Summary Xcel comprehensive of life and health insurance Final Exam_ 2022/2032.
Xcel comprehensive of life and health insurance Final Exam_ 2022/2032. Typically, Long-Term Disability benefits are coordinated with which benefit plan? The focus of major medical insurance is providing coverage for 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? 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? 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? When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)? What does the word "level: in Level Term describe? A non-contributory health insurance plan helps the insurer avoid To qualify for a resident producer license in the state of Michigan, an individual 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? 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 Who is the individual paid on a fee-for-service basis? Which of the following is NOT an illegal inducement? Making a statement that is false or maliciously critical of the financial condition of an insurer is known as Which of the following is NOT a required provision in an accident and health insurance policy? the change of occupation provision is considered an OPTIONAL provision Which of these statements about Medicaid is CORRECT? 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 The time limit for filing claim disputes is addressed in which provision of an accident and health policy? All of the following plans allow for employee contributions to be taken on a pre-tax basis EXCEPT employers contribute to health reimbursement Arrangement planz (HRA's), not employees. Which of the following gifts from a producer would NOT be considered rebating? Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. 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? Which approach predicts a person's 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) Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit options would he choose? Which of these factors would an insurer consider when determining whether to accept a group life plan? This MANDATORY health policy provision states that the policy, including endorsements and attached papers, constitutes The monthly benefit for an individual disability income policy is usually limited to a percentage of the insured's income in order to avoid >Correct Answer< over insurance When an insurance licensee changes his or her address under the Michigan Insurance Code, who MUST be notified? 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? The typical long-term care insurance policy is designed to provide a minimum of __ year(s) of coverage. How many employees must an employer have for a terminated employee to be eligible for COBRA? Which of the following policies does NOT build cash value? Which type of annuity stops all payments upon the death of the annuitant? Under the subrogation clause, legal action can be taken by the insurer against the Disability Income plans which require that the insurer can NEVER change or alter premium rates are usually considered Coordination of Benefits regulation applies to all of the following plans EXCEPT A spouse and child can be added to the primary insured's coverage as what kind of rider? 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? In order to save on premiums, a Life Insurance policy can legally be backdated up to Statements made by an insurance applicant on an application are considered to be To receive proceeds from a death benefit, a minor Which of the following services MUST be provided by HMO plans? The unfair trade practice of replacing an insurance policy from one insurer to another based on misrepresentation is called In determining whether a pre-existing condition applies, the enrollee CANNOT have more than how many days' gap in health insurance? A business will typically use which type of life insurance to cover their employees? Within how many days must a Traditional IRA be rolled over to another IRA in order to avoid tax consequences? Ron has a life insurance policy with a face value of $100,000 and a cost of living rider. If the consumer price index has gone up 4%, how much may Ron increase the face value of the policy? When an accident and health policy requires payment of an additional premium to provide coverage for a newborn, how many days after the birth is the first payment due? Peter has a policy where 80% to 90% of the premium is invested in traditional fixed income securities and the remainder of the premium is invested in contracts tied to a stipulated stock index. What kind of policy is this? 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 What is issued to each employee of an employer health plan? Ted has a health insurance plan that requires him to pay a specific sum out of pocket before any benefits are paid in a calendar year. Which of these does his health plan have? An insurer would be committing Unfair Discrimination if coverage was denied based upon A licensee who is required to take continuing education MUST include how many ethics coursework hours? Barbara's policy includes a rider which allows her to purchase additional insurance at specific dates or events without evidence of insurability. This rider is called a(n) When calculating the amount of life insurance needed for an income earner, what has to be determined when using the Needs Approach? Dorian exercised a nonforfeiture option by using his life policy's cash value to purchase an extended term insurance option. When the term insurance expires, When the insured gives birth, coverage for eligible newly born children consists of coverage of injury or sickness including Which of these is NOT considered to be a purpose of an annuity? What is the purpose for having an accelerated death benefit on a life insurance policy? 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? Life insurance policies will normally pay for losses arising from Medical Expense Insurance would cover A clause that allows an insurer the right to terminate coverage at any anniversary date is called a(n) . Which of these is NOT considered to be a risk factor in life insurance underwriting? Which of these is NOT a characteristic of the Accelerated Death Benefit option? The branch of dentistry which deals with the replacement of missing parts is called Under long-term care insurance, which of the following MUST an insurer offer to each policyowner at the time of purchase? How is a health provider reimbursed if they do NOT have an agreement in place with the insurance company? Which of the following provides Medicare supplement policies? Sonya applied for a health insurance policy on April 1. Her agent submitted the information to the insurance company on April 6. She paid the premium on May 15 with the policy indicating the effective date being May 30. On which date would Sonya have coverage? A producer MUST be appointed by the insurer within how many days from the date the agency contract application is submitted? Which of the following is a reinstatement condition? A policyowner may change two policy features on what type of life insurance? A notice of cash surrender value must be sent to a Universal Life policyowner Which of the following does Coordination of Benefits allow? Small employer group coverage is NOT required to be renewed in each of the following circumstances EXCEPT All of these are situations that allow the insurer to NOT renew small employer group coverage EXCEPT "Number of claims exceed threshold". Tom has a home health care benefit and is confined to his home. Which of these benefits is NOT typically covered? Which of the following types of deductibles would apply a single deductible to both medical and dental insurance coverage? All of these are typically sources of underwriting information for life or health insurance EXCEPT Kathy's annuity is currently experiencing tax-deferred growth until she retires. Which phase is this annuity in? Under Michigan Insurance Code, Chapter 45, insurance fraud defines financial loss as Which of the following individuals is REQUIRED to be licensed as an insurance counselor in the State of Michigan? A licensee can disclose a consumer's policy account number to all of the following EXCEPT a What is the tax liability for employer contributions in Health Savings Accounts (HSA's)? Employer-paid contributions to Health Savings Accounts are tax-free to the employee. A licensee who informs an insured of inaccurate terms, benefits, or advantages of any policy is committing which of the following violations? what is the primary reason for buying an annuity? A common exclusion with Vision plans is > In the Michigan Insurance Code, Chapter 45, insurance fraud defines financial loss as all of the following EXCEPT Which policy feature makes a universal life policy different from a whole life policy? An insurer must furnish to a claimant forms for filing proof of loss within ___ days upon receiving a notice of claim. A life insurance rider that allows an individual to purchase insurance as they grow older, regardless of insurability, is called a(n) In which of the following processes will the insurer oversee the insured's hospital stay to confirm everything is going according to schedule and that the insured will be released as planned? In an employer-sponsored contributory group Disability Income plan, the employer pays 60% of the premium and each employee pays 40% of the premium. Any income benefits paid are taxed to the employee at Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the The election of COBRA for continuation of health coverage will What activity does NOT require an insurance producer's license? Rob purchased a standard whole life policy with a $500,000 death benefit when he was age 30. His insurance agent told him the policy would be paid up if he reached age 100. The present cash value of the policy equals $250,000. Rob recently died at age 60. The death benefit would be A rehabilitation benefit is intended to what amount will be paid under a policy where the insured misstated his/her age? An example of naming a beneficiary by class would be In group health care, what is the purpose of the coordination of benefits provision? Which of the following statements is NOT true regarding a Critical Illness Plan? Dana is an employee who deposits a percentage of her income into her individual annuity. Her company also contributes a percentage into a separate Company pension plan. What kind of annuity is this considered? Which of these is considered to be a Lving Benefit option in a life insurance policy? a tax-free section 1035 exchange of a life insurance policy to a different policy is permitted if it occurs which of the following is required to be licensed as an insurance producer? ABC Insurance Agency is entering each applicant who purchases insurance through their agency into a drawing to win a free trip. This is an unlawful Insurance practice known as let and then an employer-sponsored group accident and health plan, a master contract is issued to the if the annuitants dies before the annuity start date, With a scheduled Dental policy, how are covered expenses paid? how long must an individual be unable to engage in any gainful activity due to physical or mental disability in order to qualify for Social Security total disability? which of the following protects the policyowner from a misrepresentation caused by an innocent mistake? The Entity that has power to revoke a producer's insurance license is the who has the option to renew a small employer Health Plan? when does an immediate annuity begin making payments? A policyholder has a major medical plan with a 80%/20% coinsurance and a deductible of $75. If the insured has previously met her deductible and receives a bill for $175, how much will the insurer pay? when are group disability benefits considered to be tax-free to the insured? converting a group plan to permanent life insurance requires the Do Not Call Registry offers exemptions for calls placed from all of the following EXCEPT ____________ is NOT an element of a valid contract. a Medicare supplement basic benefit is James is the insured on a life insurance policy you were his age was misstated on the application. Which of the following is CORRECT regarding the death benefit amount? Justin is receiving disability income benefits from a group policy paid for by his employer. How are these benefits treated for tax purposes? in the state of Michigan, properly filed Health claims that are not timely paid require the insurer to pay simple interest from a date 60 days from satisfactory proof of loss at the rate of which form of insurer has shareholders? the deeds and actions of her producer indicate what kind of authority? what happens to interest earned if the annuitants dies before the payout start date? premiums paid that exceeds 7.5% of an insured's Adjusted Gross Income (AGI) are tax-deductible when paid for which of the following plans? a renewable term life insurance policy allows the policyowner the right to renew the policy the acceptance of the credit Life Application requires the submission of a Certificate of Insurance to the insured Within ______ days. according to the Michigan Insurance Code, which of the following MUST a producer do when replacing a Life Insurance policy? the waiting period for disability insurance policy all of these are valid policy dividend options for life insurance policy owner EXPECT people with higher loss exposure have the tendency to purchase insurance more often than those at average risk. This is called when can a life policy no longer be canceled for non-fraudulent Miss statements after its date of issue? variable life insurance and universal life insurance are very similar. Which of these features are held exclusively by variable universal life insurance? Bob and Tom start a business. Since each partner contributes an important element to the success of the business, they decide to take life insurance policies out on each other, and name each other as beneficiaries. Eventually, they retired and dissolved the business. Bob dies 12 months later. The policies continue in force with no change. Both partners are still a married at the time of Bob's death. in this situation, who receive Bob's policy proceeds? insurable interest only has to exist at the time of the application, not at the time of the claim. Being there was no change in beneficiary prior to Bob's death, Tom was still receive the policy proceeds. upon receiving a producer complaint, the Commissioner may immediately a producer's fiduciary responsibility includes which of the following activities? all of the following occurrences may result in license revocation EXCEPT a proposed insured for a health insurance policy was treated for heart disease within the past year. When applying for health insurance, the heart disease treatment for what purpose is a life insurance application backdated? what is the name of the provision which states that a copy of the application must be attached to the policy when issued? a renewable term life insurance policy can be renewed Joanne has a $100,000 whole life policy with an accumulated $25,000 of cash value. She would like to borrow $15,000 against the cash value. Which of the following statements is TRUE? a life insurance policy normally contains a provision that restricts coverage in the event of death under all of the following situations EXCEPT the above may not be covered or have restrictions. which of the following signatures is not required on an individual insurance application? Which of the following decisions would a Health Savings Account (HSA) owner NOT to be able to make? which of the following is NOT included under health benefit plan? A Modified Endowment Contract (MEC) is best described as a guaranteed issue life insurance policy has no > which type of business insurance is meant to cover the cost of continuing to do business while the owner is disabled? which of the following is an annuity that is linked to a market-related index? producer commissions may NOT be paid to Elizabeth is the beneficiary of a life insurance policy. She's receiving the death benefit and payments of $10,000 per month until the principal and interest has been paid out. Which option was chosen? which of the following is an example of the insured's consideration? in the state of Michigan, a licensed producer which of these would NOT considered a presumptive disability? in Michigan, a small employer is comprised of which of the following would be considered a possible application and contract policy holder for group health benefits? Bill requires some nursing care and supervision but NOT full-time care. Which of these nursing home options would best serve him? Tim has a health insurance with a deductible of $500 and an 80/20 coinsurance. How much will she pay if she incurs a loss of $1,500? which of the following is a requirement for ANY change in an insurance application? what does the Consolidated Omnibus Budget Reconciliation act COBRA of 1985 allow an employee to do? when a decreasing term policies purchased, it contains a decreasing death benefit and major medical expense Plants provide coverage for each of the following EXCEPT a form of medical health insurance covering the treatment and care of gum disease is called in what form do disability income policies typically pay benefits? which of these techniques will remove the risk of losing money in the stock market by never purchasing stocks? health insurance involves two parents, accident and _______ continuous 24-hour care provided by licensed medical professionals under the direct supervision of a physician is called in what part of an insurance policy are policy benefits found? what type of policy would only provide coverage for specific types of illnesses (cancer, stroke, Etc)? Shawn, Mike, and Dave are brothers who have a $100,000 "first to die" joint life policy covering all three of their lives. If Mike dies first, the policy proceeds which of the following is NOT a common exclusion for medical expense policy? The Limited period of time given to all members to sign up for a group health plan is called the > Amy has a group medical policy through him player with a $500 deductible and the 90% coinsurance provision. She encourages $1,500 in covered Health Care Services. How much will her group insurance carrier pay? Kurt is an active-duty service man who was recently killed in an accident while home on leave. Which military service exclusion cause would pay upon his death? the unfair trade practice of using threat or Force to restrict fair trade in the transaction of insurance is called Preferred Risk policies with reduced premiums are issued by insurance companies because the insured has in a long term care policy, activities of daily living (ADL's) can be each of the following EXCEPT a producer who knowingly submits a FALSE statement in support of a be found guilty of who were Keogh plans designed to provide pension benefits for? A policyholder's unmarried child is incapable of self support due to physical disability. the child is provided medical care coverage under the parent's policy All of the following are characteristics of a Group Life Insurance Plan EXCEPT All of the following statements correctly describe the purpose of Social Security EXCEPT the authority granted to a licensed producer is provided via the according to the law of agency, the producer/agent represents the principal/insurer and is guaranteed actual, implied and apparent authority to act on behalf of the insurer. the law of agency makes the principal responsible for these acts of the agent. All of the following riders can increase the death benefit amount EXCEPT an insurer must furnished to a claimant forms for filing proof of loss within _____ days upon receiving a notice of claim. which of these is not subject to income taxation under a modified endowment contract (MEC)? which type of life insurance policy pays the face amount at the end of the specified period if the insured is still alive? an example of a tax qualified retirement plan would be a which of these is NOT considered to be a nonforfeiture option in a whole life insurance policy? limited payment whole life policy provides under and I'm qualified annuity, interest this text after the the taxable and non-taxable portions of annuity payments are determined by the exclusion ratio. how are annuities given favorable tax treatment? all the following are considered appropriate uses of life insurance for business purposes EXCEPT Shirley has a Medigap policy, which is designed to pay costs associated with what is the purpose of the medical information Bureau (MIB)? the IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted gross income. Which of the following is considered a tax deductible medical expense under this rule? which of these annuities require premium payments that vary from year to year? which of the following is considered to be an alternative to a life settlement? Joe has a life insurance policy that has a face amount of $300,000. After a number of years, the policy's cash value accumulates the $50,000 and the face amount becomes $350,000. What kind of policy is this? which annuity payout option allows the policyowner to choose a predetermined number of benefit payments? the double indemnity provision in a life insurance policy pertains to an insurance death caused by an call the following are examples of a business continuation plan EXCEPT in addition to the actual policy, an entire contract includes which of the following? which type of policy combines the flexibility of a universal policy with investment choices? > without a section 125 plan in place, what would happen to an employee's payroll contribution to an HSA? and insurer, in general business practice, fails to promptly provide a reasonable explanation for the denial of a claim. This is considered to be in Michigan, legal action can be taken against insurer for failure to pay LIFE insurance claims for a period not to exceed The purpose of Medicare supplement insurance is to address gaps in Medicare coverage, which can include a Securities license is required for life insurance provider to sell which of the following nursing home options would BEST suit an individual who needs some nursing Care and supervision but NOT full-time care? Mark continues working after the age of 65 and is covered through his employers Group Health Plan. Which of the following statements is TRUE? deferred commissions may be paid to a person who sold an insurance policy when the person sole Proprietors are permitted tax deductions for health costs paid from their earnings in the amount of when can a life policy no longer be canceled for non fraudulent statements after its date of issue? "maximum benefits" refers to the an Indemnity plan a provision in a whole life policy that allows a policy owner to terminate the policy in return for a reduced paid-up policy of the same time is called a in Michigan, legal action can be taken against an insurer for fail to pay HEALTH insurance claims for a period not to exceed the period in which there are no Social Security benefits for the surviving spouse is called the the elimination period under a hospital Indemnity plan is Group insurance premiums made by an employer under the terms of a taft-hartley trust or paid directly to the after an insured gives notice of loss, what must he or she do if the insurer does not furnish forms? which of these describes the result of a modified endowment contract that failed to meet the seven pay test? group dental plans with frequently place a limit on annual benefits in order to minimize Rehabilitation benefit is intended to which of these premium payment frequencies is not typically available to a policyowner? Pharmacy benefit covers prescription drugs derived from a list called a a health insurance policy that allows an insurer to change the policy owners premiums, but NOT cancel the policy is called when an accident and health policy requires payment of an additional premium to provide coverage for a newborn, how many days after the birth is the first payment due? a group disability income plan that pays tax free benefits to cover employees is considered in order for a contract to be valid, it must Krissa purchases a 10 year level term life insurance policy that has a death benefit of $200,000. Which of these statements is true? what happens to the coverage under a children's term Rider when that child reaches a certain specified age? which type of annuity stops all payments upon the death of the annuitant? all of the following are included as part of the contract in the entire contract provision EXCEPT the under which criteria may a Group Health Plan exclude participation? low-frequency diseases can be exclusively covered by what kind of Health policy is?
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- February 20, 2023
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xcel comprehensive of life and health insurance final exam 20222032
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xcel comprehensive of life and health insurance final exam
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long term disability benefits are coordinated with which be
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