NY Life, Accident and Health Practice Exam, Exams of Nursing

Download NY Life, Accident and Health Practice Exam and more Exams Nursing in PDF only on Docsity!

PSI - NY Life, Accident and Health Practice

Exam 17-55| 75 Questions - Actual Test|

GRADED A

Which of the following amends the Social Security Act to make Medicare secondary to group health plans? - CORRECT ANSWER>>TEFRA

What does coinsurance mean? - CORRECT ANSWER>>The insurer and the insured share expenses over the deductible.

Which policy provision permits the policy-owner to take a specified number of days to examine the contract, and allows for cancellation and a full refund if the policy-owner rejects the terms or costs? - CORRECT ANSWER>>Free Look

All of the following are requirements to qualify for Social Security disability benefits EXCEPT when: - CORRECT ANSWER>>unable to work in occupation in which the worker was trained or educated.

All of the following are characteristics of COBRA EXCEPT - CORRECT ANSWER>>change in medical privacy procedures.

Which of the following is the most common method to supplement Medicare coverage? - CORRECT ANSWER>>Coverage offered by private insurers

How do most disability policies handle the case of a recurrent disability occurring at least 90 days after the first claim? - CORRECT ANSWER>>It must be handled as a new claim for a new period of disability, requiring a new elimination period.

Which of the following is true of a cancelable policy? - CORRECT ANSWER>>All unearned premiums must be returned to the insured.

When can the premiums of an individually owned health insurance policy be deducted from the individual's income tax? - CORRECT ANSWER>>When the taxpayer's medical expenses exceed 7.5% of adjusted gross income during a taxable year

Which plan is most commonly paired with a High Deductible Health Plan? - CORRECT ANSWER>>Health Savings Account (HSA)

Obtaining consumer information reports under false pretenses is prosecutable by which of the following? - CORRECT ANSWER>>Fair Credit Reporting Act

When the courts look at a contract to determine the intent of the parties which of the following is considered? - CORRECT ANSWER>>The entire contract

Which of the following, by definition, provides benefits for expenses incurred as a result of in-hospital medical treatment and surgery as well as certain outpatient expenses such as doctor's visits, laboratory tests, and diagnostic services? - CORRECT ANSWER>>hospitalization insurance

Which of the following is defined as the dollar amount beyond which the insured no longer participates in payment of medical expenses? - CORRECT ANSWER>>Stop Loss Limit

What are two characteristics of Health Maintenance Organizations (HMOs)? - CORRECT ANSWER>>Containing costs and early treatment

What does it mean if a health policy is conditionally renewable? - CORRECT ANSWER>>Insurer may elect NOT to renew only under conditions specified in the policy.

Which of the following occurs immediately after the application is submitted and the initial premium paid? - CORRECT ANSWER>>the underwriting process begins

How do warranties differ from representations? - CORRECT ANSWER>>A warranty is guaranteed to be true, a representation is believed to be true to the best of one's knowledge.

Which one of the following is particularly important for an insurance producer to explain to a client upon delivery of a life insurance policy? - CORRECT ANSWER>>any exclusions

In a case where an individual's health is insured by both their own policy and their spouse's policy, which policy pays in the event of an illness? - CORRECT ANSWER>>The individual's policy pays first, the spouse's policy pays the remaining up to coverage amount.

Which of the following must be given to the insurer within 20 days after occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible? - CORRECT ANSWER>>notice of claim

All of the following are required signatures on a life insurance application EXCEPT - CORRECT ANSWER>>the minor in a juvenile policy.

Whose responsibility is it to make sure that the company is notified of a death claim at the earliest possible opportunity (in most cases)? - CORRECT ANSWER>>the producer

How are issues of ambiguity usually resolved because insurance contracts are contracts of adhesion? - CORRECT ANSWER>>In favor of the insured because the insurance company drafts the language in the contract.

What is the waiver of premium provision? - CORRECT ANSWER>>In a long term care contract, the premium is waived after the insured has been confined for a specific period of time.

Managed care plans increase efficiency by all of the following means EXCEPT - CORRECT ANSWER>>transferring the management of costs to the insureds.

If a company provides group disability insurance to its employees, which of the following may be tax- deductible? - CORRECT ANSWER>>The premiums paid by the company as a business expense

Which of the following is the time limit on certain defenses after which the policy becomes incontestable? - CORRECT ANSWER>>2 years

Which type of coverage pays the operating costs of a small business when the owner becomes disabled?

• CORRECT ANSWER>>Business overhead expense disability insurance

When should a buy-sell agreement include a provision for the buy-out of an owner's business interest in the event of a disability? - CORRECT ANSWER>>When there is a buy-sell agreement funded with life insurance to buyout the interest of a deceased owner or partner.

A basic vision care package includes all of the following EXCEPT - CORRECT ANSWER>>safety glasses.

During which period of a Disability Income Policy is coverage effective but during which no benefits will be paid under the policy? - CORRECT ANSWER>>probationary period

What is granted to the insured in the consideration clause? - CORRECT ANSWER>>Insurance coverage if premiums are paid

Why are insurance policies considered conditional contracts? - CORRECT ANSWER>>Certain conditions need to be met to make the contract legally enforceable.

What is the difference between copayment and coinsurance? - CORRECT ANSWER>>A copayment is a set dollar amount, while coinsurance is set as a percentage.

Which type of receipt makes the insurer liable for the risk from the date of application, regardless of the applicant's insurability? - CORRECT ANSWER>>binding receipt

In order for an insurer to increase the premium on a non-cancelable policy, which of the following MUST be true? - CORRECT ANSWER>>The premium increase must be in the contract at the time it is issued.

What is an impairment rider? - CORRECT ANSWER>>It lists specific conditions in the contract that are excluded from the contract

What does it mean if a health policy is optionally renewable? - CORRECT ANSWER>>Insurer may elect NOT to renew for any reason only on the policy anniversary or premium due date.

Which is the primary purpose of Health Reimbursement Accounts (HRAs)? - CORRECT ANSWER>>To assist covered employees with the payment of medical expenses on a high deductible plan funded through pre-tax contributions.

Which of the following is TRUE in a key employee life insurance policy? - CORRECT ANSWER>>The corporation is the applicant and policy holder. The employee is the insured.

According to the time of payment of claims provision, the insurer must make the payment immediately after receiving proof of loss EXCEPT - CORRECT ANSWER>>For claims involving periodic payments

In which of the following cases are premiums paid by a business NOT tax deductible as a business expense? - CORRECT ANSWER>>Key person disability income insurance

Which option enables the insured to purchase additional disability income protection at specified future dates at the applicable premium rate at the attained age at the time of future purchase? - CORRECT ANSWER>>Guaranteed insurability

All of the following are common exclusions from loss found in disability income policies EXCEPT for that incurred while: - CORRECT ANSWER>>committing a misdemeanor

How long after being entitled to disability benefits will an individual be eligible to receive Medicare benefits? - CORRECT ANSWER>>2 years

What is the major reason that insurance regulators are often critical of dread disease insurance policies?

• CORRECT ANSWER>>Buyers often think they are getting broader coverage than they actually purchase.

Which part of an insurance contract contains the promise to pay losses covered by the policy in exchange for the insured's premium and compliance with policy terms? - CORRECT ANSWER>>insuring clause

A group conversion option may be used in all the following instances EXCEPT - CORRECT ANSWER>>a life-changing event, such as marriage, divorce, or childbirth.

In which of the following types of contracts is only one party is legally required to do something after the insured has completed the act of paying the premium? - CORRECT ANSWER>>Unilateral