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Health and Life from THE EXAM SIMULATOR

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show Unilateral  
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The insurer must be able to rely on the statements in the application, and the insured must be able to rely on the insurer to pay valid claims. In the forming of an insurance contract, this is referred to as   show
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Which of the following is not an essential element of an insurance contract? Consideration, Agreement, Legal Purpose, Incompetent parties   show
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Which provision states that if a policy allows for greater compensation than the financial loss incurred, the insured may only receive benefits for the amount lost?   show
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show Are considered true to the best of the applicant's knowledge.  
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show Beneficiary's consent.  
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show Representations  
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When applying for an individual life insurance policy, an applicant states that he went to the doctor for nausea, but fails to mention that he was also having severe chest pains. What is this act called?   show
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show Concealment  
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show The right to determine the wording of a policy  
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Because an insurance policy is a contract between the insurer and the insured, it must conform to the state laws governing contracts which require all of the following elements EXCEPT. Conditions. Competent parties. Legal purpose. Offer and acceptance.   show
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An insured modifies his insurance claims, illegally adjusting them to display a lower amount. What insurance concept does this violate?   show
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entails that the insured and insurer must be able to rely on one another for valid critical information.   show
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Which of the following is a statement that is guaranteed to be true, and if untrue may breach an insurance contract? Concealment, Indemnity, Representation, Warranty   show
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show Direct response marketing  
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An individual applies for a life policy. Two years ago he suffered a head injury from an accident, so he cannot remember parts of his past, but is otherwise competent. He has also been hospitalized for drug abuse, but does not remember this when applying   show
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show Estoppel, ABC had waived its right to receive answers to the missing information once the policy was issued; therefore, they are estopped from enforcing those waived rights.  
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show Blanket.  
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show blanket policy.  
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show Medical Information Bureau  
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receives information that an applicant provides in insurance applications and issues it in a coded format to insurers who request these reports.   show
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show Birth certificate.  
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show MIB report, medical exam, Agent's report, Attending physician report, Investigative consumer report.  
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Tyler applied for an individual health insurance policy. While completing the application, his agent told him that all of the following statements would be underwriting factors EXCEPT His avocations include scuba diving, Three years ago, he was convicted   show
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Which term describes the phenomenon that people who are the most likely to have claims are also the most likely to seek insurance?   show
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Which of the following is NOT true? * State Life and Health Guaranty Association was created to protect policyowners financially if their insurers become insolvent. * The Life and Health Guaranty Association is comprised of representatives from the DOIs   show
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What is an important feature of a dental expense insurance plan that is not typically found in a medical expense insurance plan?   show
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Under a credit disability policy, payments to the creditor will be made for the insured until what point?   show
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Which document is used to assess risk associated with an applicant’s lifestyle and character?   show
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show The capital amount in a lump sum  
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show policies pay a capital amount in lump sum  
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show The principal amount is paid in lump sum  
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All of the following statements concerning Accidental Death and Dismemberment coverage are correct EXCEPT *Accidental death and dismemberment insurance is considered to be limited coverage. *Death benefits are paid only if death occurs within 24 hours o   show
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show 90 days of the accident.  
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Which of the following best details the underwriting process for life insurance?   show
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Jack was treated for hypertension prior to applying for a major medical policy. As the producer who is writing the replacing policy, what should you tell Jack?   show
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show accident-only  
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Which of the following would NOT be considered a primary risk factor in underwriting individual health insurance policies? Marital status, Physical condition of the applicant, Occupation of the applicant, Moral hazard   show
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Rose bought three policies from the same insurer. Her benefits have exceeded the maximum allowed by the insurer. Which of the following will happen?   show
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show Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class.  
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Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within   show
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show Time of Payment of Claims  
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show Period of time  
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show Period of Time  
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show A reinstated policy provides immediate coverage for an illness.  
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show The insurer can increase the policy premium on an individual policy.  
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Which of the following is true regarding a term health policy? It is conditionally renewable. It is guaranteed renewable. It is noncancelable. it is nonrenewable.   show
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Jake carries health insurance with two different providers and is covered on an expense-incurred basis. He has an appendectomy and files the claims to both insurers. Neither company is notified in advance that Jake has other coverage. What should each ins   show
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show Optionally renewable  
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Which renewability provision allows an insurer to terminate a health insurance policy on any date specified in the policy, for any reason, and to increase the premiums for any class of insureds?   show
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show Unpaid Premium  
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show They can be changed only with the written consent of that beneficiary.  
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show The correct payment was made.  
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show Legal Actions  
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show A construction worker pays a higher premium and receives a poorer classification of disability.  
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Which rider, when added to a disability income policy, provides for changes in the benefits payable based on changes in the consumer price index?   show
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show Waiver of Premium feature.  
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show Waiver of premium benefit  
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Income benefits or monthly indemnity benefits are characterized by all of the following statements EXCEPT *The income benefit can be paid monthly or weekly. *The amount to be paid is stated in the policy. *The amount to be paid is unlimited. *The am   show
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If a policy is rated-up, what is true?   show
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show Preference.  
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show Six months to two years.  
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show Taxable income to the employee.  
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A business wants to make sure that if a key employee becomes disabled, the business will be protected from any resulting loss. Which kind of insurance will protect the business?   show
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show None  
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show Welfare benefits.  
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show Prevent over utilization and malingering.  
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Dan is the sole breadwinner in his family of four. He wants to make sure that if he becomes totally disabled, his family will be protected against financial loss. Which plan would best serve Dan’s needs?   show
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If an employer provides long-term group disability insurance for its employees, what percentage of monthly wages are lower-paid employees eligible to collect?   show
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show 1 year  
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show Subscribers  
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show Subscribers  
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The HMO provides the member with inpatient hospital care, in or out of the service area for at least ________ per year for treatment of injury or illness. For treatment of mental, emotional or nervous disorders, including alcohol or drug rehabilitation or   show
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show Antibiotics  
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daily needs and pain relief are provided for hospice patients, but curative measures are not.   show
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show All of the above are correct  
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HIPAA applies to groups of ____________ .   show
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show Usual, customary and reasonable.  
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A __ is a specific dollar amount of the cost of care that must be paid by the member.   show
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show The average age of the group.  
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show 12 months of creditable coverage  
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Under HIPAA, group health plans cannot impose more than a 12 month pre-existing conditions exclusion for a person who sought medical advice, treatment, or diagnosis within the last   show
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show Illness basis  
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Which of the following is a specific dollar amount of the cost of care that must be paid by an HMO member?   show
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Under which provision can a physician submit claim information prior to providing treatment?   show
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When an insurer offers services like preadmission testing, second opinions regarding surgery, and preventative care, which term would best apply?   show
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To be eligible under HIPAA regulations, for how long should an individual converting to a new group plan have been covered under the previous group plan?   show
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Which of the following provisions give an employee the right to exchange group insurance for an individual policy within 31 days from termination of employment?   show
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An association could buy group insurance for its members if it meets all of the following requirements EXCEPT -The group is contributory. -The group has at least 50 members. -The group has a constitution and by-laws. -The group holds semiannual meetin   show
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The per capita administrative cost in group health insurance is _______ the administrative cost found in individual coverage.   show
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show Group coverage must be extended for terminated employees up to a certain period of time at the employee's expense.  
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True or False under COBRA? By law, the new, individual policy must provide the same benefits as the group insurance policy.   show
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True or False under COBRA? The employee can convert from group to individual insurance within 31 days of termination.   show
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True or False under COBRA? The premium of the individual health insurance policy can be higher than the original policy.   show
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True or False under COBRA? Continuation of group coverage need not include dental, vision, or prescription drug benefits.   show
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Employees actively at work on the date coverage is transferred to another insurance carrier are   show
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show They do not represent a good risk.  
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When employees are actively at work on the date coverage can be transferred to another insurance carrier, what happens to coinsurance and deductibles?   show
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show Percentage of participation by the employees  
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How many eligible employees must be included in a contributory plan?   show
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show Must have dependents.  
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Is a difference between individual and group health? In individual policies, the individual selects coverage options, while in a group plan all employees are covered for the same coverage which is chosen by the employer.   show
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Is a difference between individual and group health? Individual coverage can be written on an occupational or nonoccupational basis, while group plans cover only nonoccupational.   show
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show yes  
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Is a difference between individual and group health? Individual insurance does not require medical examinations, while group insurance does require medical examinations.   show
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show Experience rating helps employers with low claims experience because they get lower premiums.  
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show COBRA  
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show To guard against adverse selection and reduce cost  
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show Nonscheduled  
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show Periodontics  
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show 6 months  
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Max needs to have his wisdom teeth removed. Which dental treatment would cover the costs of the extraction?   show
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show Co-insurance and Deductibles.  
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show Medical  
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show Scheduled  
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All of the following are usually provided under an employer group dental insurance plan EXCEPT -Preventive care for up to two visits per year. -The dental plan is typically written in conjunction with group health insurance. -The dental plan places lim   show
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Which type of dental treatment involves the replacement of natural teeth with artificial devices?   show
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show A combination plan  
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Which type of care re-establishes functional use to natural teeth?   show
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show Restorative  
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show Prosthodontics  
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show Major service  
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two types of services under nonscheduled plans:   show
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include treatments such as fillings, oral surgery, periodontics, and endodontics.   show
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include treatments such as inlays, crowns, dentures and orthodontics.   show
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Under most dental plans, what limitations are posed for denture replacement?   show
🗑
Prior to issuance of a Long-Term Care policy to an applicant age 80 or older, the insurer must obtain all of the following   show
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show contract must be guaranteed renewable in order to be qualified, as well as satisfy certain consumer protection provisions concerning model regulation and model act provisions, disclosure, and nonforfeitability.  
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A person buys an individual long-term care policy and is not satisfied with the provisions. Within how many days will the insured be able to return the policy for a full premium refund?   show
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When an employee is still employed upon reaching age 65, is Medicare enrollment an option?   show
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show Medigap policies cover the cost of extended nursing home care.  
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True or False? Care needed because of aging is covered by Medicare but not by Medicare supplements.   show
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True or False? Care needed because of aging is covered by Medicare.   show
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true or false? Medicare does not pay for nursing home care in any case.   show
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show true  
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True or False? For the first 90 days of hospitalization, Medicare Part A pays 100% of all covered services, except for the initial deductible.   show
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show false  
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true or false? Each individual covered by Medicare Part A is allowed one 90-day benefit period per year.   show
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true or false? Medicare Part A is automatically provided when an individual qualifies for Social Security benefits at age 65.   show
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For how many days of skilled nursing facility care will Medicare pay benefits?   show
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under medicare, Treatment in a skilled nursing facility is covered in full for   show
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Bob has Medicare Part D coverage. He has reached his initial benefit limit and must now pay 100% of his prescription drug costs. What is the term for this gap in coverage?   show
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Once the initial benefit limit is reached, a gap called a doughnut hole occurs, in which the beneficiary is responsible for 100% of prescription drug costs.   show
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True or False, Medicare Part A services cover Post hospital Skilled Nursing Facility Care.   show
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show true  
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show true  
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True or False, Medicare Part A services cover Outpatient Hospital Treatment.   show
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show B  
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show Custodial Care Facility  
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show Both the applicant and agent  
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show true  
🗑
show true  
🗑
show true  
🗑
show false  
🗑
Which of the following programs expands individual public assistance programs for people with insufficient income and resources?   show
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show Cosmetic surgery is available.  
🗑
show Are made by the business and are not tax-deductible.  
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Mr. Raines is the recipient of an Accidental Death and Dismemberment (AD&D) policy purchased by his employer. The policy pays triple indemnity in case of accidental death. If Mr. Raines died 2 months after an accident, as a result of an accident stipulate   show
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show Deductible to the employer as an ordinary business expense.  
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With group long-term care insurance, under which condition would an employee’s premium payments be tax deductible?   show
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show 100%  
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show true  
🗑
True or false regarding benefits paid to disabled employees? The benefits are attributable to the employer’s contribution   show
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show true  
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show false  
🗑
show 100%  
🗑
True or false of medical expense coverage for sole proprietors and partners? The deduction may not exceed the taxpayer's earned income for the tax year.   show
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True or false of medical expense coverage for sole proprietors and partners? The 100% deduction is a deduction in arriving at an individual's adjusted gross income, and as such, may not be used to satisfy the 7.5% threshold for itemized medical expenses.   show
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show false  
🗑
True or false of medical expense coverage for sole proprietors and partners? Sole proprietors and partners may deduct 100% of the cost of a medical expense plan provided to them and their families under a plan carried by the sole proprietor or partnership   show
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show A disability buy-sell plan protects the insured in case of disability. It allows the policyowner to buy out the partner's interest in the business, and the benefits are tax free.  
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Which of the following determines whether insurance benefits are taxed?   show
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Long-term care premium payments are deductible as a medical expense to the extent that when added to all other unreimbursed medical expenses, the total exceeds _______ of the taxpayer's adjusted gross income if the taxpayer itemizes his/her deductions.   show
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show true  
🗑
show true  
🗑
show true  
🗑
show false  
🗑
What percentage of individually-owned disability income is taxable?   show
🗑
Medical expense premiums are deductible as medical expenses, provided that when the premiums are added to all of the other unreimbursed medical expenses, the total exceeds __% of the adjusted gross income.   show
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Lilly is covered by a group major medical plan that is provided through her employer. Her employer contributes 75% of the premium and Lilly contributes the remaining 25%. If Lilly received a benefit from this policy in the amount of $1,000, how much of th   show
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An insurer publishes intimidating brochures that portray the insurer's competition as financially and professionally unstable. Which of the following best describes this act?   show
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show Coercion.  
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show 60  
🗑
In comparison to consumer reports, which of the following describes a unique characteristic of investigative consumer reports?   show
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Which type of misrepresentation persuades an insured, to his or her detriment, to cancel, lapse, or switch policies from one to another?   show
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Which of the following is the most precise synonym for an "authorized" insurer?   show
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show false  
🗑
Insurance companies selling whole life, term and health insurance must comply with the standards set forth by the USA PATRIOT Act   show
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show true  
🗑
show true  
🗑
What is the penalty for violations of the insurance code that are NOT willful?   show
🗑
show Apply and pay a fee to a non-resident state that reciprocates.  
🗑
To be a Managing General Agent a person MUST   show
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To be a Managing General Agent a person MUST NOT   show
🗑
Act as an attorney-in-fact for a reciprocal or inter-insurance exchange IS a duty of a Managing General Agent.   show
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show false  
🗑
show false  
🗑
show false  
🗑
When Producer A was reviewing Bruce's insurance that is written by another company, she made several oral statements that were maliciously critical of that other insurer. Producer A could be found guilty of   show
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show 60  
🗑
show $5  
🗑
Applicant must be 18 years old is required of an applicant for an insurance license in Michigan?   show
🗑
A Certificate of Completion from the required pre-licensing study course is required of an applicant for an insurance license in Michigan?   show
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show false  
🗑
The passing of a written examination is required of an applicant for an insurance license in Michigan?   show
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Who may complete a paramedical report?   show
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show Group Insurance  
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show true  
🗑
True or False? The Life and Health Guaranty Association is comprised of representatives from the DOIs of every state.   show
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True or False? The Association’s liability is generally limited to that of the impaired insurance company.   show
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show true  
🗑
show yes  
🗑
is Debt cancellation a legitimate need that would be paid by insurance proceeds?   show
🗑
show yes  
🗑
show no  
🗑
When Jeremiah applied for a life insurance policy, the agent informed him that a medical exam would be required. The exam may be completed by   show
🗑
show yes  
🗑
does Term insurance require proof of insurability?   show
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does Individual insurance require proof of insurability?   show
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show no  
🗑
show The amount received is tax-free.  
🗑
If an insured changes his payment plan from monthly to annually, what happens to the total premium?   show
🗑
show Human life value approach.  
🗑
How many policies are necessary to cover a cross purchase (buy/sell agreement) between 3 people?   show
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Andrea wants to apply for an individual life insurance policy. She has a nearly flawless health history and wants only limited coverage. Which type of medical report is the least that would probably be required?   show
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show To create an estate  
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The factor added to the net premium to cover the costs of the insurer in obtaining and maintaining the business is called   show
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An insurer is helping a married couple determine their children's needs, assets, and liabilities, in the event that one or both of the spouses should die. What is the term most closely associated with this?   show
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Which of the following statements is correct about a Standard risk classification in the same age group and with similar lifestyles?   show
🗑
show Annual Renewable Term.  
🗑
The insurance company reserves the right to adjust the mortality charges and/or interest rate.is a characteristic of a Universal Life policy.   show
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show true  
🗑
In effect, Universal Life is a combination of term insurance and a separate savings account joined in a single contract.is a characteristic of a Universal Life policy.   show
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The planned premium pays for mortality charges and expenses and any excess is returned to the policyowner. is a characteristic of a Universal Life policy.   show
🗑
Which of the following distinguishes a Group Life Policy from an Individual Life Insurance Policy?   show
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Norm and Vera own a permanent policy which covers both of their lives and pays the face amount of the policy only upon the death of the first. Norm and Vera own a   show
🗑
show increase or decrease the premium; changing the premium-paying period; increase or decrease the face amount of coverage; or change the period of protection.  
🗑
Annually renewable term policies provide a level death benefit for a premium that   show
🗑
Graded-Premium Whole Life policy premiums are typically lower initially, but gradually increase for a period. After the increase period, the premiums will   show
🗑
true or false regarding a Straight Life policy? It has the lowest annual premium of the three types of Whole Life policies.   show
🗑
true or false regarding a Straight Life policy? Its premium steadily decreases over time, in response to its growing cash value.   show
🗑
true or false regarding a Straight Life policy? The face value of the policy is paid to the insured at age 100.   show
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show true  
🗑
charge a level annual premium throughout the insured’s lifetime and provide a level, guaranteed death benefit.   show
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show true  
🗑
true or false about Group Life? The group sponsor will receive a "Certificate of Insurance" and participants get a master contract.   show
🗑
true or false about Group Life? The policy can be converted to an individual Term insurance policy.   show
🗑
true or false about Group Life? The policy cannot be attached, garnished, seized, or given to any debtor.   show
🗑
show Joint life pays a death benefit on the first death, while Survivorship Life pays on the last death.  
🗑
Ed decided to purchase a $100,000 Annual Renewable Term Life Policy to provide additional protection until his children finished college. Ed discovered that his policy   show
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show Life Paid-Up at Age 65  
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show no  
🗑
show yes  
🗑
show yes  
🗑
show yes  
🗑
show Joint Life policy  
🗑
Creditor requiring that a debtor buys insurance from a certain insurer is allowed in credit life insurance?   show
🗑
show yes  
🗑
Creditor requiring that a debtor has a life insurance is allowed in credit life insurance?   show
🗑
show yes  
🗑
show The original age is used for premium determination  
🗑
A policy owner fails to pay the premium due on his whole life policy after the grace period passes, but the policy remains in force. This is due to what provision?   show
🗑
What is true about Spouse Term Riders?   show
🗑
show surrender the policy at its current cash value. Only any excess of value is taxable as income. Once the policyholder opts for cash surrender, the policy is immediately inactive.  
🗑
What provision in a life insurance policy would allow the insurer, after the death of the insured, to pay benefits to a person not named in the policy as beneficiary?   show
🗑
What limits the amount that a policyowner may borrow from a whole life insurance policy?   show
🗑
The amount available to the policyowner for a loan is   show
🗑
What is true regarding the taxation of accelerated benefits?   show
🗑
When a reduced-paid up nonforfeiture option is chosen, what happens to the face amount of the policy?   show
🗑
show Mary  
🗑
show true  
🗑
True or False concerning Waiver of Premium riders? There is a maximum age limit for the Waiver of Premium rider to activate.   show
🗑
show true  
🗑
show false  
🗑
show true  
🗑
Michigan insurance policies can specify a time limit on the number of years that an insured can wait before taking legal action against the insurer. This time limit, however, has to be ___ years or greater.   show
🗑
To meet the “entire contract” provision of the Code, a policy must contain   show
🗑
If an insured receives accelerated death benefits, what is the least amount of the original death benefit that the beneficiary would receive after the insured’s death?   show
🗑
show false  
🗑
show false  
🗑
True or false regarding life insurance benefits for minors? The trustee is not accountable for assets   show
🗑
show true  
🗑
True or false regarding life insurance benefits for minors? The guardian and trustee may be the same person or different people. The primary difference in function is that the trustee is accountable for assets, whereas the guardian may or may not be accou   show
🗑
show Transfer of all ownership rights in a policy.  
🗑
true or false about a group annuity? The annuity must be purchased by a group, but could be owned by an individual.   show
🗑
true or false about a group annuity? The annuity could be obtained through a group of people identified by their relationship to a single entity buying a contract.   show
🗑
true or false about a group annuity? Group annuity could be considered qualified.   show
🗑
show true  
🗑
show true  
🗑
show is paid in a single lump sum. The annuity payments begin within a year of the date of purchase. A deferred annuity can be purchased with either a lump sum or through periodic payments, but the benefit is not paid until after one year or more has lapsed  
🗑
show The period of time during which accumulated money is converted into income payments  
🗑
show Payments for 15 years  
🗑
show are not securities, but they invest on a relatively aggressive basis to aim for higher returns. Like a fixed annuity the Equity Indexed Annuity has a guaranteed minimum interest rate. The current interest rate that is actually credited is often tied to a  
🗑
What characteristic must an annuity have if it is used to accumulate funds in an IRA?   show
🗑
A prospective deferred annuity owner is concerned about what would happen if he surrendered the annuity before the annuitization period. The agent most likely explained which of the following?   show
🗑
show immediate, distribution starts within 1 year of purchase.  
🗑
Which of the following is another term for the accumulation period of an annuity?   show
🗑
show accumulation period/Pay-in period  
🗑
When an annuity is written, whose life expectancy is taken into account?   show
🗑
An insurance company forwards fixed annuity premiums to their general account, where the money is invested conservatively. The guaranteed minimum interest is set at 3%. During an economic downswing, the investments only drew 2.5%. How much will the insure   show
🗑
show Individual  
🗑
show Life income with period certain.  
🗑
If an annuitant chooses a lump-sum settlement at annuitization, which of the following taxes would be imposed in all cases?   show
🗑
The equity in an equity index annuity is linked to   show
🗑
In life insurance policies, cash value increases   show
🗑
True or false of Section 1035 Policy Exchanges? It requires an absolute assignment of the existing policy to the replacing company who surrenders the contract and issues a replacement policy.   show
🗑
True or false of Section 1035 Policy Exchanges? It is an IRS Code which permits like kind exchanges of property.   show
🗑
show true  
🗑
show false  
🗑
show true  
🗑
show must begin no later than age 70½ in order for the annuitant to avoid penalties. The penalty is 50% of the shortfall from the required annual amount.  
🗑
show Settlement Option  
🗑
show Annuities payments  
🗑
show Only the premiums paid will be included in Melanie’s estate.  
🗑
Who can make a fully deductible contribution to their IRA?   show
🗑
show It determines if the insurance policy is an MEC.  
🗑
An employee quits her job where she has a balance of $10,000 in her qualified plan. If she decides to rollover her plan to a Traditional IRA, how much will she receive from the plan administrator and how long does she have to complete the tax-free rollove   show
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An employee quits her job where she has a balance of $10,000 in her qualified plan. If she decides to do a direct transfer from her plan to a Traditional IRA, how much will be transferred from one plan administrator to another and what is the tax conseque   show
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After what age could a Roth IRA distribution be classified as "qualified"?   show
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During the accumulation period in a non-qualified annuity, what are the tax consequences of a withdrawal?   show
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If $100,000 of life insurance proceeds were used in a settlement option, which paid $13,000 per year for ten years, which of the following would be taxable annually?   show
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show On a tax-deferred basis.  
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Taxation occurs only when any of the cash value is distributed to the policyowner (i.e., withdrawals and surrenders).   show
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show Section 1035 Policy Exchange  
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Cinderella divorces Prince Charming at age 35 and collects distributions on their retirement plan as a result. What penalties will she have to pay?   show
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Which of the following scenarios will incur a 10% tax penalty on distributions?   show
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the tax advantage of a qualified retirement plan?   show
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show It satisfies all requirements of the Internal Revenue Service for favorable tax treatment.  
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qualified plan   show
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An employer has sponsored a qualified retirement plan for its employees where the employer will contribute money whenever a profit is realized. What is this called?   show
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Employer contributions made to a qualified plan are   show
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The advantage of qualified plans to employers is   show
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Which of the following is an IRS qualified retirement program for the self-employed?   show
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show yes  
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show yes  
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A loan from the plan is considered exceptions to the early distribution rule and, therefore, are not subject to the penalty tax?   show
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show no  
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The following are considered exceptions to the early distribution rule   show
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show A person must have worked at least 1000 hours per year  
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show The plan must be permanent, written and legally binding. The plan must be communicated to all employees. The plan must be for the exclusive benefits of the employees and their beneficiaries. Plans must meet the general requirements established by IRS.  
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show Retirement  
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show Executive bonus plan  
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example of a qualified retirement plan   show
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When Barkley started work for the Ace Company, he was told he could participate in a Simplified Employee Pension Plan. This plan is   show
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