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Questions and Answers

Which components are typically associated with major medical insurance policies?

  • Both B and C only (correct)
  • Elimination period
  • Maximum out-of-pocket amount
  • Policy deductible

Ted, a health insurance agent, offers an applicant a weekend vacation to a local resort in exchange for purchasing a policy. Is this practice permitted, and what is it called if it is not?

  • No; it is known as twisting.
  • Yes; it is perfectly acceptable as a marketing strategy.
  • No; it is known as rebating. (correct)
  • No; it is known as misrepresentation.

Sara is delivering a health insurance policy to a client. Besides handing over the document, what additional step should she emphasize to ensure a thorough understanding?

  • Encouraging the client to immediately seek additional coverage options.
  • Immediately starting the coverage as soon as the policy is handed over.
  • Advising the client to store the policy in a secure location immediately.
  • Thoroughly reviewing the policy with the client to ensure understanding and accuracy. (correct)

An agent persuades a client to let their existing insurance policy lapse so that the agent can sell them a new, similar policy. Is this permissible, and what is this action called if it is not?

<p>No; this is known as twisting and is unethical. (C)</p> Signup and view all the answers

What is the term for the amount an insured person pays for a medical expense at the time of their visit?

<p>Copay (C)</p> Signup and view all the answers

An applicant makes false statements on their insurance application but reasonably believed them to be true at the time. What is this considered?

<p>Unintentional Misrepresentation (A)</p> Signup and view all the answers

What is the primary purpose of the Coordination of Benefits (COB) provision in a health insurance policy?

<p>To determine which insurance plan has primary responsibility for payment when an insured is covered by more than one plan. (A)</p> Signup and view all the answers

Which statement accurately differentiates indemnity plans from reimbursement plans?

<p>Indemnity plans provide a fixed benefit, while reimbursement plans repay actual expenses. (C)</p> Signup and view all the answers

For an underwriter to properly issue an insurance policy, which party MUST demonstrate insurable interest?

<p>Owner (A)</p> Signup and view all the answers

Which legal principle applies when a person is authorized to act on another's behalf, creating legal relationships with a third party?

<p>Law of agency (B)</p> Signup and view all the answers

What range of factors is relevant when conducting a life insurance needs analysis to determine the appropriate amount of coverage?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following events is LEAST likely to prompt a change in the amount of life insurance coverage needed?

<p>Change in job title (B)</p> Signup and view all the answers

What is the primary purpose of requiring an insurable interest in a life insurance policy?

<p>To prevent wagering on human life. (D)</p> Signup and view all the answers

An insurance agent is acting in a fiduciary capacity when they:

<p>Act in the best interest of their client. (C)</p> Signup and view all the answers

If a life insurance policy includes a 'spendthrift clause', what protection does it offer?

<p>Protects the beneficiary from creditors seizing the policy proceeds. (B)</p> Signup and view all the answers

Which of the following examples BEST demonstrates the 'Law of Agency' in an insurance context?

<p>An agent binding coverage on behalf of an insurance company. (D)</p> Signup and view all the answers

In life insurance, if a policy is sold to a third party for an amount greater than its cash value, what are the potential tax implications for the beneficiary upon the insured's death?

<p>Only the amount exceeding the purchaser's basis in the policy may be subject to income tax. (A)</p> Signup and view all the answers

A policyowner takes out a loan against the cash value of their permanent life insurance policy. Under what circumstances, if any, would this loan become taxable?

<p>The loan is taxable if the policy lapses or is surrendered and the outstanding loan balance exceeds the policy's cost basis. (D)</p> Signup and view all the answers

A life insurance policy is classified as a Modified Endowment Contract (MEC). What is the primary tax consequence regarding distributions (including loans) from the policy?

<p>Distributions are taxed on a last-in-first-out (LIFO) basis, meaning earnings are taxed before the return of the cost basis. (A)</p> Signup and view all the answers

An employer provides group term life insurance coverage to its employees. What are the tax implications for the employee regarding the premiums paid by the employer?

<p>The premiums are taxable to the employee only if the coverage exceeds $50,000. (B)</p> Signup and view all the answers

If annual premiums paid for a life insurance policy that is owned by someone other than the insured exceed the annual gift tax exclusion, what are the potential tax consequences?

<p>The excess amount must be reported on a gift tax return (Form 709) and may reduce the donor's lifetime gift and estate tax exemption. (D)</p> Signup and view all the answers

An annuitant is considering withdrawing funds from their annuity during the surrender period. What potential consequence should they anticipate?

<p>The withdrawal will incur a penalty or surrender charge. (C)</p> Signup and view all the answers

An individual is seeking an annuity that will provide income specifically during their advanced age, starting well beyond the typical retirement age. Which type of annuity is most suitable for this objective?

<p>A longevity annuity. (C)</p> Signup and view all the answers

An annuity contract owner wants to enhance their annuity with additional features not included in the standard contract. How can they typically accomplish this?

<p>By adding a rider to the annuity. (A)</p> Signup and view all the answers

What key factors primarily influence the payout rate of an immediate annuity when it begins making payments?

<p>The annuitant's age, life expectancy, and the initial investment amount. (D)</p> Signup and view all the answers

An annuitant selects a "period certain" feature for their annuity. What assurance does this feature provide?

<p>The annuity will pay out for a minimum guaranteed number of years, regardless of the annuitant's lifespan. (D)</p> Signup and view all the answers

An individual anticipates needing long-term care in the future and wants to use an annuity to cover these potential costs. What type of rider could they add to their annuity contract to address this concern?

<p>A long-term care rider. (D)</p> Signup and view all the answers

Which of the products listed represents a contract with an insurance company where the insurer promises to make periodic payments to you immediately or at some future date?

<p>An annuity (A)</p> Signup and view all the answers

What is the primary purpose of the accumulation phase in an annuity contract?

<p>To grow the invested funds tax-deferred. (D)</p> Signup and view all the answers

How might a deferred annuity be advantageous for retirement planning compared to an immediate annuity?

<p>It allows for tax-deferred growth of assets over time. (B)</p> Signup and view all the answers

What is a potential disadvantage of choosing a variable annuity over a fixed annuity?

<p>Exposure to market risk. (D)</p> Signup and view all the answers

Which statement accurately describes an immediate annuity?

<p>An annuity purchased with a single premium that begins payments within one year of purchase. (B)</p> Signup and view all the answers

What is the primary function of annuitization within an annuity contract?

<p>The process of converting a lump sum into a stream of payments. (D)</p> Signup and view all the answers

Which type of annuity is specifically designed to address potential expenses associated with long-term care?

<p>Long-Term Care Annuity (A)</p> Signup and view all the answers

In the context of a deferred annuity, what does the 'accumulation phase' refer to?

<p>The period during which the annuity funds are invested before payments start. (A)</p> Signup and view all the answers

What distinguishes an indexed annuity from other types of annuities?

<p>The return is linked to a specific stock market index. (D)</p> Signup and view all the answers

Which of the following is NOT a typical benefit associated with annuities?

<p>Immediate access to all funds without penalty. (D)</p> Signup and view all the answers

An individual is considering purchasing an annuity to supplement their retirement income. Which type of annuity would provide a guaranteed stream of income, regardless of market conditions?

<p>Fixed Annuity (B)</p> Signup and view all the answers

Which of the following scenarios would LEAST likely be a suitable use case for an annuity?

<p>A young individual seeking high-growth investments with immediate liquidity. (D)</p> Signup and view all the answers

What is a significant risk associated with variable annuities compared to fixed annuities?

<p>The potential loss of principal due to market fluctuations. (D)</p> Signup and view all the answers

If an annuitant dies during the accumulation phase of a deferred annuity, what typically happens to the annuity's value?

<p>It is paid out as a lump-sum death benefit to a designated beneficiary. (B)</p> Signup and view all the answers

Flashcards

Maximum Out-of-Pocket

The total amount an insured person pays out-of-pocket for covered medical expenses in a policy year.

Rebating

Offering inducements to purchase a policy

Policy Delivery (Agent's Role)

Reviewing the policy with the client to ensure understanding and accuracy of all terms, conditions, and coverage details.

Twisting

Persuading a client to lapse an existing policy to sell a new one without real benefit to the client.

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Coinsurance

A fixed dollar amount you pay for a covered health care service after you've paid your deductible.

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Copayment

A fixed amount you pay for a covered health care service, usually when you receive the service.

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Premium

The amount you pay for your health insurance every month.

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Indemnity Insurance

Pays a set amount for services, regardless of actual costs.

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Reimbursement Plan

Pays back actual expenses up to a limit, usually after a deductible.

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Insurable Interest

The policy owner must have an insurable interest in the insured's life at the start of the policy.

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Agent

Someone authorized to act on behalf of another; creates legal relationships with a third party.

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Law of Agency

Governs the relationship where one person acts on behalf of another.

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Principal

The party who authorizes someone to act on their behalf.

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Life Insurance Needs Analysis

Calculating the appropriate amount of life insurance coverage needed.

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Key factors in life insurance needs

Dependents and future financial obligations.

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Life-Changing Events

Birth of a child, divorce, and marriage are all examples.

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Immediate Annuity

An annuity bought with a single payment that starts paying out within one year.

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Annuitization

Converting an annuity's value into a series of regular payments.

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Long-Term Care Annuity

An annuity designed to help cover expenses related to long-term care needs.

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Accumulation Phase (Annuity)

The period when your money grows tax-deferred inside an annuity, before payouts begin.

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Indexed Annuity

An annuity where returns are linked to a stock market index, like the S&P 500.

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Transfer for Value

Selling or transferring a life insurance policy for consideration, potentially leading to taxable income.

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Tax treatment for policy loan

Generally not taxable, providing a tax-advantaged way to access cash value while the policy is active.

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Exceeding MEC Rules

When an insurance policy becomes a Modified Endowment Contract, loans and withdrawals exceeding the cost basis are taxed as ordinary income, potentially with penalties if withdrawn before age 59½.

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Employer-Paid Premiums Tax

Premiums for coverage over $50,000 are considered taxable income to the employee.

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Exceeding Gift Tax Exclusion

The excess amount must be reported and may be subject to gift tax.

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Annuity Surrender Period

The period when withdrawing funds incurs penalties.

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Longevity Annuity

Provides income starting at an advanced age (e.g., 85).

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Annuity Rider

An optional feature added to an annuity for extra benefits at a cost.

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Immediate Annuity Payout Factors

Annuitant's age, life expectancy, and initial investment.

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Annuity 'Period Certain' Feature

Guarantees annuity payout for a minimum number of years.

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Variable Annuity

Offers payments that can vary based on the performance of an investment portfolio.

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Fixed Annuity

Offers a guaranteed rate of return.

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Annuity

A contract in which the insurer promises to make a series of payments to the recipient in exchange for a premium or premiums.

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Annuitant

The person who receives payments from the annuity.

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Study Notes

  • 300 practice questions are included in this resource.

Key Insurance Concepts - Questions and Answers

  • An actuary is a mathematician who analyzes and prices insurance policies based on the probability of specific events.
  • A tertiary beneficiary will receive insurance proceeds if both the primary and secondary beneficiaries are deceased.
  • Adjustable life insurance policies provide greater flexibility compared to other plans, allowing changes to premiums and face value.
  • A "free-look" provision permits a policyholder to return the policy within a certain period for a full refund if not satisfied.
  • Alternative coverage options, such as a short-term Accidental Death and Dismemberment policy, can provide coverage when a life insurance policy has a dangerous policy exclusion.
  • An employee can continue group health insurance coverage, subject to the health insurer's approval, while on approved leave due to a work injury that is being compensated through worker's compensation.
  • Unearned income, such as interest or investment income, continues even when a person is unable to work.
  • Programming is a method of calculating the necessary amount of disability insurance for an individual.
  • A "free-look’’ provision allows a refund if not satisfied within a set period.
  • A spouse term insurance rider adds term life insurance coverage to a whole life insurance policy for a spouse.
  • COBRA (Consolidated Omnibus Budget Reconciliation Act) allows employees to continue their group health insurance coverage after leaving employment under certain conditions.
  • With a 5-year graded vesting schedule, 20% vests each year, hence, after three years, 60% would be vested.
  • STOLI (Stranger-Originated Life Insurance) policies are primarily investment vehicles lacking insurable interest between the insured and policy owner.
  • Sending policy documents to applicants is not a common underwriting position for a health insurance company: this is typically the responsibility of the agent or broker.
  • A rider is an add-on to an insurance policy that modifies or adds coverage or terms.
  • A Certificate of Insurance (COI) verifies insurance coverage, detailing coverage type and terms.
  • If Lechter is becomes disabled before age 22 and is at least 18 years old Lechter can receive Social Security benefits as a dependent child.
  • Health insurance premiums shouldn't be based on gender; but rather age, tobacco use, and weight
  • A viatical settlement involves the sale of a life insurance policy to a third party for less than its death benefit and more than its cash surrender value.
  • Medicaid is a joint federal-state program providing healthcare to low-income individuals, administered by each state within federal guidelines.
  • Underwriters are not party to a life insurance contract; while the owner and insured are typically the parties involved/ concerned
  • Life insurance policies can provide living benefits.
  • Significant life events, such as the birth of a child, should prompt a review of life insurance coverage to ensure adequate support for the individual's dependents
  • A grace period lets policyholders pay the overdue premium within a certain timeframe, typically 30 days, without the policy lapsing.
  • Terms of life insurance are most suitable for covering Jack’s temporary financial obligation. This ensures Lyn can pay off the home if Jack were to pass away during the term.
  • Universal life insurance is a permanent coverage offering for death benefit and a cash value component.
  • Group Life Insurance is an employer or membership benefit package, provided employees or member of a group at reduced cost.
  • Term life insurance gives financial protection only if the insured dies during a specified term.
  • Insurers evaluate health, occupation and hobbies to determine whether or not to provide coverage and premium rates.
  • Underwriting in ife insurance means evaluating risk of an individual to determine insurability and premium rates.
  • ‘Utmost Good Faith’ means that the insured/insurer should disclose all relevant information.
  • Owner must have an insurable interest to ensure legitimate risk is transferred and to prevent gambling on human life.
  • Law of agency governs the relationship between the principal and the agent, facilitating a legal relationship with a third party through the agent's actions.
  • Life insurance needs analysis should take into account the policyholder's age, lifestyle, hobbies, number of dependents, and future financial obligations
  • Change in job title is not a life-changing event, life events like birth of a child, divorce, and marriage are
  • Recommended that permanent life insurance is used so coverage last when term life is used it could expire before the insurance is needed.
  • Cover estate taxes and final expenses is the way life insurance benefits beneficiaries after death.
  • Life insurance can ensure business continuity by providing funds to cover operational costs, pay debts and even buy out deceased partners’ share.
  • Corporate life insurance can be made for new hires, debts and employees stock.
  • Life insurance policies always have death benefit and cash value as components.
  • Death benefit is the most common life insurance component.
  • Reduced paid-up insurance and cash surrender value allow policyholders to retain some value with premium payments preventing all loss of benefits. Cosmetic surgery is a common exclusion mostly, it is not life saving.
  • Policy deductible and maximum out-of-pocket amount are parts of a good insurance policy.
  • Offering/accepting inducements in exchange for business is against the law, and known as rebating.
  • Thoroughly review the policy with the client to ensure is understanding and accurate is the crucial part of the delivery process.
  • “Twisting" means persuading a client to lapse an existing policy.
  • Copayment meaning some money person needs to pay but it is fixed amount.
  • Higher deductibles mean lower premiums.
  • In a long-term care policy, the 'deductible' is called an elimination period.
  • Exact procedures are shown in a health insurance claim by CPT codes.
  • Indemnity plans provide a fixed benefit and reimbursement plans pay the person back.
  • Owner needs to have insurable interest to issue is insurance.
  • Law of agency is the relationships set to give 3rd parties right to act on others.
  • Must think about how old the policyholder is all around.
  • Life events must be thought about a child.
  • If no insurance permanent insurance is recommended.
  • Estate plan is taxes and final expenses when all dies.
  • Operation cost or even debts this insures the continuity.
  • Corporate Life insurance can be need of corporation debts to have and train new employees. Death and cash if you want life long insurance.
  • Benefit is for the death.
  • Beneficiary knows where to receive death benefit.
  • If company does the good steps there will be no issues.
  • Living Benefit riders make it so you access proceed before death if person wants too.
  • The differences depend on if they dying of cancer, or not in other situation.
  • Living benefit is used by lump sum or anything.
  • If one has LTC what is an exception =own occupation. Cosmetic surgery is not included.
  • Out of pocket has to be what they put in.
  • Giving gifts and vacation can be rebutting.
  • Agents review to have then understand it all because the client is getting all to understand.
  • Twisting is convincing to sell them new ones.
  • Copayment is the amount insured person pays out for it. Higher deductibles means there less premiums.
  • Elimination period is when deductibles are gone to cover.
  • CPT codes is a way to get insurance done.
  • Indemnity mean fixed and reimbursement means to take out to pay. Owner needs one for each person.
  • Law of Agency with out people helps facilitate through the third persons actions. lifestyle and hobbies is what impacts them. Change title not recommended but rather child divorce and marriage.

More notes to come, this resources only got to 15 %

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