plan that adheres to ERISA laws and rules is WHAT kind of plan?
A nonqualified plan
A deferred payment plan
A qualified plan
A pick and choose plan
Distributions from a qualified retirement plan before age 59 1/2 are subject to WHAT penalty if the account holder is not eligible for a premature distribution?
A ten percent premature distribution penalty on the entire amount withdrawn
A 50% penalty on the amount that should have been taken, but was not
15 percent, unless the account holder has suspended contributions to the account
Penalties for premature distributions were repealed more than a decade ago
Proof of coverage for an employee under an employer's group life insurance plan is evidenced by:
The master contract
An insurance policy
A certificate of insurance
Just an ID card showing the name of the insurer
An employee resigns and is no longer covered under their group life plan. Does the employee have the right to continue insurance coverage?
Yes, the conversion privilege allows the individual to convert his group term coverage to an individual term insurance policy at attained age pricing and no proof of health
No, there is no allowance for conversion from a group plan in this state
No, the former employee will have to go and purchase an individual policy of their choosing and have to prove health
Yes, the employee will be offered a permanent insurance policy with no health proof at original age pricing
Premiums paid for personal life insurance are:
Tax deductible
Deductible only in third-party ownership contracts
Not tax deductible
Partially deductible
Bob's company has a profit sharing plan that asks him to contribute to the plan on a voluntary basis. This is a:
A Savings Incentive Match Plan for Employees
401(k) plan
A KEOGH Plan
Defined benefit retirement plan
For those age 50 and older, HOW much is the catch-up contribution amount for Health Savings Accounts?
5000
7500
2500
1000
Medicare Advantage, or MA plans, are technically called:
Part C plans
Optional Plans
Private plans
Required plans
The primary qualifier to receive disability insurance benefits is WHICH of the following?
An injury that prevents the insured from getting a different job
The fact that the insured could be out of work for up to at least one week
An inability to perform the duties of one's occupation
The insured must file a claim stating that he or she wants to receive benefits.
Policies that pay benefits based on the typical charge in a geographical area pay on WHAT basis?
Coinsurance provision policies
The actual billing amount, regardless of the actual charge
These are expense incurred policies, and pay on a usual, reasonable and customary charge basis
Copayment policies
An individual disability income policy may exclude coverage for preexisting conditions for HOW long?
Up to six months after the effective date of the policy
A maximum of three months
Preexisting condition exclusions are no longer allowed under the Affordable Care Act
Up to one year from the policy issue date
Medicare is:
A federal savings program that uses private insurance companies to provide benefits
A state-run program for those who cannot afford medical insurance
A program meant for those at or below the federal poverty level
A federal health care program for those age 65 and over, and certain people under age 65 with qualifying disabilities
WHAT medical plan has a network, but allows non-network access at any time?
PPOs
Major medical policies
Gatekeeper plans
HMOs
Under the Loss of Earnings test, insurers have the right to have the insured undergo a physical examination for disability claims every:
Three months
Quarterly
Six months
Annually
For 2020, WHAT is the maximum that may be contributed to a flexible savings account per employee?
2750 (for 2025 it is 3.3k,for2026itis 3.4k)
3250
No limit, but only for 2020, due to the pandemic
3500
WHICH medical plan offers prepaid coverage and emphasizes prevention?
Limited benefit plans
Major medical policies
PPOs
HMOs
WHAT disability contract provision will pay the insured benefits even if he or she can work in another occupation?
Occupational policies
Non-occupational policies
An own occupation provision
An any occupation provision
WHAT is the name of the policy given to the sponsor of a group insurance plan?
The employer only received a certificate of insurance
The Group Contract
The Employer edition of the policy
The master contract, or policy
In order to purchase group health insurance through the Small Business Health Options Program, or SHOP, how many employees may a business have?
2 to 100
1 to 25
1 to 50
Under 100 employees, including owners
If a group plan is terminated for any reason, those who are disabled, injured, or ill will receive WHICH of the following?
The Coordination of Benefits provision will come into play, and require the plan to pay the benefits on any plan that has been terminated
If a group plan is terminated for material misrepresentations, there will be no further claim payments made for any reason
The loss will continue to be covered under the plan, but only if the employee has converted to an individual plan of insurance
An extension of benefits under the policy for three months for basic plans, and 12 months for major medical coverage
Stella's employer switched group insurance plans, but she had a claim filed with the previous carrier. What happens with Stella's claim?
The new insurer has the choice of whether to cover the claim, and can choose not to provide any benefits to Stella
Stella is out of luck as there is no coverage remaining for her loss, and she will have to pay for it out of her own pocket
The new carrier will pay for the claim, and then ask the previous carrier for reimbursement
It will continue to be paid under No Loss No Gain statutes
Small employers in the same or similar industry that band together to purchase health insurance are known as:
Group Purchasing Trusts, or GPTs
Blanket Insurance Trusts, or BITs
Multiple Employer Trusts, or METs
Multiple Business Health Groups, or MBHGs
Premium rating that is based on geography within a particular region is known as:
Experience rating
Average risk rating
Community rating
Claims rating
Employees in an employer-sponsored group plan receive WHAT as proof of coverage?
Nothing, they are part of a list of covered employees kept by the insurance company
Policies
Only Identification cards
Certificates of insurance
Other than nursing home care, WHICH of the following is the highest level of care afforded by a long-term care policy?
Community care
Skilled nursing facility, or SNF care
Custodial care
Intermediate care
Employers that self-insure commonly purchase WHAT kind of coverage to protect them in case the self-insured funds are used up?
Excess insurance coverage
Stop-loss insurance
Workers' Compensation coverage
Excess liability coverage
ALL of the following are limited risk policies EXCEPT:
Major medical coverage
Cancer insurance
Travel accident policies
School and athletic team policies
ALL of the following will terminate a group plan EXCEPT:
Fraud or material misrepresentation by the sponsor
Too many claims for the group have been filed
Nonpayment of premium
Misuse or harassment of a provider network
Regarding rate increases for an individual on ACA plans, an insurer may only raise premium rates:
Based on the age of the insured
If it can prove that its losses are attributable to a class of specific insureds, such as electricians
If the insured has had losses in excess of the national averages
The ACA prevents rate increases and they are not allowed under any circumstances
The concept of paying medical expenses that are based on where a person lives is known as:
Coinsurance
Scheduled coverage
A benefit schedule
Usual, Reasonable and Customary charges
The Time Limit on Certain Defenses provision, also known as the Incontestable provision, gives the insurance company HOW LONG to contest payment under the policy for misrepresentations?
There is no time limit, insurers may contest payment under the policy for misrepresentations made in the application for insurance
Two years
Five years
Three years
If an insurer is allowed to exclude coverage for a pre-existing condition, WHAT form will they use?
This cannot happen, as no insurance policy may exclude coverage for pre-existing conditions due to the Affordable Care Act
There is no form for this, the insurer will simply deny all claims associated with the pre-existing condition
A medical declination provision
An impairment rider or waiver
The renewal provision that guarantees the insured the ability to renew until at least age 60 or 65 is WHAT renewal provision?
Noncancellable
Guaranteed renewable
Future Purchase Option renewal provision
Cancellable policies
Insurers must provide claim forms to the insured within HOW MANY days after the insured has provided Notice of Claim?
90
As soon as reasonably possible
30
15
WHICH of the following statements would best describe the Misstatement of Age provision?
An insurer cannot cancel a policy due to age misstatements, and can only adjust either the benefits payable or the premium.
The insurance company will give the insured a period of 180 days to correct the deficiency
The insurer may cancel the policy with at least 10 days' notice
Age misstatements are considered fraudulent misrepresentations, so the policy will be canceled immediately
If a person is receiving disability income benefits, the insurer can require the insured undergo a physical examination every:
3 months
6 months
Month
12 months
A child ages out and is no longer eligible for coverage under his parent's policy. At WHAT age does a young adult age out of coverage under the ACA?
30
26
65
27
If an insured submits a claim, but owes the insurer premium, WHAT can the insurance company do?
Deduct the premium owed from any claims payment
Deny the claim until the past due premiums are paid, and then pay the claim
Delay paying the claim until the insured can prove he has the financial ability to pay the premiums
The insurer may obtain a legal judgment that forces the insured to pay the premium
HOW LONG is the grace period contained in an ACA plan purchased through the Health Insurance Marketplace?
90 days
14 days
180 days
120 days
The Medicare blood coverage requires:
The patient has others in his family donate blood to the Red Cross on the patient's behalf
That the beneficiary donate any potentially needed blood before treatment begins
That the beneficiary have a blood type that is listed in the National Blood Registry
The beneficiary pay for the first three pints of blood, unless the blood was received free of charge by the facility
Medicaid:
Is no longer applicable, as the Affordable Care Act replaced the need for the program
May only be accessed by those who are considered uninsurable
Is administered by the individual state insurance divisions
Is a state run program that is jointly financed between the states and federal government, and is intended for those at or below certain income levels, and others
In order for a person to receive 100 percent of their Primary Insurance Amount as a retirement benefit, the person must have:
Reached full retirement age
The only way that a person can receive 100 percent of their PIA is if the person has paid more into the Social Security system than is required by law
Delayed receiving their retirement benefit until age 70
Applied to Social Security prior at age 62
The three benefits available through OASDI, better known as Social Security are:
Disability, unemployment protection and retirement benefits
Disability, retirement and survivors benefits
Hospital, Medical and Surgical services
Part A, Part B, and Part D
WHAT is the Social Security Disability Insurance waiting period?
90 days
Five months, with benefits payable at the end of the sixth month
There is only a waiting period if the beneficiary does NOT have private disability coverage
One year
A doctor who does not accept Medicare assignment may do WHICH of the following?
Require the patient to obtain a pre-authorization for treatment from Medicare
Require the patient to submit his claim through his personal insurance policy and not submit it to Medicare
Charge an additional 15 percent above the Medicare Approved Amount
Charge the patient the going Usual, Reasonable and Customary rate for the service
WHEN does Medicare's annual general open enrollment period occur?
The annual enrollment period is only for those who are planning on changing their Medigap or Medicare Advantage provider
November 15 through December 7 annually
Medicare does not have an annual open enrollment period
January 1 through March 31, the first three months of each year
In a Medicare Supplement policy, the core package is known as:
Plan C
Plan B
Plan G
Plan A
Part A of Medicare provides WHICH of the following?
Hospital and facilities coverage
Medical coverage that pays for doctors
Skilled nursing facilities
Prescription drugs
Can a Medigap policy apply a pre-existing conditions exclusion?
No, never
Yes, but only if applied for during open enrollment
Only in the event the proposed insured fails a medical exam during the open enrollment period
Yes, but only for six months, and only if enrollment is requested outside of the open enrollment period
Medicare's version of a fee schedule is called WHICH of the following?
The Agreed Payment Schedule
The Maximum Allowance Schedule
The National Payment Schedule
The Medicare Approved Amount
An ACA compliant health insurance policy allows HOW LONG to report the birth of a child to the insurer in order to maintain coverage?
The ACE does not require that children be reported as they are covered automatically from the moment of birth
90 days
Six months
60 days
If a policyowner wanted to split up a death benefit between beneficiaries, he would use WHICH of the following designations?
A succession designation
A per stirpes designation
An even-split designation
A per capita designation
Workers' Compensation requirements may be met by:
Proving that the employer has fewer than 25 employees
Buying a Workers' Compensation policy from an insurer, or the entity may self-insure for losses
Obtaining a waiver from the federal government that provides the employer with a Workers' Compensation insurance exemption
Purchasing both group medical insurance and group disability insurance for the employees
In order for a partnership or sole proprietor to deduct health insurance premiums for medical coverage on the owners and family members, the entity must:
Apply for the policy in the name of the business, and not in the names of the owners
Register as an S corporation with the state
Not have more than five insureds on the family health insurance policy
Provide group health benefits for its employees
WHAT policy is designed to pay for injuries and illnesses sustained at the workplace?
Workers' Compensation
Social Security Disability Income
Disability income policies
Personal health insurance
Under the rules of the Affordable Care Act, adult children may be covered under their parent's policy WHAT age?
26
No limiting age under any circumstances
25
21
WHAT type of beneficiary designation means to, or through family lines?
Per stirpes
Per capita
Per classes
Per succession
WHICH of the following disability income policies will pay the insured even if working in a different occupation?
Non-occupational policies
Any occupation policies
Workers' Compensation contracts
Own occupation policies
The frequency of premium payments is known as:
Premium payment requirements
Modes of premium payment, or Modal Premium
Due date intervals
Billing intervals
Of the following, WHICH benefit received would result in a taxable event to the employee?
Medical expense benefits paid that are equal to or less than the medical expenses that were incurred
Accidental Death and Dismemberment benefits
Benefits received by a business from a key person policy
Disability income benefits from premiums paid for by employers
For a person to be able to deduct medical expenses, the expenses must exceed WHAT percentage of their Adjusted Gross Income for 2020?
0.1
0.3
0.075
0.15
