Xcel Final Exam Questions and Answers
1. Typically, Long-Term Disability benefits are coordinated with
which benefit plan?
ANS Social Security
2. The focus of major medical insurance is providing coverage for
ANS medical and hospitalization expenses
3. 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?
ANS $200
because this policy has a zero deductible, the insures is only responsible for the 20% coinsurance on this
claim, or $200
4. 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?
ANS $5,000
5. 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?
ANS Medicare supplement Plan F
6. When can a group health policy renewal be denied according to the
Health Insurance Portability and Accountability Act (HIPAA)?
ANS when contribution or participation rules have been violated
7. What does the word "level; in Level Term describe?
ANS the face amount
8. A non-contributory health insurance plan helps the insurer avoid
ANS adverse selection
because all eligible employees are usually covered, non-contributory plans are desirable from an
underwriting standpoint because adverse selection is minimized.
9. To qualify for a resident producer license in the state of Michigan, an
individ-
ual
ANS must complete the required pre-licensing education within 12 months of license application
10. 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?
,ANS 12 months
pre-existing conditions may be excluded for a maximum of 12 months from the date of enrollment.
11. 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
ANS benefit schedule
benefits schedule set predetermined limits or maximums on how much money and insured can be
reimbursed for a covered loss.
12. Who is the individual paid on a fee-for-service basis?
ANS Provider
13. Which of the following is NOT an illegal inducement?
ANS 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.
14. Making a statement that is false or maliciously critical of the
financial condi- tion of an insurer is known as
, ANS defamation
15. Which of the following is NOT a required provision in an
accident and health insurance policy?
ANS change of occupation
the change of occupation provision is considered an OPTIONAL provision
16. Which of these statements about Medicaid is CORRECT?
ANS Funded by federal, sate, and local taxes
Medicaid is funded by federal, state, and local taxes but is administered by each state.
17. All of these are considered key factors in underwriting life
insurance EXCEPT-
ANS Marital Status
Correct
tobacco use, health history, age
18. The time limit for filing claim disputes is addressed in which
provision of an accident and health policy?
ANS legal actions
1. Typically, Long-Term Disability benefits are coordinated with
which benefit plan?
ANS Social Security
2. The focus of major medical insurance is providing coverage for
ANS medical and hospitalization expenses
3. 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?
ANS $200
because this policy has a zero deductible, the insures is only responsible for the 20% coinsurance on this
claim, or $200
4. 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?
ANS $5,000
5. 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?
ANS Medicare supplement Plan F
6. When can a group health policy renewal be denied according to the
Health Insurance Portability and Accountability Act (HIPAA)?
ANS when contribution or participation rules have been violated
7. What does the word "level; in Level Term describe?
ANS the face amount
8. A non-contributory health insurance plan helps the insurer avoid
ANS adverse selection
because all eligible employees are usually covered, non-contributory plans are desirable from an
underwriting standpoint because adverse selection is minimized.
9. To qualify for a resident producer license in the state of Michigan, an
individ-
ual
ANS must complete the required pre-licensing education within 12 months of license application
10. 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?
,ANS 12 months
pre-existing conditions may be excluded for a maximum of 12 months from the date of enrollment.
11. 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
ANS benefit schedule
benefits schedule set predetermined limits or maximums on how much money and insured can be
reimbursed for a covered loss.
12. Who is the individual paid on a fee-for-service basis?
ANS Provider
13. Which of the following is NOT an illegal inducement?
ANS 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.
14. Making a statement that is false or maliciously critical of the
financial condi- tion of an insurer is known as
, ANS defamation
15. Which of the following is NOT a required provision in an
accident and health insurance policy?
ANS change of occupation
the change of occupation provision is considered an OPTIONAL provision
16. Which of these statements about Medicaid is CORRECT?
ANS Funded by federal, sate, and local taxes
Medicaid is funded by federal, state, and local taxes but is administered by each state.
17. All of these are considered key factors in underwriting life
insurance EXCEPT-
ANS Marital Status
Correct
tobacco use, health history, age
18. The time limit for filing claim disputes is addressed in which
provision of an accident and health policy?
ANS legal actions
