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Questions and Answers
What will the insurer pay?
What will the insurer pay?
$10,000 minus any applicable deductibles and coinsurance
All of the following are qualifying events required to access an Accelerated Death Benefit EXCEPT:
All of the following are qualifying events required to access an Accelerated Death Benefit EXCEPT:
- The insured has received long-term care
- The insured has undergone a critical illness
- The insured's home is facing foreclosure (correct)
- The insured has a terminal illness
What do insureds covered under a group policy receive as proof of coverage?
What do insureds covered under a group policy receive as proof of coverage?
A certificate of insurance
Which of the following must be covered at no cost to the patient under the Affordable Care Act?
Which of the following must be covered at no cost to the patient under the Affordable Care Act?
Any discrimination in rates or availability of insurance must be based on:
Any discrimination in rates or availability of insurance must be based on:
Does the Waiver of Premium rider have a waiting period that must elapse before benefits are paid due to a disability?
Does the Waiver of Premium rider have a waiting period that must elapse before benefits are paid due to a disability?
Which of these statements would best define suitability?
Which of these statements would best define suitability?
What is the shortest benefit period a long-term care insurer is allowed to sell?
What is the shortest benefit period a long-term care insurer is allowed to sell?
According to the Uniform Simultaneous Death Act, who died first in the case of Bob and Fred?
According to the Uniform Simultaneous Death Act, who died first in the case of Bob and Fred?
Which trust takes effect after the death of the insured?
Which trust takes effect after the death of the insured?
What indicates the percentage of gain paid on cash value in an equity indexed annuity policy?
What indicates the percentage of gain paid on cash value in an equity indexed annuity policy?
How long does the Medicaid look back period extend once a person has applied for Medicaid benefits?
How long does the Medicaid look back period extend once a person has applied for Medicaid benefits?
How will claims be paid if an insured has coverage through two different insurance companies?
How will claims be paid if an insured has coverage through two different insurance companies?
What does Medicaid's right of recovery provide for?
What does Medicaid's right of recovery provide for?
Which term policy has coverage that lessens during the term?
Which term policy has coverage that lessens during the term?
What does an assignment form allow an insured to do?
What does an assignment form allow an insured to do?
It is ethical and legal for a physician to overlook medical problems in life insurance exams out of compassion.
It is ethical and legal for a physician to overlook medical problems in life insurance exams out of compassion.
What type of licenses are required to sell a variable annuity?
What type of licenses are required to sell a variable annuity?
How frequently must disability income benefit payments be made by the insurer?
How frequently must disability income benefit payments be made by the insurer?
What is the maximum benefit period for short-term disability (STD) policies?
What is the maximum benefit period for short-term disability (STD) policies?
Which of the following would be inappropriate for a licensed agent to receive?
Which of the following would be inappropriate for a licensed agent to receive?
Who is designated to receive policy proceeds if the annuitant dies?
Who is designated to receive policy proceeds if the annuitant dies?
What is a benefit period in a long-term care policy?
What is a benefit period in a long-term care policy?
What does an 'any-occupation' disability income policy mean for Bill?
What does an 'any-occupation' disability income policy mean for Bill?
Disability insurance policies can contain a preexisting conditions exclusion.
Disability insurance policies can contain a preexisting conditions exclusion.
On which tax basis do funds placed into an annuity grow?
On which tax basis do funds placed into an annuity grow?
It is legal and ethical for three insurance agents to merge but pretend to be separate agencies.
It is legal and ethical for three insurance agents to merge but pretend to be separate agencies.
What is a Social Insurance Supplement (SIS)?
What is a Social Insurance Supplement (SIS)?
Which type of group insurance premium rating takes claims into account?
Which type of group insurance premium rating takes claims into account?
When replacing a long-term care policy, what notices must be provided?
When replacing a long-term care policy, what notices must be provided?
What do customers generally do when they purchase insurance coverage?
What do customers generally do when they purchase insurance coverage?
Which statement would be accurate regarding morals versus ethics?
Which statement would be accurate regarding morals versus ethics?
How long can Karen stay on COBRA after getting divorced?
How long can Karen stay on COBRA after getting divorced?
What rule requires that the state in which a policy is delivered has regulatory jurisdiction?
What rule requires that the state in which a policy is delivered has regulatory jurisdiction?
What type of insurance is contained within the risk corridor of a Universal Life policy?
What type of insurance is contained within the risk corridor of a Universal Life policy?
What unfair practice occurs if an insurance company demands multiple copies of a claimant's cost estimate for surgery?
What unfair practice occurs if an insurance company demands multiple copies of a claimant's cost estimate for surgery?
Where are premiums placed when paid into a variable annuity?
Where are premiums placed when paid into a variable annuity?
If an employer installs a SIMPLE plan, how many employees can they have?
If an employer installs a SIMPLE plan, how many employees can they have?
Who administers Medicaid?
Who administers Medicaid?
What is a prepaid medical expense plan?
What is a prepaid medical expense plan?
What type of policies might pay policy dividends?
What type of policies might pay policy dividends?
Which of the following would be considered an accidental injury?
Which of the following would be considered an accidental injury?
What is TRICARE best defined as?
What is TRICARE best defined as?
Which policy provision states that the application, policy, and any attached papers make up the entire policy?
Which policy provision states that the application, policy, and any attached papers make up the entire policy?
Which characteristics are associated with basic medical plans?
Which characteristics are associated with basic medical plans?
What are the reasons to purchase individual life insurance?
What are the reasons to purchase individual life insurance?
When must an insured provide notice of a medical expense claim to the insurer?
When must an insured provide notice of a medical expense claim to the insurer?
It is ethical for an insurer or insurance producer to make a fair profit.
It is ethical for an insurer or insurance producer to make a fair profit.
What is the death benefit amount for a Universal Life policy Option B with a face amount of $500,000 and cash value of $100,000?
What is the death benefit amount for a Universal Life policy Option B with a face amount of $500,000 and cash value of $100,000?
What must a producer complete if a policy is issued for a nonstandard risk applicant?
What must a producer complete if a policy is issued for a nonstandard risk applicant?
What benefits and facilities are covered in a comprehensive LTC contract?
What benefits and facilities are covered in a comprehensive LTC contract?
What is equity as a legal term often described as?
What is equity as a legal term often described as?
What details a person's medical history, treatments, attending physicians, etc.?
What details a person's medical history, treatments, attending physicians, etc.?
What is a disability policy benefit period?
What is a disability policy benefit period?
In addition to a life insurance license, what must a producer take to sell any type of annuity?
In addition to a life insurance license, what must a producer take to sell any type of annuity?
What is a deductible best described as?
What is a deductible best described as?
How will taxation apply upon surrender of an annuity?
How will taxation apply upon surrender of an annuity?
What are the three nonforfeiture options available in a permanent life insurance policy?
What are the three nonforfeiture options available in a permanent life insurance policy?
What is a cross purchase plan in the context of business owners purchasing life insurance policies?
What is a cross purchase plan in the context of business owners purchasing life insurance policies?
What percentage of benefits would be taxable if an employee paid 100% of his group disability premiums on an after-tax basis?
What percentage of benefits would be taxable if an employee paid 100% of his group disability premiums on an after-tax basis?
If a person wants to pay premiums for only a short period of time, which option should they select?
If a person wants to pay premiums for only a short period of time, which option should they select?
What do insurers refer to those covered through an HMO or PPO as?
What do insurers refer to those covered through an HMO or PPO as?
Which life insurance cost comparison method will show the cost of the policy if it is surrendered?
Which life insurance cost comparison method will show the cost of the policy if it is surrendered?
Tax qualified annuities are purchased primarily by?
Tax qualified annuities are purchased primarily by?
What are the three main factors used in determining health insurance premiums?
What are the three main factors used in determining health insurance premiums?
Which of the following best describes cognitive impairment?
Which of the following best describes cognitive impairment?
If an insured has medical bills totaling $45,000 with a $5,000 deductible, 80/20 coinsurance, and no stop loss, how much will the insured pay if nothing has been paid toward the deductible?
If an insured has medical bills totaling $45,000 with a $5,000 deductible, 80/20 coinsurance, and no stop loss, how much will the insured pay if nothing has been paid toward the deductible?
What is the penalty tax for failure to take a Required Minimum Distribution?
What is the penalty tax for failure to take a Required Minimum Distribution?
All of the following are concerns of LTC underwriters except what?
All of the following are concerns of LTC underwriters except what?
What conversion would Sarah choose if she wants the least expensive premium for her term insurance?
What conversion would Sarah choose if she wants the least expensive premium for her term insurance?
Which type of term insurance policy has the same face amount throughout the contract term?
Which type of term insurance policy has the same face amount throughout the contract term?
What does a non-contributory plan mean for Bob at work?
What does a non-contributory plan mean for Bob at work?
What is the term for a group policy owner?
What is the term for a group policy owner?
Which ethical approach states that a person makes ethical decisions based on their own beliefs?
Which ethical approach states that a person makes ethical decisions based on their own beliefs?
Which is included in the NAIFA Code of Ethics?
Which is included in the NAIFA Code of Ethics?
Sickness in health insurance policies does not include what?
Sickness in health insurance policies does not include what?
What would the policy owner pay taxes on upon endowment?
What would the policy owner pay taxes on upon endowment?
What are premiums for term insurance based on?
What are premiums for term insurance based on?
On which basis are gross premiums calculated by the insurer?
On which basis are gross premiums calculated by the insurer?
What types of losses are excluded from coverage in a DI policy, except for what?
What types of losses are excluded from coverage in a DI policy, except for what?
What does allocation mean in the context of a 401k plan?
What does allocation mean in the context of a 401k plan?
How long could a late enrollee into a group plan face preexisting conditions exclusion?
How long could a late enrollee into a group plan face preexisting conditions exclusion?
Which statement would best describe a disability policy elimination period?
Which statement would best describe a disability policy elimination period?
When may an insured bring suit against his carrier for failure to pay a claim?
When may an insured bring suit against his carrier for failure to pay a claim?
What trust rating did insurance producers have compared to insurance companies in a 2019 Gallup survey of honesty and ethics?
What trust rating did insurance producers have compared to insurance companies in a 2019 Gallup survey of honesty and ethics?
When an employee converts group life insurance, what type of plan will they receive?
When an employee converts group life insurance, what type of plan will they receive?
Which provisions limit the amount of coinsurance and deductibles an insured has to pay annually?
Which provisions limit the amount of coinsurance and deductibles an insured has to pay annually?
What does a major medical insurance plan represent?
What does a major medical insurance plan represent?
What does a policy that contains the carryover provision allow?
What does a policy that contains the carryover provision allow?
If a whole life policy has a face amount of $100,000 and there is $20,000 of cash value, what is the amount at risk?
If a whole life policy has a face amount of $100,000 and there is $20,000 of cash value, what is the amount at risk?
Which rider will pay for the insurance element in a Universal Life policy if the policy owner becomes disabled?
Which rider will pay for the insurance element in a Universal Life policy if the policy owner becomes disabled?
What does the Right to Examine, or free-look, allow?
What does the Right to Examine, or free-look, allow?
When an annuitant starts receiving payments from the annuity, what phase is the annuitant in?
When an annuitant starts receiving payments from the annuity, what phase is the annuitant in?
What must a producer provide to the applicant showing how the insurer will protect the client's information?
What must a producer provide to the applicant showing how the insurer will protect the client's information?
What type of annuity requires the producer to hold only a life insurance license?
What type of annuity requires the producer to hold only a life insurance license?
Who has the authority to modify or change policy language?
Who has the authority to modify or change policy language?
Why might an agency or insurer prohibit giving or receiving gifts of inappropriate nature or value?
Why might an agency or insurer prohibit giving or receiving gifts of inappropriate nature or value?
What is the maximum length of time an employer may require for an employee's employment probation under federal law?
What is the maximum length of time an employer may require for an employee's employment probation under federal law?
Being accountable is best defined as?
Being accountable is best defined as?
What is Adverse Selection best defined by?
What is Adverse Selection best defined by?
Study Notes
Long-Term Care Insurance
- Long-term care insurers must sell policies with a minimum benefit period of 12 months.
- Medicaid's look-back period is typically 5 years when applying for benefits.
Beneficiaries and Claims
- Under the Uniform Simultaneous Death Act, if the insured and primary beneficiary die simultaneously, the beneficiary is deemed to have died first.
- Claims from multiple insurance providers will be prorated based on the total amount of coverage.
Trusts and Policies
- Testamentary trusts take effect only after the death of the insured.
- Equity indexed annuity policies include a participation rate detailing the percentage of gains credited to the cash value.
Disability Income Insurance
- Disability benefits must be paid monthly and can include preexisting condition exclusions, not exceeding 12 months post-issue.
- Short-term disability policies have a maximum benefit period of one year.
Licensing and Ethical Practices
- Selling variable annuities requires both life insurance and securities licenses.
- It is unethical and illegal for an agent to facilitate misleading medical evaluations for insurance.
Insurance Agreements
- An assignment form enables the direct payment from the insurer to a healthcare provider.
- The insured must notify the insurer of a medical claim within 20 days or as soon as possible.
Group Plans and COBRA
- Employees covered under a group plan may face exclusions for preexisting conditions for up to 12 months if they enroll late.
- Individuals on COBRA can remain covered for up to 36 months after a divorce from a policyholder.
Health Insurance Provisions
- Benefit periods in long-term care insurance define the duration benefits are paid, such as a 3-year period.
- The Doctrine of Comity establishes jurisdiction for the state where a policy is delivered.
Taxation and Annuities
- Proceeds from individual life insurance may be taxed on amounts exceeding premiums when received as endowments.
- Annuities are generally tax-deferred, impacting taxation upon withdrawal or surrender.
Medically Related Policies
- The term "subscribers" refers to individuals covered under HMOs or PPOs.
- The maximum out-of-pocket provision limits annual deductibles and coinsurance costs.
Ethical Considerations in Insurance
- The NAIFA Code of Ethics emphasizes collaboration among service providers to better serve clients.
- Individuals seeking insurance should understand their moral and ethical obligations in disclosure and business practices.
Health Insurance Trends
- The "any-occupation" policy type means benefits are contingent upon the ability to find work in any field.
- Cognitive impairment includes significant memory loss and confusion regarding time, place, and people.
State and Federal Regulations
- The Affordable Care Act mandates coverage for preventive services at no cost to patients.
- Federal law permits a maximum of 90 days for employment probation periods.
Claim Processing
- Unfair claims practices include excessive demands for documentation from policyholders.
- Upon surrender of an annuity, the owner can recover premiums without a taxable event but will incur taxes on gains.
Continuing Education and Compliance
- Insurance producers must complete a one-time 4-hour course on annuity suitability to sell annuities.
- Ethical conduct in insurance includes avoiding conflicts of interest and adhering to laws related to inducements and gifts.
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Description
This quiz covers various aspects of insurance policies, including long-term care, disability income, trusts, and claims. It explores important regulations, such as benefit periods and simultaneous death clauses, to enhance understanding of how these policies function. Test your knowledge on ethical practices and licensing in the insurance industry.