Certificate of Authority
States require companies to ave a license to sell insurance in the state. The license is called
The Law of Large Numbers
What do insurance companies use to help predict how many losses will occur in a group or class of individuals
Captive Agent
Which of the following individuals represent only one company
Apparent Authority
Which authority represents what others believe his power is by actions taking
Direct Response
Which of the following types of advertising does not involve an agent and is conducted through the mail, by advertisements in newspapers and magazines, etc.
Principal
Agency is a relationship in which one person is authorized to represent and act for another person or for a corporation. In insurance, the insurance agent acts on behalf of the Principal
Contract
Which of the following terms describes a legal agreement between two competent parties that promises a certain performance in exchange for a certain consideration
Insurance
What is a contract or device for transferring risk from person, business or organization to an insurance company.
Retention
Since he lives in a good neighborhood and across the street is the fire station, Jeff decided to cancel his life insurance policy, this is an example of which risk
Residual Market
A type of insurance owned by federal government that is not typically available from other private insurers is called
Underwriting Process
Process of evaluating a risk to determine if the risk is one that the insurance company wishes to insure is the
Producers Report
Part of application that require the agent to provide information regarding proposed insured, such as habits, character, and relationship to insured
Beneficiary
Which of the following is not required to sign the application form
Height and Weight
Which of the following is not included in the general form of the insurance application
Insurer
During underwriting process, medical exams and testing are paid by
Medical Information Bureau
Non profit insurance trade association that maintains underwriting info on applicants from hundreds of insurers
Marital Status
Which of the following is NOT prohibited from use in order to classify a risk
Substandard
Which of the following is an above average risk of loss and unfavorable to an insurance company
A Notice Of Applicants
The Fair Credit Reporting Act requires which of the following to be issued to all applicants for life or health insurance
Standard Risk
A risk that bears the same health, habits, and occupational characteristics as the persons won whose the mortality table was based upon is known as the
Investigative Consumer Report
A general in regard to the applicants finances, health, character, work, hobbies, and other habits that is usually completed by interviewing friends and associates is known as
6 months
Most states allow backdating to be done up to
Part 2 Health Information
Section of application that includes info regarding the proposed insureds physical condition, medical history, and alcohol and drug use is known as
Conditional Receipt
Which of the following receipts is covered as of the date of the application as long as the applicant is found to be insurable under company's standard underwriting rules?
HIPAA (Health Insurance Portability and Accountability Act)
Which of the following imposes a requirement that the insurer must keep all medical information confidential and protect the applicants privacy
Preferred Risk
A risk that represents a chance of experiencing a loss that is below average and therefore favorable to the company is a
Consumers Report
Used to determine a consumers eligibility for personal credit, insurance, or employment
Statement of Good Health
While delivering the policy, the producer must obtain a signed document tat the insured's health is the same as when he or she applied for the insurance policy. This document is called
An Estate
Assets left behind after an individuals death is known as
Third Party Ownership
Which of the following is not a personal use of life insurance
Only at time policy is Purchased
In life insurance contracts, when must insurable interest exist
Blackout Period
The preretirement period, one of the distinct income needs periods, is also known as
Business Owner's Life
In a buy-sell agreement, the life insurance policy is written on the
Human Life Value Principle
Which of the following states the purpose of life insurance is to replace the economic value of an individual
Annual
Life insurance premiums are lowest under which premium payment mode
Permanent Life Insurance
Living and death benefits, level premiums and lifetime coverage are characteristics of which of the following classes of insurance
Mortality
The number of individuals who die each year at a given age is known as
Producer Certification
Which of the following does not have an effect on the insurance premium rates
Industrial Life Insurance
Which of the following types of insurance has premiums due weekly and collected in person
Deferred Compensation Plans
Which of the following describes an employer that agrees to pay an employer a states amount of income beginning at retirement rather than paying them now
Executive Bonus Plan
All of the following are examples of buy sell agreements except
Liquidity
Which of the following terms refer to how easily an asset can be turned into cash without loss of value
Beneficiary
What party is not part of a three party contract
Term Life Insurance
Which of the following classes of life insurance has a death only, increasing premiums temporary coverage and expires at end of the term
Net Premium
What premium is mortality minus interest elements
Tom would like to buy life insurance for his best friend
All of the following are examples of insurable interest except
Social Security
All of the following are distinct income need periods except
Premiums are higher than other types of life insurance policies
All of the following statements about term insurance are correct except
Decreasing Terms
In which type of policy does the annual premium remain level throughout the policy while death benefit decreases
Limited-Pay Whole Life
Which whole life policy allows for a lifetime of premiums to be paid in a shorter period of time such as 10 or 20 years
Fixed and Level
Death benefit of a whole life policy is
Permanent Insurance
Whole life is often referred to as
Flexible Policies are temporary insurance
Which of the following statements about flexible policies is NOT correct
Separate Account
The distinguishing feature of a variable policy is that all of the earnings depend on the investment performance of a
Most Variable life policies offer a guarantee of a minimum return
All of the following statements regarding variable life insurance are true EXCEPT
Joint Life Policy
Which of the following specialized policies insures two people and pays its benefits when the first one dies
Age 18
When does the face amount of a jumping juvenile policy typically increase
Renewable Term
Pam owns a 1 year policy. At end of year, she may purchase another identical policy without showing proof of insurability. Pam's policy is a
Limited-Pay policy
Zelda agrees to pay premiums on her policy every year for 20 years. After that, she will no longer have to pay premiums, but her insurance protection will continue until she dies. she has a
Continuous Premium Whole Life Policy
Ashley has a policy that she must pay premiums on until she is 100 years old or dies. Ashley has
Guaranteed Interest Rate
Which of the following is not flexible in a universal life policy
$100,000
Martha has a universal life policy several years ago. At that time, the death benefit policy was $100,000. Her cash value is now $50,000 and she selected death benefit option A. How much is her current death benefit
$120,000
Karen has a universal life policy several years ago. At that time, the death benefit in the policy was $100,000. Her cash value is now $20,000 and she selected death benefit option B. How much is her current death benefit
Registration with the NAIE
Which of the following is not required to be able to sell variable insurance
Term Life Insurance
Which type of life insurance is designed to provide life insurance protection for only a limited time.
Whole Life Insurance
Which of the following types of insurance requires a level premium and provides lifelong protection
Convertible Term Insurance
Christy has a term policy that will allow her to switch over to a whole life policy at any time during the first half of the term without providing evidence of insurability. What type of policy is this?
Premiums are reduced by 80% during any period insured is disabled
All of the following statements about waiver of premium is true except
A Rider
Which of the following terms describes something that is used to add benefits to a life insurance policy and customize the coverage to an insured's particular needs
Accelerated Benefits Rider
Which rider allows insureds who are terminally ill to obtain benefits from insurance prior to death
Cost of Living
Which rider lets insureds buy coverage without proof of insurability in order to keep pace with inflation
90
For an accidental death benefit ride to be payable the insured must die within how many days of the accident
$200,000
Tommy has $100,000 life insurance policy with double indemnity rider, Tammy is killed in an automobile accident, how much will his policy pay
Disability Income Rider
Kumar has life insurance policy with rider that will pay him $1,000 per month if he is totally and permanently disabled. What type of rider does he have
Payor Rider
Paul has life insurance policy on his son for which he pays all premiums. If Paul becomes permanently and totally disabled , the premium will be paid until his son reaches 21. What type of rider does he have
Long-Term Care Rider
Which of the following rider allows for an advance of death benefit if insured is confined to nursing home or can't perform activities of daily living
Waiver of Premium Rider
Alberta is concerned if she became permanently and totally disabled, she won't be able to pay her life insurance premiums and her policy will lapse. Which rider should she consider
Return of Premium
Which of the following riders is increasing term insurance that always equal total premiums paid during time policy is in effect
Waiver of Premium
Which of the following is waiver of all future premiums in the event of total and permanent disability
guaranteed Insurability
Which is a guarantee that at specified ages, dates, or events, insured may buy additional insurance without medical exam
Principal sum
Amount of money paid by accidental death benefit rider if the insured dies in an accident is referred to as
Capital sum
Amount of money paid by accidental death and dismemberment rider if insured is disabled in an accident is referred to as
Interest Only
Which settlement option only pays earning on death benefit to a beneficiary
Fixed-Period Option
Emily chose to receive payout from her husband's life policy so that she will receive an income for the next 15 years. At the end of the period, entire proceeds will be paid out. Emily selected the
Nonforfeiture Options
Cash surrender, reduced paid up insurance, and extended term insurance are examples of
Dividends can be guaranteed to be paid every year
All statements about policy dividends are true except
Dividends are used to purchase additional insurance protection
Which of the statements about paid up additions is true
Life Income Option
Heath has chosen to receive the payout from his wife's life insurance policy in such a way that he would have a income for the remainder of his life, regardless of how long he lives. Heath selected the
Interest only Option
Jim has selected to receive only the interest from his mother's life insurance policy. when Jim dies, his children will receive the lump sum benefit in addition to the benefit from his life policy. Jim selected the
Joint and Survivorship Life Income Option
Walter is the beneficiary of his mothers life policy. He wants to make sure proceeds will last not only as he lives but as long as his wife lives as well. Walter should select the
Life Only
Out of all life income options, which settlement option has the largest payment
The Capital Amount
Which of the following is not a factor in determining the amount the beneficiary will receive each time a payment i made under the fixed amount option
Fixed Amount Option
Carmen selected to receive $10,000 per month until the principal and interest on her husbands life insurance policy have been paid out. Carmen selected
Payments continue even if beneficiary dies shortly after payments begin
All of the following statements regarding the life only settlement are correct except
Refund Annuity Option
Thomas chose to receive the settlement from his wife's $100,000 life insurance policy according to the life income option. Under the option he chooses, he will receive an income for his life and his daughter will receive will receive payments if he dies b
Age of beneficiary
Which of the following is not a factor in determining the amount the beneficiary will receive each time a payment is made under the fixed period option
New protection is for same amount as original policy
Which of the following statements about reduced paid up insurance option is not true
Insuring Clause
Which clause contains basic promise of life insurance company to pay a specified sum of money to beneficiary upon death of insured
Entire Contract Clause
Which clause identifies components of contract
Uniform Simultaneous Death Act
An insured and primary beneficiary died in car accident. Which of the following states that the primary eneficiary died first unless there is evidence to the contrary
Ginny will receive benefits before any other beneficiary upon mothers death
Ginny is a revocable primary beneficiary on her mothers life insurance policy. Which of the following statements is true
Steve is an irrevocable beneficiary
Steve is the beneficiary on his spouses life insurance policy. When they divorce, his spouse cannot remove him as beneficiary on the policy without his written permission because
Consideration Clause
Which clause identifies the fact that the policy owner must pay something of value for the insurers promise to pay benefit
Policies are paid directly to beneficiary in monthly installments
Which of the following is allowed when policy proceeds are paid through spendthrift clause
Coverage will be lowered because premium is lower than it should have been
Carl purchased a life insurance policy when he was 44. The insurer accidentally recorded his age as 42
select a beneficiary
If named beneficiaries cannot be found, under the facility of payment provision the insurer may
2 years
Incontestability is usually in effect for
Proceeds are split 2 ways between the remaining children only.
John leaves his $300,000 estate t his 3 children to split evenly according to a per capita distribution. One of his children dies before john does. Upon Johns death, which of the following statements is true
Rosemary is the primary beneficiary, and George is the contingent beneficiary
When Tom dies, Rosemary recieves the death benefit. If Rosemary had died before Tom, George would have received the benefit. Which of the following statements is true
Proceeds are split 3 ways between remaining children and the beneficiary of deceased child's estate
John leaves his $300,000 estate for his 3 children to split evenly according to a per Stirpes distribution. One of his children dies before john does. Upon Johns death, which of the following statements is true
Certificate of Insurance
For group insurance policies, the covered individual receives proof of coverage in the form of
75%
If a group insurance policy is contributory, what percentage of employees must participate
Probationary Period
Kathleen is hired to work at an restaurant. She is not eligible to join the group insurance plan for 30 days. This is an example of
Stringent Medical Underwriting
Group Insurance Generally does not require
It is more expensive than individual credit life insurance
Which of the following characteristics about group credit is not correct
Individual policy will be provided to all members of the group
All of the following are correct regarding group insurance except
Employers can choose which individuals will be covered and which will not be covered
All of the following insurance eligibility requirements re true except
annuitization period
Period during which a person receives the annuity benefits is called the
Immediate Annuity
Under which annuity do the benefit premium payments begin within 12 months of the purchase
Temporary annuities
Fixed period and fixed amount are types of
General Accounts
Fixed annuities are supported by insurers
Accumulate a sum of money and distribute a lifetime income
Annuities exist to
single premium annuity
Liz purchases an immediate annuity. Annuity contract must be
Premiums paid for executive bonus plan
None of the following premiums are tax deductible for business except
If death occurs during accumulation period, proceeds paid in lump sum to beneficiary are never taxable
All of the following statements regarding taxation of annuities are correct except
Life Insurance
Which of the following products cant be used to fund an IRA
Premature Withdrawal at age 55 in order to pay off credit card
Which of the following early withdrawals from an IRA would be subject to a 10% penalty
Mitch is unemployed but does receive rental income for $2000 a month
All of the following individuals meet eligibility requirements for setting up an IRA EXCEPT
Participation
Which of the following requirements of all employer-sponsored qualified retirement plans states that plans must benefit all regular employees, not just a select few?
Profit-Sharing Plans
Which of the following employee sponsored retirement plans does not require the employer to make a funding contribution each year?
Defined-Benefit Plan
Curtis knows that when he retires after age 65, he will receive 80% of his salary as pension. This is an example of
The amount of annual contributions is set by employee
All of the following statements about profit-sharing plans are correct except
50
At what age can people begin making catch-up contribtuions to their individual retirement plans
10%
Premature distribution from a qualified plan or an IRA can result in the amount being taxed as income plus a penalty tax of
60
A rollover from one IRA to another or from a qualified plan to an IRA must be accomplished wihin how mant days if the owner is to avoid an income tax liability on the amount rolled over?
59 1/2
At what age is an individual no longer subject to early withdrawal penalties under an IRA
Public School System
Which of the following organizations would be eligible to offer a 403 (b) arrangement
A SEP
Carmen owns a business with 200 employees that provides a retirement plan whereby the business makes contributions on the employees behalf. Carmen's plan is most likely
A Keogh Plan
Delbert is self employed and sets up a retirement plan for himself. Delbert most likely sets up
50% tax penalty
Kim is required to take a $2,000 minimum annual distribution from her IRA. she fails to comply and only takes a $1,000 distribution. Because of this failure, kim will be subject to
Each person has a policy
All of the following are characteristics of a group health insurance plan except
Long Term Care Insurancr
Which of the following types of health insurance covers the cost of providing nonmedical custodial care to individuals with cognitive problems
Insured
With a hospital income plan, the flat dollar payment is made directly to the
Injury in a natural disaster
All of the following are common exclusions in health insurance policies except
An Accident-only Policy
Julia has a policy that excludes any type of sickness or disease and covers only accidents as a peril. Julia probably has
A hospital income insurance policy
George's brother, Jerry, has a policy that will provide him an income if he is disabled from illness or injury, but only if he is confined to a hospital. Geroges broter probably has
Cover only specific diseases as named in the policy, such as heart disease , kidney failure, or cancer
Dread disease policies
Sin Lan
Sin Lan has a hospital income policy that will pay $50 a day. If Sin Lin is hospitalized to whom will the insurer make payments
Debtor
Credit disability (health) insurance covers
Insureds are given certificates of insurance instead of a policy
All of the following apply to indvidual health insurance policies except
An Accident
Any unintentional bodily injury caused by an unforeseen event is known as
A Sickness
A need for medical care due to a cause other than an accident is known as
Disability Income Insurancr
Melissa was involved in an accident that left her unable to work for an extended period of time. She has a policy that will pay her a stated amount of income on a regular basis while she is off work. Melissa most likely has
Blanket Coverage
A type of group insurance where the group members are identified as all persons engaged in a similar activity is known as
Social Insurance Program
Which of the following is NOT a common name for the Affordable Care Act?
A grandfathered plan is required to comply with all of the consumer protections of the ACA
All of the following statements are true regarding grandfathered plans except
Up to age 26
Group health plans and health insurance issuers offering group or individual health insurance coverage that provide dependent coverage to children of the insured must make covrage available for adult children
A pre-existing condition
A limitation or exclusion of benefits based on a physical or mental condition that was present before the effective date of coverage is also known as
$2000 per full time employee
What is the penalty for an employer that does not offer health coverages and has 50 or more full-time employees
Navigators can legally provide advice to consumers about which health plan to choose
All of the following statements about navigators are correct except
Policy must provide certain recommended preventive services for free
Which of the following is NOT a consumer protection that applies to both grandfathered and nongrandfathered
Maska, age 27, an American Indian
Which of the following individuals is excluded from the required ,minimum essential coverage
On-Site medical Clinics
Minimum essential coverage means coverage from any of the followinf except
80%
Which of the followin percentages represents the average portion of expected costs covered in the Gold plan
There is a requirement to cover the child of a dependent child
All of the following statements regarding the essential health benefit of coverage of children to age 26 are correct except
Moving to a new state with same health plans
Jodi missed the deadline for the annual open enrollment. Which of the following qualifying events would not allow her to have a special enrollment
90%
Which of the following percentages represents that average portion of expected costs covered in Platinum plan
50% of premiums paid
ABC Printing, a small tax nonexempt company, can get tax credits to help offset the cost of the company's health plan premium contribution for its employees. The maximum credit is
Less than 25
How many full-time employees (FTES) must a company have to be eligible for the Health Care Tax Credit for Small Employers
Silver
Advanced premium tax credit (APTC) may be applied to lower the insureds monthly premiums. The cost-sharing reduction is only available through a health plan from which tier?
Renewability
All of the following are mandatory health insurance provisions, except
10 days
Marcus pays his insurance premium monthly and has a grace period of
5
How many days notice must the insured be given if an insurer cancels a policy
Change of Beneficiary
All of the following are optional health insurance provisions except
Free Look Period
Which provision allows new insureds the right to examine a policy for a specified period of time with the option to return it
A consideration
The exchange of something of value is known as
Premium Payment
According to the entire contract provision, the entire contract includes all of the following except
90
generally , written proofs of loss must be furnished within how many days after the loss
Insureds estate
If there is no beneficiary listed on a policy, benefit will be paid to
The state has an applicable law that forbids autopsy
The insurer may generally require an autopsy at its own expense unless
Limits will be lowered
When Betty purchased her insurance policy, her age was recorded as 32 when she was actually 34. Assuming her policy includes the misstatement of age provision and the insurance company discovers this four years later, Betty's policy
Limits will be lowered
The optional provisions that deal with multiple insurance policies of the same type on a single insured deal with the problem
Over-Insurance
A pro rate return is one in which the insurer returns
The proportionate amount of the unearned premium
A pro rate return is one in which the insurer returns
Premium payment frequency
Grace period varies according to
After 45 days
Mike allows his policy to lapse, then applies for reinstatement using the company's required application. At what point can Mike consider the policy reinstated
Accidents immediately and sickness after 10 days
A reinstated policy will cover
Disability Income Insurance
Which type of insurance protects against loss of earned income due to sickness or injury sustained in an accident
Presumptive Disability
Which of the following terms describes a condition that automatically qualifies insureds for disability benefits whether or not they can work
Elimination period
The amount of time an insured must be disabled before receiving benefits is known as the
Partial Disability
Rachel was injured but is still able to perform some of the essential duties of her occupation. Regardless of income lost, rachelle will receive 50% of the benefit for total disability for 6 months. Rachelle most likely has a
Future Increase Option Rider
Which of the following allows insureds to buy additional amounts of disability income insurance coverage at stated future times without having to provide proof of insurability
A Car Accident
All of the following are common exclusions found in disability income policies except for losses arising from
Short term disability policies have long elimination periods
All of the following statements about short-term disability are treu EXCEPT
Insureds Occupation
Which of the following is the most important factor in underwriting disability income insurance
Accidental death and dismemberment
All of the following define a disability EXCEPT
The rehabilitation benefit
The benefit that pays for the insured to learn to work in a new occupation is known as
Additional Monthly Benefit Rider
The rider that provides additional benefits during the first 6-12 months of a claim is known as
Time Dedictible
The elimination period may be thought of as
The higher the policy's premium
The longer the benefit period
Own Occupation
Which definition of total disability is more favorable to the insured
Loss of dominant hand
Which of the following generally is NOT considered to be a presumptive disability
Recurrent Disability
Brandon injures his back working at a warehouse. 6 months later, he is well enough to go back to work lifting boxes. Two weeks into working, however, he strains his back again and has to go back on bed rest. This is an example of
A doctors office
Which of the following organizations would be most likely to be eligible for business overhead expense insurance
1-2 Years
To protect the business owner, the elimination period for disability buy-sell insurance normally is
Benefit Schedule
Which of the following terms describes a medical expense policy that pays a provider a set fee for their services regardless of the charge
Insureds
Traditional fee for service plans refer to their customers as
Mental Illness Treatment
All of the following are typically excluded from medical expense plans EXCEPT
Deductible
Major medical benefits usually begin after the insured has incurred an initial annual amount of out of pocket expense called a
Stop-Loss Limit
The out of pocket limit is also known as the
Dental Care
Which of the following is least likely to be covered by a major medical expense
Major medical expense policy
A type of health insurance that provides a much broader range of medical expenses and higher benefit amounts is a
Alleviate pain and suffering for terminally ill patients, but does not attempt to cure
Hospice care is used to
Stop-loss limit
The dollar limit beyond which the insured is no longer required to pay coinsurance the
coinsurance
The sharing of expenses between the insured and the insurer is an example of the
Corridor deductible
A deductible that falls between two periods where the insurance company pays is known as a
Subscribers/ Participants
Prepaid medical expense plans refer to their customers as
200
Sarah has a $200 deductible and a 20% coinsurance for her medical expense plan. Her first medical bill of the year is $1200. Sarah will pay the $200 deductible. How much money will sarah still need to pay
Maximum out of pocket
Which of the following terms describes the limits that a person will have to pay in any calendar year for covered medical expenses
Medical services are provided first and then they are billed and paid for
All of the following are features of HMOs EXCEPT
HMO
The gatekeeper concept, co-payments and limited choice of provider are characteristics of an
Open Panel networks
PPO subscribers are not strictly limited to using providers that have contracts with the PPO. PPOs are
Point of service plan
A type of HMO that does not have a gatekeeper and allows subscribers to obtain care from either providers that do or not belong to the HMO is called a
Second surgical opinion
Which of the following cost saving measures allows or requires insureds to consult a doctor other than their attending physician to see if an alternative method of treatment would be desirable
Utilization Management
All of the following are alternatives to hospital care EXCEPT
HMOs provide both the health care service and the health care financing, but traditional health care insurance companies provide only the financing
The main difference between traditional health insurance arrangements and HMOs are
closed panel
Gwyneth's HMO requires that she receive health care services from a specified, limited number of health care providers chosen by the HMO. Gwyneth's HMO is
open panel
David has a PPO that does not limit him to use only providers that have contracts with the PPO. David PPO is
Indemnity arrangements
All of the following are examples of managed care plans EXCEPT
PPOs operate on a prepaid basis
All of the following are characteristics of a PPO EXCEPT
Preauthorization
If treatment requiring hospitalization is recommended, the physician of the insured may have to get the expense approved prior to obtaining its treatment. This is known as
Alternative review
All of the following are points in the process of utilization management EXCEPT
Retrospective review
Which utilization management review is done after the treatment is complete
a certificate of coverage
What do the individual members of a group receive as evidence that they are covered by a group health insurance policy
It is more expensive than individual insurance
All of the following are characteristics of group health insurance EXCEPT
enrollment period
Insurers usually allow a period of 30 or 31 days for employees to sign up for health insurance without having to prove evidence of insurability. This period is known as the
26
Dependent coverage for employees must be made available to a participating employees spouse or children who are under age
a non disabled dependent child reaches age 25
All of the following are events that terminate coverage EXCEPT
Extension of benefits
A state law that requires benefits that began to be paid while a health insurance policy was in force to continue to be paid after the policy is terminated is known as the
26 year old child
All of the following could be considered dependents except the insureds
Primary plan pays up to its limits first and then the secondary plan pays the rest
The coordination of benefits provision provides that when a person is covered under more than one plan the
The plan of the parent whose birthday falls earliest in a calendar year
When both parents have employer-provided group coverage, which plan would be the primary payer that
COBRA
Which federal law requires employers with more than 20 employers to include in their group insurance plan a continuation of benefits provision for all eligible employees
60 days after the individual receives notification
The option to elect continuation of benefits after an employees group plan is terminated expires
group crediy disability insurance
A lender, or creditor may sponsor a group health insurance plan for its group of debtors. This is known as
a contributory period
A health insurance plan where the employees pay part of the cost and at least 75% of those eligible must participate in is known as
probationary period
An insurer requirement that new employees must wait for a certain period of time before they can enroll in an employers group health plan is called an
18 months
Under COBRA, the maximum period of coverage for termination of employment or a reduction in hours is
Experience Rating
A method of establishing the premium of a group based on the groups previous claim experience is known as
scheduled
A dental plan that has benefits limited to specified maximums per procedure with first dollar coverage is considered to be
oral surgery
Which of the following dental expense plans covers the removal of wisdom teeth
teeth that are knocked out in an accident
All of the following are common exclusions in a dental policy EXCEPT
Adverse selection
The ability of an individual to wait until covered by dental insurance before seeking treatment for dental issues is an example of
endotonics
A root canal is an example of which of the following types of dental treatment
PPOs
Today, most dental plans are offered through
nonscheduled plan
A dental plan that pays on a usual, customary, and reasonable basis (UCR) is also known as
Basic services such as fillings and crowns are covered without deductibles and coinsuranceno
All of the following statements regarding deductibles that apply to various levels of dental treatment EXCEPT
Predetermination of benefits
A written treatment plan provided to patients showing the estimated charge for each service to be performed, along with a breakdown or how much the cost is expected to be paid by the dental plan is known as a
most dental expense coverage is integrated into a comprehensive health plan
All of the following statements regarding group dental expense plans are correct EXCEPT
restorative dental treatment
Filings, crowns, and restoring teeth that have been damaged by tooth decay is an example of
local anesthesia
All of the following are examples of major dental services EXCEPT
hospice care
All of the following are exclusions under Medicare Part A EXCEPT
Skilled nursing facility
Which of the following Medicare Part A coverages is for individuals that need round-the-clock medical care provided by licensed nurses, but do not need the acute care provided by a hospital
3 months before the months person turns 65
The initial enrollment period for Medicare Part B begins
Routine foot, vision, dental, or hearing care
All of the following are covered under Medicare EXCEPT
medicare supplement insurance
Which of the following is a commercial coverage designed to pay some of the medical expenses that the original Medicare leaves to the beneficiary
original medicare
Medicare Part A and Part B are often referred to as
medicare specialty plan
Which of the following types of Medicare Advantage plans focus on the particular needs of a defined group of patients such as those with a certain medical condition
Medicare SELECT
A coverage offered through a restricted provider network, like a managed care plan is known as
Medigap policies are not guaranteed renewable
All of the following statements regarding Medigap required provisions are true EXCEPT
Year
Under Medicare Part B, individuals pay a deductible each
assignment
Doctors and suppliers who agree to accept the amount Medicare will pay are said to have agreed to
Hearing exams
Which of the following outpatient services is excluded from Part B coverage
medicare Parts A and B
The Original Medicare Plan consists of
do nothing, she is automatically enrolled for free
Michelle is 65 and starting to receive Social Security benefits. To receive Medicare Part A she needs to
Part D
What part of Medicare covers only prescription drugs outside the hospital
January 1
The annual general enrollment period for Medicare Part B begins on
medigap policies
Medicare supplement policies are also known as
All standard Medigap plans exclude the cost of the first 3 pints of blood
All of the following statements about Medigap insurance are correct EXCEPT
Ginny, who is over 65 and working as a manager of a retail outlet
Which of the following individuals is NOT likely to be eligible for Medicaid
working
All of the following are activities of daily living EXCEPT
custodial care
The type of care that provides assistance with the activities of daily living performed by unskilled helpers is known as
elimination period
An insured must receive care for a stated number of days before a long term care policy can pay benefits. This time deductible is known as the
Alzheimer's
All of the following are exclusions in long term care insurance policies EXCEPT
Employer paid premiums are tax deductible to employee
All of the following statements regarding tax treatment of long term care insurance are true EXCEPT
30 days
Marketing standards for long-term care policies requires a free look period of
time deductible
Elimination period may be thought of as a
driving
Which of the following is NOT considered an activity of daily living
adult day care
All of the following are levels of facility based long-term care EXCEPT
dollars per day
Benefit amounts in a long-term care policy are usually expressed as
elimination period
All of the following are optional benefits in a long-term care insurance policy EXCEPT
Nervous disorder without organic cause
Which of the following is excluded in a long-term care insurance policy
HIPAA prohibits the sale of these policies
All of the following statements about a non qualified long-term care insurance policy are true EXCEPT
intermediate care
Medical or rehabilitative care performed on an intermittent basis is known as
assisted living care
Individuals that need assistance from time to time but can live more independently than people who need custodial care may need
Whether an individual can perform the activities of daily living
In regards to underwriting considerations of long-term care policies, the key decision is based on
100%
Self-employed persons are allowed to deduct what percentage of the amount they pay for health insurance
deductible to the employer
Employer paid group medical and dental health insurance benefits are tax free and the premiums are
Health Savings Account
Which of the following was created to help employees and self-employed individuals pay for their medical care expenses on a tax advantaged basis
flexible spending arrangement
Which of the following is a cafeteria plan benefit and is funded with employee money by means of a salary reduction
100%
Wandas employer pays the entire premium for her group disability coverage. If wanda became disabled, how much of her benefits from this coverage would be subject to tax
0%
If wanda paid her entire premium for ehr group disability coverage, how much of her benefits from this coverage would be subject to tax
business overhead expense
The XYZ Coffee Company may deduct its premiums from taxes but the benefits are taxable. The type of business disability plan that the company must have is a
Tax deductible by the company and not considered taxable income to employees
Premiums paid by a company for group medical for its employees are
Received income tax free
Benefits paid by personally owned accident, health, disability, or long term care policies generally are
Deductible by the company but not the employee
Qualified group long term care coverage premiums that are paid for by the employer are
Not deductible to the insured, but the benefit are received tax free
Personally owned disability income insurance premiums are
High deductible health plan
A health plan that offers relatively low premiums but requires that the insured pay a high deductible is a
Contributions to an HSA are not tax deductible
All of the following statements about a health savings account (HSA) are correct EXCEPT
business overhead expense
The premiums are deductible and the benefits are taxable for which of the following business disability plans