Comprehensive Final Certification Exam: Illinois Health Insurance (Xcel Solutions)

Comprehensive Final Certification Exam: Illinois Health Insurance (Xcel Solutions) Which type of long-term care benefit would be most appropriate for a stroke victim who requires speech therapy administered at her home? - Answer ️️ -home health care Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n) - Answer ️️ -deductible When a producer submits an insurance applicaton, the application is REQUIRED to contain the producer's - Answer ️️ -name and address Which of these provisions is required under an inidvidual Accident and Health policy? - Answer ️️ -renewal, continuation, or nonrenewal provision Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA? - Answer ️️ -it would be considered taxable income to the employee If an insurance company issues a Disability Income policy that it cannot cancel or for which it cannot increase premiums, the type of renewability that best desribes this policy is called - Answer ️️ -noncancellable What should an insured do if the insurer does not send claims forms within the time period set forth in a health policy's Claims Forms provision? - Answer ️️ -submit the claim in any form Kathy pays a monthly premium on her health insurance policy. How long is her grace period? - Answer ️️ -10 days All of the following statements correctly describe the purpose of Social Security EXCEPT - Answer ️️ -it provides a source of income for a meaningful standard of living during retirement 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? - Answer ️️ - Calendar-year deductible A policyowner decides to cancel an insurance policy within 90 days of the issue date. As a result of this cancellation, the producer is REQUIRED to refund a prorated portion of any fee charged within __ days of recieving the cancellation notice - Answer ️️ -30 A(n) _____lines producer may sell Travel Accident insurance in Illinois - Answer ️️ -limited Benefits provided by a Medicare Supplement policy must NOT - Answer ️️ -duplicate Medicare benefits Which of these would NOT be considered a presumptive disability? - Answer ️️ -loss of a leg or arm When does a health insurance policy typically become effective? - Answer ️️ -when initial premium is collected and policy is issued An insurer must furnish to a claimaint forms for filing proof of loss within __ days upon recieving a notice of claim - Answer ️️ -15 When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates? - Answer ️️ -change of occupation provision Which of these is considered a mandatory provision? - Answer ️️ -payment of claims In an insurance contract, the applicatns "consideration" is the - Answer ️️ -statements made in the application and the premium The clause identifying which losses resulting from an accident or sickness are insured by the policy is called the: - Answer ️️ -insuring clause According to Illinois law, when must a producer deliver the Outline of Coverage to a Medicare Supplement applicant? - Answer ️️ -at the time of application What determines the full amount of Social Security retirement beneits a qualified individual is entitled to recieve? - Answer ️️ -Primary Insurance Amount (PIA) In an employer-sponsored group accident and health plan, a master contract is issued to the - Answer ️️ -employer Which statement would be prohibited in an Accident and Health advertisement? - Answer ️️ - "all hospital bills will be paid by your policy" An insurance aplicant with a below-average likelihood of loss typically considered to be a - Answer ️️ -preferred risk J purchased a Medicare Supplement policy through a direct-response solication. J is allowed at LEAST __days after policy delivery to return the policy and recieve a full refund - Answer ️️ - 30 A medicare supplement policyholder has __ days to return the policy and recieve a full premium refund - Answer ️️ -30 Q the producer gave his client a rebate as an enticement to purchase insurance. Q may be found guilty of a - Answer ️️ -class B misdemeanor All of the following are examples of insurance advertisement EXCEPT - Answer ️️ -a memo from an employer announcing the availability of coverage for employees Which of these actions is the Director empowered to do? - Answer ️️ -administer insurance licensing exams __is NOT an element of a valid contract? - Answer ️️ -Countersignature M's insurance company denied a reinstatement application for her lapsed health insurance policy. The company did not notify M of this denial. How many days from the reinstatement application date does the insurance company have to notify M of the denial before the policy will be automatically placed back in force? - Answer ️️ -45 days What percentage of a participant's income are group long-term disability benefit amounts typically limited to? - Answer ️️ -60% A lapsed producer's license may be reinstated within _______ years of the license renewal date - Answer ️️ -12 T owns an Accident & Health policy and notifies her insurance company that she has chosen a less hazardous occupation. Under the Change of Occupation provision, which of the following actions may her insurance company take? - Answer ️️ -increase her policy's coverage amount At what point may a health insurer modify coverage for an individual health policy? - Answer ️️ -at the time of coverage renewal Joe is a Medicare participant who receives his benefits through a Managed Health Care Plan. Which Medicare plan does he have? - Answer ️️ -Part C To continue health coverage for a newborn, the policyowner must notify the insurer of birth and provide the first premium payment within _____ days of birth. - Answer ️️ -31 Which of these gaps in Medicare coverage is addressed with Medicare Supplemental Insurance? - Answer ️️ -medicare in-hospital deductable All of the following are primary risk factors in underwriting individual health insurance policies EXCEPT - Answer ️️ -geographical location Which of the following is considered an activity of daily living (ADL) as defined under a long- term care policy? - Answer ️️ -dressing All of the following are functions of an insuring clause EXCEPT - Answer ️️ -primarly describes the free-look period Insurable interest does NOT occur in which of the following relationships? - Answer ️️ - business owner and business client Long-term care policies issued in Illinois MUST be - Answer ️️ -guaranteed rene