Kaplan Life and Accident and Health exam Prep

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