Texas Health and Life Insurance Exam With Answers 2024, Exams of Public Health

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Texas Health and Life Insurance Exam

With Answers 2024

Why does an insurer have a 2-year suicide clause? a) because the commissioner of insurance requires it. b) suicide is never paid for in life insurance. c)to prevent payment of an immediate claim for a person contemplating suicide. d) to help an insurer be more profitable. - ✔️Answer: C To prevent payment of an immediate claim for a person contemplating suicide. Which of these could the owner of a life insurance policy do when there is a collateral assignment? a) determine how the dividends are used. b) cash surrender the policy. c) obtain another loan. d) cancel the policy. - ✔️Answer: A Determine how the dividends are used. When only the insurer is allowed to alter an insurance contract, the clause that provides this is called? a) ownership b) entire contract c) consideration d) incontestable - ✔️Answer: B Entire contract Which of these is required to reinstate a lapsed policy? a) obtain a loan b) fill out a new application c) pay a late fee d) provide evidence of insurability - ✔️Answer: D Provide evidence of insurability The insuring clause in an adjustable life policy has all the following EXCEPT? a) insured b) insurer c) amount of premium d) amount of death benefit - ✔️Answer: C Amount of premium Which of the following cannot request or make a change to alter a life insurance policy?

a) the agent who wrote the policy b) the policy owner c) an executive officer of the insurer d) a person who has absolute assignment - ✔️Answer: A The agent who wrote the policy Which of these cannot sign or request a change in an insurance contract? a) policy owner b) insured c) executive officer of insurer d) producer of insurer - ✔️Answer: D Producer of insurer When the policy owner pays a premium in exchange for the insurer's promise to pay, what provision is this? a) consideration b) entire contract c) insuring clause d) changes - ✔️Answer: A Consideration When the insurer cannot contest a claim after 2 years, that is called? a) suicide clause b) incontestability clause c) entire contract d) consideration clause - ✔️Answer: B Incontestability clause Misstatement of age or gender on the application will result in? a) the policy being considered void or cancelled b) return of premiums c) death benefit paid adjusted to fit true age and gender d) full death benefit regardless - ✔️Answer: C Death benefit paid adjusted to fit true age and gender. What happens if a person returns a policy during the free look period? a) the insured may apply for another policy without a medical exam b) the policy is immediately terminated; the insurer retains the premium for the underwriting costs c) a refund of premiums minus the number of days the policy was in effect d) a full refund of all premiums paid is returned - ✔️Answer: D A full refund of all premiums paid is returned.

An applicant did not disclose a medial condition on a life insurance application 5 years later that person died due to the non disclosed condition. The insurer will? a) keep all premiums and void the policy b) refund all premiums and void the policy c) pay the whole amount of the policy to the beneficiary d) pay half of the policy to the beneficiary - ✔️Answer: C Pay the whole amount of the policy to the beneficiary An applicant lied about their age for a universal life policy. The insurer found out the truth at the time of death. The insurer will? a) request the beneficiary to pay back the premiums for the correct age before paying the death benefit b) refund all premiums and void the policy c) pay the policy death benefit to reflect the correct age d) pay the policy as it was issued - ✔️Answer: C Pay the policy death benefit to reflect the correct age A policy owner/insured takes a loan of 1/2 the cash value. The owner doesn't pay any interest that accumulates on the loan. which of these would be true? a) dividends are withheld until the loan is paid back b) interest is added to the loan annually c) interest is deducted from the loan annually d) dividends and interest are both withheld until the loan is paid back - ✔️Answer: B Interest is added to the loan annually Which of the following is NOT a non forfeiture option? a) reduced paid up b) extended term c) cash surrender d) life income - ✔️Answer: D Life income When an insured die with an outstanding loan on the policy which of the following applies? a) nothing is payable the loan voids the policy's death benefits b) the death benefit is payable minus any outstanding loans plus interest on the loan c) all of the death benefit is paid without reductions d) the loan must be repaid before any death benefits are paid - ✔️Answer: B The death benefit is payable minus any outstanding loans plus interest on the loan G has a life policy with his wife listen as primary beneficiary. They both die in a car accident. They don't know who died first. According to the Uniform Simultaneous Death Act where will the policy proceeds be paid? a) wife's estate b) g's estate

c) g's next of kin d) wife's next of kin - ✔️Answer: B G's estate G has a life policy with his new wife listed as primary beneficiary and his son listed as contingent beneficiary. The whole family dies in the same accident. According to the Common Disaster Clause where will the policy proceeds be paid? a) wife's estate b) g's estate c) son's estate d) wife's and g's estate both share equally - ✔️Answer: B G's estate In which of these settlement options for life insurance would the death benefit not be paid out over a period of time? a) fixed period b) fixed amount c) life income only d) interest only - ✔️Answer: D Interest only Which of the following statements concerning settlement options is true? a) principal payments and interest are income taxable b) only the interest is taxable c) the policy owner may not elect the settlement option, only the beneficiary can d) principal payments and interest are not income taxable - ✔️Answer: B Only the interest is taxable When would the tertiary beneficiary receive death benefit in a life insurance policy? a) if the insured dies before the he contingent beneficiary b) if the primary and contingent beneficiary dies before the insured c) if the primary and contingent beneficiary dies after the insured d) if the contingent beneficiary dies after the insured - ✔️Answer: B If the primary and contingent beneficiary dies before the insured Cobra would cover dependents of an employee for how long after the death of the employee? a) no months b) 18 months c) 36 months d) 20 months - ✔️Answer: C 36 months What is the minimum number of employees to be eligible for Cobra coverage?

a) 50 b) 100 c) 10 d) 20 - ✔️Answer: D 20 A conversion privilege in a group health plan allows which of the following? a) 31 days to request Cobra coverage under your group health insurance policy without proof of insurability b) continuation of coverage for a dependent beyond age 26 for physical or mental handicap c) 31 days to convert the group coverage to an individual health insurance policy without proof of insurability d) the right to convert your ex-employers group health to your new employers group health - ✔️Answer: C 31 days to convert the group coverage to an individual health insurance policy without proof of insurability Flexible Spending Accounts FSA's pay for which of these? a) elective cosmetic surgeries b) reimbursed medical expenses c) cancer treatment only d) unreimbursed medical expenses - ✔️Answer: D Unreimbursed medial expenses A certificate would be given to which of these in a group health plan? a) spouses b) employee c) policy owner d) employer - ✔️Answer: B Employee M switched his job and enrolled on his new employers group health plan. 3 months laters M was prescribed a new allergy medication. The health insurer will? a) pay none of the new prescription b) void the policy for preexisting conditions c) pay the whole cost minus the deductible and coinsurance d) pay 1/2 of the new prescription - ✔️Answer: C Pay the whole cost minus the deductible and coinsurance Which of these is true for medicaid? a) part of social security b) sold by insurers c) federal and state funded d) for people 65 and older -

✔️Answer: C Federal and state funded In order to have Medicare part C the individual must have? a) A and B b) A only c) B only d) A, B and D - ✔️Answer: A A and B In order for a claimant to be eligible for _______ benefits, they must qualify based upon income and medical need. a) medicare supplement b) medicaid c) long-term care d) medicare - ✔️Answer: B Medicaid Every Long-Term Care policy must provide a ______-day free look period from the date the policy is delivered. a) 45 b) 20 c) 10 d) 30 - ✔️Answer: D 30 You are the producer selling Medicare supplements, you must introduce yourself as an employee of ______? a) insurer b) insured c) social security d) federal government - ✔️Answer: A Insurer According to the Affordable Care Act all of these would be eligible for a catastrophic health plan, EXCEPT? a) those with a hardship exemption b) people who can't qualify for medicaid c) people under 30 d) those who can't afford insurance - ✔️Answer: D Those who can't afford insurance Medicare A and B pays for? a) A the doctor, B the hospital b) A the hospital, B prescription drugs

c) A the physical exam, B the hospital d) A the hospital, B physicians service - ✔️Answer: D A the hospital, B physicians service Of the following listed choices, which is true as it pertains to Medicare Part A? a) all recipients pay a monthly premium b) it is prepaid through FICA taxes c) it covers all prescription drugs d) provides coverage for outpatient services - ✔️Answer: B It is prepaid through FICA taxes All of the following are prohibited provisions in a long term care policy, except? a) limits or denies benefits to a policy holder who is diagnosed with any destructive brain tissue disease with will result in loss of brain function b) provides coverage for only skilled nursing care instead of lower levels of care c) canceling a policy due to nonpayment of premium d) cancels, non-renews, or terminates the policy on the grounds of age or deterioration of the mental or physical health of the insured - ✔️Answer: C Canceling a policy due to nonpayment or premium The OASDHI Old Age, Disability, and Health Insurance is also known as? a) medicaid b) medicare c) social security d) worker's compensation - ✔️Answer: C Social security What part of medicare pays for prescription drugs? a) part a b) part d c) part b d) part c - ✔️Answer: B Part D Long term care policies pay for all of these, EXCEPT? a) skilled nurses b) rehabilitation c) substance abuse d) home health care - ✔️Answer: C Substance abuse In order to have Medicare part C the individual must have? a) A, B and D b) A only

c) A and B d) B only - ✔️Answer: C A and B P is 65 years old, he has medical coverage that pays his doctors visits and his hospital bills. he most likely has? a) major medical b) medicare A and B c) Long term care d) cancer policy - ✔️Answer: B Medicare A and B Medicare A and B pays for? a) A the hospital, B physicians service b) A the doctor, B the hospital c) A the physical exam, B the hospital d) A the hospital, B prescription drugs - ✔️Answer: A A the hospital, B physicians service Which policy provides the most protection for the least amount of money? a) term life b) universal life c) equity indexed whole life d) adjustable life - ✔️Answer: A Term life Which policy is a 2nd or last to die policy? a) joint life b) variable life c) modified whole life d) joint survivor life - ✔️Answer: D Joint life survivor Where is the Straight Whole Life insurance policy will you find the parties in the contract? a) consideration clause b) common disaster clause c) incontestable clause d) insuring clause - ✔️Answer: D Insuring clause P wants a life policy with quick cash value accumulation. Which policy should the producer recommend? a) straight whole life

b) 20 year level term c) 20 pay limited life d) both the 20 pay limited whole life and the straight whole life have the same accumulation rate - ✔️Answer: C 20 pay limited life Which policy pays the face amount at the end of the payment period? a) life paid up at age 60 b) endowment at age 65 c) 20 pay whole life d) 15 pay whole life - ✔️Answer: B Endowment at age 65 Which of the following would be true if a child rider on a life insurance policy? a) the child will be offered a conversion option to convert a permanent plan without proof of insurability at a specific age such as 21 b) the policy owner must request the new child be added to the policy and pay the additional premium c) if the policy has the rider and a new child is born the new child is covered from the moment of birth d) all children must prove good health to join the rider even after the rider is in force and another child is born - ✔️Answer: A The child will be offered a conversion option to convert a perm plan without proof of insurability at a specific age such as 21 In which policy does the premium and face amount remain level all the way to age 100? a) modified whole life b) straight whole life c) limited pay whole life d) universal life - ✔️Answer: B Straight whole life Which of the following would be used to pay premiums on a life policy for an insured should they become disabled? a) waiver of payor premium rider b) return of premium rider c) guaranteed insurability rider d) waiver of premium rider - ✔️Answer: D Waiver of premium rider What happens to the cash values in a whole life policy if an insured is disabled and the waiver of premium riders becomes active? a) it is reduced for each payment made by the rider

b) cash value and dividends continue to increase just as if the regular premium payments have been made c) it is increased for each payment made by the rider d) the cash value remains unchanged, until the insured is no longer disabled - ✔️Answer: B Cash value and dividends continue to increase just as if the regular premium payments have been made Which of the following life insurance policies provides protection for a limited period of time? a) single premium whole life policy b) universal life policy c) term policy d) limited pay whole life policy - ✔️Answer: C Term policy This rider guarantees a policy on a minor will continue even though the parent paying premiums became disabled? a) payor benefits b) guaranteed insurability c) return of premium d) waiver of premium - ✔️Answer: A Payor benefit Which of the following policies would be a limited pay whole life? a) premiums and policy expire after a limited period of time b) policy lasts for a limited time then expires c) premiums payable for a limited time then expire but the policy goes on d) premiums are limited for a while then they increase - ✔️Answer: C Premiums payable for a limited time then expire but the policy goes on The right to change a term policy to a permanent policy without proof of insurability if called? a) changeable b) convertible c) level d) renewable - ✔️Answer: B Convertible In which of the following policies is the cash value in the policy invested in stocks and/or bonds? a) universal life b) limited pay whole life c) single premium whole life d) variable life - ✔️Answer: D

Variable life An insurance company incorporated in New York selling polices in Texas would be called? a) domestic b) mutual c) alien d) foreign - ✔️Answer: D Foreign A person is told they won't receive any aid processing a claim unless they sign a release form. This is known as? a) coercion b) discrimination c) intimidation d) boycott - ✔️Answer: A Coercion An insurer wishing to dissolve their relationship with a producer would? a) terminate producers insurance license b) non renew producers insurance license c) file a law suit d) terminate producers appointment - ✔️Answer: D Terminate producers appointment For which if the following polices must an Outline of Coverage be delivered? a) major medical b) medicare supplement c) HMO d) disability - ✔️Answer: B Medicare supplement After an investigation, an insurer denies a false claim. The insurer must? a) terminate policy as of claim date b) provide a reasonable explanation c) immediately terminate the policy back to issue date d) wait until the renewal to non renew the policy - ✔️Answer: B Provide a reasonable explanation When a person or a company voluntarily surrenders a known right, this is known as? a) warranties b) waiver c) fraud d) agreement - ✔️Answer: B

Waiver When an insurance policy is know as a "Take it or leave it" contact it is? a) aleatory b) contract of adhesion c) warranties d) unilateral contact - ✔️Answer: B Contract of adhesion If an insurer accepts an incomplete application and issues the policy, what must they do? a) get the application competed within the incontestability period b) void the policy and rewrite it c) honor the policy d) resubmit a new application immediately - ✔️Answer: C Honor the policy Offer, acceptance and consideration are all parts of? a) law of agency b) negotiation c) apparent authority d) elements of a legal contract - ✔️Answer: D Elements of a legal contract An incorporated insurance company that sells shares would be? a) stock b) fraternal c) mutual d) lloyd's - ✔️Answer: A Stock Statements made on the application that are believed to be true to the best of the applicants knowledge are? a) misrepresentations b) waivers c) representations d) concealments - ✔️Answer: C Representations A statement made in an application for life insurance which is substantially true would be considered? a) warranty b) representation c) waiver d) misrepresentation -

✔️Answer: B Representation Statements made on a claim form or on an application for insurance that are believed to be true are? a) waivers b) misrepresentations c) warranties d) representations - ✔️Answer: D Representations S and W are partners in a business. They both buy and own policies on the other. 3 years later the business dissolved. S and W are both married. They don't change the beneficiaries on the policies. They no longer have insurable interest on each other. 5 months late S dies, who will receive the proceeds? a) W b) S's wife c) W's wife d) the partnership - ✔️Answer: A W Which of these is a requirement for licensing in Texas? a) U.S. citizen b) high school diploma c) must be honest, fair and in good standing d) must be 17 years old - ✔️Answer: C Must be honest, fair and in good standing If an applicant or insured discovers error in their credit report, the fair credit reporting act requires the following to correct the report? a) applicant/insured b) producer c) credit reporting agency d) underwriter - ✔️Answer: C Credit reporting agency AIDS testing requires all of these, EXCEPT? a) gathering of data on positive results for studies b) questions about HIV and AIDS are illegal c) underwriting required testing d) signed consent for testing - ✔️Answer: A Gathering of data on positive results for studies Which of these would be a requirement for obtaining a temporary license in Texas? a) pass these written exam

b) 21 years old c) be considered for appointment by an insurer d) U.S. citizen - ✔️Answer: C Be considered for appointment by an insurer A long term care policy will provide payment for which of these? a) pre-hospital doctor visit b) home health c) post hospital doctor visit d) hospitalization - ✔️Answer: B Home health How many hours of continuing education hours must be ethics per renewal period? a) 24 b) 10 c) 12 d) 2 - ✔️Answer: D 2 Which of these cannot request information about fraudulent health claims? a) local police b) insured c) district attorney d) commissioner of insurance - ✔️Answer: B Insured Dividends paid by stock insurers are paid to: a) service providers b) shareholders c) policy holders d) agencies - ✔️Answer: B Shareholders The department of insurance does all the following except? a) computes reinsurance reserves b) releases reinsurance reserves if needed c) administers the worker's compensation system d) ensures fair competition in the industry - ✔️Answer: B Releases reinsurance reserves if needed How long after passing your exam must you apply for your insurance license? a) 6 months b) 24 months c) 18 months

d) 12 months - ✔️Answer: D 12 According to the fair credit reporting act, when must an applicant be informed of obtaining a credit report in the underwriting of the policy? a) at the time of application b) at the time of policy issuance c) at the time of policy delivery d) at the time of underwriting - ✔️Answer: A At the time of application Which of these cannot charge a fee for advice? a) limited lines b) counselor c) managing general agent d) financial planner - ✔️Answer: A Limited Lines Which of the following designations allow a person to obtain a Life and Health insurance license without testing? a) certified public accountant b) chartered life underwriter c) chartered financial consultant d) certified financial planner - ✔️Answer: B Chartered life underwriter Who determines whether or not the applicant will receive a policy from the insurance company once an application is submitted? a) insured doctors b) home office underwriting department c) home office actuarial department d) the producer that wrote the application - ✔️Answer: B Home office underwriting department What is not necessary to contract? a) agreement b) consideration c) negotiation d) legal purpose - ✔️Answer: C Negotiation An application for life insurance was submitted without all the questions being answered. The policy was issued and the incomplete application was attached. Which of these apply?

a) the insurer waived their right to use any information from the unanswered questions. b) the policy will later be found to be incomplete, it will be voided and all premiums refunded. c) The insurer issued a normal policy and all provisions will apply regardless of the unanswered questions. d) The insurer will deny a claim if the information from the unanswered questions were the result of the insured's death - ✔️Answer: A The insurer waived their right to use any information from the unanswered questions A corporation hires a new president. Concerned about losing him in an accident or to an illness. All of these would be true, except? a) the employer would request a key person plan b) the employee picks the beneficiary c) the employee must sign the application d) employer is the applicant/owner - ✔️Answer: B The employee picks the beneficiary V has a disability income policy paying $500 per month with a 30 day elimination period. V becomes disabled on May 1, returns to work on May 15. V becomes disabled again on June 1 and returns to work on December 1. How much did the disability income policy pay? a) 0 b) $ c) $ d) $2750 - ✔️Answer: B $ A business owner buys a disability income policy paying $2000 per month which of these riders could be used to increase the benefits as his business grows without having to prove insurability? a) elimination period b) guaranteed purchase option c) impairment rider d) waiver of premium - ✔️Answer: B guaranteed purchase option X is disabled for 3 1/2 months. His policy pays $500 per month for total disability with a 30 day elimination period. The benefit paid would be? a) $ b) $ c) $ d) $1750 - ✔️Answer: C $

J injures his lower back loading his furniture into a moving van. He recovers and then four months later reinjures the same area. What type of disability is this? a) temporary disability b) recurrent disability c) residual disability d) presumptive disability - ✔️Answer: B recurrent disability which rider in a disability income policy allows the insured to purchase additional monthly benefits at specific ages, dates or occurrences without providing proof of good health? a) guaranteed purchase option b) impairment rider c) elimination period d) waiver of premium - ✔️Answer: A guaranteed purchase option what is not used to determine premium in a disability income policy? a) Health history b) spouses occupation c) avocation d) income - ✔️Answer: B spouses occupation with a business overhead expense policy, all of the following are claims that are covered except? a) employee labor b) Office rent c) Utilities d) The salary or profit of the business owner - ✔️Answer: D The salary or profit of the business owner which of these annuities pays based on units? a) fixed annuity b) indexed annuity c) flexible annuity d) variable annuity - ✔️Answer: D variable annuity in which retirement plan, if the employer puts money in his own account must he also put money in his employees account? a) simple b) IRA c) SEP d) TSA -

✔️Answer: C SEP in an IRA a 10% penalty is levied for which of these? a) money withdrawn before age 59 1/ b) money withdrawn before age 62 c) money withdrawn before age 65 d) money withdrawn after age 70 1/2 - ✔️Answer: A money withdrawn before age 59 1/ all of the following are eligible to participate in a Keogh Plan except? a) sales person b) Manager c) secretary d) silent partner - ✔️Answer: D silent partner The systematic liquidation of funds is the primary function of? a) universal life b) whole life c) variable life d) annuity - ✔️Answer: D annuity which of these would be a reason for someone to purchase an annuity? a) replaces insured's income in the event of death b) protects against outliving retirement benefits c) guarantees benefits to pay mortgage in the event of premature death d) pays off debt in the event the insured dies prematurely - ✔️Answer: B protects against outliving retirement benefits which retirement plan, if the employer puts money in his own account with yoursupport money and his employees account? a) 401K b) KEOGH c) IRA d) 403B - ✔️Answer: B KEOGH The time limit on certain defenses period is ____ years under individual health and disability contracts. a) 3 b) 5 c) 7 d) 2 -

✔️Answer: D 2 which provision in a health insurance plan is used to avoid over insurance when a person is covered by more than one plan? a) coordination of benefits b) schedule of benefits c) primary care coverage d) extension of benefits - ✔️Answer: A coordination of benefits this is the only accident and health insurance policy that pays out a lump sum benefit upon the death of the insured in certain situations. a) accidental death and dismemberment policy b) Long term care policy c) cancer policy d) disability income policy - ✔️Answer: A accidental death and dismemberment policy A person has a major medical policy with premiums due on the 1st of every month. The individual does not pay May or June's payment and goes into the hospital on June 18. the insurer will? a) deny the claim b) Pay the claim minus the premium due c) request May's payment d) request May and June's payment - ✔️Answer: A deny the claim which of the following would allow the insured to purchase additional insurance on a disability income policy in the event of marriage, promotion, or the birth of a child, without having to prove insurability? a) waiver of insurability b) guaranteed insurability c) additional insurance protection d) Family - ✔️Answer : B guaranteed insurability which provision states that the insurance company must pay claims immediately? a) Time of payment of claims b) payment of claims c) legal actions d) relation of earnings to insurance - ✔️Answer: A Time of payment of claims

fraudulent misstatements on a health policy causes claims to be denied because of which of these? a) entire contract b) payment of claims c) reinstatement d) Time limit on certain defenses - ✔️Answer: D Time limit on certain defenses Time payment of claims in health insurance means which of these? a) The insurer has 15 days to pay the claim once received b) The insurer has 20 days to pay the claim once received c) The insurer must pay the claim immediately d) The insurer has 90 days to pay the claim once received - ✔️Answer: C The insurer must pay the claim immediately A person is shot while committing a crime. What will the health insurer do? a) Pay the whole hospital bill b) Pay none of the hospital bill c) Pay the whole hospital bill minus the deductible d) Pay only half of the hospital bill - ✔️Answer: B Pay none of the hospital bill under the legal actions mandatory uniform provision, an insured must wait at least____days after providing proof of loss before he or she can take legal action against the insurer. a) 90 days b) 180 days c) 60 days d) 45 days - ✔️Answer: C 60 days When payment under a medical expense policy is based on the average fee charged by all doctors in a given geographical area, and the balance of any overcharges or cost of any disallowed services are the insured's responsibility, the payment is known as? a) scheduled payment b) usual, customary, reasonable (USR) payment. c) cash payment d) blanket payment - ✔️Answer: B usual, customary, reasonable (USR) payment A cancer policy covers all of these, except? a) chemotherapy b) immunotherapy c) Appendectomy

d) Physical therapy - ✔️Answer: C appendectomy an accidental death and dismemberment will pay which of these? a) A person dies of cancer b) commercial pilot dies in an airplane accident c) A person dies in a car crash d) A person dies of a heart attack - ✔️Answer: C A person dies in a car crash providers that are paid on a fee-for-service basis are part of what arrangement? a) POS b) PPO c) indemnity d) HMO - ✔️Answer: B PPO which of these would be considered a gatekeeper when talking about health insurance? a) A hospital b) A long-term care facility c) A surgeon d) A primary care physician - ✔️Answer: D A primary care physician H and Q are coprimary beneficiaries on an accidental death and dismemberment policy on their mom for $100,000. The husband is the contingent beneficiary. Q dies of cancer and the mom days 2 months later in an auto accident. How much did the policy pay the father? a) $0 b) $50,000 c) $100,000 d) $25,000 - ✔️Answer: A $0 when an insurer pays benefits based on the average fee charged in a geographical area? This is called? a) scheduled b) reimbursement c) cash d) usual customary and reasonable - ✔️Answer: D Usual customary and reasonable Basic medical expense plans pay for benefits how?

a) unlimited amount b) 1/2 the total cost of all charges c) The full amount of the bill d) as per policy schedule - ✔️Answer: D As per policy schedule in medical expense insurance, newborn infants born with congenital defects are covered? a) 15 days old b) not covered without a rider c) from the moment of birth d) 14 days old - ✔️Answer: C from the moment of birth in health insurance, newborn infant coverage covers all of the following, except: a) routine care b) birth abnormalities c) SIDS (sudden infant death syndrome) d) congenital defects - ✔️Answer: C SIDS (sudden infant death syndrome) and insured has 2000 in medical bill on a policy with $100 deductible and 80/20 coinsurance. The insurer paid? *2000-100•0.8=? a) $1520 b) $1600 c) $480 d) $380 - ✔️Answer: A $1520 how do you PPO's save consumers in their healthcare costs? a) they offer senior discounts b) they charge minors less than adults c) they waive their charges in cases of emergency care d) they charge patients within the PPO less than those who are not in the PPO - ✔️Answer: D they charge patients within the PPO less than those who are not in the PPO providers paid on a capitation system are what type of healthcare system? a) HMO b) PPO c) MIB d) POS - ✔️Answer: A HMO HMO certificates of authority must be approved by?

a) commissioner of insurance b) governor c) HMOs board of directors d) HMOs shareholders - ✔️Answer: A commissioner of insurance Lorraine's position has been terminated, and she is interested in converting her group life coverage to an individual policy. In the process, she will find all of the following to be true, except? a) she will be converting her group term benefit to an individual term benefit b) she has 31 days of eligibility to convert to the private plan without having to prove insurability c) The premium will be at a higher than normal to include the insurers guaranteed convertible surcharge d) if she waits until the eligibility period has closed, the insurer may require evidence of insurability to reduce adverse selection - ✔️Answer: A she will be converting her group term benefit to an individual term benefit employees in a group life insurance plan would find information about their benefits in? a) Insurance policy b) notice of coverage c) nothing only the employer d) certificate of insurance - ✔️Answer: D certificate of insurance employer paid premiums in a group life policy are taxable to? a) The employee if the death benefit exceeds $50,000 b) The employee if the death benefit exceeds $25,000 c) The employer if the death benefit exceeds $25,000 d) The employer if the death benefit exceeds $50,000 - ✔️Answer: A The employee if the death benefit exceeds $50,000 what is not required in group life plans? a) each employee must prove good health in order to participate b) employer pays all the cost. 100% participation required c) employees share cost. 75% participation required d) The employer receives the master policy - ✔️Answer: A each employee must prove good health in order to participate death proceeds in a group life plan our? a) gift taxable to the beneficiary b) tax free to the beneficiary c) taxable to the beneficiary d) only partially taxable to the beneficiary -

✔️Answer: B tax free to the beneficiary Premiums paid by the employer in a group plan are? a) no tax consequences b) tax deductible by the beneficiary c) tax deductible by the employer as a business expense d) tax deductible by the employee as a business expense - ✔️Answer: C tax-deductible by the employer as a business expense how are death benefits received from a group life insurance policy? a) income tax free b) Capital gains taxable c) income taxable only to the extent the employee paid premiums d) fully income taxable - ✔️Answer: A income tax free What is the plan called when employees must pay part of the premium? a) participating b) non-participating c) contributory d) non-contributory - ✔️Answer: C contributory Credit life is insurance for which of these? a) Insurance on the life of the debtor b) Insurance on the life of the lender c) it is a type of disability insurance d) Insurance to pay your credit card - ✔️Answer: A Insurance on the life of the debtor participants in a group life insurance plan receive? a) certificate of insurance b) notice of coverage c) Insurance policy d) nothing only the employer - ✔️Answer: A certificate of insurance L has a debt and purchases a credit life policy. What does it do? a) pays L's loan at L's death b) pays L's spouse at L's death c) pays L's credit card debt at L's death d) pays L's employer atL's death - ✔️Answer: A pays L's loan at L's death

A person submitted an application for a disability income policy. The applicant submitted the premium and received a conditional receipt. The person suffers a disability before the medical was completed. What will the insurer do? a) Pay the claim and issue the policy b) deny the claim but not issue the policy c) Pay the claim but not issue the policy d) deny the claim and issue the policy - ✔️Answer: B deny the claim but not issue the policy an insurer paying claims under usual, customary and reasonable would be which of these? a) a way for the insurer to decrease premiums b) A way for the insurer to limit what they pay of the medical cost c) a way for the insurer to increase premiums d) a way for the insurer to pay 100% of the medical cost - ✔️Answer: B A way for the insurer to limit what they pay of the medical cost R applies for a life insurance policy. He tells the producer he applied for life insurance with another company five years ago, it was declined for a medical condition. R states his doctor never diagnosed him with the condition so he doesn't want to disclose it. The producer should advise him the company will probably find out through? a) previous insurer b) MIB c) inspection report d) medical exam - ✔️Answer: B MIB which of these is true for an individual life insurance policy? a) premiums are tax deductible and the death benefit is taxable to the beneficiary b) premiums are not tax-deductible and the death benefit is tax-free to the beneficiary c) premiums are not tax-deductible and the death benefit is taxable to the beneficiary d) premiums are tax deductible and the death benefit is tax-free to the beneficiary - ✔️Answer: B premiums are not tax-deductible and the death benefit is tax-free to the beneficiary premiums paid by an employee for an individual life policy are? a) tax deductible for the employee b) not tax-deductible for the employee c) tax deferred for employee d) tax deductible for the employer - ✔️Answer: B not tax-deductible for the employee which of these is not a party in a third-party contract?