Bryce Purchased a Disability Income Policy with a Rider

A 66 year-old is covered under a group health plan while employed with a business that has 40 employees. If she injures herself while walking in the park, what coverage would be considered primary? - Her group health plan A Business Overhead Expense policy - covers business expenses such as rent and utilities A Business Overhead Expense policy would cover which of the following if a business owner becomes disabled? - Utilities and office rent A comprehensive major medical health insurance policy contains an Eligible Expenses provision which identifies the types of health care services that are covered. All of the following health care services are typically covered EXCEPT for - experimental and investigative services A Disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim? - Claim will be paid and coverage will remain in force A life insurance arrangement which circumvents insurable interest statutes is called - InvestorOriginated Life Insurance A life insurance policy would be considered a wagering contract WITHOUT - insurable interest A Long Term Care insurance contract shall provide coverage for a minimum of how many months? - 12 months A medical care provider which typically delivers health services at its own local medical facility is known as a - HMO A newly licensed agent must complete __ hours of continuing education every 2 years. - 24 hours A physician opens up a new practice and qualifies for a $7,000/month Disability Income policy. What rider would the physician add if he wants the ability to increase his policy benefit as his practice and income grow? - Guaranteed Insurability Option rider A policy of adhesion can only be modified by whom? - Insurance company A policyowner's rights are limited under which beneficiary designation? - Irrevocable A prospective insured completes and signs an application for health insurance but intentionally conceals information about a pre-existing heart condition. The company issues the policy. Two months later, the insured suffers a heart attack and submits a claim. While processing the claim, the company discovers the pre-existing condition. In this situation, the company will - continue coverage but exclude the heart condition A Qualified Long Term Care policy requires the Free Look provision to refund 100% of premiums paid within how many days of policy delivery? - 30 days After a hearing, the State Corporation Commission may order an agent who willfully violates any provision of the insurance code to pay a MAXIMUM penalty per violation of - $5,000 After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms? File written proof of loss Agents may combine business funds and insured's premiums - when duly appointed and contractually authorized by an insurer All of the following actions by a licensee may result in license suspension except when the licensee - shares commission with a similarly licensed agent All of the following statements about health coverage for physically handicapped dependents of insureds are correct EXCEPT that the dependent must - have been over ten years of age when the handicap was incurred All of the following statements about Major Medical benefits are true EXCEPT - Benefits have no maximum limit All of these are considered sources of underwriting information about an applicant EXCEPT Rating Services All students attending a large university could be covered by - Blanket Policy An Accident & Health policy must provide Essential Benefits without annual and lifetime limits when purchased - individually or with group coverage through the Federal Marketplace An accident policy will most likely pay a benefit for a(n) - off the job accident An accident policy will most likely pay a benefit for a(n) - OFF THE JOB ACCIDENT An agent may share commissions with which of the following individuals? - A licensed agent with the same license type An agent must maintain records of insurance transactions for a MINIMUM of how many previous calendar years? - 3 years An agent takes an individual Disability Income application, collects the appropriate premium, and issues the prospective insured a conditional receipt. The next step the insurance company will take is to - determine if the applicant is an acceptable risk by completing standard underwriting procedures An applicant's medical information received from the Medical Information Bureau (MIB) may be furnished to the - applicant's physician An assignment of benefits of a Health Policy - transfers payments to someone other than the policyowner An insurance agent is guilty of twisting if the agent - misrepresents a policy to induce a policyowner to surrender an existing policy An insurance agent's license may be suspended or revoked if the agent has - engaged in twisting An insurance company may NOT reject a prospective insured's insurance application on the basis of which of the following factors? - Gender An insurance company would MOST likely pay benefits under an Accidental Death and Dismemberment policy for which of the following losses? - Loss of eyesight due to an accidental injury An insurance licensee is required to provide records of insurance transactions to the State Corporation Commission - Promptly upon request for examination of the licensee An insured covered by a group Major Medical plan is hospitalized after sustaining injuries that resulted from an automobile accident. Assuming the plan had a $1,000 deductible and an 80/20 Coinsurance clause, how much will the INSURED be responsible to pay with $11,000 in covered medical expenses? - 3000 An insured owns an individual Disability Income policy with a 30-day Elimination Period for sickness and accidents and a monthly indemnity benefit of $500. If the insured is disabled for 3 1/2 months, what is the MAXIMUM amount he would receive for an approved claim? - $1,250 An insurer who quotes different policy rates to individuals in the same class of risk may be guilty of - unfair discrimination Any administration service fees charged by an insurance agent require the written signature by a consumer - in all instances Basic Medical Expense insurance - has lower benefit limits than Major Medical insurance Before holding a hearing regarding an agent's unfair or deceptive practice, the Commission MUST give how many days notice? - 10 days Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this? - Guaranteed insurability rider Circulation of any oral or written statement or any pamphlet, circular, article, or literature that is false or maliciously critical of or derogatory to the financial condition of an insurer is known as defamation Comprehensive Major Medical policies usually combine - Major Medical with Basic Hospital/Surgical coverage During the appeal period, an agent may successfully appeal license termination due to continuing education requirements if - proof of compliance is provided During the appeal period, an agent may successfully appeal license termination due to continuing education requirements if - proof of compliance is provided Each agent shall complete all continuing education requirements by no later than November 30, and shall be given a final opportunity to complete such requirements by - December 31 every even year G is an accountant who has ten employees and is concerned about how the business would survive financially if G became disabled. The type of policy which BEST addresses this concern is - Business Overhead Expense Group/voluntary long-term care policy premiums are typically deducted from the employee's income and - are less costly as compared to individual long term care coverage Health coverage provided under the Affordable Care Act (ACA) shall be made available for dependents until the child attains the age of - 26 How does group insurance differ from individual insurance? - Premiums are lower How long is the typical free look period for Long Term care insurance policies? - 30 days How would a contingent beneficiary receive the policy proceeds in an Accidental Death and Dismemberment (AD&D) policy? - If the primary beneficiary dies before the insured If a contract of adhesion contains complicated language, to whom would the interpretation be in favor of? - insured If an individual has an Accidental Death and Dismemberment policy and dies, an autopsy can be performed in all these situations EXCEPT - When the state prohibits this by law If an insurance company issues a Disability Income policy that it cannot cancel or for which it cannot increase premiums, the type of renewability that best desribes this policy is called noncancelabe If the insured and primary beneficiary are both killed in the same accident and it cannot be determined who died first, where are the death proceeds to be directed under the Uniform Simultaneous Death Act? - Insured's contingent beneficiary