Xcel Final Exam Questions and complete
solutions
Typically, Long-Term Disability benefits are coordinated with which benefit plan? CORRECT ANSWERS Social Security
The focus of major medical insurance is providing coverage for CORRECT ANSWERS 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? CORRECT ANSWERS $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? CORRECT ANSWERS $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? CORRECT ANSWERS Medicare supplement Plan F
When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)? CORRECT ANSWERS when contribution or participation rules have been violated
What does the word "level: in Level Term describe? CORRECT ANSWERS the face amount
A non-contributory health insurance plan helps the insurer avoid CORRECT ANSWERS 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 CORRECT ANSWERS 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? CORRECT ANSWERS 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 CORRECT ANSWERS 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? CORRECT ANSWERS Provider
Which of the following is NOT an illegal inducement? CORRECT ANSWERS 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 CORRECT ANSWERS defamation
Which of the following is NOT a required provision in an accident and health insurance policy? CORRECT ANSWERS change of occupation the change of occupation provision is considered an OPTIONAL provision
Which of these statements about Medicaid is CORRECT? CORRECT ANSWERS 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 CORRECT ANSWERS Marital Status
Correct: tobacco use, health history, age
The time limit for filing claim disputes is addressed in which provision of an accident and health policy? CORRECT ANSWERS legal actions
All of the following plans allow for employee contributions to be taken on a pre-
tax basis EXCEPT CORRECT ANSWERS 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? CORRECT ANSWERS $5 pen
A producer quoting life insurance may give an applicant an article of merchandise having an invoice value of $5.00 or less.
Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. CORRECT ANSWERS 20
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? CORRECT ANSWERS 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? CORRECT ANSWERS 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) CORRECT ANSWERS hedge against inflation
Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit options would he choose? CORRECT ANSWERS 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? CORRECT ANSWERS 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 CORRECT ANSWERS the entire insurance contract between the parties
solutions
Typically, Long-Term Disability benefits are coordinated with which benefit plan? CORRECT ANSWERS Social Security
The focus of major medical insurance is providing coverage for CORRECT ANSWERS 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? CORRECT ANSWERS $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? CORRECT ANSWERS $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? CORRECT ANSWERS Medicare supplement Plan F
When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)? CORRECT ANSWERS when contribution or participation rules have been violated
What does the word "level: in Level Term describe? CORRECT ANSWERS the face amount
A non-contributory health insurance plan helps the insurer avoid CORRECT ANSWERS 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 CORRECT ANSWERS 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? CORRECT ANSWERS 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 CORRECT ANSWERS 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? CORRECT ANSWERS Provider
Which of the following is NOT an illegal inducement? CORRECT ANSWERS 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 CORRECT ANSWERS defamation
Which of the following is NOT a required provision in an accident and health insurance policy? CORRECT ANSWERS change of occupation the change of occupation provision is considered an OPTIONAL provision
Which of these statements about Medicaid is CORRECT? CORRECT ANSWERS 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 CORRECT ANSWERS Marital Status
Correct: tobacco use, health history, age
The time limit for filing claim disputes is addressed in which provision of an accident and health policy? CORRECT ANSWERS legal actions
All of the following plans allow for employee contributions to be taken on a pre-
tax basis EXCEPT CORRECT ANSWERS 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? CORRECT ANSWERS $5 pen
A producer quoting life insurance may give an applicant an article of merchandise having an invoice value of $5.00 or less.
Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. CORRECT ANSWERS 20
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? CORRECT ANSWERS 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? CORRECT ANSWERS 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) CORRECT ANSWERS hedge against inflation
Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit options would he choose? CORRECT ANSWERS 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? CORRECT ANSWERS 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 CORRECT ANSWERS the entire insurance contract between the parties
