Xcel Final Exam (Comprehensive Of
Life And Health Insurance) Q&A
Typically, Long-Term Disability benefits are coordinated with which benefit
plan? ✔️Ans - Social Security
The focus of major medical insurance is providing coverage for ✔️Ans -
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? ✔️Ans - $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?
✔️Ans - $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? ✔️Ans - Medicare supplement Plan F
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
What does the word "level: in Level Term describe? ✔️Ans - the face
amount
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.
,To qualify for a resident producer license in the state of Michigan, an
individual ✔️Ans - 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? ✔️Ans - 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
✔️Ans - 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? ✔️Ans - Provider
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.
Making a statement that is false or maliciously critical of the financial
condition of an insurer is known as ✔️Ans - defamation
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
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.
All of these are considered key factors in underwriting life insurance EXCEPT
✔️Ans - 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? ✔️Ans - legal actions
All of the following plans allow for employee contributions to be taken on a
pre-tax basis EXCEPT ✔️Ans - 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? ✔️Ans - $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. ✔️Ans - 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? ✔️Ans - 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? ✔️Ans - Human life
value approach
Life And Health Insurance) Q&A
Typically, Long-Term Disability benefits are coordinated with which benefit
plan? ✔️Ans - Social Security
The focus of major medical insurance is providing coverage for ✔️Ans -
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? ✔️Ans - $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?
✔️Ans - $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? ✔️Ans - Medicare supplement Plan F
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
What does the word "level: in Level Term describe? ✔️Ans - the face
amount
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.
,To qualify for a resident producer license in the state of Michigan, an
individual ✔️Ans - 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? ✔️Ans - 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
✔️Ans - 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? ✔️Ans - Provider
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.
Making a statement that is false or maliciously critical of the financial
condition of an insurer is known as ✔️Ans - defamation
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
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.
All of these are considered key factors in underwriting life insurance EXCEPT
✔️Ans - 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? ✔️Ans - legal actions
All of the following plans allow for employee contributions to be taken on a
pre-tax basis EXCEPT ✔️Ans - 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? ✔️Ans - $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. ✔️Ans - 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? ✔️Ans - 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? ✔️Ans - Human life
value approach
