NY Accident and Health |! |! |! |!
Insurance Agent/Broker Exam |! |!
with correct detailed
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solutions
Sally is considering her Medicare options. She understands that
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to enroll in Medicare Part B, she will have to pay a monthly
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premium. Since she is healthy, she is considering delaying her
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enrollment until later. Will she be able to enroll at a later date?
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1.Yes, she can enroll at anytime in the future
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2.Yes, however; she would have a permanent premium penalty
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when she does enroll
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3.No, this is a take or leave it situation
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4.Yes, but she would have to show evidence of good health. -
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Correct answer ✔Yes, however; she would have a permanent
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premium penalty when she does enroll |! |! |! |! |!
Under Medicare Part A, a spell of illness begins again and is
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subject to a new deductible for another admission when:
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1.The patient has been discharged from a prior stay and 45 days
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have elapsed
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2.The patient has been discharged from a prior stay and 30 days
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have elapsed
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,3.The patient has been discharged from a prior stay and 60 days
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have elapsed
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4.The patient has been discharged from a prior stay and 90 days
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have elapsed - Correct answer ✔The patient has been
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discharged from a prior stay and 60 days have elapsed |! |! |! |! |! |! |! |! |!
What type of insurer retains risk?
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1.Government insurance. |!
2.Reinsurers.
3.Self insurers. |!
4.Assessment insurers. - Correct answer ✔Self insurers. |! |! |! |! |! |!
A variety of types of care are provided under a long-term care
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policy. All of the following are types of care generally provided
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EXCEPT:
1.Home health care |! |!
2.Intensive care |!
3.Custodial care |!
4.Skilled care - Correct answer ✔Intensive care |! |! |! |! |! |!
Melvin has a long-term care policy with a 30-day elimination
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period. The policy has a daily benefit of $100/day. The policy has
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a 3-year benefit period. If Melvin is confined to a nursing home
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for 9 months, how much in benefits will his policy pay?
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,1.$27,000
2.$18,000
3.$24,000
4.$17,000 - Correct answer ✔$24,000 |! |! |! |!
Martin and his friends were at a local tavern celebrating his
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birthday. Martin left the bar to drive home, but unfortunately, he
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was involved in a fatal accident, killing himself and two other
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individuals. An autopsy reveals that Martin was well above the
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legal limit on his blood alcohol test. Martin's family will receive
|! |! |! |! |! |! |! |! |! |! |!
the following from his Accidental Death and Dismemberment
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policy:
1.His family will receive reduced benefits since other deaths
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were involved. |!
2.His family will receive the principal sum since this was death
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3.His family will receive no benefits, since he was in the act of
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committing a felony |! |!
4.His family will receive no benefits since there was no
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dismemberment involved. - Correct answer ✔His family will |! |! |! |! |! |! |! |!
receive no benefits, since he was in the act of committing a
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felony
An exclusion that always appears in a health policy is:
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1.No coverage for drug or alcohol related illness
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2.Hernia from an accident |! |! |!
, 3.Travel outside of the USA |! |! |! |!
4.Injury in the act of committing a felony - Correct answer
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✔Injury in the act of committing a felony
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Bruce owns a plan that pays $100 daily benefit for a hospital
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stay with no deductible. This kind of policy is known as a (an):
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1.Major medical plan |! |!
2.Basic plan |!
3.Indemnity plan |!
4.Reimbursement plan - Correct answer ✔Indemnity plan |! |! |! |! |! |!
Under what conditions is the death benefit (principal sum)
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payable under an Accidental Death and Dismemberment (AD&D)
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policy?
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1.The insured dies from a grave illness
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2.The insured dies from natural causes
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3.The insured dies from an accident
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4.All of the above - Correct answer ✔The insured dies from an
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accident
An insurance agent told a member of his church who had
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recently experienced several personal and financial losses that
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he could see that she got a more favorable rate on her
|! |! |! |! |! |! |! |! |! |! |! |!
insurance policies than her health and general circumstances
|! |! |! |! |! |! |! |!
would warrant. The woman had been his kindergarten teacher
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Insurance Agent/Broker Exam |! |!
with correct detailed
|! |! |! |!
solutions
Sally is considering her Medicare options. She understands that
|! |! |! |! |! |! |! |! |!
to enroll in Medicare Part B, she will have to pay a monthly
|! |! |! |! |! |! |! |! |! |! |! |! |!
premium. Since she is healthy, she is considering delaying her
|! |! |! |! |! |! |! |! |! |!
enrollment until later. Will she be able to enroll at a later date?
|! |! |! |! |! |! |! |! |! |! |! |!
1.Yes, she can enroll at anytime in the future
|! |! |! |! |! |! |! |!
2.Yes, however; she would have a permanent premium penalty
|! |! |! |! |! |! |! |! |!
when she does enroll
|! |! |!
3.No, this is a take or leave it situation
|! |! |! |! |! |! |! |!
4.Yes, but she would have to show evidence of good health. -
|! |! |! |! |! |! |! |! |! |! |! |!
Correct answer ✔Yes, however; she would have a permanent
|! |! |! |! |! |! |! |! |!
premium penalty when she does enroll |! |! |! |! |!
Under Medicare Part A, a spell of illness begins again and is
|! |! |! |! |! |! |! |! |! |! |! |!
subject to a new deductible for another admission when:
|! |! |! |! |! |! |! |!
1.The patient has been discharged from a prior stay and 45 days
|! |! |! |! |! |! |! |! |! |! |!
have elapsed
|! |!
2.The patient has been discharged from a prior stay and 30 days
|! |! |! |! |! |! |! |! |! |! |!
have elapsed
|! |!
,3.The patient has been discharged from a prior stay and 60 days
|! |! |! |! |! |! |! |! |! |! |!
have elapsed
|! |!
4.The patient has been discharged from a prior stay and 90 days
|! |! |! |! |! |! |! |! |! |! |!
have elapsed - Correct answer ✔The patient has been
|! |! |! |! |! |! |! |! |! |!
discharged from a prior stay and 60 days have elapsed |! |! |! |! |! |! |! |! |!
What type of insurer retains risk?
|! |! |! |! |!
1.Government insurance. |!
2.Reinsurers.
3.Self insurers. |!
4.Assessment insurers. - Correct answer ✔Self insurers. |! |! |! |! |! |!
A variety of types of care are provided under a long-term care
|! |! |! |! |! |! |! |! |! |! |! |!
policy. All of the following are types of care generally provided
|! |! |! |! |! |! |! |! |! |! |!
EXCEPT:
1.Home health care |! |!
2.Intensive care |!
3.Custodial care |!
4.Skilled care - Correct answer ✔Intensive care |! |! |! |! |! |!
Melvin has a long-term care policy with a 30-day elimination
|! |! |! |! |! |! |! |! |! |!
period. The policy has a daily benefit of $100/day. The policy has
|! |! |! |! |! |! |! |! |! |! |!
a 3-year benefit period. If Melvin is confined to a nursing home
|! |! |! |! |! |! |! |! |! |! |! |! |!
for 9 months, how much in benefits will his policy pay?
|! |! |! |! |! |! |! |! |! |!
,1.$27,000
2.$18,000
3.$24,000
4.$17,000 - Correct answer ✔$24,000 |! |! |! |!
Martin and his friends were at a local tavern celebrating his
|! |! |! |! |! |! |! |! |! |! |!
birthday. Martin left the bar to drive home, but unfortunately, he
|! |! |! |! |! |! |! |! |! |! |!
was involved in a fatal accident, killing himself and two other
|! |! |! |! |! |! |! |! |! |! |!
individuals. An autopsy reveals that Martin was well above the
|! |! |! |! |! |! |! |! |! |!
legal limit on his blood alcohol test. Martin's family will receive
|! |! |! |! |! |! |! |! |! |! |!
the following from his Accidental Death and Dismemberment
|! |! |! |! |! |! |! |!
policy:
1.His family will receive reduced benefits since other deaths
|! |! |! |! |! |! |! |! |!
were involved. |!
2.His family will receive the principal sum since this was death
|! |! |! |! |! |! |! |! |! |!
3.His family will receive no benefits, since he was in the act of
|! |! |! |! |! |! |! |! |! |! |! |! |!
committing a felony |! |!
4.His family will receive no benefits since there was no
|! |! |! |! |! |! |! |! |! |!
dismemberment involved. - Correct answer ✔His family will |! |! |! |! |! |! |! |!
receive no benefits, since he was in the act of committing a
|! |! |! |! |! |! |! |! |! |! |! |!
felony
An exclusion that always appears in a health policy is:
|! |! |! |! |! |! |! |! |!
1.No coverage for drug or alcohol related illness
|! |! |! |! |! |! |!
2.Hernia from an accident |! |! |!
, 3.Travel outside of the USA |! |! |! |!
4.Injury in the act of committing a felony - Correct answer
|! |! |! |! |! |! |! |! |! |! |!
✔Injury in the act of committing a felony
|! |! |! |! |! |! |!
Bruce owns a plan that pays $100 daily benefit for a hospital
|! |! |! |! |! |! |! |! |! |! |! |!
stay with no deductible. This kind of policy is known as a (an):
|! |! |! |! |! |! |! |! |! |! |! |!
1.Major medical plan |! |!
2.Basic plan |!
3.Indemnity plan |!
4.Reimbursement plan - Correct answer ✔Indemnity plan |! |! |! |! |! |!
Under what conditions is the death benefit (principal sum)
|! |! |! |! |! |! |! |! |!
payable under an Accidental Death and Dismemberment (AD&D)
|! |! |! |! |! |! |!
policy?
|!
1.The insured dies from a grave illness
|! |! |! |! |! |!
2.The insured dies from natural causes
|! |! |! |! |!
3.The insured dies from an accident
|! |! |! |! |!
4.All of the above - Correct answer ✔The insured dies from an
|! |! |! |! |! |! |! |! |! |! |! |!
accident
An insurance agent told a member of his church who had
|! |! |! |! |! |! |! |! |! |! |!
recently experienced several personal and financial losses that
|! |! |! |! |! |! |! |!
he could see that she got a more favorable rate on her
|! |! |! |! |! |! |! |! |! |! |! |!
insurance policies than her health and general circumstances
|! |! |! |! |! |! |! |!
would warrant. The woman had been his kindergarten teacher
|! |! |! |! |! |! |! |! |!
