maximum benefits
upper limit of total lifetime benefits that the insurance company will pay
Misrepresentation
falsifying terms, benefits, advantages, or conditions of insurance policy
defamation
publishing information that is false and maliciously critical to an insurer and intended to cause injury
An insurer can exclude coverage for a pre-existing condition on Medicare Supplement policy for up to ___ months
6 months
A minor may receive a life insurance policy's death benefit ONLY if
minor is at least 12 years old
minor approved by superintendent
minor is blood relative
minor has appointed guardian
minor has appointed guardian
An insurer may deny health insurance claims based on misstatements in application for how long from policy's date of issue?
2 years
A life insurance policyowner is allowed ___ days upon policy delivery to return policy for full premium refund?
10 days
A life policy loan in Ohio cannot charge fixed rate of interest higher than:
8%
An agent's license may only be suspended or revoked if the agent:
has been afforded the right to a hearing
has engaged in replacement of an existing policy
filed for bankruptcy
did not meet a sales quota
afforded the right to a hearing
Mary's Medicare Supplement policy had been in effect for 12 months. She recently replaced policy with a new one that provides better coverage. The replacing policy may only impose a ___ month time exclusion for pre-existing conditions.
0 months
The XYZ Corporation took out billboard ads in Ohio indicating that it can transact business in Ohio. This insurer is not approved in Ohio. XYZ is guilty of:
false advertising
Kiara filled out a life insurance application and was given a policy illustration that showed future premiums being paid out of nonguaranteed values. The illustration must disclose that:
she may need to resume premium payments depending on actual results
The branch of dentistry which deals with replacement of missing parts is called:
endodontics
periodontics
orthodontics
prosthodontics
prosthodontics
As of January 1, 2014, an employer with up to 25 FTE's with average annual wages < $50,000 may be eligible for a tax credit of ___% of the premiums paid by the employer.
50%
If an insurer refuses to pay a claim, how many days must the insured wait to take legal action against a health insurer after submitting written proof of loss?
60 days
A life insurance applicant in Ohio may backdate the application for up to ___ months
3 months
A common exclusion or limitation on dental policy is:
endodontics
Coverage for newborns under accident and health plan MUST include coverage for:
birth abnormalities
An example of endodontic treatment is a:
bridge
crown
filling
root canal
root canal
An employee has ___ days after date of marriage to add a new spouse to a small group health plan.
30 days
In Ohio, semi annual premium health insurance must provide a grace period of at least:
7 days
10 days
20 days
31 days
31 days
A licensed agent must be ___ by an insurer to be eligible for soliciting insurance contracts.
appointed
REPLACEMENT can be BEST described as:
exchanging a new policy for one already in force
When screening an applicant for HIV, the insurer:
may require a blood test for HIV
may inquire about applicant's sexual history
may inquire about applicant's sexual orientation
may ask applicant's relatives confirming sexual orientation
may require blood test for HIV
Inducement is BEST defined as
offer to buy, sell, give or allow the prospective insured employment, stock, or special favors in exchange for insurance transaction
An agent's license has been suspended for non-renewal. The agent may apply for reinstatement within ___ months of the license renewal date
12 months
The first payment for newborn accident and health coverage is due ___ days after birth
31 days
How are health plans classified according to the Affordable Care Act?
Bronze, Silver, Gold and Platinum
An insurer may refuse to renew an employer's small group health plan due to:
nonpayment of premium
If an agent is believed to be causing considerable harm, the superintendent may:
issue a cease and desist order against the agent
An insurance company has just received a request for verification from a viatical settlement provider. The insurer is required to respond within ___ calendar days to this request.
30 days
Prior to conducting an HIV-related test, the insurer must obtain:
written authorization from the proposed insured
An agent is legally permitted to share his/her commissions with:
another licensed agent
Long-term care policies or certificates issued in Ohio are required to have:
nonforfeiture value
Tim's life insurance policy has just recently lapsed. His policy may be reinstated at any time within ___ year(s).
3 years
An employer with under 20 employees must allow a terminated employee to continue accident and health coverage for a MINIMUM of ___ months
12 months
Pete the Agent recently had his license suspended because he was found in violation of a state insurance law. Due to this suspension, Pete:
may be assessed administrative costs sustained by the department
An advertisement for an insurance product may contain:
the insurer's name
A foreign insurance company doing business in Ohio is:
a company domiciled under the laws of another state
An agent's renewal date for his/her license is on or before:
the last day of the licensee's birth month
Unmarried children who are incapable of self support and have proof of incapacity are included under their parents' health coverage until:
policy termination
Advertising regulations exist in order to:
demonstrate full and truthful disclosures to the public
To be eligible for small employer group coverage, an employee must work a MINIMUM of ___ hours in a typical week.
25 hours
Long-term care insurance applications MUST contain plain and unambiguous health questions. The exception to this rule would be application for:
guaranteed issue
Advertisements for accident and health policies that ONLY cover a stated illness MUST display a statement that:
the policy is limited
An agent has committed insurance crime that violates US Code 1033 (interstate commerce). Who would be responsible for the prosecution of this crime?
United States Attorney General
An insurance company advertises an accident and health insurance product in a local Ohio newspaper and refers to dollar amount benefits. The insurer may also disclosed what in the advertisement?
any applicable benefit reduction
Knowingly making an untrue or incomplete statement during an insurance transaction is considered an example of:
misrepresentation
An agent's appointment may only be terminated by the:
insurer
All of these are responsibilities of the superintendent EXCEPT:
administering oaths
subpoena a witness
approving policy forms
endorsing insurers
endorsing insurers
A life insurance policy that contains a guaranteed interest rate with the chance to earn a rate that is higher than the guaranteed rate is called:
universal life
Credit accident and health plans are designed to:
help pay off existing loans during periods of disability
A whole life insurance policy accumulates cash value that becomes:
the policy value which the insured may borrow against
Ownership of a life insurance policy may be temporarily transferred with a(n)
collateral assignment
A limited payment whole life policy provides:
lifetime protection
All of the following are core benefits of Medicare Supplement Plan A EXCEPT:
Deductible payments for the first 60 days of hospitalization under Medicare hospitalization insurance
A life insurance policy that has premiums fully paid up within a stated time period is called:
limited payment insurance
All Health Benefit Plans issued after January 1, 2014 must provide
preventive health services
Sole proprietors are permitted tax deductions for health costs paid from their earnings in the amount of:
100% of costs
Which of the following annuity payout options makes no additional payments regardless of when annuitant dies:
life only
A life insurance policy that is subject to contract interest rate is:
universal life
Field underwriting performed by the producer involves:
completing the application and collecting initial premium
A type of insurer that is owned by its policyowners is called
mutual
How much does Medicare Part B pay for physician fees?
80%
Disability insurance benefits from a group policy for by an employer is considered ___________ income
taxable
What is the tax liability for employer contributions in Health Savings Accounts (HSA's)?
No tax payment needed
How is the cost of a policy affected when a policyowner pays premiums more frequently?
Not affected
Increases
Decreases
Depends on the type of coverage
increases
The analysis of applicant's personal information and determining whether insurance should be issued or declined is called:
underwriting
A non-admitted insurer
is not afforded protection by the guaranty fund
When does life insurance policy typically become effective?
when initial premium is collected and policy is issued
What is the elimination period of individual disability policy?
time period disabled person must wait before benefits are paid
Under the Affordable Care Act, a grandfathered health plan can lose its grandfathered status if:
insurer significantly raises co-insurance charges, deductibles or co-payment charges
What is a condition or situation that creases or increases a chance of loss called?
hazard
What are the 3 types of hazards?
Physical, Moral, Morale
Who is responsible for assembling the policy forms for insureds?
insurance carriers
The deeds and actions of a producer indicate _______ authority
apparent
A professional liability for which producers can be sued for mistakes of putting a policy into effect is called:
errors and omissions
Which contract element is insurable interest a component of?
legal purpose
The authority granted to a licensed producer is provided via the:
law of agency
According to the principle of Utmost Good Faith, the insured answers questions to the best of their knowledge and pay the premium, while the insurer will deal fairly with the insured and its:
promises made
A decreasing term policy has decreasing death benefits and ____ premiums.
level
A ________ life policy pays a death claim in the amount of the death benefit PLUS the savings element.
universal
What is a corridor in relation to a Universal Life insurance policy?
The gap between total death benefit and the policy's cash value
What does "level" refer to with Level Term?
the death benefit or face amount, that does NOT change throughout the life of the policy
What is an advantage of child's term rider?
It can be converted to permanent coverage without evidence of insurability
What happens to policy proceeds if someone dies with "first to die" joint life insurance?
Policy proceeds will no longer provide insurance protection
What type of policy has flexible premiums, flexible death benefit, and choice of how cash value will be invested?
variable universal policy
level premium, decreasing death benefit
decreasing term
level premium, increasing death benefit
increasing term
What type of insurance ends at age 100, has cash value (savings element), level premiums, and level death benefit?
whole life
What is another term for cash value?
nonforfeiture value
What are two advantages of living benefits?
1) can borrow against cash value when policy is in effect
2) can receive cash value when the policy is surrendered
What type of life insurance allows for partial surrender?
universal life
Which policy allows flexibility with investment choices?
variable universal life
True or false. Loans obtained by a policyowner against the cash value of a life insurance policy is NOT treated as taxable income.
True
What are the 3 types of whole life insurance?
1) straight: fixed premium till death, age 100
2) limited pay: limited premiums (e.g. for 20 years)
3) single premium: one time lump sum
A guaranteed issue insurance policy has no:
medical underwriting
What are group disability benefits considered tax-free to the insured?
When the recipient pays the premiums
One of the most important considerations when replacing health insurance would be:
exclusions on a new policy
Which of these is considered a major tax advantage of life insurance?
Income tax is not typically owed on proceeds paid directly to a beneficiary
An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called
coinsurance
An order issued by the superintendent that prohibits a specific practice listed in the order is called a(n)
cease and desist order
Within how many days must a rollover be completed in order to avoid being taxed as current income?
60 days
An insurer is REQUIRED to offer what to each long-term care applicant at the time of purchase?
inflation protection
The standard grace period for a life insurance policy sold in Ohio is ____ month(s).
1 month
An unauthorized insurer may place insurance business in Ohio through a(n):
surplus lines agent
Every admitted insurance company in Ohio MUST have their financial affairs examined by the superintendent at LEAST
3 years
An employer may qualify for health care tax credits through SHOP Marketplace if that employer has fewer than ____ employees
25 employees, full-time, make an average of $50,000/year or less
How many days is a temporary agent's license valid?
180 days
A Buyer's Guide MUST
have its content approved by the superintendent
Greg has recently been terminated from his job that covered him for group life insurance. How many days does he have to convert his coverage to an individual policy?
31 days
Open enrollment for Medicare Supplement coverage starts:
3 months before your 65th birthday
According to the Affordable Care Act, any plan in existence prior to what date is considered a grandfathered plan?
March 23, 2010
According to the Affordable Care Act, the maximum amount an individual can contribute to a Flexible Spending Account is:
$2,500
Proof of loss on a health insurance must be submitted to an insurer within _____ days after the insured's date of loss
90 days
In Ohio, legal action may be taken up to _____ years against an insurer for failure to pay health insurance claims after proof of loss was submitted.
3 years
Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss.
20 days
In Ohio, a long-term policy must be ___________ renewable
guaranteed
In Ohio, an agent may have his/her license revoked for
failure to pay state income tax
A life insurance policy must be in effect for ___ years before the policyowner may use the nonforfeiture provision.
3 years
If health insurance benefits are not paid in a timely basis, the benefits paid shall bear simple interest from a date ___ month(s) after satisfactory proof of loss was received by the insurer.
2 months
One of the most important considerations in replacing health insurance would be the:
exclusions on a new policy
Which signature is not required on an individual insurance application?
insurer
Lorenzo is self employed with an S corporation. He is unmarried and had a net profit for the tax year. What are the tax ramifications of his health insurance premiums paid for the year?
100% of his health insurance costs can be deducted from his gross income
Pierre is covered by his employer's group major medical plan. His employer pays for 75% of the premium and he pays for 25%. How much would a $10,000 benefit be taxable as income under this plan?
$0
A clause that allows an insurer the right to terminate coverage on any anniversary date is called a(n)
optionally renewability clause
A health insurance policy where the insurer has the right to terminate the policy for reasons other than the insured's health is called:
conditionally renewable
Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this?
guaranteed insurability rider
Typically, Long-Term Disability benefits are coordinated with which benefit plan?
social security
The Do Not Call Registry offers exemptions for calls placed from all of the following EXCEPT
insurance sales calls
How does life insurance create an immediate estate?
after first premium is paid, the face amount may be available to the beneficiary
Kristi purchases an annuity that will pay her husband an income for 15 years. If he dies, this income will become payable to their children for the remainder of the period. Kristi has what kind of annuity?
temporary annuity certain
An example of a tax-qualified retirement plan would be:
defined contribution plan
Erica is 35 years old and owns an IRA. At what age can she begin to receive distributions without a tax penalty?
59.5 years
Donald is the primary insured of a life insurance policy and adds a children's term rider. What is the advantage of adding this rider?
can be converted to permanent coverage without evidence of insurability
What type of insurance offers flexible premiums, a flexible death benefit, and the choice of how the cash value will be invested?
variable universal policy