MISSOURI LIFE AND HEALTH EXAM 2025

MISSOURI LIFE AND HEALTH EXAM 2025 In a Life insurance contract, an insurance company's promise to pay stated benefits is called the: a) insuring clause b) consideration clause c) entire contract d) owner's rights - Correct Answer-insuring clause Under which circumstance MUST a health insurer have an expedited grievance review procedure? - Correct Answer-when the enrollee's life or health is jeapordized The Consideration clause in a life insurance contract contains what pertinent information? - Correct Answer-amount of premium payments and when they are due Long Term Care policies will usually pay for eligible benefits using which of the following methods? a) delayed b) fee for service c) expense incurred d) respite - Correct Answer-Expense incurred T is receiving $3,000/month from a Disability Income policy in which T's employer had paid the premiums. How are the $3,000 benefit payments taxable? - Correct Answer Benefits are taxable to T A statement made by an insured in an insurance application that must be true to the best of one's knowledge and which becomes a part of the contract is known as - Correct Answer-a representation Which long term care insurance statement is true? - Correct Answer-Pre-existing conditions must be covered after the coverage has been in force for six months Pre-existing conditions are those for which medical advice or treatment was recommended by or received from a health provider within 6 months preceding the effective date of an individual long-term care policy. which of the following is NOT allowed in regards to the Medigap (Medicare Supplement) policy? - Correct Answer-Issuing an additional Medigap policy to ensure no out-of pocket exposure for the insured MISSOURI MISSOURI Jasmine is a salaried employee of an insurance company. Which of the following duties would require her to be licensed as an insurance producer? a) adjusting claims b) underwriting insurance applications c) administrative assistant to the VP of Sales d) soliciting insurance policies - Correct Answer-Soliciting insurance policies All of these are characteristics of an Adjustable Life policy EXCEPT a) adjustable premiums b)adjustable premium payment period c) combination of term and whole life insurance d) face amount can be adjusted using policy dividends - Correct Answer-face amount can be adjusted using policy dividends The Director of Insurance is authorized a) to enforce state laws relating to insurance b) to pass state laws relating to insurance c) to set insurance rates for foreign insurers d) to set sales quotas - Correct Answer-to enforce state laws relating to insurance When a group accident and health policy is issued to an employer, a) a blanket policy is issued to each employee b) the free-look period is 60 days c) a policy is issued to the employer and a certificate is issued to each employee d) a certificate is issued to the employer and a policy is issued to each employee - Correct Answer-a policy is issued to the employer and a certificate is issued to each employee which of the following statements is CORRECT about accelerated death benefits? - Correct Answer-Must have a terminal illness to qualify. T is covered by an Accidental Death and Dismemberment (AD&D) policy that has an irrevocable beneficiary. What action will the insurance company take if T requests a change of beneficiary? - Correct Answer-Request of the change will be refused which of these statements is INCORRECT regarding the federal income tax treatment of life insurance -Premiums are normally not tax deductible -Cash dividends are normally not taxed -Entire cash surrender value is taxable -Proceeds are received tax-free if there is a named beneficiary - Correct Answer-Entire cash surrender value is taxable A producer is circulating incorrect information about the benefits of a policy. This producer may be found guilty of a) misrepresentation MISSOURI MISSOURI b) sliding c) boycotting d) coercion - Correct Answer-misrepresentation The first portion of a covered Major Medical insurance expense that the insured is required to pay is called the: a) corridor deductible b) initial deductible c) stop-loss deductible d) coinsurance deductible - Correct Answer-initial deductible Any changes made on an insurance application requires the initials of whom? - Correct Answer-Applicant A policy of adhesion can only be modified by whom? - Correct Answer-The insurance company Which of the following health policy provisions states that the producer does NOT have the authority to change the policy or waive any of its provisions? a) Time Limit on Certain Defenses b) Reinstatement c) Entire Contract d) Change of Beneficiary - Correct Answer-Entire Contract all of the following are considered to be typical characteristics describing the nature of an insurance contract, EXCEPT: Unilateral Bilateral aleatory adhesion - Correct Answer-Bilateral The Accidental Death and Dismemberment (AD&D) provision in a life insurance policy would pay additional benefits if the insured: a) dies of natural causes b) becomes critically ill c) becomes chronically ill d) is blinded in an accident - Correct Answer-is blinded in an accident Which health policy clause stipulates that an insured company must attach a copy of the application to the policy to ensure that it is part of the contract? a) consideration b) Entire Contract c) Free-look d) Insuring - Correct Answer-Entire Contract MISSOURI MISSOURI Coverage for human leukocyte antigen testing for bone marrow transplantation is REQUIRED to be provided in all a) Long-term care policies b) Short-term disability policies c) Cancer policies d) Group comprehensive health policies - Correct Answer-Group comprehensive health policies The phrase "This policy will only pay for a semi-private room" is an example of a(n): a) maximum policy limit b) internal limit c) stop loss d) participation percentage - Correct Answer-internal limit T and S are named co-primary beneficiaries on a $500,000 Accidental Death and Dismemberment policy insuring their father. Their mother was named contingent beneficiary. Five years later, S dies of natural causes and the father is killed in a scuba accident shortly afterwards. How much of the death benefit will the mother receive? a) $1,000,000 b) $500,000 c) $250,000 d) $0 - Correct Answer-$0 A comprehensive major medical health insurance policy contains an Eligible Expenses provision which identifies the types of health care services that are covered. All of the following health care services are typically covered, EXCEPT for: - Correct Answer experimental and investigative services an insured recently took out a cancer insurance policy. The time limit on certain defenses provision in this policy allows the insurer - Correct Answer-to deny the amount of a claim for misstatements on the application occurring prior to the expiration of the first two policy years Which type of renewability best describes a Disability Income policy that covers an individual until the age of 65, but the insurer has the right to change the premium rate? - Correct Answer-Guaranteed renewable Periodic health claim payments MUST be made at least: a) monthly b) weekly c) daily d) annually - Correct Answer-monthly If a retiree on Medicare required five hospital stays in one year, which policy would provide the best insurance for excess hospital expenses? - Correct Answer-Medicare supplement MISSOURI MISSOURI Who benefits in Investor-Originated Life Insurance (IOLI) when the insured dies? a) beneficiary b) insured c) policyowner d) insured - Correct Answer-policyowner P is a forty year old woman and would like to purchase an annuity that will provide a lifetime income stream beginning at age sixty. Which of the following did she NOT buy? a) a straight life deffered annuity b) a straight life annuity c) an immediate annuity d) a deferred annuity - Correct Answer-an immediate annuity Many small business owners worry how their business would survive financially if the owner becomes disabled. The policy which BEST addresses this concern is: a) Business Overhead Expense b) Disability Income c) Key Employee Life d) Contributory - Correct Answer-Business overhead expense Which of the following health insurance policy provisions specifies the health care services a policy will provide a) Insuring clause b) Usual, Customary, and Reasonable clause c) Consideration clause d) Benefit clause - Correct Answer-Insuring clause Which of the following services is NOT covered under a hospitalization expense policy? a) daily room and bored b) surgeon's fees c) intensive care d) miscellaneous expenses - Correct Answer-surgeon's fees The provision that defines to whom the insurer will pay benefits to is called: a) Entire Contract b) Proof of Loss c) Claim Forms d) Payment of Claims - Correct Answer-Payment of Claims When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain a) gender of beneficiary b) address of payor c) suitability information d) owner's place of employment - Correct Answer-suitability information MISSOURI MISSOURI what benefit does the Payer clause on a Juvenile Life policy provide? - Correct Answer premiums are waived if the payor becomes disabled which of the following provisions guarantees that premiums will be waived if a Juvenile Life policyowner becomes disabled? - Correct Answer-Payor Clause The conversion provision in a group health insurance policy a) is an option for the insurer b) is mandated by the NAIC c) is mandated by state requirements d) requires evidence of insurability - Correct Answer-is mandated by state requirements Which of these actions should a producer take when submitting an insurance application to an insurer? a) Issue a binding receipt to applicant if no initial premium is submitted b) disclose to the applicant the amount of commissions to be earned on this transaction c) inform insurer of relevant information not included on the application d) Arrange for a copy of the Attending Physician Statement (APS) to be sent to the producer - Correct Answer-inform insurer of relevant information not included on the application N purchases an annuity by making payments in an amount no less than $100 quarterly. This describes which of the following annuities? a) installment immediate b) fixed installment deferred c) flexible installment deferred d) flexible premium immediate - Correct Answer-Flexible installment deferred Which of these is a TRUE statement regarding the regulatory authority of the Director? a) the Director may set insurance rates for alien insurers b) the Director may arbitrate claims for domestic insurers c) the Director may establish guidelines for continuing education d) The director may establish insurance laws - Correct Answer-The director may establish guidelines for continuing education Health coverage for the administration of general anesthesia and hospital charges for dental care MUST be provided to a(n) a) insured who requires a tooth extraction b) insured who needs teeth cleaning and x-rays c) child under the age of five d) pregnant women - Correct Answer-child under the age of five C is trying to determine whether to convert her convertible term life policy to whole life insurance using her original age or attained age. What factor would affect her decision the most? - Correct Answer-The cost MISSOURI MISSOURI A long-term care rider in a life insurance policy pays a daily benefit in the event of which of the following? a) critical illness b) terminal illness c) inability of the insured to perform more than 2 Activities of Daily Living (ADL's) d) - Correct Answer-Inability of the insured to perform more than 2 Activities of Daily Living (ADL's) What is the purpose of the Missouri Life and Health Insurance Guaranty Association? - Correct Answer-ensures that claims filed against insolvent insurance companies will be paid Which of the following statements about a Guaranteed Renewable Health Insurance policy is CORRECT? a) premiums normally decrease at time of renewal b) premiums normally increase at time of renewal c) policy can renewed at any time by the company d) policy can be cancelled at any time by the company - Correct Answer-Premiums normally increase at time of renewal which of these statements regarding health coverage for physically handicapped dependents is FALSE? - Correct Answer-The dependent must have been over the age of 10 when the handicap was incurred Which Unfair Trade Practice involves making a false statements about the financial condition of another insurance company? a) sliding b) defamation c) twisting d) rebating - Correct Answer-defamation What type of renewability guarantees premium rates and renewability? - Correct Answer-Noncancellable insurers may request a hearing within ______ if their policy is rejected - Correct Answer-20 days K pays on a $20,000 20-Year Endowment policy for 10 years and dies from an automobile accident. How much will the insurance company pay the beneficiary? a) Return of premiums paid b) cash value plus interest c) $20,000 death benefit d) Face amount plus interest - Correct Answer-$20,000 death benefit Which entity issues Medicare Supplement insurance? MISSOURI MISSOURI a) insurance companies b) Medicaid c) Medicare d) NAIC - Correct Answer-insurance companies What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy? a) Premiums may increase at time or renewal b) Premiums may increase at any time c) Policy may be renewed at the discretion of the insured d) Policy may be amended by insurer at any time - Correct Answer-Premiums may increase at time of renewal Which of these statements accurately describes the Waiver of Premium provision in an Accident and Health policy? - Correct Answer-Premiums are waived after the insured has been totally disabled for a specified time period Which of the following statements BEST describes what the Legal Actions provision of an Accident and Health policy requires? a) An insured must settle a claim within 60 days after Proof of Loss is submitted b) An insured must wait at least 30 days after Proof of Loss has been submitted before a lawsuit can be filed c) An insured must wit at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed d) an insured must settle a claim within 30 days after Proof of Loss is submitted - Correct Answer-An insured must wait at least 60 days after Proof of Loss has been submitted before a lawsuit can be filed S has a Whole Life policy with a premium payment due soon. Which provision would keep the policy in force if S does not make the required payment and the policy has adequate cash value from which the premium payment can be made? a) automatic Policy Loan b) assignment c) grace period d) waiver of premium - Correct Answer-automatic Policy Loan All of these Settlement options involve the systematic liquidation of the death proceeds in the event of the insured's death EXCEPT Fixed Period Interest Only Fixed Amount Life Income - Correct Answer-Interest Only A policyowner's rights are limited under which beneficiary designation? a) revocable b) tertiary MISSOURI MISSOURI c) contingent d) irrevocable - Correct Answer-irrevocable In Missouri, all health policies must address diabetes coverage in which way? a) Cover all diabetes treatment and medical supplies 100% b) Cover all diabetes treatment only if Type 1 c) The maximum out-of-pocket expense for diabetes coverage is 50% d) Apply the same deductible and copays to covered diabetic supplies as other medical conditions - Correct Answer-Apply the same deductible and copays to cover diabetic supplies as other medical conditions Upon delivery of a rated life insurance policy, the Producer must obtain each of the following EXCEPT: a) signed HIPAA disclosure b) signed amendment c) signed statement of Good health d) the required premium - Correct Answer-signed HIPAA disclosure Life insurance and annuity replacement can be BEST described as a) converting term coverage to a permanent policy b) exchanging an existing life policy for a mutual fund c) accepting a reduced paid-up policy d) exchanging an existing policy for a new policy - Correct Answer-exchanging an existing policy for a new policy A prepaid application for individual Disability Income insurance was recently submitted to an insurer. When the insurer received the Medical Information Bureau (MIB) report, the report showed that the applicant had suffered a stroke 18 months ago, something that was not disclosed on the application. Which of the following actions would the insurance company NOT take? a) send the initial premium back to the applicant b) send a notice to the applicant that the coverage was declined c) send a notice to the MIB that the applicant was declined d) send a notice to the agent that the applicant was declined - Correct Answer-Send a notice to the MIB that the applicant was declined S recently received a $500,000 lump sum retirement buyout from her employer. She would like to buy an annuity that will immediately furnish her with a guaranteed income for life. What type of annuity is best suited for her situation? - Correct Answer-single premium Post-tax dollar contributions are found in - Correct Answer-Roth IRA investments The sections of an insurance contract which limit coverage are called: a) waivers b) riders MISSOURI MISSOURI c) exclusion d) limitations - Correct Answer-exclusions A nondisabled individual is first eligible for a Medicare Supplement policy at age a) 60 b) 62 c) 65 d) 70 1/2 - Correct Answer-65 Insureds in the same risk classification are being charged different premiums by an insurance company. This insurer is committing the illegal act of a) rebating b) twisting c) unfair discrimination d) defamation - Correct Answer-unfair discrimination J, an Accidental Death and Dismemberment (AD&D) policy holder, dies after injuries sustained in an accident. J's age as stated on the application five years ago was foun