Xcel FINAL Exam Questions with 100% Correct Answers Latest
Graded A+
Question:
Typically, Long-Term Disability benefits are coordinated with which benefit plan?
Answer:
Social Security
Question:
The focus of major medical insurance is providing coverage for
Answer:
medical and hospitalization expenses
Question:
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
Question:
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
Question:
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
,Question:
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
Question:
What does the word "level: in Level Term describe?
Answer:
the face amount
Question:
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.
Question:
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
Question:
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.
Question:
,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.
Question:
Who is the individual paid on a fee-for-service basis?
Answer:
Provider
Question:
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.
Question:
Making a statement that is false or maliciously critical of the financial condition of an insurer is
known as
Answer:
defamation
Question:
Which of the following is NOT a required provision in an accident and health insurance policy?
Answer:
change of occupation
Question:
the change of occupation provision is considered an OPTIONAL provision 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.
Question:
All of these are considered key factors in underwriting life insurance EXCEPT
Answer:
Marital Status
Correct: tobacco use, health history, age
Question:
The time limit for filing claim disputes is addressed in which provision of an accident and health
policy?
Answer:
legal actions
Question:
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.
Question:
Which of the following gifts from a producer would NOT be considered rebating?
Answer:
$5 pen
Question:
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.
Answer:
20
Graded A+
Question:
Typically, Long-Term Disability benefits are coordinated with which benefit plan?
Answer:
Social Security
Question:
The focus of major medical insurance is providing coverage for
Answer:
medical and hospitalization expenses
Question:
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
Question:
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
Question:
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
,Question:
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
Question:
What does the word "level: in Level Term describe?
Answer:
the face amount
Question:
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.
Question:
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
Question:
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.
Question:
,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.
Question:
Who is the individual paid on a fee-for-service basis?
Answer:
Provider
Question:
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.
Question:
Making a statement that is false or maliciously critical of the financial condition of an insurer is
known as
Answer:
defamation
Question:
Which of the following is NOT a required provision in an accident and health insurance policy?
Answer:
change of occupation
Question:
the change of occupation provision is considered an OPTIONAL provision 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.
Question:
All of these are considered key factors in underwriting life insurance EXCEPT
Answer:
Marital Status
Correct: tobacco use, health history, age
Question:
The time limit for filing claim disputes is addressed in which provision of an accident and health
policy?
Answer:
legal actions
Question:
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.
Question:
Which of the following gifts from a producer would NOT be considered rebating?
Answer:
$5 pen
Question:
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.
Answer:
20