CERTIFICATION EXAM SCRIPT 2026
COMPLETE QUESTIONS AND VERIFIED
ANSWERS
◉ 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? Answer: $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? Answer: $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? Answer: Medicare
supplement Plan F
,◉ When can a group health policy renewal be denied according to
the Health Insurance Portability and Accountability Act (HIPAA)?
Answer: when contribution or participation rules have been violated
◉ What does the word "level: in Level Term describe? Answer: the
face amount
◉ A non-contributory health insurance plan helps the insurer avoid
Answer: 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 Answer: 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? Answer: 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 Answer: 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? Answer:
Provider
◉ Which of the following is NOT an illegal inducement? Answer:
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 Answer: defamation
◉ Which of these statements about Medicaid is CORRECT? Answer:
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 Answer: Marital Status
Correct: tobacco use, health history, age
◉ All of the following plans allow for employee contributions to be
taken on a pre-tax basis EXCEPT Answer: 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? Answer: $5 pen
A producer quoting life insurance may give an applicant an article of
merchandise having an invoice value of $5.00 or less.
◉ 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