California Life, Accident, and Health Licensing Exam Questions and Answers Latest Update 2, Exams of Health sciences

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California Life, Accident, and Health Licensing Exam Questions and

Answers Latest Update 2025

Co-insurance - ☑️☑️ The policy provision which requires the insurer and the insured to share in the cost of services rendered Exclusion ratio - ☑️☑️ The formula which is used by the IRS to determine how much is taxable to an annuitant during the pay out period. Occupational policy - ☑️☑️ When a disability income policy provides coverage for injuries which occur on and off the job Most disability income policies are non occupational, meaning - ☑️☑️ They only cover the insured if they become disabled while away from work. Self employed individuals doesn't have - ☑️☑️ workers compensation coverage. They need coverage both on and off the job (occupational). A life agent who offers for sale or sells any financial product on the basis of its treatment under the MediCal Program must provide - ☑️☑️ The Notice Regarding Standards for Medi-Cal Eligibility. Must be signed by applicant. A widow or widower without any children is eligible for social security survivors benefits at age - ☑️☑️ 60

A surviving spouse is eligible for social security survivor's benefits at age - ☑️☑️ 60 An authorized, or admitted carrier (insurer) - ☑️☑️ one which is under compliance with the California Insurance Code (CIC) and can operate legally in California Which type of life insurance utilizes the "level premium concept" - ☑️☑️ Traditional whole life Disability income policy proceeds must be paid out at least - ☑️☑️ monthly What life insurance rider will pay a monthly benefit to the insured when they become disabled - ☑️☑️ The disability income rider. It is a type of health (disability) insurance Dread (Specified) Disease policies, such as cancer insurance, covers - ☑️☑️ Treatment for one specific disease The benefit paid out for a residual disability in a disability income policy is based upon - ☑️☑️ a loss of a minimum of 20% of income Agent may be either - ☑️☑️ Captive (Exclusive) or independent Captive agents - ☑️☑️ agents who agree by contract to represent only one insurer in the sale of insurance

Traditional indemnity plan - ☑️☑️ the insured generally is supposed to submit their claims directly to an insurer, in reality an "assignment of benefits" form is utilized and the medical care provider submits the claim on the insured's behalf Participants in a managed care indemnity plan - ☑️☑️ select a provider and submits claims to the insurer When an insurer wants to have the applicant complete an HIV test, they must do - ☑️☑️ 1) Have the applicant sign a consent form

2. Find out which doctor they should provide the results to
3. Provide information on where they can receive counseling When an insurer wants to have the applicant complete an HIV test, they do not need to - ☑️☑️ go over a privacy notice 75% of all eligible employees must enroll in a contributory plan. All eligible employees are required to enroll in a - ☑️☑️ non contributory plan Loss exposure - ☑️☑️ a situation which presents the possibility of loss Deductibles, co-payments and co-insurance are all features of health insurance which are called - ☑️☑️ cost sharing Life insurance death benefit policy proceeds paid from an insurer are - ☑️☑️ Federal tax free when paid to a beneficiary

When an insured with a cash value elects to take the reduced paid-up non- forfeiture option, the cash value will be - ☑️☑️ used to buy him a new hole life policy with a reduced face amount that is paid-up for life The traditional net cost method of evaluating the true cost of insurance does not take into consideration - ☑️☑️ the time value of money The primary difference between using the interest adjusted net cost method and the net cost method when evaluating the true cost of a life insurance policy - ☑️☑️ time value of money Dividends may never be - ☑️☑️ guaranteed All are true about "stock" insurance companies - ☑️☑️ 1) Dividends are taxable

2. The stockholders own the company
3. They may pay dividends to share holders out of divisible surplus
4. they issue non-participating policies Under the Family and Medical Leave Act, how many weeks of leave must be provided per year for a qualifying person - ☑️☑️ 12 weeks ESOP invest in - ☑️☑️ Stock of the employer Riders may be added to a policy at issue for an additional premium charge. Examples of riders - ☑️☑️ 1) accidental Death benefit

403(b) are available to - ☑️☑️ employees of public educational institutions and certain non-profit charitable or religious organizations. Contributions are made in before tax dollars on a payroll deduction basis Renewable term has a level death benefit and - ☑️☑️ increasing premium. Each time the policy renews, the premium will go up The automatic premium loan rider will go into effect at the end of - ☑️☑️ the grace period. It can only be added to a cash value policy and was created to keep the policy in force if the insured forgets to pay their premium HMOs are required to cover all of the following - ☑️☑️ preventive services, physician services, emergency services. Except prescription drugs Insurance contracts must identify 6 required specifications - ☑️☑️ 1) the parties between whom the contract is made

2. the property or life insured
3. the interest of the insured in the property insured
4. the risks (perils) insured against
5. the policy period
6. the premium Primary (also known as "ceding") insurers who elect to offer insurance coverage for high risk exposures, such as earthquake, often buy reinsurance from larger reinsurance companies (reinsurers) in an effort to lower their exposure to - ☑️☑️ catastrophic risk.

Under the CIC, an insured may cover a child attending an educational institutional as a dependent on their group life insurance policy through - ☑️☑️ age 24 What does a deferred annuity have that an immediate annuity does not? - ☑️☑️ an accumulation period Standard levels of care provided by LTC insurance does not include - ☑️☑️ Medical expenses Part A of Medicare covers - ☑️☑️ Hospital services. For example, Hospitalization, Hospice care, home health care Part B of Medicare covers - ☑️☑️ Physician services Life annuity - ☑️☑️ a product that will pay out every year for the rest of a person's life To be considered as disability for social security - ☑️☑️ a person must be total disability Flexible premium variable life - ☑️☑️ also known as variable universal life. Allows the insured to pay a flexible premium and direct the case value into a varying selection of investments

If the owner of the policy has named on irrevocable beneficiary, they cannot - ☑️☑️ assign the policy without their consent underwriting risk classification - ☑️☑️ preferred, standard, non-standard Frequency pricing principle - ☑️☑️ Determining how frequently or how often a loss will occur within a group of individuals, how these loses will effect rates Non medical life insurance applications - ☑️☑️ usually buy low amount of coverage, need not take a physical exam, usually young. but they have to answer medical questions on the application If a person returns a variable annuity invested in mutual funds during the free look, they will receive a return of - ☑️☑️ the value of the account on the date of cancellation In an insurance contract, a representation qualifies as - ☑️☑️ an implied warranty If a whole life policy is being kept in-force by the Waiver of Premium rider - ☑️☑️ the cash value will continue to increase as if the insured paid the premium Roth IRA - ☑️☑️ Contributions are not tax deductible, qualified distributions are not taxable

A qualified distribution for Roth IRA is - ☑️☑️ one made to a participant who has been participating in the Roth for at least 5 years and is at least age 59 and a half When a disability income policy provides occupational coverage and the insured has 2 jobs, the insurer will base the premium on - ☑️☑️ the most hazardous job AD&D (Accidental Death and Dismemberment) insurance - ☑️☑️ is not a life insurance AD&D (Accidental Death and Dismemberment) insurance - ☑️☑️ has both a Capital and Principal sum. Principal sum pays a lump sum for accidental death. Capital Sum pays a lump sum for accidental dismemberment Principle of indemnity - ☑️☑️ the insured should not profit from a loss or damage but should be returned (as near as possible) to the same financial position that existed before the loss or damaged occurred Managing General Agents (MGA) - ☑️☑️ Fire and Casualty broker/ agent or a life agent who represents one or more admitted insurers and manages the transaction of insurance by those insurers in a specific territory Surplus Lines Broker - ☑️☑️ a person licensed by the Commissioner to solicit and place insurance with non-admitted insurers when the insurance cannot be procured from admitted insurers

Characteristics of Ideally insurable risk - ☑️☑️ Loss must not be catastrophic in nature, must create economic hardship, must be definable. EXCEPT loss must be certain. Death is certain but it is okay because time of death is uncertain Coordination of benefits - ☑️☑️ the provision that applies in group insurance when an insured has coverage under multiple plans at one time Industrial life insurance has a face amount of - ☑️☑️ 2000 or less Industrial life is sold by - ☑️☑️ debit insurance agents who call the clients in person on a weekly basis. Policies accrue a cash value. Premiums are paid weekly, the grace period is 28 days a supplementary benefit in a dread disease policy - ☑️☑️ Treatment, travel and lodging expenses when treatment is far from home, and normal living expenses such as a car payment, mortgage/rent and utility bills Medicare Supplement insurance policies - ☑️☑️ Insurers may offer plans that contain only the "core" benefits. (Plan A) There are 12 standardized Medicare Supplement policies, identified as - ☑️☑️ Plans A through L Medicare Supplements are sold by private insurers to supplement Medicare, which is generally only available to those who are at least age - ☑️☑️ 65 In disability income insurance in order for bodily injury to be classife3d as accidental - ☑️☑️ the cause may be intentional but the result must be accidental

Which of the following best illustrates the Principle of Indemnity - ☑️☑️ Insurable Interest Factors used to underwrite group medical expense insurance policies - ☑️☑️ the location of the group, term of the probationary period, the age and gender of those making up the group morbidity - ☑️☑️ the likelihood of illness or injury The minimum number of employees which must be covered in a group life insurance plan in California is - ☑️☑️ 2 Persistency - ☑️☑️ the continued existence of a policy being in force. At what point in time may a representation be altered or withdrawn - ☑️☑️ Prior to the insurance going into effect only During the waiting (elimination period) - ☑️☑️ the insured is not eligible for benefits. They have to wait after becoming totally disabled before receiving any benefits Concealment - ☑️☑️ The failure to disclose a material fact that a party knows and ought to communicate Concealment, whether intentional or not, entitles - ☑️☑️ the injured party to rescind (void) the contract

An insurer who provides for all of its liabilities and purchases reinsurance on all of its outstanding risks is considered to be - ☑️☑️ Insolvent On a fully contributory group disability income policy, the benefits payable to disabled employees are - ☑️☑️ not taxable On what type of Life insurance is the beneficiary also the policyholder - ☑️☑️ Credit Life Survivorship life - ☑️☑️ Policies pays a death benefit when the second insured person dies Equity Indexed Annuity - ☑️☑️ an annuity with a fixed minimum rate of return with the potential for excess stock market like returns Required duties regarding the organizational license of a co-partnership whose membership has changed - ☑️☑️ 1) pay the required fees

2. must file within 30 days an application for registering the change in membership signed by a general partner
3. at least one person authorized to exercise the agency powers of the original partnership must continue with the surviving partnership When membership has changed in a co-partnership for the organizational license - ☑️☑️ they do not need to return the old license with the signatures of all the original member to the co-partnership to the commissioner Joint Life - ☑️☑️ Policies pays a death benefit when the first insured person dies

Incontestability - ☑️☑️ the provision which keeps a policy which has been in force for two years from being rescinded by the insurer A difference between group and individual life insurance plans - ☑️☑️ Insurers use experience rating for group life policies Cost of Living rider - ☑️☑️ increase coverage relative to cost of living changes in the economy. Once an upward adjustment occurs, coverage will never be decreased. If the face amount is adjusted up, the premium will increase It is the materiality of the concealment which will ultimately determine the importance of a - ☑️☑️ representation the insurer require what when an applicant reveals conditions that require more information - ☑️☑️ Attending physicians statement The elimination period in a disability income policy is most similar to - ☑️☑️ deductible in a medical expense policy if there is a loan outstanding at the time of death, and the Fixed period settlement option by the beneficiary, what effect will it have on payout - ☑️☑️ it will reduce the value of the payments made only An avocation is a another name for - ☑️☑️ a hobby

If a corporation uses life insurance to buy shares under a buy-sell agreement, this is true regarding taxation - ☑️☑️ The IRS will treat the sale of the shares as a loss or gain depending on the purchase and sale price, if the stock is common. COBRA - ☑️☑️ federal law that enable employees covered by group health insurance to continue their group coverage by paying their own premiums, generally for up to 18 months. Job termination for gross misconduct cause no eligibility - ☑️☑️ for COBRA Mortality tables - ☑️☑️ the annual probability of death Group stop-loss plans does not covered by - ☑️☑️ the Life and Health Insurance Guaranty Fund The commissioner may deny an application for an agent's license, without hearing if - ☑️☑️ the applicant has had a previously issued license revoked with the past 5 years The underwriting department - ☑️☑️ responsible for the evaluation, distribution and selection of risks Annual mode of premium payment has the lowest - ☑️☑️ overall cost for the customer The guaranteed insurability rider - ☑️☑️ allows the insured to purchase additional amounts of life insurance at specific points in the future without having to prove insurability

Under the CIC an insured may cover an unmarried child as a dependent on their group life insurance policy up to - ☑️☑️ age 21 Variable annuity premiums may be invested in - ☑️☑️ mutual funds, money markets, fixed income investments Worker Compensation - ☑️☑️ 1) it covers occupational injury or sickness

2. it requires that employers be responsible for their employees
3. there are no time or dollar limits on covered expenses Under the California Insurance Code, anyone who diverts or appropriates customer funds while acting in a fiduciary capacity to their own use is guilty of

• ☑️☑️ theft Fiduciary - ☑️☑️ the trust that is placed in an agent with regard to the handling of funds in a capable responsible and honest manner Foreign company - ☑️☑️ An insurance company domiciled in another state but transacting business in California A person may not transact insurance without a valid license from the Commissioner. To do so would be - ☑️☑️ a misdemeanor Miscellaneous insurance - ☑️☑️ insurance written to indemnify the producer of any motion picture, television, theatrical, sporting event or exhibition against loss by reason of interruption, postponement, or cancellation due to death,