Podcast
Questions and Answers
Which of the following annuities would best suit the needs of a 35 year old factory worker who is concerned about inflation and wants to establish a retirement plan?
Which of the following annuities would best suit the needs of a 35 year old factory worker who is concerned about inflation and wants to establish a retirement plan?
- Immediate annuity
- Fixed annuity
- Deferred annuity
- Flexible premium variable annuity (correct)
When a producer submits an insurance application to the company, the producer must take all of the following actions EXCEPT?
When a producer submits an insurance application to the company, the producer must take all of the following actions EXCEPT?
- Collect the premium
- Obtain signatures
- Submit a completed medical information report (correct)
- Explain the policy details
The statement is CORRECT about group life conversion privileges: death during the conversion period is covered even if the departing employee chose not to convert the policy.
The statement is CORRECT about group life conversion privileges: death during the conversion period is covered even if the departing employee chose not to convert the policy.
True (A)
What is the primary reason for selecting a variable whole life policy instead of a traditional whole life policy?
What is the primary reason for selecting a variable whole life policy instead of a traditional whole life policy?
Under the Social Security Retirement benefits, all of the following factors influence the monthly income benefit except the individual's?
Under the Social Security Retirement benefits, all of the following factors influence the monthly income benefit except the individual's?
Which policy provision states that the application is part of the policy?
Which policy provision states that the application is part of the policy?
If a life insurance policy applicant is classified as a substandard risk, what is the MOST likely action of the insurance company?
If a life insurance policy applicant is classified as a substandard risk, what is the MOST likely action of the insurance company?
The right to change a beneficiary designation is reserved for the?
The right to change a beneficiary designation is reserved for the?
When does coverage become effective if an applicant for life insurance submits a completed application without paying the first premium?
When does coverage become effective if an applicant for life insurance submits a completed application without paying the first premium?
If a policy contains a Guaranteed Insurability rider, what right does the insured have?
If a policy contains a Guaranteed Insurability rider, what right does the insured have?
What does the Waiver of Premium provision of a life policy allow the insurer to do?
What does the Waiver of Premium provision of a life policy allow the insurer to do?
An employer can deduct premium payments as an ordinary business expense for which of the following life coverages?
An employer can deduct premium payments as an ordinary business expense for which of the following life coverages?
Which insurance policy would BEST meet the needs of a client who needs substantial protection but has limited financial resources?
Which insurance policy would BEST meet the needs of a client who needs substantial protection but has limited financial resources?
What refers to the transfer of some or all of the ownership rights of a life insurance policy from one individual to another?
What refers to the transfer of some or all of the ownership rights of a life insurance policy from one individual to another?
What benefit does a payor benefit rider provide?
What benefit does a payor benefit rider provide?
What type of retirement plan is tax-qualified?
What type of retirement plan is tax-qualified?
What does the consideration clause in an accident and health policy state?
What does the consideration clause in an accident and health policy state?
Which of the following reports may include information obtained by a telephone call to the proposed insured?
Which of the following reports may include information obtained by a telephone call to the proposed insured?
Health insurance policies are offered on a 'take it or leave it' basis and referred to as?
Health insurance policies are offered on a 'take it or leave it' basis and referred to as?
What is the insurance policy clause that identifies the contracting parties and defines the scope and limits of coverage?
What is the insurance policy clause that identifies the contracting parties and defines the scope and limits of coverage?
Which of the following statements is CORRECT about a Waiver of Premium provision in a Disability Income Policy?
Which of the following statements is CORRECT about a Waiver of Premium provision in a Disability Income Policy?
What is the purpose of the coordination of benefits clause found in group health master contracts?
What is the purpose of the coordination of benefits clause found in group health master contracts?
Which provision designates to whom claim payments are made?
Which provision designates to whom claim payments are made?
Medicare supplement policies are primarily designed to?
Medicare supplement policies are primarily designed to?
In the event both the insured and the primary beneficiary die at the same time, to whom will the policy proceeds generally be paid?
In the event both the insured and the primary beneficiary die at the same time, to whom will the policy proceeds generally be paid?
What percentage of eligible individuals MUST be offered coverage under a noncontributory group health plan?
What percentage of eligible individuals MUST be offered coverage under a noncontributory group health plan?
Under a Guaranteed Renewable Accident and Health policy, can an insurer increase the premium rate?
Under a Guaranteed Renewable Accident and Health policy, can an insurer increase the premium rate?
What is provided by a group long-term disability plan integrated with Social Security?
What is provided by a group long-term disability plan integrated with Social Security?
When does the Ten-Day Free Look provision start for a newly delivered policy?
When does the Ten-Day Free Look provision start for a newly delivered policy?
What is the primary purpose of the MIB?
What is the primary purpose of the MIB?
What law requires an insurer to notify an applicant in writing that an investigative consumer report may be made on them?
What law requires an insurer to notify an applicant in writing that an investigative consumer report may be made on them?
What is the Probationary Period?
What is the Probationary Period?
How many days does an insurer have to provide claim forms to an insured after notice of an Accident & Health Claim?
How many days does an insurer have to provide claim forms to an insured after notice of an Accident & Health Claim?
Under a group health plan, on what basis can an employer offer additional benefits to employees?
Under a group health plan, on what basis can an employer offer additional benefits to employees?
What type of disability does Residual Disability cover?
What type of disability does Residual Disability cover?
Which statement is CORRECT about a disability income policy with a Guaranteed Insurability rider?
Which statement is CORRECT about a disability income policy with a Guaranteed Insurability rider?
According to the IRS, how are disability income benefits paid under an employer-paid group disability income treated?
According to the IRS, how are disability income benefits paid under an employer-paid group disability income treated?
What contract would a producer MOST likely recommend to financially protect a small business from disability?
What contract would a producer MOST likely recommend to financially protect a small business from disability?
What is the purpose of coinsurance?
What is the purpose of coinsurance?
What action is the insurer likely to take if it discovers a policyholder misrepresented their age on a disability application?
What action is the insurer likely to take if it discovers a policyholder misrepresented their age on a disability application?
If an insured becomes disabled three years after a Disability Income Policy is issued, what will likely happen if the disability was pre-existing but not excluded?
If an insured becomes disabled three years after a Disability Income Policy is issued, what will likely happen if the disability was pre-existing but not excluded?
What is an element required on a contract?
What is an element required on a contract?
What type of rider might an individual with a heart murmur expect on their individual disability policy?
What type of rider might an individual with a heart murmur expect on their individual disability policy?
Which expenses does Medicare Part A cover?
Which expenses does Medicare Part A cover?
How often must an insurer make periodic claim payments under a long-term disability income policy?
How often must an insurer make periodic claim payments under a long-term disability income policy?
What is the PRIMARY purpose of Medicaid?
What is the PRIMARY purpose of Medicaid?
What describes a health care plan that reimburses a flat fee for medical care at a clinic it owns?
What describes a health care plan that reimburses a flat fee for medical care at a clinic it owns?
When must insurable interest exist under an AD&D policy?
When must insurable interest exist under an AD&D policy?
What statement is CORRECT about a child who is disabled under their father's group plan?
What statement is CORRECT about a child who is disabled under their father's group plan?
What type of provision guarantees renewability unless certain events occur?
What type of provision guarantees renewability unless certain events occur?
What is a precertification review prior to a nonemergency hospitalization an example of?
What is a precertification review prior to a nonemergency hospitalization an example of?
Under the Claims Forms provision, if the insurer fails to send claim forms in a timely manner, what should the insured do?
Under the Claims Forms provision, if the insurer fails to send claim forms in a timely manner, what should the insured do?
Which health policy has both renewability and premiums guaranteed?
Which health policy has both renewability and premiums guaranteed?
What type of disability can a disability income policy provide benefits for?
What type of disability can a disability income policy provide benefits for?
An A&H policy Notice of Claim provision requires how many days to give written notice after a loss?
An A&H policy Notice of Claim provision requires how many days to give written notice after a loss?
Which health policy requires a beneficiary designation?
Which health policy requires a beneficiary designation?
In an AD&D policy, what does the term 'capital sum' refer to?
In an AD&D policy, what does the term 'capital sum' refer to?
Which benefits does the Social Security program NOT provide?
Which benefits does the Social Security program NOT provide?
What happens if an insured fails to notify the insurer after taking a new job in a more hazardous occupation?
What happens if an insured fails to notify the insurer after taking a new job in a more hazardous occupation?
What should a producer NOT do when delivering a policy to a client?
What should a producer NOT do when delivering a policy to a client?
What does the Elimination Period in most Disability Income policies apply to?
What does the Elimination Period in most Disability Income policies apply to?
What is legally defined as making an inquiry for an offer in insurance applications?
What is legally defined as making an inquiry for an offer in insurance applications?
What policy feature addresses suicide, pre-existing conditions, and self-inflicted injuries?
What policy feature addresses suicide, pre-existing conditions, and self-inflicted injuries?
What action should NOT be taken by a producer who completes an application for a health policy without a premium?
What action should NOT be taken by a producer who completes an application for a health policy without a premium?
Which types of healthcare services might be excluded under a comprehensive major medical policy?
Which types of healthcare services might be excluded under a comprehensive major medical policy?
Which provision explains that a producer does not have the authority to waive the provisions of an insurance contract?
Which provision explains that a producer does not have the authority to waive the provisions of an insurance contract?
What is the major difference between a mutual insurer and a stock insurer?
What is the major difference between a mutual insurer and a stock insurer?
Who acts for another in negotiating a contract of insurance for the purpose of collecting premiums?
Who acts for another in negotiating a contract of insurance for the purpose of collecting premiums?
What is CORRECT about Medicare supplement coverage?
What is CORRECT about Medicare supplement coverage?
What type of group policy covers carriers for a newspaper or publisher?
What type of group policy covers carriers for a newspaper or publisher?
What is provided for an insured's newborn child after birth, without notice or additional payment?
What is provided for an insured's newborn child after birth, without notice or additional payment?
A major medical policy generally cannot deny coverage for a pre-existing condition after how many years?
A major medical policy generally cannot deny coverage for a pre-existing condition after how many years?
Who can obtain a temporary insurance producer license without passing the examination?
Who can obtain a temporary insurance producer license without passing the examination?
What must Credit A&H insurance provide coverage for?
What must Credit A&H insurance provide coverage for?
Who is authorized to enforce state insurance laws?
Who is authorized to enforce state insurance laws?
What must an insurer operate under to conduct business in a state?
What must an insurer operate under to conduct business in a state?
What organization provides health care services in return for a fixed prepaid premium?
What organization provides health care services in return for a fixed prepaid premium?
What is an example of rebating in the insurance industry?
What is an example of rebating in the insurance industry?
What right does an applicant have regarding a long-term care policy if not satisfied?
What right does an applicant have regarding a long-term care policy if not satisfied?
Who is considered an individual appointed by an insurer to solicit insurance applications?
Who is considered an individual appointed by an insurer to solicit insurance applications?
What must a producer provide to an applicant when taking an application for a Medicare supplement policy?
What must a producer provide to an applicant when taking an application for a Medicare supplement policy?
What legal term is guilty by making false statements that harm another insurer's reputation?
What legal term is guilty by making false statements that harm another insurer's reputation?
What statement is prohibited in A&H insurance advertisements?
What statement is prohibited in A&H insurance advertisements?
What could make a producer guilty of misrepresentation?
What could make a producer guilty of misrepresentation?
What must nonresident applicants hold to be eligible for an insurance producer license?
What must nonresident applicants hold to be eligible for an insurance producer license?
What happens to producers who do not satisfy continuing education requirements?
What happens to producers who do not satisfy continuing education requirements?
What can cause the insurance commissioner to revoke or suspend a producer's license?
What can cause the insurance commissioner to revoke or suspend a producer's license?
When can the Insurance Commissioner examine the records of an insurer?
When can the Insurance Commissioner examine the records of an insurer?
What option does an employee who has been covered under a group's health plan for six months have when terminated for cause?
What option does an employee who has been covered under a group's health plan for six months have when terminated for cause?
What is an insurer formed under the law of a state other than where licensed called?
What is an insurer formed under the law of a state other than where licensed called?
Which individual is exempt from the definition of controlled business for a producer?
Which individual is exempt from the definition of controlled business for a producer?
When does the Free Look provision in life insurance begin?
When does the Free Look provision in life insurance begin?
What must a producer collect on the delivery of a life insurance policy if the initial premium was not collected with the application?
What must a producer collect on the delivery of a life insurance policy if the initial premium was not collected with the application?
What is the primary purpose of an inspection report?
What is the primary purpose of an inspection report?
How long is a life policy usually contestable due to material misrepresentation?
How long is a life policy usually contestable due to material misrepresentation?
What is a contract that systematically liquidates accumulated assets through periodic payments called?
What is a contract that systematically liquidates accumulated assets through periodic payments called?
What will an insurer do if an insured commits suicide after the suicide clause has expired?
What will an insurer do if an insured commits suicide after the suicide clause has expired?
What likely causes a 25% increase in premium for one of two identical policies for twins?
What likely causes a 25% increase in premium for one of two identical policies for twins?
Which group life plan requires at least 75% of eligible members to participate?
Which group life plan requires at least 75% of eligible members to participate?
What provides income for the family during a designated time following an insured's death?
What provides income for the family during a designated time following an insured's death?
Study Notes
Insurance Policy Clauses and Provisions
- The consideration clause in accident and health policies requires the applicant to pay the initial premium.
- An insuring clause delineates the contracting parties and the extent of coverage.
- The payment of claims provision designates who receives claim payments.
- Waiver of Premium provision allows insured to keep the policy active during disability without paying premiums.
Health Insurance Policies
- Health insurance is generally offered on a "take it or leave it" basis, known as contracts of adhesion.
- Medicare supplement policies aim to provide extra benefits not covered by Medicare.
- Group health insurance under a noncontributory plan must offer coverage to 100% of eligible individuals.
Claims and Benefits
- The coordination of benefits clause helps prevent double payments when an insured has multiple group coverages.
- Under group plans, an insurer must provide claim forms within a maximum of 15 days after notice of a claim.
- A claim for pre-existing conditions cannot be denied after a major medical policy has been active for 2 years.
Disability and Coverage Details
- Permanent partial disability is covered under the term "residual disability."
- Disability income policies can contain guaranteed insurability riders allowing for periodic benefit increases.
- The elimination period typically applies to each separate disability.
Policy Delivery and Consumer Rights
- The Ten-Day Free Look provision allows applicants to return the policy for a full refund within 10 days of delivery.
- A group long-term disability plan typically works in conjunction with Social Security benefits to establish combined maximum limits.
Medicare and Medicaid
- Medicare Part A covers hospital room and board.
- Medicaid provides medical coverage for individuals meeting specific income requirements.
Insurance Regulations and Licensing
- The Fair Credit Reporting Act mandates insurers inform applicants of potential investigative consumer reports.
- The Insurance Commissioner is authorized to enforce state insurance laws and conduct records examinations.
Roles and Responsibilities
- A producer, acting on behalf of an insurer, can solicit insurance applications and must provide applicants with an outline of coverage.
- An insurance producer may be guilty of defamation if making false statements affecting others' reputations.
Beneficiary Designations and Claims Handling
- Under an AD&D policy, insurable interest must exist at inception.
- Beneficiaries' rights in claim payments can vary, especially under AD&D policies where capital sums apply for dismemberment.
Special Circumstances
- An insured experiencing disability due to a pre-existing condition may not be penalized if not specifically excluded from coverage.
- Claims-related issues must be settled according to the premiums paid based on risky occupations when undisclosed to the insurer.
General Policy Provisions
- Both renewability and premiums being guaranteed occur in noncancellable policies.
- The entire contract provision establishes that the application becomes part of the policy itself.
Important Definitions
- Assignment refers to the transfer of ownership rights of a life insurance policy from one individual to another.
- The payor benefit rider provides payment benefits in case a policyholder becomes disabled and cannot pay premiums.
Group Policies and Business Considerations
- Contributory group life plans necessitate participation from at least 75% of eligible members.
- Provide necessary coverage deductions on group life policies as standard business expenses to employers.
Conclusion
- Life insurance policies are contestable for two years based on misrepresentation.
- An annuity facilitates systematic liquidation of assets through periodic payments, serving a critical function for retirees.
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Prepare for your insurance licensing exam with our Kansas Insurance Practice Exam flashcards. This quiz covers key concepts and terms related to accident and health policies, providing a valuable tool for test-takers. Master the essentials to ensure your success in the insurance field!
