California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /, Exams of Nursing

Download California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly / and more Exams Nursing in PDF only on Docsity! California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) What distinguishes a deferred annuity from an immediate annuity? - Correct Answers ✅The time at which benefit payments start Cindy buys a 10-year certain annuity with an installment refund. After receiving monthly payments for 5 years, Cindy dies. How many remaining payments will the insurer make to her beneficiary? - Correct Answers ✅60 payments What is a common reason people purchase an annuity? - Correct Answers ✅To protect against the risk of outliving their financial resources What kind of annuity pays income to two annuitants until their deaths? - Correct Answers ✅Joint and survivor annuity What is a joint and survivor annuity? - Correct Answers ✅Provides payments the annuity to two people. If either person dies, the same income payments continue to the survivor for life. When the surviving annuitant dies, no further payments are made to anyone. California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) Victoria owns a life annuity and elects to receive annuity payments monthly for the remainder of her life with "ten years certain". Her annuity will make payments - Correct Answers ✅for a minimum of 120 months and a maximum of the remainder of her life Which of the following statements regarding a life insurance policy dividend is TRUE? - Correct Answers ✅It is the distribution of excess of funds accumulated by the insurer on participating policies. An insured owned by its policyholders is called a - Correct Answers ✅mutual insurer An insurer enters into a contract with a third party to insure itself against losses from insurance policies it issues. What is the agreement called? - Correct Answers ✅Reinsurance What is reinsurance? - Correct Answers ✅An arrangement by which an insurance company transfers a portion of a risk it has assumed to another insurer California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) Minimum participation standards exist for group health insurance plans in order to - Correct Answers ✅prevent adverse selection The problem of overinsurance is addressed in which health insurance provision? - Correct Answers ✅Coordination of benefits What is the purpose of the coordination of benefits (COB) provision? - Correct Answers ✅To avoid duplication of benefit payments and overinsurance when an individual is covered under more than one group health plan Who is financially liable for the payment of covered claims in a fully insured group health plan? - Correct Answers ✅Insurer The insurer has the option of terminating a health insurance policy on a date stated in the contract. What type of policy is this? - Correct Answers ✅Optionally renewable California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) What is an optionally renewable policy? - Correct Answers ✅A provision allowing an insurer to terminate the policy on a date specified in the contract Bruce is involved in an accident and becomes totally and permanently disabled. His insurance policy continues in force without payment of further premiums. Which policy provision is responsible for this? - Correct Answers ✅Waiver of premium provision Christine has a health insurance policy that has been in force beyond the incontestable period. The insurer has discovered that a fraudulent statement was made on the application. What would the insurer have to pay on a claim, assuming this wasn't a guaranteed renewable policy? - Correct Answers ✅Nothing What type of health insurance policy cannot be canceled by the insurer nor increase the premiums? - Correct Answers ✅Noncancellable The conditions, times, and circumstances under which an insured is NOT covered by a health policy are called? - Correct Answers ✅exclusions California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) What are exclusions in a health policy? - Correct Answers ✅Specified hazards listed in a policy for which benefits will not be paid Under a health insurance policy, the provision that states the kind of benefits provided and the circumstances under which they will be paid is called the? - Correct Answers ✅insuring clause What does an insuring clause state? - Correct Answers ✅Under a health insurance policy, the provision that states the kind of benefits provided and the circumstances under which they will be paid Which of these is NOT a relevant factor in the health insurance principle of morbidity? - Correct Answers ✅Intelligence How does rising morbidity rates affect health insurance? - Correct Answers ✅Increased premiums California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) Which of these is the automatic mode of settlement for life insurance policy proceeds? - Correct Answers ✅Lump-sum A spendthrift clause in a life insurance policy - Correct Answers ✅restricts the ability of the beneficiary to sign benefits Premiums are best described as - Correct Answers ✅the amount an insured pays per unit of coverage What does the grace period allow a life insurance policy owner to do? - Correct Answers ✅Make a premium payment after the due date without any loss of coverage Which of the following does a policyowner NOT have a right to change? - Correct Answers ✅Dividend schedule When does a life insurance policy's waiver of premium take effect? - Correct Answers ✅Insured becomes totally disabled California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) What are collateral assignments normally associated with? - Correct Answers ✅Bank loans Jerry is an insured who understated his age on his life insurance application, paying $12 per $1,000 of insurance instead of $15 per $1,000. If he dies, how will the adjusted death benefit be calculated? - Correct Answers ✅12/15th of the policy's face amount How is a life insurance policy dividend legally defined? - Correct Answers ✅A return of excess premium and not taxable If an insured dies because of an accident, which type of life insurance rider will provide additional coverage? - Correct Answers ✅Accidental death rider What time period allows an insured's life insurance policy to remain in force even if the premium was not paid of the due date? - Correct Answers ✅Grace period California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) An insurer can be protected from adverse selection with which policy provision? - Correct Answers ✅Suicide clause A life insurance policy can be surrendered for its cash value under which policy provision? - Correct Answers ✅Nonforfeiture options In a modified endowment contract, the penalty tax imposed on premature withdrawals is - Correct Answers ✅10% A life insurance policy's limit of liability would be - Correct Answers ✅the policy's face amount Tom is shopping for a policy that covers two people and would pay the face amount ONLY when the first person dies. The type of life policy he is looking for is called a - Correct Answers ✅Joint life policy What is a joint life policy? - Correct Answers ✅It covers two or more people and pays the face amount at the first insured's death California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) What are members of the Medical Information Bureau (MIB) required to report? - Correct Answers ✅Medical ailments discovered during the underwriting process Which of the following does specified disease insurance NOT cover? - Correct Answers ✅costs covered by medical expense insurance Major medical expense plans typically use a cost containment measure for emergency hospital care. This is referred to as a(n) - Correct Answers ✅deductible At what point does a self-insured group qualify for stop-loss coverage? - Correct Answers ✅When claims exceed a specified limit in a set period of time What does a Hospital Confinement indemnity policy pay for? - Correct Answers ✅Pays a specified daily amount while the insured is confined to a hospital California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) Medical expense policies will typically cover which of the following? - Correct Answers ✅Injuries caused by accidents All of these are examples of cost sharing in a health insurance policy EXCEPT - Correct Answers ✅Coordination Wat is considered the most common type of specified disease insurance policy? - Correct Answers ✅Cancer Moral hazard is described as - Correct Answers ✅increased chance of a loss because of an insured's dishonest tendencies Which of the following is any situation that presents the possibility of a loss? - Correct Answers ✅Loss exposure Which of the following is a situation where there is a possibility of either a loss or a gain? - Correct Answers ✅Speculative risk California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) Which of these statements correctly describes risk? - Correct Answers ✅Pure risk is the only insurable risk All of the following circumstances must be met for loss retention to be an effective risk management technique, EXCEPT - Correct Answers ✅Probability of loss is unknown A situation in which there is ONLY a chance of loss or no loss is a - Correct Answers ✅pure risk Which of the following refers to a condition that may increase the chance of a loss? - Correct Answers ✅Hazard A hazard can be best described as - Correct Answers ✅a condition that may increase the likelihood of a loss occurring How are Roth IRA's treated for tax purposes? - Correct Answers ✅Non- deductible contributions and tax-free distributions California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) In order to be considered "currently insured" under Social Security, an individual must be credited with: - Correct Answers ✅6 quarters of coverage during the last 13-quarter period Key person insurance is intended to - Correct Answers ✅cover business losses due to the death of a key employee Which of the following pieces of information is NOT gathered during the personal financial planning process? - Correct Answers ✅An individual's civic organization memberships The Human Life Value concept is based on - Correct Answers ✅income An insurance policy issued in California may be called a comprehensive long- term care insurance policy if benefits are provided for - Correct Answers ✅Institutional (nursing facilities) and home care California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) According to the PPACA, an adult can be covered by a parent's health care plan until what age? - Correct Answers ✅Age 26 Kimberly is an employee on leave under the Family and Medical Leave Act (FMLA). What will happen to her group health coverage? - Correct Answers ✅She continues to be enrolled during the leave People with low income can be provided with medical assistance through which program? - Correct Answers ✅Medi-Cal When selling a long term care insurance rider to an applicant, a life agent must take into consideration all of these factors, EXCEPT - Correct Answers ✅Attending physician's statement In what order are people on the MRMIP waiting list allowed to enroll? - Correct Answers ✅Based on the date an individuals's application is received Which of the following is NOT an accurate description of Access for infants and Mothers Program (AIM)? - Correct Answers ✅Only women who have California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) private insurance plans with a maternity-only deductible or copayment greater than $1,500 are eligible Which of the following actions is NOT allowed by Health Insurance Counseling and Advocacy Program (HICAP) counselors? - Correct Answers ✅Charge a fee What is the purpose of the Pre-Existing Condition Insurance Plan (PCIP)? - Correct Answers ✅PCIP was created by the PPACA for people rejected by private health insurers due to pre-existing conditions What effect did the Pregnancy Discrimination Act have on the health industry? - Correct Answers ✅Pregnancy must be treated as any other medical condition The California Insurance Code allows an individual how many days to cancel a life policy for a full-refund? - Correct Answers ✅Between 10 and 30 days California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) Tim was recently terminated from his employment and opted to change his existing group term life insurance to individual permanent life insurance. What is this process called? - Correct Answers ✅Conversion Who are the parties to the master contract in a group life insurance policy? - Correct Answers ✅Insurer and employer Which of the following does Medicare Part A NOT provide coverage for? - Correct Answers ✅Doctor's services Which of the following healthcare providers provides both the healthcare services and healthcare coverage? - Correct Answers ✅Health Maintenance Organization (HMO) Individuals become eligible for Medicare Part A benefits at what age? - Correct Answers ✅65 After the annual deductible is met, a Medicare Part B patient will pay ____ of the remaining covered expenses. - Correct Answers ✅20% California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) After the annual deductible is met, Medicare Part B will pay ____ of the remaining approved charges. - Correct Answers ✅80% Medicare Part B covers - Correct Answers ✅physician expenses How is a Medicare claim submitted? - Correct Answers ✅Expenses are submitted to Medicare by the health provider Jon's health plan pays benefits of 90% for in-network providers and 70% for out-of-network providers. What kind of plan is this? - Correct Answers ✅PPO What is PPO? - Correct Answers ✅A Preferred Provider Organization pays more for care received from a network provider than it pays for care from a non-network provider Individual health insurance coverage typically excludes injuries at an employee's workplace because - Correct Answers ✅it's covered by the state Workers' Compensation program California Life, Accident, and Health Insurance Final Exam: Questions Answered Correctly /Verified Answers (Latest Update 2023) If a healthcare provider is considered to be a "service provider", what does this mean? - Correct Answers ✅Payment for services goes directly to the provider Which statement is TRUE regarding Workers' Compensation coverage - Correct Answers ✅Employer pays the entire premium for Workers' Compensation coverage Jim is applying to become an insurance agent and has a past misdemeanor conviction that was later expunged due to California Penal Code 1203.4. Which of the following statements is correct? - Correct Answers ✅Jim must still disclose the conviction on his insurance license application The California Insurance Code requires that an insurer must have enough assets to cover its liabilities and for reinsurance of all outstanding risks. To remain solvent, it must also possess additional assets equal to what amount? - Correct Answers ✅Its paid-in capital