STATE OF COLORADO SALES LICENSE STUDY GUIDE
2025/2026 QUESTIONS AND ANSWERS GRADED A+
✔✔Benefits that are received are taxed based on whether the benefits were paid for by
the employees or the employer - ✔✔If the employer and employees each pay a portion
of the premiums for a group disability income policy, how are benefits received taxed?
✔✔No - ✔✔An insured seeks to file a civil suit against the insurer of his health
insurance policy. It has been 3 years and 7 months since the insured filed proof of loss
with the insurer, can the insured initiate a legal action against his insurer?
✔✔A fee-for-service medical plan - ✔✔An insured individual, after receiving medical
treatment, pays the doctor and then files a claim with the insurer for reimbursement.
What kind of medical plan is the individual insured through?
✔✔Placing any pre-existing condition restrictions on anyone - ✔✔According to the
provisions of the Patient Protection and ACA, health plans with the exception of
grandfathered plans, are prohibited from
✔✔Recurrent Hospitalization Provision - ✔✔What provision of an indemnity plan covers
patients who must return to the hospital for a previously treated injury and allows them
to not pay the deductible again?
✔✔Divorce or legal separation of a covered employee - ✔✔Several events can cause
workers and their family members to lose group health coverage may result in the right
to coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). This
includes which of the following?
✔✔Long-term care - ✔✔Which of the following is not a common exclusion found in a
health insurance policy?
✔✔To get a clearer idea of the applicants health and any health based risk factors from
the applicants doctor - ✔✔What is the purpose of an attending physician statement?
✔✔$4,450 - ✔✔An individual is covered by an Archer Medical Savings Account. The
individual is also covered by self-only high deductible health plan (HDHP) with an
annual deductible of $12,000. However, the individual is only covered by the HDHP plan
for a total of 7 months. What is the annual deductible limit on the Archer MSA? (Annual
Deductible Limit (Self-Only-Plan) = 65% of the Proportion of the Annual Deductible (7
months))
✔✔No - ✔✔The divorced spouse of a social security benefits recipient is seeking to
draw his own share of social security benefits. This individual is 60 years old, was
married to his spouse for 7 years, has been divorced for 5 years, has not remarried, and
, is not eligible for equal or better benefits based on his work. Is this individual eligible to
draw social security benefits?
✔✔Occasional care for a long-term care patient in the home in order to give relief to the
primary caregivers (usually the family) - ✔✔Respite care is WHICH of the following?
✔✔A single deductible that is applied to multiple health insurance policies at once. -
✔✔What is an integrated deductible?
✔✔Residual Disability - ✔✔A factory worker is disabled in a way that does not prevent
him from performing the substantial "material" duties of his occupation. However, the
resulting disability does force him to cut back the hours on the job which cause is
income to drop by 40%. What is the term for this kind of disability?
✔✔On the date of the medical exam - ✔✔An applicant of health insurance requires a
medical examination as part of the approval process. Assuming the application is
approved and the applicant is paid the initial premium at the time of the application,
what would coverage from the policy begin with?
✔✔This provision sets the maximum dollar limit on coinsurance - ✔✔What is the
purpose of a Stop Loss provision?
✔✔Elimination period - ✔✔Rather than a deductible, most disability income policies
have a set period of time that must pass before the policy will pay out benefits. What is
the term for this period of time?
✔✔A document that allows an insurer to sell policies in PA - ✔✔What is a certificate of
authority?
✔✔Premium = Mortality Factor + Expenses - Interest - ✔✔What is the standard
equation for calculating insurance premium?
✔✔Primary Care Physician - ✔✔All the medical services used by individuals enrolled in
HMOs are coordinated through a single physician known as the..
✔✔Rehabilitation benefit rider - ✔✔Which of the following pays for vocational or other
job training for a disabled worker who is attempting to start a new occupation?
✔✔The policyholder and the insurer - ✔✔After an insurer turns 65, who is permitted to
cancel a health insurance policy with a noncancelable provision?
✔✔Mary's group plan as the primary insurer and John's group plan as the secondary
insurer. - ✔✔John was born on May 21, 1962 and Mary was born on January 7, 1965.
2025/2026 QUESTIONS AND ANSWERS GRADED A+
✔✔Benefits that are received are taxed based on whether the benefits were paid for by
the employees or the employer - ✔✔If the employer and employees each pay a portion
of the premiums for a group disability income policy, how are benefits received taxed?
✔✔No - ✔✔An insured seeks to file a civil suit against the insurer of his health
insurance policy. It has been 3 years and 7 months since the insured filed proof of loss
with the insurer, can the insured initiate a legal action against his insurer?
✔✔A fee-for-service medical plan - ✔✔An insured individual, after receiving medical
treatment, pays the doctor and then files a claim with the insurer for reimbursement.
What kind of medical plan is the individual insured through?
✔✔Placing any pre-existing condition restrictions on anyone - ✔✔According to the
provisions of the Patient Protection and ACA, health plans with the exception of
grandfathered plans, are prohibited from
✔✔Recurrent Hospitalization Provision - ✔✔What provision of an indemnity plan covers
patients who must return to the hospital for a previously treated injury and allows them
to not pay the deductible again?
✔✔Divorce or legal separation of a covered employee - ✔✔Several events can cause
workers and their family members to lose group health coverage may result in the right
to coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). This
includes which of the following?
✔✔Long-term care - ✔✔Which of the following is not a common exclusion found in a
health insurance policy?
✔✔To get a clearer idea of the applicants health and any health based risk factors from
the applicants doctor - ✔✔What is the purpose of an attending physician statement?
✔✔$4,450 - ✔✔An individual is covered by an Archer Medical Savings Account. The
individual is also covered by self-only high deductible health plan (HDHP) with an
annual deductible of $12,000. However, the individual is only covered by the HDHP plan
for a total of 7 months. What is the annual deductible limit on the Archer MSA? (Annual
Deductible Limit (Self-Only-Plan) = 65% of the Proportion of the Annual Deductible (7
months))
✔✔No - ✔✔The divorced spouse of a social security benefits recipient is seeking to
draw his own share of social security benefits. This individual is 60 years old, was
married to his spouse for 7 years, has been divorced for 5 years, has not remarried, and
, is not eligible for equal or better benefits based on his work. Is this individual eligible to
draw social security benefits?
✔✔Occasional care for a long-term care patient in the home in order to give relief to the
primary caregivers (usually the family) - ✔✔Respite care is WHICH of the following?
✔✔A single deductible that is applied to multiple health insurance policies at once. -
✔✔What is an integrated deductible?
✔✔Residual Disability - ✔✔A factory worker is disabled in a way that does not prevent
him from performing the substantial "material" duties of his occupation. However, the
resulting disability does force him to cut back the hours on the job which cause is
income to drop by 40%. What is the term for this kind of disability?
✔✔On the date of the medical exam - ✔✔An applicant of health insurance requires a
medical examination as part of the approval process. Assuming the application is
approved and the applicant is paid the initial premium at the time of the application,
what would coverage from the policy begin with?
✔✔This provision sets the maximum dollar limit on coinsurance - ✔✔What is the
purpose of a Stop Loss provision?
✔✔Elimination period - ✔✔Rather than a deductible, most disability income policies
have a set period of time that must pass before the policy will pay out benefits. What is
the term for this period of time?
✔✔A document that allows an insurer to sell policies in PA - ✔✔What is a certificate of
authority?
✔✔Premium = Mortality Factor + Expenses - Interest - ✔✔What is the standard
equation for calculating insurance premium?
✔✔Primary Care Physician - ✔✔All the medical services used by individuals enrolled in
HMOs are coordinated through a single physician known as the..
✔✔Rehabilitation benefit rider - ✔✔Which of the following pays for vocational or other
job training for a disabled worker who is attempting to start a new occupation?
✔✔The policyholder and the insurer - ✔✔After an insurer turns 65, who is permitted to
cancel a health insurance policy with a noncancelable provision?
✔✔Mary's group plan as the primary insurer and John's group plan as the secondary
insurer. - ✔✔John was born on May 21, 1962 and Mary was born on January 7, 1965.
