Exam simulator, Questions with accurate answers. Health insurance policies. Rated A/ 2022-2023

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Exam simulator, Questions with accurate answers. Health insurance policies. Rated A/ 2022-2023 What action can a policyowner take if an application for a bank loan requires collateral? - ✔✔As... sign policy ownership to the bank Which of the following individual health insurance policies will provide the broadest protection? - ✔✔Major Medical What is the initial requirement for an insured to become eligible for benefits under the Waiver of Premium provision? - ✔✔Insured must be under a physician's care Agent J takes an application and initial premium from an applicant and sends the application and premium check to the insurance company. The insurance company returns the check back to J because the check is made out to J instead of the insurance company. What action should J take? - ✔✔Return to the customer, collect a new check made out to the insurance company, and send the new check out to the insurance company If a contract of adhesion contains complicated language, to whom would the interpretation be in favor of? - ✔✔Insured According to Missouri's rules on disclosure, a life insurance applicant is expected to be provided with - ✔✔a Buyer's Guide and Policy Summary A policy summary must be given for all of the following policies EXCEPT - ✔✔credit life All of these insurance products require an agent to have proper FINRA securities registration in order to sell them EXCEPT for - ✔✔Modified Whole Life Credit Life insurance is - ✔✔issued in an amount not to exceed the amount of indebtedness At what age is a nondisabled person first eligible for coverage under a Medicare Supplement policy? - ✔✔Sixty-five The provision in a Group Health policy that allows the insurer to postpone coverage for a covered illness 30 days after the policy's effective date is referred to as the - ✔✔Waiting Period N is a student pilot with a large life insurance policy. Which of these features would limit the insurer's obligation in the event N was killed while flying as a student pilot? - ✔✔Exclusion N is covered under an individual Disability policy with a 30-day Elimination period and a monthly benefit of $500. N is totally disabled for 3 1/2 months. N's total benefit received on this claim is - ✔✔$1,250 G is an accountant who has ten employees and is concerned about how the business would survive financially if G became disabled. The type of policy which BEST addresses this concern is - ✔✔Business Overhead Expense On January 8, an applicant filled out an application for a life insurance policy but did not include the initial premium. The insurance company approved the application on January 14 and issued the policy January 15. The producer delivered the policy on January 26 and collected the first premium. When did the coverage become effective? - ✔✔January 26 Which of the following combination plans is designed to protect an insured from an unpaid mortgage balance upon premature death? - ✔✔Joint Life Which is true concerning a Variable Universal Life policy? - ✔✔Policyowner controls where the investment will go and selects the amount of the premium payment Which of the following consists of an offer, acceptance, and consideration? - ✔✔Contract J is a subscriber to a plan which contracts with doctors and hospitals to provide medical benefits at a predetermined price. What type of plan does J belong to? - ✔✔Health Maintenance Organization Which type of policy is considered to be overfunded, as stated by IRS guidelines? - ✔✔Modified Endowment Contract Variable Whole Life Insurance can be described as - ✔✔both an insurance and securities product An annuity promises that, if the annuitant dies before receiving payments equal to the correct value, the payments will be continued to a beneficiary until an amount equal to the contract value has been paid. This type of annuity is called - ✔✔An installment Refund annuity G purchased a Family Income policy at age 40. The policy has a 20-year rider period. If G were to die at age 50, how long would G's family receive an income? - ✔✔10 years K has a life insurance policy where her husband is beneficiary and her daughter is contingent beneficiary. Under the Common Disaster clause, if K and her husband are both killed in an automobile accident, where would the death proceeds be directed? - ✔✔Daughter A major medical policy typically - ✔✔provides benefits for reasonable and necessary medical expenses, subject to policy limits A written application for a health insurance policy may only be altered with the consent of the - ✔✔applicant in writing An insurance producer acts in a fiduciary capacity when conducting routine business with all of the following principals EXCEPT - ✔✔the Director From what authority derives the requirement that an insurance application contains a disclosure stating that an investigative consumer report may be obtained on an applicant? - ✔✔Fair Credit Reporting Act A Family Income Policy is a combination of Whole Life and - ✔✔Decreasing Term insurance Under Missouri law, when one group health plan's contract replaces a plan of similar benefits of another group health plan, - ✔✔the succeeding carrier shall give credit for the satisfaction of any deductibles or waiting periods satisfied or partially satisfied under the prior carrier's plan Which of the following statements is CORRECT regarding the tax treatment of a lump-sum payment paid to a life insurance policy's primary beneficiary? - ✔✔All proceeds are income tax free in the year they are received. If a life insurance policy has a stated beneficiary, all the proceeds are income tax free in the year which they are received. Which of the following is a requirement for obtaining a resident producer license in Missouri? - ✔✔Pay a $100 license fee B has a $100,000 Accidental Death and Dismemberment policy that pays triple indemnity for common carrier death. If B is killed from an accident on a commercial flight, what will the policy pay B's beneficiary? - ✔✔$300,000 If a retiree on Medicare required five hospital stays in one year, which policy would provide the best insurance for excess hospital expenses? - ✔✔Medicare Supplement The co-payment for a chiropractic service cannot exceed how much of the total cost of providing the service? - ✔✔50% How long is the required free-look period in a Medicare supplement policy? - ✔✔30 days Which plan is intended to be used by a sole proprietor and the employees of that business? - ✔✔Keogh Plan. A Keogh Plan may be used by a sole proprietor only if the employees of the business are included. T has Disability Income policy that pays a monthly benefit of $5000. If T becomes partially disabled, what can he likely expect? - ✔✔Less than $5,000 per month benefit regardless of the cause A Disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim? - ✔✔Claim will be paid and coverage will remain in force An insurer must provide an insured with claim forms within __ days after receiving notice of a loss. - ✔✔15 S is employed by a large corporation that provides group health coverage for its employees and their dependents. If S dies, the company must allow his surviving spouse and dependents to continue their group health coverage for a maximum of how many months under COBRA regulations? - ✔✔36 Which of the following provisions guarantees that premiums will be waived if a Juvenile Life policyowner becomes disabled? - ✔✔Payor clause Which of the following policies combines investment choices with a form of Term coverage? - ✔✔Variable Universal Life Under federal tax laws, what is the tax treatment for an employer providing $50,000 of a contributory group Term Life plan to all its eligible employees? - ✔✔Portion of the premiums paid for by the employer may be a tax deduction All of these are characteristics of an Adjustable Life policy EXCEPT - ✔✔face amount can be adjusted using policy dividends The suicide provision for life policies would apply to - ✔✔subsequent increases in benefits On a life insurance policy, who is qualified to change the beneficiary designation? - ✔✔Policyowner If an individual has an Accidental Death and Dismemberment policy and dies, an autopsy can be performed in all these situations EXCEPT - ✔✔When the state prohibits this by law, Applicable state laws that prevent an autopsy take precedence. The percentage of an individual's Primary Insurance Amount (PIA) determines the benefits paid in which of the following programs? - ✔✔Social Security Disability Income Which of the following will a Long Term Care plan typically provide benefits for? - ✔✔home health care The life insurance and annuity replacement regulation defines replacement as - ✔✔exchanging an existing policy for a new policy Which statement regarding the Misstatement of Age provision is considered to be true? - ✔✔Coverage will be adjusted to reflect the insured's true age if a misstatement of age is discovered A person whose application for a license was denied may request a hearing within a MAXIMUM of how many days after receipt of the denial - ✔✔Thirty An individual has a Major Medical policy with a $5,000 deductible and an 80/20 Coinsurance clause. How much will the INSURED have to pay if a total of $15,000 in covered medical expenses are incurred? - ✔✔$7,000 No person shall act as an insurer and no insurer shall transact insurance EXCEPT as authorized by the - ✔✔Director of Insurance An insured covered by Accidental Death and Dismemberment (AD&D) insurance has just died. What will happen if the primary beneficiary had already died before the insured and contingent beneficiary? - ✔✔Proceeds will go to the contingent beneficiary Which policy is required to contain chemical dependency coverage? - ✔✔Comprehensive major medical P died five years after purchasing a life policy. While investigating the claim, the insurer discovered material misrepresentations made by P during the application process. Which of these actions will the insurer take? - ✔✔Beneficiary will be paid the Death Benefit Insurance contracts are known as ____ because certain future conditions or acts must occur before any claims can be paid. - ✔✔conditional Which of the following is a standard provision of the conversion privileges in a Group Life policy? - ✔✔Group Life coverage can be converted to an individual policy at regular rates on an attained-age basis Which of these is NOT a reason for purchasing life insurance on the life of a minor? - ✔✔If both parents were to die, it would provide death benefits to the child In a Life insurance contract, an insurance company's promise to pay stated benefits is called the - ✔✔Insuring clause A term life insurance policy matures - ✔✔upon the insured's death during the term of the policy A life insurance application must be signed by all of these EXCEPT - ✔✔beneficiary, Beneficiaries are not required to sign an insurance application. Which of the following types of health coverage frequently uses a deductible? - ✔✔Major Medical policy Life policies must contain a provision limiting the fixed interest rate on policy loans to a MAXIMUM of - ✔✔8% According to the Mandatory Uniform Policy Provisions, what is the maximum amount of time after the premium due date during which the policy remains in force even though the premium has not been paid? - ✔✔31 days Continuing education (CE) providers must report to the director a licensee's earned credit hours within - ✔✔30 days of course completion Which of these options can an individual use their medical flexible spending account to pay for? - ✔✔Prescription drugs When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain suitability information. Suitability information includes - ✔✔age, annual income, financial experience A Medical Information Report (MIB) report may disclose which of the following - ✔✔Prior use of marjuana. A Medical Information Report (MIB) may disclose lifestyle habits such as drugs, drinking, overeating and smoking. What determines the full amount of Social Security retirement benefits a qualified individual is entitled to receive? - ✔✔Primary Insurance Amount (PIA) If X wants to buy $50,000 worth of permanent protection on his/her spouse and $25,000 worth of 10-year Term coverage on X under the same policy, the applicant should purchase - ✔✔A Whole Life Policy with an Other Insured Rider F needs life insurance that provides coverage for only a limited amount of time with a death benefit that changes regularly according to a schedule. What kind of policy is needed? - ✔✔Decreasing term policy E and F are business partners. Each takes out a $500,000 life insurance policy on the other, naming himself as primary beneficiary. E and F eventually terminate their business, and four months later E dies. Although E was married with three children at the time of death, the primary beneficiary is still F. However, an insurable interest no longer exists. Where will the proceeds from E's life insurance policy be directed to? - ✔✔F A Limited-Pay Life policy has - ✔✔premium payments limited to a specified number of years On delivery of a policy, a signed statement of good health is typically requested if - ✔✔The application was submitted without the initial premium Which of these types of life insurance allows the policyowner to have level premiums and to also choose from a selection of investment options? - ✔✔Variable Life The Accidental Death and Dismemberment (AD&D) provision in a life insurance policy would pay additional benefits if the insured - ✔✔is blinded in an accident Within how many days of a pre-trial hearing must a producer report to the Director any felony charges or crimes of moral turpitude? - ✔✔30 days Which type of policy would pay an employee's salary if the employer was injured in a bicycle accident and out of work for six weeks? - ✔✔Business Overhead Expense Statements made on an insurance application that are believed to be true to the best of the applicant's knowledge are called - ✔✔representations Prior to a universal life insurance policy being terminated, written notice must be given to the policyowner at least - ✔✔30 days of termination date Which requirement must be met for an association to be eligible for a group life plan? - ✔✔Group was formed for a purpose other than acquiring insurance A policyowner would like to change the beneficiary on an Accidental Death and Dismemberment (AD&D) insurance policy and make the change permanent. Which type of designation would fulfill this need? - ✔✔Irrevocable An individual Disability Income insurance applicant may be required to submit all of the following information EXCEPT - ✔✔spouse's occupation Under Missouri law, a state regulated health benefit plan must - ✔✔cover, with no prior authorization necessary, childhood immunization services whether provided in a medical physician's regular office or a qualified hospital emergency room T files a claim on his Accident and Health policy after being treated for an illness. The insurance company believes that T misrepresented his actual health on the initial insurance application and is, therefore, disputing the claim's validity. The provision that limits the time period during which the company may dispute a claim's validity is called - ✔✔Time Limit on Certain Defenses A 42-year-old executive wants to purchase life insurance that will allow for increases or decreases to coverage as his/her needs change. Which of the following policies will best meet this need? - ✔✔Universal Life Which of the following limits may be applied to coverage of treatment of autism spectrum disorders? - ✔✔Medically necessary treatment in accordance with a treatment plan When a misrepresentation on a life insurance policy application is discovered, what action may an insurance company take? - ✔✔Void the policy only if it is discovered during the Contestable period and proven to be material Which mode of payment is NOT used by health insurance policies? - ✔✔Single premium S is close to retiring and would like to purchase a policy that will yield greater gains than bonds, but will still protect the principal with a minimum level or risk. Which product would S be advised to purchase? - ✔✔Equity index insurance P, age 50, purchased an annuity that P will fund with $500/ month for 15 years. The annuity will then pay P retirement payments after the 15 years. Which type of annuity did P purchase? - ✔✔Deferred A life policy with a death benefit that can fluctuate according to the performance of its underlying investment portfolio is referred to as - ✔✔Variable Life What type of annuity has a cash value that is based upon the performance of it's underlying investment funds? - ✔✔Variable A policyowner is able to choose the frequency of premium payments through what policy feature? - ✔✔Premium Mode Which of the following statements BEST describes dental care indemnity coverage? - ✔✔Services are reimbursed after insurer receives the invoice An employee with $25,000 group term life coverage was recently fired. This employee's group coverage may be converted to a - ✔✔$25,000 individual whole life policy J, an Accidental Death and Dismemberment (AD&D) policy holder, dies after injuries sustained in an accident. J's age as stated on the application five years ago was found to be understated by ten years. Which of the following actions will the insurance company take? - ✔✔The insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age Before an insurance company can issue a small employer group policy, it MUST - ✔✔be authorized to write accident and health insurance in this state N is a 40-year old applicant who would like to retire at age 70. He is looking to buy a life insurance policy with level premiums, permanent protection, and be paid-up at retirement. Which of these should N purchase? - ✔✔30 Pay Life At the point in time that person applies for coverage, major medical health plans (including HMOs) MUST - ✔✔offer coverage for prosthetic devices for dependents under age 18 Continuing education units for producers may be granted for participation in all of the following activities EXCEPT - ✔✔meeting sales production requirements When determining the monthly benefit amount for a Disability Income policy, the factor that limits the amount a prospective insured may purchase is - ✔✔income V is insured under an individual Disability Income policy with a 30-day Elimination period. On July 1, he is involved in an accident and temporarily disabled. He returns to work on December 1. How many months of benefit are payable? - ✔✔4 months Under Missouri law, a health carrier shall have expedited grievance review procedures for - ✔✔situations in which the standard time frames for grievance procedures could seriously jeopardize the enrollee's life or health [Show More]

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