CALIFORNIA LIFE, ACCIDENT AND HEALTH CRAM
COURSE EXAM 1-3 WITH A 200+ COMPLETE STUDY
GUIDE EXAM QUESTIONS WITH CORRECT
ANSWERS WITH RATIONALES LATEST UPDATE 2026
Medical Information Bureau (MIB) members must report which of the following:
A Life insurance death claims
B Health conditions discovered during the underwriting process
C Insurance company actions taken
D Adverse underwriting decisions -Correct ANS-B RATIONALE:
The MIB is a non-profit information agency formed to assist health insurers
uncover misrepresentations or fraudulent actions by applicants for insurance.
MIB members that find an impairment in underwriting report such findings, as
well as situations which applicants have previously been involved in and
information received from physicians or other persons commenting on the status
of a proposed insured.
If a $100,000 Whole Life insurance policy with a cash value of $10,500 lapsed and
the insured selected the reduced paid-up non-forfeiture option, all of the
following would be true
EXCEPT:
A The new policy would have a cash value
B The new policy would have a face amount of $100,000
C The new policy would not require proof of insurability
D The new policy would provide coverage to age 100 -Correct ANS-B RATIONALE:
,If the insured selects the reduced-paid up non-forfeiture option, the insurer will
use the cash value in the lapsed policy to buy the insured a new Whole life policy
at the insured's current age without evidence of insurability. The new policy will
be paid-up until age 100 or the insured's death, whichever comes first, and will
have an immediate cash value. However, $10,500 would not be enough to buy
the insured a $100,000 policy, so coverage will be reduced.
Under the Women's Health and Cancer Rights Act all health insurance plans which
cover mastectomies must also cover which of the following:
A Rehabilitation
B Reconstructive surgery
C Home health care
D Prescription drug coverage -Correct ANS-B RATIONALE:
Under WHCRA, group health plans, insurance companies and health maintenance
organizations (HMOs) offering mastectomy coverage also must provide coverage
for certain services relating to the mastectomy in a manner determined in
consultation with a attending physician. This required coverage includes all stages
of reconstruction of the breast on which the mastectomy was performed, surgery
and reconstruction of the other breast to produce a symmetrical appearance, and
prostheses and treatment of physical complications of the mastectomy.
Medical Information Bureau (MIB) members consist of:
A Life & Health insurers
B Workers Compensation insurers
C All answer options are incorrect
D Fire & Casualty insurers -Correct ANS-A RATIONALE:
The MIB is a nonprofit information agency supported by Life & Health insurance
companies, in order to help insurers uncover misrepresentations or fraudulent
actions by applicants. MIB member companies that find health impairments in
,underwriting report their findings to the MIB in the form of a code number. The
MIB discloses to underwriters the applicants prior health history, including
information received from doctors. However, insurance company underwriting
actions are not recorded anywhere in MIB files.
A Comprehensive Major Medical Expense policy generally includes all of the
following EXCEPT:
A First dollar coverage with high lifetime limits
B A deductible
C A capitation fee
D Co-insurance -Correct ANS-c
RATIONALE:
'Capitation' fees are a characteristic of HMOs, not policies written by insurance
companies. A 'capitation' fee is a per person fee that an HMO pays a doctor based
upon the number of patients they see during a specified period of time.
Comprehensive Major Medical Expense insurance is a combination of a Basic plan
and a Major Medical plan, which is generally the best coverage you can obtain
from an insurance company.
When an Agent pleads 'nolo contendere' to a violation of the insurance code, it
means:
A He is pleading guilty to a violation of the insurance code
B He is pleading not guilty to a violation of the insurance code
C He is leaving the determination of guilt up to the opinion of the Commissioner
D. He has been convicted of a violation of the insurance code -Correct ANS-c
RATIONALE:
, A plea of 'nolo contendere' means that the agent neither admits or disputes the
charges against him, and is an alternative to pleading guilty or not guilty. It is also
called a plea of 'no contest'. The Commissioner can use his or her own judgment
as to whether or not a violation has occurred, and if so, what the penalties should
be.
Carol is injured driving a company car at work. Her Health insurance coverage:
A. Provides excess or supplementary coverage
B. Will provide coverage on a pro-rata basis with Workers Compensation
C. Will cover her injuries
D. Will not cover her since this is an occupational injury -Correct ANS-D
RATIONALE:
Most Health insurance provides 'non-occupational' (off the job) coverage for
sickness or injury, meaning that occupational coverage is excluded. However, if a
person is not required to be covered by Workers Compensation, some Health
policies will cover both on and off the job, which is known as 'occupational'
coverage.
The minimum participation percentage for large group insurance under the
California code is:
A. 50%
B. 40%
C. 75%
D. 25% -Correct ANS-C
RATIONALE:
COURSE EXAM 1-3 WITH A 200+ COMPLETE STUDY
GUIDE EXAM QUESTIONS WITH CORRECT
ANSWERS WITH RATIONALES LATEST UPDATE 2026
Medical Information Bureau (MIB) members must report which of the following:
A Life insurance death claims
B Health conditions discovered during the underwriting process
C Insurance company actions taken
D Adverse underwriting decisions -Correct ANS-B RATIONALE:
The MIB is a non-profit information agency formed to assist health insurers
uncover misrepresentations or fraudulent actions by applicants for insurance.
MIB members that find an impairment in underwriting report such findings, as
well as situations which applicants have previously been involved in and
information received from physicians or other persons commenting on the status
of a proposed insured.
If a $100,000 Whole Life insurance policy with a cash value of $10,500 lapsed and
the insured selected the reduced paid-up non-forfeiture option, all of the
following would be true
EXCEPT:
A The new policy would have a cash value
B The new policy would have a face amount of $100,000
C The new policy would not require proof of insurability
D The new policy would provide coverage to age 100 -Correct ANS-B RATIONALE:
,If the insured selects the reduced-paid up non-forfeiture option, the insurer will
use the cash value in the lapsed policy to buy the insured a new Whole life policy
at the insured's current age without evidence of insurability. The new policy will
be paid-up until age 100 or the insured's death, whichever comes first, and will
have an immediate cash value. However, $10,500 would not be enough to buy
the insured a $100,000 policy, so coverage will be reduced.
Under the Women's Health and Cancer Rights Act all health insurance plans which
cover mastectomies must also cover which of the following:
A Rehabilitation
B Reconstructive surgery
C Home health care
D Prescription drug coverage -Correct ANS-B RATIONALE:
Under WHCRA, group health plans, insurance companies and health maintenance
organizations (HMOs) offering mastectomy coverage also must provide coverage
for certain services relating to the mastectomy in a manner determined in
consultation with a attending physician. This required coverage includes all stages
of reconstruction of the breast on which the mastectomy was performed, surgery
and reconstruction of the other breast to produce a symmetrical appearance, and
prostheses and treatment of physical complications of the mastectomy.
Medical Information Bureau (MIB) members consist of:
A Life & Health insurers
B Workers Compensation insurers
C All answer options are incorrect
D Fire & Casualty insurers -Correct ANS-A RATIONALE:
The MIB is a nonprofit information agency supported by Life & Health insurance
companies, in order to help insurers uncover misrepresentations or fraudulent
actions by applicants. MIB member companies that find health impairments in
,underwriting report their findings to the MIB in the form of a code number. The
MIB discloses to underwriters the applicants prior health history, including
information received from doctors. However, insurance company underwriting
actions are not recorded anywhere in MIB files.
A Comprehensive Major Medical Expense policy generally includes all of the
following EXCEPT:
A First dollar coverage with high lifetime limits
B A deductible
C A capitation fee
D Co-insurance -Correct ANS-c
RATIONALE:
'Capitation' fees are a characteristic of HMOs, not policies written by insurance
companies. A 'capitation' fee is a per person fee that an HMO pays a doctor based
upon the number of patients they see during a specified period of time.
Comprehensive Major Medical Expense insurance is a combination of a Basic plan
and a Major Medical plan, which is generally the best coverage you can obtain
from an insurance company.
When an Agent pleads 'nolo contendere' to a violation of the insurance code, it
means:
A He is pleading guilty to a violation of the insurance code
B He is pleading not guilty to a violation of the insurance code
C He is leaving the determination of guilt up to the opinion of the Commissioner
D. He has been convicted of a violation of the insurance code -Correct ANS-c
RATIONALE:
, A plea of 'nolo contendere' means that the agent neither admits or disputes the
charges against him, and is an alternative to pleading guilty or not guilty. It is also
called a plea of 'no contest'. The Commissioner can use his or her own judgment
as to whether or not a violation has occurred, and if so, what the penalties should
be.
Carol is injured driving a company car at work. Her Health insurance coverage:
A. Provides excess or supplementary coverage
B. Will provide coverage on a pro-rata basis with Workers Compensation
C. Will cover her injuries
D. Will not cover her since this is an occupational injury -Correct ANS-D
RATIONALE:
Most Health insurance provides 'non-occupational' (off the job) coverage for
sickness or injury, meaning that occupational coverage is excluded. However, if a
person is not required to be covered by Workers Compensation, some Health
policies will cover both on and off the job, which is known as 'occupational'
coverage.
The minimum participation percentage for large group insurance under the
California code is:
A. 50%
B. 40%
C. 75%
D. 25% -Correct ANS-C
RATIONALE:
