Maryland Life and Health Insurance Exam Flashcards
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Questions and Answers

What are statements made by an insurance applicant on an application considered to be?

Representations

What act is committed by an insurance producer who replaces an existing policy by making false written or oral statements?

Twisting

Which disability policy provision addresses concerns of benefits decreasing over time?

Cost of living benefit

What is a plan called in which an employer pays insurance benefits from a fund derived from their current revenues?

<p>A self-funded plan</p> Signup and view all the answers

How long must an individual be unable to engage in gainful activity due to disability to qualify for Social Security Total Disability?

<p>12 months</p> Signup and view all the answers

What are Credit Accident and Health plans designed to do?

<p>Help pay off existing loans during periods of disability</p> Signup and view all the answers

What does the Group Life underwriting risk selection process help protect insurance companies from?

<p>Adverse selection</p> Signup and view all the answers

What is a common exclusion with Vision plans?

<p>Lasik surgery</p> Signup and view all the answers

What is a requirement for any change in an insurance application?

<p>Change must be initialed by the applicant</p> Signup and view all the answers

Who assumes the investment risk with a fixed annuity contract?

<p>The insurer</p> Signup and view all the answers

After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms?

<p>File written proof of loss</p> Signup and view all the answers

Which of these factors help determine an insured's life insurance premium?

<p>Avocation (hobby)</p> Signup and view all the answers

The Life and Health Guaranty Corporation provides funds to carry out its powers by assessing?

<p>Member insurers</p> Signup and view all the answers

A limited payment whole life policy provides what kind of protection?

<p>Lifetime protection</p> Signup and view all the answers

The least expensive option to pay off a 30-year mortgage balance would be?

<p>Decreasing term life</p> Signup and view all the answers

A noncancellable policy may raise premiums.

<p>False</p> Signup and view all the answers

What is an insurance policy's grace period?

<p>Period of time after the premium is due but the policy remains in force</p> Signup and view all the answers

The standard grace period for a life insurance policy sold in Maryland is?

<p>30 days</p> Signup and view all the answers

Which of the following is NOT a requirement for soliciting insurance in Maryland?

<p>At least 21 years old</p> Signup and view all the answers

Which type of plan would be most appropriate for an individual on Medicare who is concerned that Medicare will NOT pay for charges exceeding the approved amount?

<p>Medicare Supplement Plan F</p> Signup and view all the answers

A securities license is required for a life insurance producer to sell?

<p>Variable life insurance</p> Signup and view all the answers

What is the contract called that is issued to an employer for a Group Medical Insurance Plan?

<p>Master policy</p> Signup and view all the answers

Insurable interest can be established sufficiently by sentimental attachment alone.

<p>False</p> Signup and view all the answers

Which of the following is NOT information found in a life insurance buyer's guide?

<p>How to take legal action against an insurance company</p> Signup and view all the answers

The premium for a Modified whole life policy is?

<p>Lower than the typical whole life policy during the first few years and then higher than typical for the remainder</p> Signup and view all the answers

A producer who is licensed in Maryland but resident in another state is called a?

<p>Nonresident producer</p> Signup and view all the answers

Justin is receiving disability income benefits from a group policy paid for by his employer. How are these benefits treated for tax purposes?

<p>Taxable income</p> Signup and view all the answers

The waiting period for a disability insurance policy excludes payments for?

<p>A short-term illness or injury</p> Signup and view all the answers

A policyowner may change two policy features on what type of life?

<p>Adjustable Life</p> Signup and view all the answers

Which of the following is NOT a required provision in an accident and health insurance policy?

<p>Change of occupation</p> Signup and view all the answers

Fixed period settlement options are considered to be a form of a(n)?

<p>Annuity</p> Signup and view all the answers

Which of these factors is NOT taken into account when determining an applicant's life insurance needs?

<p>Automobile</p> Signup and view all the answers

A life insurance policy normally contains a provision that restricts coverage in the event of death under all of the following situations EXCEPT?

<p>As a fare-paying passenger</p> Signup and view all the answers

According to the Affordable Care Act, what metal tier is required to have an actuarial value of 70% with covered individuals paying 30% through deductibles, co-pays, and other cost sharing features?

<p>Silver Plan</p> Signup and view all the answers

The identity of the ____ must be made clear in every health insurance advertisement.

<p>Insurer</p> Signup and view all the answers

When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT?

<p>Obtain the beneficiary's signature</p> Signup and view all the answers

Generally speaking, which three levels of care are Long-Term Care policies provided with?

<p>Skilled nursing, intermediate, and custodial care</p> Signup and view all the answers

What is the nonforfeiture value of an annuity before annuitization?

<p>All premiums paid, plus interest, minus any withdrawals and surrender charges</p> Signup and view all the answers

The purpose of the Coordination of Benefits provision in group accident and health plans is to?

<p>Avoid overpayment of claims</p> Signup and view all the answers

An insurance producer is BEST defined as?

<p>A person who has a contract with an insurance company to represent it</p> Signup and view all the answers

An ____ ____ sells, solicits, or negotiates insurance contracts for compensation.

<p>Insurance producer</p> Signup and view all the answers

A whole life policy option where extended term insurance is selected is called a(n)?

<p>Nonforfeiture option</p> Signup and view all the answers

A policyowner suffers an injury that renders him incapable of performing one or more important job duties. Any decrease in income resulting from this injury would make him eligible for benefits under which provision?

<p>Partial disability</p> Signup and view all the answers

An insurance producer who convinces a prospective insured to purchase a policy by exaggerating the benefits of the policy may be found guilty of?

<p>Misrepresentation</p> Signup and view all the answers

Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA?

<p>It would be considered taxable income to the employee</p> Signup and view all the answers

Under a small group health plan, an insurer is required to provide a newly-married employee at least ____ days to add the new spouse to the plan.

<p>60</p> Signup and view all the answers

David submits a $500 claim for medical expenses. There is a past-due amount owed for insurance premiums of $200. As a result, the insurer only pays $300 for the claim. This deduction came as a result of which provision?

<p>Unpaid provision</p> Signup and view all the answers

The renewability provision for an individual long-term care insurance policy must be located on the policy form's?

<p>First page</p> Signup and view all the answers

A long-term care policy typically provides all of the following levels of care EXCEPT?

<p>Acute care</p> Signup and view all the answers

What happens to the coverage under a children's term rider when that child reaches a certain specified age?

<p>Coverage is eliminated</p> Signup and view all the answers

HIPAA considers which of the following as 'individually identifiable health information'?

<p>A person's health claim information</p> Signup and view all the answers

How many employees must an employer have for a terminated employee to be eligible for COBRA?

<p>20</p> Signup and view all the answers

When does an immediate annuity begin making payments?

<p>After the first premium has been paid</p> Signup and view all the answers

In which of the following processes will the insurer oversee the insured's hospital stay to confirm everything is going according to schedule?

<p>Concurrent review</p> Signup and view all the answers

Which of the following annuity payout options makes no additional payments regardless of the annuitant dying?

<p>Life only</p> Signup and view all the answers

Which of the following nursing home options would BEST suit an individual who needs some nursing care and supervision but NOT full-time care?

<p>Assisted living facilities</p> Signup and view all the answers

Group dental plans will frequently place a limit on annual benefits in order to minimize adverse selection.

<p>True</p> Signup and view all the answers

Kristi purchases an annuity that will pay her husband an income for 15 years. If he dies, this income will become payable to their children for the remainder of the period. Kristi has what kind of annuity?

<p>Temporary annuity certain</p> Signup and view all the answers

Which approach predicts a person's earning potential and determines how much of that amount would be devoted to dependents?

<p>Human life value approach</p> Signup and view all the answers

A medical provider that accepts Medicare Assignment must?

<p>Accept payment based upon a defined Medicare schedule as payment in full</p> Signup and view all the answers

Medicare Part B covers?

<p>Doctor's charges</p> Signup and view all the answers

A policyowner may exercise which of these dividend options that uses the dividend to pay all or part of the next premium due?

<p>The reduction of premium dividend option</p> Signup and view all the answers

When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)?

<p>Participation or contribution rules have been violated</p> Signup and view all the answers

Which of these statements about Medicaid is CORRECT?

<p>Funded by federal, state, and local taxes</p> Signup and view all the answers

Which of these gaps in Medicare coverage is addressed with Medicare Supplemental Insurance?

<p>Medicare in-hospital deductible</p> Signup and view all the answers

Each delivered life insurance policy in Maryland MUST include a(n)?

<p>Legible and brief description of the policy on the first page</p> Signup and view all the answers

In an employer-sponsored group accident and health plan, a master contract is issued to the?

<p>Employer</p> Signup and view all the answers

When a decreasing term policy is purchased, it contains a decreasing death benefit and?

<p>Level premiums</p> Signup and view all the answers

Under the Affordable Care Act, a large employer that does NOT provide health insurance and owes an employer mandate penalty MUST pay an annual penalty, which is calculated by multiplying $2,000 by?

<p>The number of full-time employees minus 30</p> Signup and view all the answers

Which of the following does Medicare Part D cover?

<p>Prescription drugs</p> Signup and view all the answers

A Renewable Term Life insurance policy can be renewed?

<p>At a predetermined date or age, regardless of the insured's health</p> Signup and view all the answers

Which of the following is NOT a reason for the Commissioner to deny or refuse a producer license application?

<p>False</p> Signup and view all the answers

Which of the following provides Medicare supplement policies?

<p>Private insurance companies</p> Signup and view all the answers

The monthly benefit for an individual disability income policy is usually limited to a percentage of the insured's income in order to avoid?

<p>Over insurance</p> Signup and view all the answers

Limited policies can exclusively cover what kind of health insurance policies?

<p>Low frequency diseases</p> Signup and view all the answers

Which of the following is NOT an eligible dependent on an Accident and Health policy?

<p>27 year old married child</p> Signup and view all the answers

Funding for Medicare Part B is partially provided by?

<p>User premiums</p> Signup and view all the answers

Written notice of a health insurance claim should be given to the insurer within ____ days after the occurrence of any loss covered by the policy.

<p>20</p> Signup and view all the answers

A provision that allows a policyowner to temporarily give up ownership rights to secure a loan is called a(n)?

<p>Collateral assignment</p> Signup and view all the answers

Ron has a new employer and wishes to enroll in the company's group health plan. In determining whether his pre-existing health condition applies, Ron cannot have more than a ____ day gap without previous health insurance.

<p>63</p> Signup and view all the answers

Level premium permanent insurance accumulates a reserve that will eventually?

<p>Equal the face amount of the policy</p> Signup and view all the answers

A life insurance policy written on one contract for two people in which it is payable upon the first death is called?

<p>Joint</p> Signup and view all the answers

What does the word 'level' in Level Term describe?

<p>The face amount</p> Signup and view all the answers

What is issued to each employee of an employer health plan?

<p>Certificate</p> Signup and view all the answers

Which of these is NOT subject to income taxation under a Modified Endowment Contract (MEC)?

<p>Death benefit</p> Signup and view all the answers

All of these are considered key factors in underwriting life insurance EXCEPT?

<p>Marital status</p> Signup and view all the answers

Interest on death benefits are NOT required to be paid by an insurance company as long as proceeds are paid within ____ after the date of the death of the insured.

<p>30 days</p> Signup and view all the answers

Which of the following would be a valid reason why a policy premium would be higher than the standard premium?

<p>The insured does not meet established underwriting requirements</p> Signup and view all the answers

Which of these would be the best example of a limited pay life insurance policy?

<p>Whole life policy with premiums paid up after 20 years</p> Signup and view all the answers

Any advertisement that mentions a dollar amount, period of time for which any benefit is payable, cost of policy, policy benefit, or the loss for which the benefit is payable MUST disclose?

<p>The exceptions, reductions, and limitations affecting the basic provisions of the policy</p> Signup and view all the answers

A separate converted policy may, at the option of the insurance company, be issued to cover a(n)?

<p>Dependent</p> Signup and view all the answers

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 a full disability income check every month. How does his policy define total disability?

<p>Own occupation</p> Signup and view all the answers

The free-look provision gives the policyowner?

<p>The right to return the policy for a full refund within a specified number of days</p> Signup and view all the answers

When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)?

<p>When contribution or participation rules have been violated</p> Signup and view all the answers

John the insurance producer has an insurance license that expires in 6 months. If he files an application for renewal before the expiration date, his license will?

<p>Remain in effect until a new one is issued</p> Signup and view all the answers

A policyowner is prohibited from making any changes to the policy without the beneficiary's written consent under which beneficiary designation?

<p>Irrevocable beneficiary</p> Signup and view all the answers

Which of these will have the highest monthly payout upon annuitization?

<p>Straight life</p> Signup and view all the answers

The IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted gross income. Which of the following is considered a tax-deductible medical expense under this rule?

<p>Long Term Care Insurance premiums</p> Signup and view all the answers

Who were Keogh plans designed to provide pension benefits for?

<p>The self-employed</p> Signup and view all the answers

If a producer has been engaged in an administrative action by any governmental agency, within how many days following the final deposition must the producer report the action to the Commissioner?

<p>30</p> Signup and view all the answers

Study Notes

General Insurance Concepts

  • Written Proof of Loss: Required if the insurer does not provide forms after notice of loss is given.
  • Life Insurance Premium Determinants: Avocation or hobbies can significantly impact the calculation of life insurance premiums.

Life and Health Guaranty Corporation

  • Funding Source: Members insurers are assessed to provide the necessary funds for the corporation's powers and duties.

Policy Types and Features

  • Limited Payment Whole Life Policy: Offers lifetime protection with premiums paid for a limited time.
  • Decreasing Term Life Policy: An economical choice for covering a mortgage balance over 30 years, as the death benefit decreases over time.
  • Noncancellable Policies: Guarantees that premiums may never be increased, unlike guaranteed renewable policies.
  • Modified Whole Life Policy Premiums: Lower premiums initially, rising above typical rates in the later years.

Insurance Terms and Provisions

  • Grace Period: Period after which a premium is due but the insurance remains in effect, typically 30 days in Maryland.
  • Medicare Supplement Plan F: Ideal for Medicare recipients concerned about exceeding approved charges.
  • Insurable Interest: Requires more than sentimental attachment; a business or economic interest is typically necessary.

Annuities and Health Insurance

  • Fixed Period Settlement Options: Represent a type of annuity.
  • Coordination of Benefits: Aims to prevent overpayment on claims by identifying primary and secondary insurers.
  • Temporary Annuity Certain: Provides guaranteed payments for a specified period, transferable to beneficiaries if the annuitant dies early.

Medicaid and Medicare

  • Funding for Medicaid: Financed through federal, state, and local taxes.
  • Medicare Part B Coverage: Includes doctor's charges; additionally, Medicare Part D covers prescription drugs.

Regulations and Compliance

  • HIPAA Regulations: Group health policy renewals can be denied if participation rules are violated.
  • Producer License Renewals: A producer's license remains valid if a renewal application is submitted before the expiration date.

Disability Insurance

  • Definition of Total Disability: Often linked to the inability to perform one's current occupation.
  • Waiting Periods: Disability insurance policies generally exclude coverage for short-term illnesses or injuries.

Miscellaneous Concepts

  • Irrevocable Beneficiary: Requires the policyowner to obtain the beneficiary's consent for any policy changes.
  • Adverse Selection: Concerns around this are mitigated by placing limits on annual benefits in group dental plans.
  • Twisting: Refers to the illegal act of misleading a prospective insured to purchase a policy through false statements.

Employment and Group Policies

  • Eligibility for COBRA: Requires a minimum of 20 employees for a terminated employee to maintain health coverage.
  • Employer-Sponsored Plans: Master contracts are issued to employers, defining the coverage details for employees.

Taxation and Financial Considerations

  • Tax Treatment of Disability Benefits: Income received from employer-paid group disability policies is typically taxable.
  • Nonforfeiture Value of Annuities: Defined as the total of all premiums paid plus interest, minus any withdrawals or charges before annuitization.

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Test your knowledge and preparation for the Maryland Life and Health Insurance Licensing Exam with these comprehensive flashcards. Cover essential concepts such as proof of loss, life insurance premiums, and the role of the Life and Health Guaranty Corporation.

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