Final Exam: California Life, Accident, and Health Insurance

Final Exam: California Life, Accident, and Health Insurance What is considered the most common type of specified disease insurance policy? Cancer Minimum participation standards exist for a group health insurance plans in order to Prevent Adverse Selection How does underwriting differ between group life and individual life insurance? Medical questions must be answered on individual life insurance when handling premiums for an insured an agent is acting in which capacity? Fiduciary what is the term used to describe the frequency and severity of certain illnesses and accidents? Morbidity Which of the following describes the statement "The more times an event is repeated, the more predictable the outcome becomes"? Law of large numbers In order to be considered "currently insured" under Social Security, an individual must be credited with? 6 quarters of coverage during the last 13-quarter period How long must a policy be in force before an insurer is prohibited from denying claims based on misstatements made on the health policy application? 2 Years Which of the following does the California Insurance Code NOT require an insurance policy to specify? Insurer's financial rating Which of the following is NOT required in the content of a policy? Probability of loss Which of the following pieces of information is NOT gathered during the personal financial planning process? An individual's civic organization memberships Which of the following is not considered to be an unfair claims settlement practice? Advising a claimant to hire an attorney When an applicant applies for insurance, the process by which the insurer determines whether to issue a policy is called? Underwriting How is a Medicare claim submitted? Expenses are submitted to Medicare by the health provider According to the PPACA, the medical enrollment tier that has 80% actuarial value is called: Gold Employer contributions to qualified plans are Tax-deductible by the employer Employee participation in a noncontributory group life plan must be 100% What does the term "illustration" mean when used in the phrase "life insurance policy illustration", according to the California Insurance Code? Presentation of policy features that includes non-guaranteed elements Which of the following is NOT a characteristic of a preferred provider organization (PPO)? Primary physicians serve as gatekeepers John owns an insurance policy that gives him the right to share in the insurer's surplus. What kind of policy is this? Participating a life agent who has misappropriated fiduciary funds to his own use. What is Pete guilty of? Theft If an insured dies because of an accident, which type of life insurance rider will provide additional coverage? Accidental death rider Tom is shopping for a policy that covers two people and would pay the face amount ONLY when the first person dies. The type of life policy he is looking for is called a Joint life policy Which of these statements is NOT true concerning recurrent disabilities? The insurer continues coverage after a new elimination period An insurer owned by its policyholders is called a? Mutual Insurer Medicare Part B Covers? Physician Expenses Which of these is NOT a relevant factor in the health insurance principle of morbidity? Intelligence Which of these factors do not affect the rates of medical insurance? Race Which of the following types of life insurance is normally associated with a mortgage loan? Decreasing term which of the following is not included in comprehensive major medical plans? First-Dollar Coverage Moral hazard is described as the Increased chance of a loss because of an insured's dishonest tendencies Which principle is accurately described with the statement "Insureds are entitled to recover an amount NOT greater than the amount of their loss"? Indemnity What time period allows an insured's life insurance policy to remain in force even if the premium was not paid on the due date? Grace Period How long must life agents keep their transaction records? 5 Years What does the insurance term indemnity refer to? Make whole Individual health insurance coverage typically excludes injuries at an employee's workplace because? It's covered by the state Worker's Compensation program which of the following refers to a condition that may increase the chance of a loss? Hazard Life insurance surplus must be distributed to policy-owners at what frequency? Annually According to PPACA, what is a health benefits exchange? An entity to which individuals and small businesses can have access to affordable health coverage According to the California Insurance Code, which of the following is NOT an example of an insurable event? An insured suffers a financial loss in the state lottery at what point does a self-insured group qualify for stop-loss coverage? When claims exceed a specified limit in a set period of time The conditions, times, and circumstances under which an insured is NOT covered by a health policy are called? Exclusions Failure to report background changes within 30 days as required under section 1729.2 of the California insurance code could subject a license or applicant to? All of these Why is a life insurance policy's delivery date important? The free-look period begins on the policy delivery date The Human Life Value concept is based on? Income Which of the following is a characteristic of the disability elimination period? Benefits are not payable In California, the elderly can receive information about health related issues from? The Health Insurance Counseling and Advocacy Program (HiCAP)" In what situation does a waiver of premium provision keep a health insurance policy in force without premium payments? When an insured becomes totally disabled At age 65, which of the following is available at no cost to all individuals? Medicare Part A which of these statements correctly describes risk? Pure risk is the only insurable risk non-deductible contributions are typically associated with a? Roth IRA Which type of worker has Social Security benefits available to them? Fully insured Which of the following describes the number of deaths in a year compared to the number of people in a select group? Mortality Rate