Xcel Testing Solutions Life and Health
Insurance 215
The focus of major medical insurance is providing coverage for - ANSWER...-medical
and hospitalization expenses
An insured under a Major Medical expense plan with a zero deductible and 80/20
coinsurance provision files a $1,000 claim. How much of this claim is the insured
responsible for? - ANSWER...-$200
because this policy has a zero deductible, the insures is only responsible for the 20%
coinsurance on this claim, or $200
An insured has a stop-loss limit of $5,000 and an 80/20 coinsurance. The insured incurs
$25,000 of covered losses. How much will the insured pay? - ANSWER...-$5,000
Which type of plan would be the most appropriate for an individual on Medicare and
concerned that Medicare will NOT pay for charges exceeding the approved amount? -
ANSWER...-Medicare supplement Plan F
When can a group health policy renewal be denied according to the Health Insurance
Portability and Accountability Act (HIPAA)? - ANSWER...-when contribution or
participation rules have been violated
What does the word "level: in Level Term describe? - ANSWER...-the face amount
A non-contributory health insurance plan helps the insurer avoid - ANSWER...-adverse
selection
because all eligible employees are usually covered, non-contributory plans are
desirable from an underwriting standpoint because adverse selection is minimized.
,To qualify for a resident producer license in the state of Michigan, an individual -
ANSWER...-must complete the required pre-licensing education within 12 months of
license application
Under an expense-incurred individual health policy, what is the MAXIMUM length of
time after issuance of the policy that an insurer can exclude coverage for a pre-existing
condition? - ANSWER...-12 months
pre-existing conditions may be excluded for a maximum of 12 months from the date of
enrollment.
An insured has a health plan that pays established amounts in accordance with a list of
injuries, surgical procedures, or other losses. This list is called a - ANSWER...-benefit
schedule
benefits schedule set predetermined limits or maximums on how much money and
insured can be reimbursed for a covered loss.
Who is the individual paid on a fee-for-service basis? - ANSWER...-Provider
Which of the following is NOT an illegal inducement? - ANSWER...-Giving the insured
an article of merchandise printed with the producer's name costing $5
$5 or less of tokens or merchandise to applicants is allowed.
Making a statement that is false or maliciously critical of the financial condition of an
insurer is known as - ANSWER...-defamation
Which of these statements about Medicaid is CORRECT? - ANSWER...-Funded by
federal, sate, and local taxes
Medicaid is funded by federal, state, and local taxes but is administered by each state.
All of these are considered key factors in underwriting life insurance EXCEPT -
ANSWER...-Marital Status
Correct: tobacco use, health history, age
All of the following plans allow for employee contributions to be taken on a pre-tax basis
EXCEPT - ANSWER...-Health reimbursement Arrangement plan
employers contribute to health reimbursement Arrangement planz (HRA's), not
employees.
Which of the following gifts from a producer would NOT be considered rebating? -
ANSWER...-$5 pen
,A producer quoting life insurance may give an applicant an article of merchandise
having an invoice value of $5.00 or less.
Chris is an insured bricklayer who severed his left hand in an automobile accident.
Although his primary duty cannot be performed, Chris is also a substitute high school
teacher. He collects a full disability income check every month. How does his policy
define total disability? - ANSWER...-own occupation
the "own occupation" definition of total disability requires that the insured be unable to
perform the insured's current occupation as a result of an accident or sickness.
Which approach predicts a person's earning potential and determines how much of that
amount would be devoted to dependents? - ANSWER...-Human life value approach
The human life value approach predicts an individual's future earning potential and
determines how much of that amount would be devoted to dependents.
Index whole life insurance contains a securities component that acts as a(n) -
ANSWER...-hedge against inflation
Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which
of these benefit options would he choose? - ANSWER...-Guaranteed lifetime withdrawal
benefit
The guaranteed lifetime withdrawal benefit normally requires a fee, but it ensures that
the income benefit will be paid for life without actually annuitizing the contract.
Which of these factors would an insurer consider when determining whether to accept a
group life plan? - ANSWER...-average age
and insurer would consider the average age when determining whether to accept a
group Life Plan.
This MANDATORY health policy provision states that the policy, including
endorsements and attached papers, constitutes - ANSWER...-the entire insurance
contract between the parties
The monthly benefit for an individual disability income policy is usually limited to a
percentage of the insured's income in order to avoid - ANSWER...-over insurance
When an insurance licensee changes his or her address under the Michigan Insurance
Code, who MUST be notified? - ANSWER...-the commissioner of the Department of
Insurance and financial services (DIFS)
, Jonas is a whole life insurance policyowner and would like to add coverage for his two
children. Which of the following products would allow him to accomplish this? -
ANSWER...-Child term rider
A child term rider is a level term insurance that can be added to an existing policy.
How many employees must an employer have for a terminated employee to be eligible
for COBRA? - ANSWER...-20
Which of the following policies does NOT build cash value? - ANSWER...-Term
CORRECT: straight life, endowment, variable life
Which type of annuity stops all payments upon the death of the annuitant? -
ANSWER...-Life annuity
The type of annuity in which all payments cease upon the death of an annuitant is
referred to as a life annuity.
Under the subrogation clause, legal action can be taken by the insurer against the -
ANSWER...-responsible third party
Coordination of Benefits regulation applies to all of the following plans EXCEPT -
ANSWER...-preferred provider organization plan
CORRECT: group vision plan, self-funded group health plan, group health plan
A spouse and child can be added to the primary insured's coverage as what kind of
rider? - ANSWER...-Family term
Amy has a group medical policy through her employer with a $500 deductible and a
90% coinsurance provision. She incurs $1,500 in covered health care services. How
much will her group insurance carrier pay? - ANSWER...-$900
In this situation, the group insurance carrier will pay 90% of the covered loss after the
deductible has been applied.
In order to save on premiums, a Life Insurance policy can legally be backdated up to -
ANSWER...-6 months
Statements made by an insurance applicant on an application are considered to be -
ANSWER...-representations
To receive proceeds from a death benefit, a minor - ANSWER...-must have an
appointed guardian
Insurance 215
The focus of major medical insurance is providing coverage for - ANSWER...-medical
and hospitalization expenses
An insured under a Major Medical expense plan with a zero deductible and 80/20
coinsurance provision files a $1,000 claim. How much of this claim is the insured
responsible for? - ANSWER...-$200
because this policy has a zero deductible, the insures is only responsible for the 20%
coinsurance on this claim, or $200
An insured has a stop-loss limit of $5,000 and an 80/20 coinsurance. The insured incurs
$25,000 of covered losses. How much will the insured pay? - ANSWER...-$5,000
Which type of plan would be the most appropriate for an individual on Medicare and
concerned that Medicare will NOT pay for charges exceeding the approved amount? -
ANSWER...-Medicare supplement Plan F
When can a group health policy renewal be denied according to the Health Insurance
Portability and Accountability Act (HIPAA)? - ANSWER...-when contribution or
participation rules have been violated
What does the word "level: in Level Term describe? - ANSWER...-the face amount
A non-contributory health insurance plan helps the insurer avoid - ANSWER...-adverse
selection
because all eligible employees are usually covered, non-contributory plans are
desirable from an underwriting standpoint because adverse selection is minimized.
,To qualify for a resident producer license in the state of Michigan, an individual -
ANSWER...-must complete the required pre-licensing education within 12 months of
license application
Under an expense-incurred individual health policy, what is the MAXIMUM length of
time after issuance of the policy that an insurer can exclude coverage for a pre-existing
condition? - ANSWER...-12 months
pre-existing conditions may be excluded for a maximum of 12 months from the date of
enrollment.
An insured has a health plan that pays established amounts in accordance with a list of
injuries, surgical procedures, or other losses. This list is called a - ANSWER...-benefit
schedule
benefits schedule set predetermined limits or maximums on how much money and
insured can be reimbursed for a covered loss.
Who is the individual paid on a fee-for-service basis? - ANSWER...-Provider
Which of the following is NOT an illegal inducement? - ANSWER...-Giving the insured
an article of merchandise printed with the producer's name costing $5
$5 or less of tokens or merchandise to applicants is allowed.
Making a statement that is false or maliciously critical of the financial condition of an
insurer is known as - ANSWER...-defamation
Which of these statements about Medicaid is CORRECT? - ANSWER...-Funded by
federal, sate, and local taxes
Medicaid is funded by federal, state, and local taxes but is administered by each state.
All of these are considered key factors in underwriting life insurance EXCEPT -
ANSWER...-Marital Status
Correct: tobacco use, health history, age
All of the following plans allow for employee contributions to be taken on a pre-tax basis
EXCEPT - ANSWER...-Health reimbursement Arrangement plan
employers contribute to health reimbursement Arrangement planz (HRA's), not
employees.
Which of the following gifts from a producer would NOT be considered rebating? -
ANSWER...-$5 pen
,A producer quoting life insurance may give an applicant an article of merchandise
having an invoice value of $5.00 or less.
Chris is an insured bricklayer who severed his left hand in an automobile accident.
Although his primary duty cannot be performed, Chris is also a substitute high school
teacher. He collects a full disability income check every month. How does his policy
define total disability? - ANSWER...-own occupation
the "own occupation" definition of total disability requires that the insured be unable to
perform the insured's current occupation as a result of an accident or sickness.
Which approach predicts a person's earning potential and determines how much of that
amount would be devoted to dependents? - ANSWER...-Human life value approach
The human life value approach predicts an individual's future earning potential and
determines how much of that amount would be devoted to dependents.
Index whole life insurance contains a securities component that acts as a(n) -
ANSWER...-hedge against inflation
Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which
of these benefit options would he choose? - ANSWER...-Guaranteed lifetime withdrawal
benefit
The guaranteed lifetime withdrawal benefit normally requires a fee, but it ensures that
the income benefit will be paid for life without actually annuitizing the contract.
Which of these factors would an insurer consider when determining whether to accept a
group life plan? - ANSWER...-average age
and insurer would consider the average age when determining whether to accept a
group Life Plan.
This MANDATORY health policy provision states that the policy, including
endorsements and attached papers, constitutes - ANSWER...-the entire insurance
contract between the parties
The monthly benefit for an individual disability income policy is usually limited to a
percentage of the insured's income in order to avoid - ANSWER...-over insurance
When an insurance licensee changes his or her address under the Michigan Insurance
Code, who MUST be notified? - ANSWER...-the commissioner of the Department of
Insurance and financial services (DIFS)
, Jonas is a whole life insurance policyowner and would like to add coverage for his two
children. Which of the following products would allow him to accomplish this? -
ANSWER...-Child term rider
A child term rider is a level term insurance that can be added to an existing policy.
How many employees must an employer have for a terminated employee to be eligible
for COBRA? - ANSWER...-20
Which of the following policies does NOT build cash value? - ANSWER...-Term
CORRECT: straight life, endowment, variable life
Which type of annuity stops all payments upon the death of the annuitant? -
ANSWER...-Life annuity
The type of annuity in which all payments cease upon the death of an annuitant is
referred to as a life annuity.
Under the subrogation clause, legal action can be taken by the insurer against the -
ANSWER...-responsible third party
Coordination of Benefits regulation applies to all of the following plans EXCEPT -
ANSWER...-preferred provider organization plan
CORRECT: group vision plan, self-funded group health plan, group health plan
A spouse and child can be added to the primary insured's coverage as what kind of
rider? - ANSWER...-Family term
Amy has a group medical policy through her employer with a $500 deductible and a
90% coinsurance provision. She incurs $1,500 in covered health care services. How
much will her group insurance carrier pay? - ANSWER...-$900
In this situation, the group insurance carrier will pay 90% of the covered loss after the
deductible has been applied.
In order to save on premiums, a Life Insurance policy can legally be backdated up to -
ANSWER...-6 months
Statements made by an insurance applicant on an application are considered to be -
ANSWER...-representations
To receive proceeds from a death benefit, a minor - ANSWER...-must have an
appointed guardian
