2-40 State Exam Simulator
Please review the exam after you have completed it; the review is very important in your learning and mastery of the material. The review will also show you topics that may require additional study. Keep practicing until you score at least 90% in all categories.
You will succeed and you will pass the state exam!
Ken Toney, MBA, CLU©, ChFC©, CPCU©, SCLA©, ARM©, AIC©
American Insurance College
Phone: (866) 506-0139
Email: [email protected]
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Categories
- Accidental Death and Dismemberment Insurance (ES LHV) 0%
- Disability Income Insurance (ES LHV) 0%
- Florida Laws and Rules about Health Insurance (ES LHV) 0%
- Florida Laws and Rules about Health Maintenance Organizations (ES LHV) 0%
- Florida-Specific Laws and Rules about Insurance (ES LHV) 0%
- Government Health Insurance Programs (ES LHV) 0%
- Group Health Insurance (ES LHV) 0%
- Health Insurance (ES LHV) 0%
- Life & Health Insurance: Law and the Insurance Contract (ES LHV) 0%
- Life & Health Insurance: Licensure, Ethics, and the Insurance Producer (ES LHV) 0%
- Life & Health Insurance: Purpose (ES LHV) 0%
- Life & Health Insurance: The Insurance Industry (ES LHV) 0%
- Medical Expense Insurance (ES LHV) 0%
- Private Insurance Plans for Seniors (ES LHV) 0%
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Keep practicing until you score at least 90% in all categories.
You will notice your scores increase as you take the exam additional times.
You will succeed and you will pass the state exam!
If you require assistance at any time please contact the college by email at: [email protected] or phone: (866) 506 – 0139.
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Congratulations!
You have successfully completed the 2-14 State Exam Simulator.
Keep practicing until you score at least 90% in all categories.
You will succeed and you will pass the state exam!
If you require assistance at any time please contact the college by email at: [email protected] or phone: (866) 506 – 0139.
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- Current
- Review
- Answered
- Correct
- Incorrect
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Question 1 of 239
1. Question
____________ is knowingly making any misleading representations of any HMO contract for the purpose of inducing any person to contract or to purchase an insurance policy or HMO contract with an insurance company or HMO.
CorrectIncorrect -
Question 2 of 239
2. Question
The Florida Health Maintenance Organization Consumer Assistance Plan provides coverage up to ___ months after an HMO liquidation.
CorrectIncorrect -
Question 3 of 239
3. Question
An HMO contract, certificate, or member’s handbook must be delivered within __ working days after approval of the enrollment by the HMO.
CorrectIncorrect -
Question 4 of 239
4. Question
Florida law requires HMOs to provide up to ___ office visits to a dermatologist without a referral from a primary care physician within a twelve month time period.
CorrectIncorrect -
Question 5 of 239
5. Question
An HMO has ___ months after payment of a claim to submit a claim for overpayment to the provider; and a provider has ___ months after payment of a claim by an HMO to submit a claim for underpayment.
CorrectIncorrect -
Question 6 of 239
6. Question
An HMO has up to ____ days after the receipt of a claim from a contact provider for services/goods to pay or deny the claim.
CorrectIncorrect -
Question 7 of 239
7. Question
The HMOCAP was created by Florida statute to protect HMO plan subscribers against the failure of their HMO to perform its contractual obligations due to its insolvency. The maximum benefit to a subscriber is $_______________.
CorrectIncorrect -
Question 8 of 239
8. Question
Which of the following are filing requirements of an HMO? (choose all that apply)
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Question 9 of 239
9. Question
A __________ is the specified dollar amount that the HMO subscriber must pay for certain covered health care services.
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Question 10 of 239
10. Question
Which of the following are “savings” associated with HMOs? (choose all that apply)
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Question 11 of 239
11. Question
A ___________ is any physician, hospital, organization, or other person or institution that furnishes health care services and is licensed or otherwise authorized to practice in Florida.
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Question 12 of 239
12. Question
This HMO provision ensures that claims approved and benefits started while the contract was in force will be paid.
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Question 13 of 239
13. Question
The ________________ period is the period of time each year when an individual can sign up for health insurance coverage.
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Question 14 of 239
14. Question
Florida Healthy Kids provides health insurance coverage to *uninsured* children in families with an income below 200% of the federal poverty level who do not qualify for _________.
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Question 15 of 239
15. Question
_____ are characterized by negotiated fees for services; reduced benefits for out of service providers; and co-payments and deductibles.
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Question 16 of 239
16. Question
“The Bean” coffee shop has ten employees and has purchased a stop-loss health insurance policy. “The Bean’s” owner, Crawford has projected her future claims will be around $14,000 (based on her prior years’ experience).
What is the attachment point for “The Bean’s” renewing stop loss policy?
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Question 17 of 239
17. Question
An LTC policy may condition the payment of benefits on a determination of either the insured’s inability ability to perform up to ___ activities of daily living; or on cognitive impairment.
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Question 18 of 239
18. Question
LTC insurers are required to offer inflation protection at a rate of not less than __% compounded annually.
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Question 19 of 239
19. Question
_________ care is for the “basic activities of everyday living”; that is non-medical care which can be provided in various settings (e.g. at home, adult day care).
CorrectIncorrect -
Question 20 of 239
20. Question
Long-Term Care normally refers to care of ___ days or longer.
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Question 21 of 239
21. Question
True or False? Both Medicare and Medicare Supplements cover long term custodial and nursing home care.
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Question 22 of 239
22. Question
ERISA’s ________ clause relegates to the states the regulation of insurance.
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Question 23 of 239
23. Question
Which ‘rule’ determines whether a health insurance plan is primary or secondary for a dependent child covered by both parents’ benefit plans when the parents live together. The plan covering the parent whose birthday falls first in a calendar year provides primary coverage for the child.
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Question 24 of 239
24. Question
The Florida Health Insurance Coverage Continuation Act extends health insurance to employees of small employers and dependents if COBRA benefits are not available up to ___ months.
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Question 25 of 239
25. Question
Randall T’s doctor sent him a bill for a balance due which is an amount in addition to the agreed price already paid by his insurance company. What should Randall do?
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Question 26 of 239
26. Question
Individual and group health insurance policies are required to provide coverage for mammograms how often for any woman 50 years or older?
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Question 27 of 239
27. Question
Grandfathered Health plans must have had plans in effect on or before:
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Question 28 of 239
28. Question
The insured has up to how many days after a policy is issued to return the policy and receive a full refund of any premium paid.
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Question 29 of 239
29. Question
The purpose of the Florida Life and Health Insurance Guaranty Association’s (FLAHIGA) is to _________ the insuring public against the insolvency of an insurance company. By and large the Association provides benefits to Florida residents.
CorrectIncorrect -
Question 30 of 239
30. Question
The department has rules regarding the inappropriate use of _____________ and ______________.
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Question 31 of 239
31. Question
Micah wants to obtain his insurance license. How many times can he take an examination for a license type?
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Question 32 of 239
32. Question
Applicants for an agent license must pass an examination that will test the applicant’s ability, competence, and ___________. The exam will cover the duties and responsibilities of a licensee and the pertinent provisions of Florida law.
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Question 33 of 239
33. Question
Judith has failed to maintain an appointment with an insurer or an appointing entity during the last 48 months. Judith now has to qualify with the department as a first-time ___________.
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Question 34 of 239
34. Question
While selling Mrs. Marge an insurance policy, Homer told her the insurance company had an A++ rating. Is Homer guilty of misrepresentation if he did not know the actual rating at that time?
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Question 35 of 239
35. Question
True or False? It is lawful to reassure Kelvin Zorbo, a potential client, that FLAHIGA will provide benefits if
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Question 36 of 239
36. Question
Sorbo Health Insurance Company has gone out of business. FLAHIGA will pay for any one’s insured’s medical expenses. What is the maximum amount FLAHIGA will pay?
CorrectIncorrect -
Question 37 of 239
37. Question
______________________ is the principal in which an agent is operating in the best interest of the business of life insurance.
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Question 38 of 239
38. Question
True or False? By Statute, Insurance companies have twenty days to respond to the department once a consumer complaint has been filed.
CorrectIncorrect -
Question 39 of 239
39. Question
Which, if any, of the following statements are correct regarding a license applicant background check?
Statement I. An application for an insurance license shall be subject to a criminal background check by the department.
Statement II. An application for an insurance license shall be subject to a credit background check by the department.
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Question 40 of 239
40. Question
Grace is having her Kindness Insurance Company appointment terminated. What must Kindness do to put all parties of interest on notice of the termination?
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Question 41 of 239
41. Question
J. Jones Insurance Agency received a $5,500 group insurance premium for a group insurance policy for one of the agency’s insureds and deposited those funds it is operating account. Thereafter, the agency used part of the premium as a “float” to pay a very large and very late credit card bill. What is the agency guilty of?
CorrectIncorrect -
Question 42 of 239
42. Question
Marsha Marsha, a licensee, must notify the department, in writing, within __ days after a change of name, residence address, principal business street address, mailing address, contact telephone numbers, including a business telephone number, or email address.
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Question 43 of 239
43. Question
Any person or entity that transacts insurance without a certificate of authority is guilty of at least a __________ felony.
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Question 44 of 239
44. Question
Slade Markham is in a “one-man-band” where he is the owner, agent, and service department for his one personal health insurance agency, The Slade Markham Agency. Is Mr. Markham required to have an agency license?
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Question 45 of 239
45. Question
Which of the following are the duties and powers of the department regarding FLAHIGA and the liquidation of insurance companies?
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Question 46 of 239
46. Question
Rebating is always lawful.
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Question 47 of 239
47. Question
True or False? No person other than a licensed and appointed agent may accept any commission or other valuable compensation for soliciting or negotiating insurance.
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Question 48 of 239
48. Question
___ years of record retention are required by the department.
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Question 49 of 239
49. Question
True or False? False advertising is knowingly making, publishing, disseminating, circulating, or placing before the public untrue, deceptive, or misleading information with respect to any business of insurance.
CorrectIncorrect -
Question 50 of 239
50. Question
Mr. Rogers sold Misty a Health Insurance policy and was able to add an Accidental Death & Dismemberment policy for only $15 extra dollars a month. Misty asked if the AD&D was part of the Health policy and Mr. Rogers told her it was already included in the monthly premium she quoted her. Is Mr. Rogers guilty of sliding?
CorrectIncorrect -
Question 51 of 239
51. Question
Cameron gave Kenisha Kent a $25 gift certificate to Kenisha’s favorite restaurant as part of his schomoozing to sell her company, All Kinds of Kupcakes, Inc., a pension plan. Is Cameron guilty of unfair practice?
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Question 52 of 239
52. Question
Which of the following are benefits to an employer in providing “excellent” employer provided benefits?
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Question 53 of 239
53. Question
All of the following are benefits of group insurance coverage EXCEPT?
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Question 54 of 239
54. Question
Which, if any, of the following are correct statements regarding the tax implications of Business Overhead Expense Insurance?
Statement I. Business Overhead Expense Insurance are tax deductible as a business expense to the business.
Statement II. Benefits received from the business are taxable as income to the business.
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Question 55 of 239
55. Question
How does key person disability insurance help a business?
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Question 56 of 239
56. Question
A Cafeteria Plan is a plan governed by IRS Section 125 which allows employees to contribute a certain amount of their gross income for benefits before ______ are calculated.
CorrectIncorrect -
Question 57 of 239
57. Question
Business continuation plans assist a business with continuity of its operations and employee ____________.
CorrectIncorrect -
Question 58 of 239
58. Question
Which type of insurance would a business purchase for their exposure to a disabled owner but not for a disabled key person?
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Question 59 of 239
59. Question
If OkayTire Shop decides to purchase key person disability insurance to offset any loss of income and increased expenses if, Kenny, the top salesman, were to become disabled. How much key person DI should Okay Tire purchase if:
Kenny’s Salary $110,000
Loss of income to the shop $90,000
Extra expense of new hire, training, loss of accounts $35,000CorrectIncorrect -
Question 60 of 239
60. Question
What are the tax implications if key person disability insurance (choose all that apply)?
CorrectIncorrect -
Question 61 of 239
61. Question
Which of the following are HSA eligible qualified health care expenses?
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Question 62 of 239
62. Question
Traci Gooding’s Group Accidental Death & Dismemberment policy pays $100,000 upon her accidental death and $50,000 for the accidental loss of a hand, arm, foot, or leg.
CorrectIncorrect -
Question 63 of 239
63. Question
DI benefits coordinate with Workers Compensation benefits to the pay insured about __% of the insured’s income.
CorrectIncorrect -
Question 64 of 239
64. Question
Michele obtains her health insurance coverage through her employer; her employer pays 50% of the cost of the insurance and Michele pays the other 50%.
CorrectIncorrect -
Question 65 of 239
65. Question
Group plans are issued for employer and other group with the contract of coverage being held between the insurance company and the group. The group is issued a ___________ and individuals in the group are issued certificates of insurance which outline the plans benefits.
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Question 66 of 239
66. Question
Which of the following groups WOULD NOT QUALIFY for a group health insurance policy?
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Question 67 of 239
67. Question
True or False? To be eligible for group health coverage the group must be either a natural group; or an “unnatural group”, one which has been formed the sole purpose of obtaining group insurance.
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Question 68 of 239
68. Question
Cynthia has purchased a new Tesla and she really, really likes it. Her best friend lost her car when the friend suffered an illness which left her without work for ten months.
What policy can Cynthia purchase to make sure the payments on her car loan are made in the event she is either unable to work due to an accident or any illness?
CorrectIncorrect -
Question 69 of 239
69. Question
Jerry has filed to keep his group health insurance after terminating his employment (COBRA). The total cost of Jerry’s group health insurance was $1,000.
What is the maximum amount Jerry can be charged for his extended group coverage?
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Question 70 of 239
70. Question
Caroline has been at the same part-time job for the four years she has been in college. Her employer just started a group health insurance plan and she was told she will not be eligible for the plan.
Caroline thought there was no underwriting for a group health insurance plan and has questioned the HR director at her place of employment.
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Question 71 of 239
71. Question
True or False? Long-Term plans often use an “any occupation” definition for the first two years and an “own occupation” definition thereafter.
CorrectIncorrect -
Question 72 of 239
72. Question
Group medical expense plans are required to offer __________ benefits for all plans which insure fifteen (15) or more people.
CorrectIncorrect -
Question 73 of 239
73. Question
Florida law requires groups of ___ or more persons to be accepted as a whole or rejected as a whole for group health insurance plans.
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Question 74 of 239
74. Question
Insurers have ___________ to protect the insurance company against adverse selection and to apportion the cost of plan administration among an adequate number of insureds.
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Question 75 of 239
75. Question
AppleSnacks is a small, minority based business which makes apple fruit pies for sale on consignment. AppleSnaks has ten full time employees.
Does AppleSnacks have the minimum number of employees to be eligible for a group health insurance policy in Florida?
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Question 76 of 239
76. Question
The Coordination of Benefits (COB) provision in group health plans is in place to remove the______________ hazards of “over-insurance”.
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Question 77 of 239
77. Question
Ericka Little’s employment with the FunCoToy Company has ended. FunCoToy is moving their current distribution center to McLean, Virigina and Ericka cannot make the move due to her husband’s employment.
Ericka’s family has depended on the health insurance provided by FunCoToy.
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Question 78 of 239
78. Question
True or False? The cost for a group plan health insurance is more expensive than individually underwritten health insurance.
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Question 79 of 239
79. Question
Which of the following is an example of “adverse selection”?
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Question 80 of 239
80. Question
All of the following are moral hazards affecting Health Insurance underwriting Except?
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Question 81 of 239
81. Question
Which of the following are true regarding gender in Insurance underwriting?
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Question 82 of 239
82. Question
Joannie is a truck driver, Alice is a sous chef, and Angie is a demolition expert using explosives in underground mining.
Which occupation would have the highest probability and severity of an occupation injury?
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Question 83 of 239
83. Question
Janice is trying keep her premiums as low as possible. Which of the following might Janice use to keep her premiums “low”?
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Question 84 of 239
84. Question
___________ _____________ uses an insurer specialist to review an insured’s condition and care and to plan treatment paths for the insured that meet their medical needs in a manner that mitigates unnecessary cost.
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Question 85 of 239
85. Question
What is the morbidity for diabetes in males aged 41 to 50 if there are 49 incidences per thousand?
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Question 86 of 239
86. Question
The three primary actuarial factors are…
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Question 87 of 239
87. Question
Which, if any, of the following statements are correct regarding “risk-profiles”?
Statement I. Preferred risks have a better-than-average “risk profiles”.
Statement II. Uninsurable risks have “risk profiles” that are so low they cannot be written actuarially in a profitable way.CorrectIncorrect -
Question 88 of 239
88. Question
______________________ integrate the financing and delivery of health care services to contain cost and to provide health care and services as efficiently as possible.
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Question 89 of 239
89. Question
Individual premiums paid for Disability Income policies are not tax deductible and ___________ received are not taxed to the insured.
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Question 90 of 239
90. Question
Yuhong Song’s HMO is using which “medical cost management” approach when asking her to get a “required” second opinion before having a procedure?
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Question 91 of 239
91. Question
True or False? Health care claims increase across all ages; the older an insured the higher the insurance premium.
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Question 92 of 239
92. Question
Which of the following are insurance company/insurance policy expenses?
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Question 93 of 239
93. Question
All of the following are risk factors in Health Insurance underwriting EXCEPT?
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Question 94 of 239
94. Question
The NAIC’s main objective is the formation of a code of _______ for the industry.
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Question 95 of 239
95. Question
The Relation of Earnings to Insurance provision helps to keep an insured from unrealistically over-purchasing ___________ insurance?
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Question 96 of 239
96. Question
Jerry has a policy which is “Conditionally Renewable”. The insurance company has the contractual option to cancel the policy but any cancellation is limited to….
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Question 97 of 239
97. Question
The _________________ provision allows the insurer to adjust the premium if either the age or sex of the application was misstated on the application of insurance.
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Question 98 of 239
98. Question
The Notice of Claim provision requires the insured to place the insurance company on notice of a claim “within a __________ period of time”.
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Question 99 of 239
99. Question
Micah failed to make his scheduled monthly payment and he did not make the payment within the 30 day grace period. He has filed a reinstatement application with the company which was accepted. A week after the reinstatement Micah filed a claim for bronchitis which was denied…
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Question 100 of 239
100. Question
Johanna is late with her Health Insurance monthly payment by fourteen days.
Does Johanna’s insurance company have to accept her late payment?
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Question 101 of 239
101. Question
True or False? The Time Limit on Certain Defenses provision allows a bar of coverage after the incontestable period in the policy has expired.
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Question 102 of 239
102. Question
How does the “entire contract” provision protect an insured?
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Question 103 of 239
103. Question
Kara got hurt rollerblading January 1st; she would have until what date to submit a proof of loss to have her claim paid?
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Question 104 of 239
104. Question
True or False? The Claim Forms provision places the burden on the insurance company to provide an insured with a claim form within sixty (60) days from the notice of claim.
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Question 105 of 239
105. Question
Juliette has a son turning twenty-six next year and she is concerned that he will not be eligible for coverage on her Health Insurance plan. How will you help Julliette with her son’s Health Insurance coverage?
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Question 106 of 239
106. Question
Jerry has a policy which is “Optionally Renewable”. The insurance company has the contractual option to cancel the policy but any cancellation is limited to….
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Question 107 of 239
107. Question
Justyn owns a life insurance policy on himself and wants to change the beneficiary on the policy; he can change the policy beneficiary at any time unless the beneficiary is __________.
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Question 108 of 239
108. Question
Kara got hurt rollerblading January 1st; and filed her Proof of Loss on April 1st. By what date must the insurance company pay Kara’s claim?
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Question 109 of 239
109. Question
Kevin has had a change in his occupation; which policy type is most affected by this change in occupation?
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Question 110 of 239
110. Question
The NAIC provision “Legal Actions” provision requires an insured to wait until 60 days after filing a proof of loss with the insurance company before any formal ______ action can be taken against the insurer.
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Question 111 of 239
111. Question
You are selling Mrs. Jane Wilson a Long Term Care policy. She would like to keep the premium as low as possible.
What is the maximum elimination period that can be applied to a Florida policy?CorrectIncorrect -
Question 112 of 239
112. Question
Long-Term Care normally refers to care of ___ days or longer in an adult day care, nursing home, or at the insured’s home.
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Question 113 of 239
113. Question
Ten Koney was hospitalized and used Medicare and his Medigap Plan A benefits to pay for all of his hospital expenses. He is now in need of long term custodial care.
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Question 114 of 239
114. Question
LTC benefits are ___________ if they conform to HIPPA, the IRC, and follow model NAIC long-term care provisions.
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Question 115 of 239
115. Question
True or False? Home Health Care is in the insured’s home and Adult Day Care is in a commercial facility.
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Question 116 of 239
116. Question
*Skilled Nursing* care is continuous, around-the-clock care provided by licensed medical professionals under the direct supervision of a __________.
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Question 117 of 239
117. Question
Activities of Daily Living (ADLs) are the self care activities of:
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Question 118 of 239
118. Question
HIPAA compliant LTC policies are required to be _______________ (the policy cannot be cancelled as long as premiums are paid; up to a term of years or attained age).
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Question 119 of 239
119. Question
Elizabeth is not longer able to bathe, dress, or get in and out of bed by herself.
Is Elizabeth eligible for LTC coverage?
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Question 120 of 239
120. Question
Medigap policies pay health care cost that Medicare does not such as:
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Question 121 of 239
121. Question
Cassidy Jones has purchased a Medigap policy which her agent delivered to her ten days ago. Mrs. Jones has decided she does not want the policy.
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Question 122 of 239
122. Question
Long-Term Care services include services required by the chronically ill and/or cognitively impaired including all but which of the following?
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Question 123 of 239
123. Question
Juliana Clifford has a 60 day elimination period and LTC daily benefits of $250 per day. If she has been in long term care for 100 days will she incur any taxation on any benefits received?
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Question 124 of 239
124. Question
Ralph Keith’s LTC policy pays up to $125 per day in a nursing home and up to $75 per day for at-home care.
Keith has been at the Mountain State Elder Care facility for eight weeks and he has racked up a bill of $5,000.How much will Ralph’s LTC policy pay towards his bill?
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Question 125 of 239
125. Question
Which benefits are covered by Medicaid which are not covered by Medicare?
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Question 126 of 239
126. Question
Medicaid Reform in 2005 provided flexibility in benefits with a focus on __________________ in hopes of reducing Medicaid cost.
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Question 127 of 239
127. Question
The ___________________ program was created to provide health insurance to uninsured children.
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Question 128 of 239
128. Question
Which, if any, of the following concerning Medicare Part C are correct.
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Question 129 of 239
129. Question
Greg is Medicare eligible and is employed at Walmart and has health insurance through Walmart. Greg is hospitalized for 14 days and has $9,000 in doctor’s expenses.
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Question 130 of 239
130. Question
Medicare Part A provides a lifetime reserve of 60 days of hospital coverage when a patient has exceeded ___days of coverage in a benefit period.
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Question 131 of 239
131. Question
Medicare Part A covers Hospice care for the terminally ill patients. Hospice eligibility requires a doctor to certify the patient has a ______ month or less life expectancy.
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Question 132 of 239
132. Question
True or False? Medicare will pay for a private hospital room but will not pay for private duty nursing.
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Question 133 of 239
133. Question
Juanita’s hospitalization would be covered by Medicare Part A and her surgeon’s expenses would be covered under ______________.
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Question 134 of 239
134. Question
True or False? The federal government created Medicare to provide medical care to the rich and the famous.
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Question 135 of 239
135. Question
Juanita is eligible for Medicare and has been hospitalized for the last 59 days.
How will Medicare assist Juanita for her hospital expenses?
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Question 136 of 239
136. Question
What is the Medicare “donut hole”?
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Question 137 of 239
137. Question
Medicare Part B pays ___% of covered expenses after the deductible has been exhausted.
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Question 138 of 239
138. Question
Medicare Advantage plans pay for ____________________ basis rather than on a pay-per-service basis.
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Question 139 of 239
139. Question
Which, if any, of the following statements are correct?
Statement I. Medicare Part A covers hospital expenses.
Statement II. Medicare Part B covers health insurance coverage.
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Question 140 of 239
140. Question
Medicare is funded by employee and employer FICA contributions. Employees contribute 1.45% of all earned wages for Medicare. What amount if any is contributed by the employer?
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Question 141 of 239
141. Question
Workers Compensation insurance and/or benefits are required by state law and are an __________________ for employees when injured in work related activities.
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Question 142 of 239
142. Question
Jan Bridges was injured in the course and scope of her employment and has incurred medical expenses, lost wages, and non-economic loss due to pain and suffering.
Can Workers Compensation help Jan with any of these expenses/losses? (select all that apply)
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Question 143 of 239
143. Question
All of the following are eligible for Medicare coverage EXCEPT?
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Question 144 of 239
144. Question
Travel Insurance is an example of which type of policy?
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Question 145 of 239
145. Question
If an insured were to die in a hang gliding accident how would an AD&D policy with only the “accidental means” language in it respond to a claim?
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Question 146 of 239
146. Question
The amount payable for death in an AD&D policy is known as the policy’s _____________.
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Question 147 of 239
147. Question
The amount payable for dismemberment of loss of a stipulate body part or function in an AD&D policy is known as the policy’s ___________.
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Question 148 of 239
148. Question
True or False? Accidental Death and Dismemberment policies pay a lump-sum benefit in the event of an accidental death or injury.
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Question 149 of 239
149. Question
Examples of special risk policies might include insuring: (select all that apply)
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Question 150 of 239
150. Question
Dr. Juliet Molar was involved in a serious automobile accident and is no longer capable of working in her dental practice. If she is capable of teaching would she meet the “any occupation” definition of being disabled?
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Question 151 of 239
151. Question
Betty Turner was injured hanging curtains in her spare bedroom one sunny spring day. Unfortunately Betty had difficulty raising her right arm and turning her head or torso to the right and she was out of work for six months. When she came back to work she re-injured her neck in the first month and is again incapable of performing her regular duties at the Fred Astaire Dance Studio.
What provision in a DI policy is controlling when determining if a new elimination period starts with the re-injury or if the re-injury is considered part of the original disability?
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Question 152 of 239
152. Question
Claudio earns $3,000 a month and has a Disability Income policy which pays $2,100 of his earnings as a flat income benefit. If Claudio becomes totally disabled what amount will his DI monthly benefit be?
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Question 153 of 239
153. Question
Which, if any, of the following statements are correct?
Statement I. Group DI policies normally pay on a percentage of income basis.
Statement II. Individual DI policies normally pay on a percentage of income basis.
Statement III. Group DI policies normally pay on a flat/stated amount basis.
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Question 154 of 239
154. Question
True or False? Accidental Means is the most stringent disability provision.
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Question 155 of 239
155. Question
Calculate Sam’s partial disability benefit if he can only work half-time now and she was previously receiving $900 a week and is being paid a “flat amount” of 60% for the last twelve weeks.
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Question 156 of 239
156. Question
Shelly has suffered a serious injury and cannot sit or stand for long periods of time. Shelly has returned to work but she cannot sit or stand for long periods of time in her capacity as a butcher. Shelly’s doctor has limited her to no more than four hours per day.
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Question 157 of 239
157. Question
Which, if any, of the following are considered a presumptive total disability?
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Question 158 of 239
158. Question
Chris Johnson has a Disability Income policy with a sixty day probationary period. Three weeks after the policy went into force Chris breaks his leg playing church softball.
Will Chris be able to make a compensable DI claim?
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Question 159 of 239
159. Question
Which of the following occupations are most likely to have a “non-occupational” type Disability Income policy?
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Question 160 of 239
160. Question
Becky has purchased a DI rider which increases benefits over time to keep up with inflation.
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Question 161 of 239
161. Question
What must happen before an insured can successfully file a Disability Income claim under the DI Social Security rider?
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Question 162 of 239
162. Question
You have explained to your insured that Disability Income Insurance is very important as part of an overall plan to protect the insured against the financial loss of wages due to an injury, illness, accident or sickness.
What might you say to your proposed insured to encourage her to protect against this exposure to loss of income?
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Question 163 of 239
163. Question
High Deductible Health Care Plans are characterized by:
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Question 164 of 239
164. Question
The insured has a Basic Medical Expense plan that pays up to $10,000 for any occurrence. The insured also carries a Supplemental Major Medical policy with a $1,000 “integrated deductible”. The insured suffers a $16,000 loss.
How much if any will the Supplemental Major Medical plan cover?
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Question 165 of 239
165. Question
The insured has a Basic Medical Expense plan that pays up to $10,000 for any occurrence. The insured also carries a Supplemental Major Medical policy with a $500 deductible. The insured suffers a $12,500 loss.
How much if any will the Supplemental Major Medical plan cover?
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Question 166 of 239
166. Question
The insured has $10,000 of medical expenses and his Major Medical Expense policy has a $1,000 deductible and a 80% coinsurance provision.
How much will the insured absorb of the loss taking his deductible and coinsurance percentage into consideration?
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Question 167 of 239
167. Question
How much will the insurance company pay if an insured has $250,000 of medical expenses and his Major Medical policy has a $10,000 deductible and a 90% coinsurance provision with a “Maximum Out-of-Pocket” provision stating the insured will not pay over $10,000 during the policy term?
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Question 168 of 239
168. Question
Sheronda has a Basic Medical Expense plan and a Supplementary Major Medical Expense plan. If Sheronda has a $15,000 hysterectomy and her Basic Medical Expense plan covers $10,000 of the cost how much will her Supplementary Major Medical plan pay?
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Question 169 of 239
169. Question
After a careful review Autumn revealed that she had purchased a Basic Medical Expense plans covering only specific, select, and narrowly defined medical care issues. What she really wanted was a ________________ plan to cover on a more comprehensive basis with coverage on a broader basis.
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Question 170 of 239
170. Question
What are the lifetime policy limits for ACA compliant Major Medical Expense Insurance Plans?
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Question 171 of 239
171. Question
Which of the following are covered in a Major Medical insurance policy?
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Question 172 of 239
172. Question
Basic Surgical Expense insurance provides benefits on a:
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Question 173 of 239
173. Question
Peggy has a Basic Hospital Expense policy which pays $150 a day up to 30 days. Peggy was in the hospital for 45 days and the cost per day was $125.
How much with the insurance company pay Peggy?
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Question 174 of 239
174. Question
Kara has a “fixed-rate policy” which pays on a scheduled basis. Dolores’ policy pays for actual cost incurred.
What type of payment approach is in Dolores’ policy?
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Question 175 of 239
175. Question
To meet the OASDI “Disabled” definition an individual must be mentally or physically disabled to the extent that she cannot perform any substantial gainful work and the determination requires the disability to have an expected duration of __ months or longer.
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Question 176 of 239
176. Question
The _____________________ requires employers with twenty-five (25) or more employees to offer enrollment in an HMO if health care benefits are offered to employees.
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Question 177 of 239
177. Question
All of the following are parties to the “service provider” approach to healthcare/health insurance EXCEPT?
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Question 178 of 239
178. Question
Disabled employees are entitled to workers compensation benefits as ________________ without having to sue their employer for benefits BUT the employee correspondingly gives up the right to sue the employer.
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Question 179 of 239
179. Question
Erik has met the OASDI definition of “disabled for the past eleven months.
Does he qualify for OASDI Disability benefits?
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Question 180 of 239
180. Question
Medicare provides programs of health insurance for:
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Question 181 of 239
181. Question
Point-of-Service Plans authorize and _________ subscriber referrals to specialist and hospitals.
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Question 182 of 239
182. Question
Which of the following, if any, are characteristics of Preferred Provider Organizations?
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Question 183 of 239
183. Question
The right of assignment built into most commercial health policies lets policyowners _______ benefit payments from the insurer directly to the health care provider
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Question 184 of 239
184. Question
Employer “Self-Insured Plans” are administered by which of the following?
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Question 185 of 239
185. Question
Bill Hoover’s Health Insurance policy has a renewability provision which allows the insurer to non-renew the policy at the policy’s anniversary date.
What renewability provision is in Bill Hoover’s Health Insurance policy?
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Question 186 of 239
186. Question
Jeremy has a Health Insurance policy with a renewal provision that does not allow the insurance company to cancel the policy and his rates cannot be increased subject to an age attainment provision in the policy.
Which renewability provision is in Jeremy’s Health Insurance policy?
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Question 187 of 239
187. Question
Lucky Charms has a(n) _________ rating plan which provides either a retroactive discount or future credit on their next renewal based upon the insured’s favorable loss history and expenses.
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Question 188 of 239
188. Question
Greg is a single parent with two children; the 2018 Federal Poverty level for a three person household is $20,780.
What is the most Greg could earn to still be ACA “subsidy eligible”?
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Question 189 of 239
189. Question
Kathy wants to purchase an insurance policy that will provide income to her if she becomes disabled and unable to work.
What type of insurance would you recommend for Kathy?
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Question 190 of 239
190. Question
Darnell’s Health Insurance policy has a renewable provision which allows the insurer to non-renew his policy but only for specified reasons stated in the policy.
Which renewability provision is in Darnell’s Health Insurance policy?
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Question 191 of 239
191. Question
Which, if either, of the following are correct?
Statement I. Loss Reserves are set aside for future claims.
Statement II. Premium Reserves are set aside for current claims.
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Question 192 of 239
192. Question
The Affordable Care Act requires employers with 50 or more employees to provide health insurance or pay a fine of $______ per worker for any worker receiving federal subsidies to purchase health insurance.
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Question 193 of 239
193. Question
If you have an ACA compliant Health Insurance policy up to what age will your insurance policy and insurance company allow you to keep your graduate student daughter on your policy?
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Question 194 of 239
194. Question
_____________ is the unethical act of persuading a client to cancel a policy for the purpose of selling them another policy without regard to any negative affect it may have on the client.
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Question 195 of 239
195. Question
True or False? Life insurance should not be described or implied as a savings or retirement plan.
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Question 196 of 239
196. Question
Which, if any, of the following statements are correct?
Statement I. An “unauthorized” insurer is one duly authorized by a subsisting certificate of authority issued by the department to transact insurance in this state.
Statement II. An “authorized” insurer is one not so authorized.
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Question 197 of 239
197. Question
Unfair discrimination takes place in the sales or underwriting process when adverse decisions are made based on characteristics such as:
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Question 198 of 239
198. Question
____________ selling is presenting products that meet specific needs of clients so the client can make their own decisions about what products are best for them.
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Question 199 of 239
199. Question
True or False? The NAIC model regulations state that illustrations must not contain words like invisible premium.
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Question 200 of 239
200. Question
Policy replacement includes which of the following?
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Question 201 of 239
201. Question
Misrepresentation is any written or oral statements that do not accurately describe policy benefits or coverages AND misrepresentation is ________. Defamation is the false, malicious, or derogatory communication (oral or written) that injures another’s reputation or character AND defamation is ________.
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Question 202 of 239
202. Question
When using illustrations, agents are required to obtain a signed statement from the proposed insured acknowledging that non-guaranteed elements are subject to changes either higher or lower and that they are not ___________.
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Question 203 of 239
203. Question
Sharon is replacing Mrs. North’s insurance policy; all but which of the following are appropriate in the replacement?
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Question 204 of 239
204. Question
The courts have ruled that any ambiguities in contracts are construed in the most favorable light to the __________ party.
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Question 205 of 239
205. Question
Big Money Mountain Insurance Company has received Jill’s life insurance application and has issued the policy on a standard basis. The original application was on a super-preferred basis.
What has Big Money Mountain done?
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Question 206 of 239
206. Question
True or False? The acts of the agent are the acts of the insurer.
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Question 207 of 239
207. Question
Which of the following are requirements of an insurance agent as fiduciary?
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Question 208 of 239
208. Question
What is the difference between the concepts of waiver and estoppel?
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Question 209 of 239
209. Question
Which of the following can render a contract unenforceable? (select all that apply)
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Question 210 of 239
210. Question
Which legal concept states that when individuals put agreements in writing any oral representations made prior to or after the written contract do not change the contract and the written contract “stands on its own” as regards the agreement between the parties.
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Question 211 of 239
211. Question
With this type of authority an agent acts on behalf of its principal without express or implied authority granted by the principal.
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Question 212 of 239
212. Question
Life insurance ___ a personal contract between insurer and insured.
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Question 213 of 239
213. Question
Which of the following are required for a contract to be legal?
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Question 214 of 239
214. Question
_______ Law governs the relationship between an agent and insurer and that being that an act by the agent is an act by the principal.
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Question 215 of 239
215. Question
True or False? To be enforceable at law a contract must have a legal purpose.
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Question 216 of 239
216. Question
James has convinced his neighbor, a senior citizen, to allow James to take out life insurance on the life of the neighbor with James named as the beneficiary. James has advised he will pay all of the premiums and James has offered the neighbor $2,500 for participating in the transaction. This is an example of:
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Question 217 of 239
217. Question
Which, if any, of the following statements are correct?
Statement I. Valued Contracts pay a stipulated amount listed specifically in the policy.
Statement II. Indemnity Contracts pay the value of a loss subject to the policy limits.
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Question 218 of 239
218. Question
Insurance contracts are considered aleatory contracts because (choose all that apply):
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Question 219 of 239
219. Question
Which of the following are appropriate insurance sales practices? (select all that apply)
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Question 220 of 239
220. Question
Which association handles claims of insolvent life, accident, and health insurance companies?
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Question 221 of 239
221. Question
Which Federal Act re-established the states as the regulators of insurance?
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Question 222 of 239
222. Question
The two main purposes of industry oversight are to ensure:
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Question 223 of 239
223. Question
___________________ Organizations focus on preventive care and treatment.
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Question 224 of 239
224. Question
Dr. Jackie Vizon is an optometrist. Which of the following risk retention groups might Dr. Vizon be insured by?
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Question 225 of 239
225. Question
Social insurance programs are government programs that are funded with taxpayer dollars and serve national and state purposes. Government programs include all but which of the following?
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Question 226 of 239
226. Question
Which of the following are correct regarding “fraternal benefit societies”? (select all that apply)
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Question 227 of 239
227. Question
Which, if any, of the following statements are correct?
Statement I. Mutualization is when a mutual company converts to a stock company.
Statement II. Demutualization is when a stock company converts itself to the mutual company.
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Question 228 of 239
228. Question
Jack purchases his insurance from a company that pays him a dividend at the end or each year (lucky Jack).
What type of insurer does Jack have his insurance with?
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Question 229 of 239
229. Question
Which, if any, of the following are elements of an “insurable risk”? (choose as many as apply)
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Question 230 of 239
230. Question
Grumbly Greg Granger leaves his keys in his unlocked car when he goes to the store. Greg tells everyone I hope somebody steals that “hunk of junk” so I can make an insurance claim and buy a new car.
What type of hazard is Grumbly Greg exhibiting?
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Question 231 of 239
231. Question
Never flying in a plane will greatly reduce the likelihood of ever being involved in an airplane crash.
This is an example of which risk management technique?
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Question 232 of 239
232. Question
The aggregating of assets to create a pool of resources to address losses experienced by pool members is called:
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Question 233 of 239
233. Question
_________________ can provide a consistent flow of income to an insured for his lifetime or an allotted amount of time or until death.
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Question 234 of 239
234. Question
Geri stores her gasoline next to her matches and dynamite; to most this appears to be a ___________ which could lead to an explosion.
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Question 235 of 239
235. Question
Wearing a helmet when riding a motorcycle may not eliminate the exposure to bodily injury from a motorcycle accident BUT it would minimize any injury that would occur if an accident happened.
What type of risk treatment technique is this?
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Question 236 of 239
236. Question
Risk Transfer is a way to deal with risk so that the loss is handled by another party.
What is the most common form of risk transfer?
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Question 237 of 239
237. Question
Human Life Value is the economic valuation of an individual based on the individual’s ____________ both present and future.
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Question 238 of 239
238. Question
________________ is ONLY the chance of loss.
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Question 239 of 239
239. Question
Which, if any, of the following are considered an “insurance transaction”?
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