Life and Health

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Life and Health
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2015-07-29 11:19:24
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  1. Which of the following statements regarding a conditionally renewable policy is NOT correct?A) The insurer may refuse to renew the contract as the result of the insured's deteriorating health.B) The insurer may refuse to renew the contract as the result of the insured's retirement.C) The insured has the conditional right to renew the policy up to a given age.D) The insured has the conditional right to renew the policy up to a given date.
    The insurer may refuse to renew the contract as the result of the insured's deteriorating health.
  2. All individual health insurance policies must include a notice of claim provision requiring that a written notice of claim must be given to the insurer within how long after the occurrence of the loss?A) 10 days.B) 20 days.C) 24 hours.D) 5 days.
    B) 20 days.
  3. Which of the following statements is CORRECT?A) Group disability plans are only available on a long-term basis.B) Disability income insurance benefits are paid out immediately following the disability.C) Disability income insurance does not provide a death benefit.D) Individual disability plans are only available on a short-term basis.
    C) Disability income insurance does not provide a death benefit.
  4. Sidney makes $3,000 a month as a machine shop supervisor. His disability income policy provides for a monthly payment of $2,500 in the event of total disability. If Sidney were to become partially disabled, but continued to work at 60% of his pay, what would the policy pay, assuming it had a residual disability provision?A) $1,200 a month.B) $0, since Sidney was not fully disabled.C) $1,000 a month.D) $2,500 a month.
    Answer: CA residual disability income policy ties the benefit payments directly to the proportion of actual earnings lost. In this problem, since Sidney is earning 60% of his predisability pay, the residual benefit would be 40% of the full benefit, or $1,000, calculated as .40 x $2,500.
  5. A business disability buy-out insurance plan may include an "elective indemnity." This feature can be used to:A) postpone payment of the benefit to the insured.B) pay a lump-sum death benefit to the insured's family.C) reimburse other business owners or partners for the insured's loss of services to the business.D) enable the business owners to add other owners to the policy.
    A) postpone payment of the benefit to the insured.
  6. Which kind of deductible is entirely or partially absorbed by a basic medical expense policy?A) Corridor.B) Integrated.C) Decreasing.D) First dollar.
    B) Integrated.
  7. All of the following approaches are used by insurers to determine benefits payable under basic surgical expense insurance EXCEPT:A) traditional net cost method.B) relative value scale approach.C) reasonable and customary approach.D) surgical schedule method.
    A) traditional net cost method.
  8. When separate deductibles are required for each illness or accident, what kind of deductible is in effect?A) Per benefit.B) Revolving.C) Per cause.D) Flat.
    C) Per cause.
  9. Which of the following dental plans covers dental services on a traditional fee-for-service basis?A) Capitation plan.B) Direct reimbursement plan.C) Preferred Provider Organization.D) Comprehensive plan.
    D) Comprehensive plan.
  10. With respect to dental insurance, another name for a capitation plan is a(n):A) preferred provider organization.B) indemnity plan.C) dental health maintenance organization.D) exclusive provider organization.
    C) dental health maintenance organization.
  11. All of the following group health coverages include a conversion privilege EXCEPT:A) Accidental death and dismemberment.B) Disability income.C) Comprehensive medical expense.D) Basic medical expense.
    A) Accidental death and dismemberment.
  12. Suppose an employee recently has been divorced. His 56-year-old spouse wants to know if she can maintain coverage under the employee's group medical insurance plan. Which of the following statements best describes how this situation might be treated?A) She would no longer qualify for coverage under the employee's group medical plan because she no longer is a dependent.B) She would be able to qualify for coverage under an individual policy, provided she submits to individual underwriting and pays a premium commensurate with her risk.C) She would be able to continue coverage until age 65 by paying up to 102% of the premium required for the group coverage.D) She would be able to continue coverage, for up to 3 years, by paying up to 102% of the premium required for the group coverage.
    D) She would be able to continue coverage, for up to 3 years, by paying up to 102% of the premium required for the group coverage.
  13. Which one of the following statements about the Consolidated Omnibus Budget Reconciliation Act of 1985 is NOT correct?A) The terminated employee must pay the group premium to the insurer within a 60-day grace period.B) The employer must provide the terminated employee with a 60-day period in which to exercise any option under COBRA.C) The maximum duration of coverage for a deceased employee's dependents is 36 months.D) COBRA legislation does not apply if the employer has fewer than 20 employees.
    A) The terminated employee must pay the group premium to the insurer within a 60-day grace period.
  14. Under COBRA regulations, which of the following statements regarding coverage of a spouse after divorce from an insured employee is CORRECT?A) The divorced spouse's coverage can be converted to an individual policy.B) The divorced spouse's coverage can be continued with an increase in coinsurance and deductible.C) The divorced spouse's coverage can be continued with identical benefits for a specified period.D) All coverage ends at the time of the divorce.
    C) The divorced spouse's coverage can be continued with identical benefits for a specified period.
  15. Individual health insurance policies are typically written on which basis?A) Participating.B) Experience rated.C) Claims rated.D) Nonparticipating.
    D) Nonparticipating.
  16. Lynn is insured under Medicare Part A and enters the hospital for surgery. Assuming that Lynn has not yet tapped into her lifetime reserve, what is the maximum number of days that Medicare will pay for her hospital bills?A) 120 days.B) 150 days.C) 60 days.D) 90 days.
    B) 150 days.
  17. Which of the following statements regarding the lifetime reserve of hospital coverage for Medicare patients is CORRECT?A) The reserve does not renew with a new benefit period.B) Tapping into the reserve results in a lower daily copayment.C) The reserve may be replenished if the patient reenters a hospital after a benefit period ends and pays a new deductible.D) If a patient exhausts the reserve, he or she must pay a higher copayment.
    A) The reserve does not renew with a new benefit period.
  18. Tom is covered under Medicare Part A. He spends 1 week in the hospital for some minor surgery and returns home on July 10. It was his first hospital stay in years. Which of the following statements is CORRECT regarding his Medicare coverage?A) Medicare will not cover Tom's hospital expenses because he was not hospitalized for 10 consecutive days.B) Medicare will pay benefits, but Tom must make a daily copayment.C) After Tom pays the deductible, Medicare will pay 80% of all covered charges.D) After Tom pays the deductible, Medicare will pay 100% of all covered charges.
    D) After Tom pays the deductible, Medicare will pay 100% of all covered charges.
  19. Tom is covered under Medicare Part A. He spends 1 week in the hospital for some minor surgery and returns home on July 10. It was his first hospital stay in years. He pays his deductible and Medicare pays the balance. He is then admitted to the hospital again on November 1 of that same year, when he returns for more surgery. Which of the following statements is CORRECT?A) He will not have to pay the Part A deductible again.B) Tom will have to pay the Part A deductible again only if the second surgery is unrelated to the first surgery.C) He need not pay the Part A deductible, but must make a daily copayment.D) It will be considered the start of a new benefit period.
    D) It will be considered the start of a new benefit period.
  20. Many insurance policies contain a preexisting limitation that excludes coverage for unspecified conditions for how long?A) Three months.B) Nine months.C) One year.D) Six months.
    D) Six months.
  21. The Medicare Secondary Rule (which requires the private insurer to first pay benefits) does not apply to groups of fewer than ________persons. Therefore, it is likely that Medicare will pay benefits up to maximum eligibility. Thereafter, if the employee is covered under the group plan, that plan will then pay additional benefits.
    100
  22. To be eligible for Social Security disability benefits, one of the requirements is that the personA) be totally disabled for at least three months.B) be totally and permanently disabled for at least five months.C) be totally and permanently disabled for at least three months.D) be totally disabled for at least five months.
    B) be totally and permanently disabled for at least five months.
  23. Becky has the following unreimbursed medical expenses: $2,000 in premiums for group accidental death and dismemberment (AD&D) coverage, $500 in dental expenses, and $4,000 for other medical expenses and prescription drugs. If her adjusted gross income last year was $40,000, how much of the medical expenses can she take an income tax deduction for, if any?A) $500.00B) $1,500.00C) $3,500.00D) $6,500.00
    A) $500.00

    When determining the amount of tax deduction that can be taken for unreimbursed medical expenses, premiums paid for group AD&D coverage are not considered qualifying medical expenses. The deduction is limited to the amount exceeding 10% of Becky's adjusted gross income, which would be any amount over $4000 (10% of $40,000). Becky could therefore deduct $500 ($4,500 - $4000)
  24. Accurate Data Inc. pays $5,000 a year in premiums for a disability insurance policy covering its senior vice president, David Mills. If David later becomes disabled and receives the monthly benefits under the policy:A) David will not have to pay income and FICA tax on the benefits received.B) Accurate Data cannot take a tax deduction for the premiums paid.C) David must pay income and FICA tax on the benefits received.D) Accurate Data must pay the income and FICA tax on the benefits received.
    C) David must pay income and FICA tax on the benefits received.

    If Accurate Data Inc. purchases a disability income policy on David Mills, who receives the monthly benefits upon becoming disabled, David must pay income and FICA tax on the benefits received (note that it is David who is receiving the benefits, not Accurate Data Inc.). However, Accurate Data can take a deduction for the premiums paid.
  25. If the Commissioner believes a producer has engaged in an unfair trade practice, she will issue a notice of hearing to investigate the charges. The hearing must occur no sooner than how many days following the notice?A) 30 days.B) 21 days.C) 10 days.D) 14 days.
    B) 21 days.
  26. How long does an insurance producer license remain valid after it is issued?A) Two years from date of issue.B) Four years from date of issue.C) Three years from date of issue.D) One year from date of issue.
    C) Three years from date of issue.
  27. A producer who has been found guilty of reporting with malice in a court of law may be fined up to how much?A) $10,000.00B) $5,000.00C) $1,000.00D) $7,500.00
    B) $5,000.00
  28. If a producer is convicted of not paying premiums held for an insurer who is entitled to them and who has requested their transmission, that producer is guilty of:A) larceny.B) fraud.C) misrepresentation.D) defamation.
    larceny
  29. An insurer who is terminating a business relationship with a producer must notify the Commissioner within how many days of the termination?A) 60 days.B) 30 days.C) 10 days.D) 45 days.
    30
  30. How many hours of continuing education must a licensed producer complete during the first three-year renewal period?A) 60 hours.B) 30 hours.C) 45 hours.D) None.
    A) 60 hours.
  31. What is the MAXIMUM fine imposed on a producer who commits an unfair trade practice?A) $100.00B) $500.00C) $5,000.00D) $1,000.00
    D) $1,000.00
  32. A producer who knowingly obtains payment of a policy premium through fraudulent representations may be punished in all of the following ways EXCEPT:A) a fine of at least $100.B) a fine of not more than $1,000.C) imprisonment for up to 6 months.D) 30 hours of community service.
    D) 30 hours of community service.
  33. A producer must report to the commissioner any administrative action taken against him within how many days of the final disposition of the matter?A) 30 days.B) 15 days.C) 60 days.D) 90 days.
    A) 30 days.
  34. A producer who willfully makes a false statement of any material fact or matter in a sworn statement concerning the death or disability of a policyowner in order to obtain a benefit is guilty of:A) defamation.B) larceny.C) coercion.D) perjury.
    D) perjury.
  35. The term of a temporary producer license is how long?A) 30 days.B) 60 days.C) 90 days.D) 180 days.
    D) 180 days.
  36. How many hours of continuing education must licensees complete during the second and every subsequent 36-month period after licensure?A) 60 hours.B) 45 hours.C) 15 hours.D) 30 hours.
    B) 45 hours.
  37. An insurance company that is authorized to transact insurance in Massachusetts is most commonly referred to as a(n):A) endorsed company.B) admitted company.C) licensed company.D) certified company.
    B) admitted company.
  38. The policy loan provision for variable live insurance policies delivered in Massachusetts must:A) provide for credit on loaned amounts at a rate equal to the loan interest rate less 3%.B) provide for credit on loaned amounts at a rate at least equal to the loan interest rate less 1%.C) provide for credit on loaned amounts at a rate at least equal to the loan interest rate less 2%.D) provide for credit on loaned amounts at a rate equal to the loan interest rate.
    C) provide for credit on loaned amounts at a rate at least equal to the loan interest rate less 2%.
  39. If an employee, covered through a group plan, loses employment because of a plant closing, for how long will he remain covered under that plan?A) 60 days.B) 90 days.C) 10 days.D) 30 days.
    B) 90 days.
  40. Which of the following statements regarding the issue of accident and health insurance policies in Massachusetts is CORRECT?A) A premium is required with the application.B) An agent must identify herself as an agent of the insurance company at the time of delivery.C) The insurer must explain that the purchaser has 90 days during which to mail in the first premium.D) An appropriate disclosure form is required.
    D) An appropriate disclosure form is required.
  41. A health plan that provides coverage for the treatment of alcoholism must cover how many days of inpatient care?A) 15 days.B) 60 days.C) 30 days.D) 7 days.
    C) 30 days
  42. Medicare supplement insurance policies must give the insured the right to examine the policy for at least:A) 7 days.B) 45 days.C) 60 days.D) 30 days.
    D) 30 days.
  43. The minimum loss ratio for Medicare supplement policies is ____%.
    65%
  44. To qualify for the MassHealth exemptions, long-term care policies may include an elimination period not to exceed:A) 200 days.B) 365 days.C) 100 days.D) 180 days.
    B) 365 days.
  45. Which of the following organizations reimburses its insureds for covered medical expenses? A)Blue Cross/Blue Shield. B)Preferred provider organizations. C)Commercial insurers. D)Health maintenance organizations.
    Commercial insurers.
  46. Claire's employer is self-insured and establishes an exclusive provider organization (EPO) in town. When Claire goes to the doctor, which of the following is most likely to happen? A)She will have a deductible and will need to pay coinsurance. B)Her care will be provided through a nationwide network of HMOs. C)All of her expenses will be covered if she uses a physician who is approved under the plan. D)All her outpatient expenses will be covered, but hospital costs will be covered on a per diem basis.
    She will have a deductible and will need to pay coinsurance.
  47. With respect to dental insurance, another name for a capitation plan is a(n): A)exclusive provider organization. B)dental health maintenance organization. C)preferred provider organization. D)indemnity plan.
    dental health maintenance organization.
  48. A master policy is issued with each of the following forms of insurance EXCEPT: A)blanket health insurance. B)group major medical insurance. C)franchise insurance. D)group disability income insurance.
    franchise insurance.
  49. When refusing to renew a plan, the insurer must provide at least ___ days' advance notice of its intent not to renew.
    50
  50. In reinsurance, the insurance company that transfers part of a risk it underwrites to another insurer is called the: A)ceding insurer. B)reinsurer. C)retroceding company. D)assuming insurer.
    A)ceding insurer.
  51. Except for direct response insurers, companies must deliver a Buyer's Guide to all prospective buyers:A) before the agent commences a sales presentation.B) before accepting an initial premium or premium deposit.C) at the time of policy delivery.D) before the signing of the application.
    B) before accepting an initial premium or premium deposit.
  52. All of the following descriptions of buy-sell plans in close corporations are correct EXCEPT:A) Like a partnership, a corporation ceases to exist after the death of one of its owners. It is not necessary to make an agreement to dispose of a deceased stockholder's interests.B) A corporation has a stock redemption plan for its officers, all stockholder-employees. The total stock is valued at $600,000 and held equally by the three officers. A $200,000 policy will be purchased by the corporation on each of its three officers.C) A close corporation that has four stockholder-employees plans to set up an insured buy-sell agreement. A stock redemption plan will require fewer policies than a cross-purchase plan.D) A corporation has an insured cross-purchase buy-sell plan agreed to by the corporate president and vice president, the two owners. The president and vice president own and pay the premiums for the life insurance policies in the plan.
    A) Like a partnership, a corporation ceases to exist after the death of one of its owners. It is not necessary to make an agreement to dispose of a deceased stockholder's interests.
  53. Three equal partners in a business worth $600,000 decide to set up an insured cross-purchase buy-sell agreement. How large a policy would each partner buy to insure the lives of the other partners?A) $200,000.00B) $50,000.00C) $150,000.00D) $100,000.00
    D) $100,000.00

    Each partner's share of the $600,000 business equals $200,000. Thus, if each partner were to purchase a $100,000 policy covering the lives of the other two, the benefits payable at the death of a partner--a total of $200,000--would enable the two survivors to purchase the deceased's interest in full and retain an equal partnership basis.
  54. Sam applied for a term life insurance policy, paid the initial premium, and received a conditional receipt on December 1. If the insurer issued the policy on January 1 and the agent delivered the policy on January 3, the policy effective date will be:A) December 1.B) when the policy is delivered and a statement of continued good health is obtained.C) January 3.D) January 1.
    A) December 1.
  55. The best reason for designating a trust as a life insurance policy beneficiary is to:A) make it possible to manage the policy proceeds for the long-term benefit of an individual or organization.B) make it possible to benefit an individual or organization that might have otherwise been ineligible to be a designated beneficiary.C) make it possible to accumulate income tax-free interest on the policy proceeds once paid into the trust.D) remove the policy proceeds from the insured's taxable estate.
    A) make it possible to manage the policy proceeds for the long-term benefit of an individual or organization.
  56. Hazel, Philip, and Anita are equal partners in a partnership worth $150,000. They decide to arrange an insured cross-purchase buy-sell agreement. Which of the following statements pertaining to this arrangement is CORRECT?A) If Hazel dies, Philip and Anita will each have a partnership interest of $50,000.B) Each individual partner must purchase and maintain a $50,000 policy on each of the other partner's lives.C) Hazel will purchase and maintain a $25,000 life insurance policy each on the lives of Philip and Anita.D) The partnership will purchase and maintain a $50,000 policy on each of the partner's lives.
    C) Hazel will purchase and maintain a $25,000 life insurance policy each on the lives of Philip and Anita.
  57. Which of the following statements pertaining to deferred compensation plans is CORRECT?A) A deferred compensation arrangement is a non-qualified plan funded by the employer.B) A deferred compensation arrangement is a qualified plan funded by the employer.C) A deferred compensation arrangement is a qualified plan funded by the employee.D) A deferred compensation arrangement is a non-qualified plan funded by the employee.
    D) A deferred compensation arrangement is a non-qualified plan funded by the employee.
  58. All of the following statements regarding nonqualified deferred compensation plans are correct EXCEPT:A) a deferred compensation plan is an unsecured promise made by an employer to pay an employee part of the employee's compensation in the future.B) most deferred compensation plans are unfunded.C) under a nonqualified deferred compensation plan, an employee can rely on guaranteed future benefits.D) the employer receives no tax deduction for the amount of the compensation deferred until the compensation is actually distributed.
    C) under a nonqualified deferred compensation plan, an employee can rely on guaranteed future benefits.
  59. Regarding the Life Insurance Surrender Cost Index, a low index figure represents a relatively:A) high cash surrender value at the end of the designated period.B) high policy cost in the event of policy surrender value at the end of the designated period.C) low cash surrender value at the end of the designated period.D) low policy cost in the event of policy surrender at the end of a designated period.
    D) low policy cost in the event of policy surrender at the end of a designated period
  60. Since only the insurer prepares the insurance contract, it is called a contract of:A) condition.B) estoppel.C) unilateral terms.D) adhesion.
    D) adhesion.
  61. A company with three partners is considering a buy-sell plan. All of the following statements pertaining to buy-sell plans and this partnership are correct EXCEPT:A) no benefits will accrue to the partnership from the buy-sell agreement until one of the partners dies.B) an insured entity buy-sell agreement designates the partnership as the beneficiary.C) if they choose a cross-purchase plan, each partner would have to purchase two policies for a total of six plans.D) if they choose an entity buy-sell agreement, the business would be party to the agreement.
    B) an insured entity buy-sell agreement designates the partnership as the beneficiary.
  62. All of the following statements about a modified whole life policy are correct EXCEPT:A) the premium-paying period continues to age 100.B) it is basically an endowment policy.C) cash value builds until the insured reaches age 100 so long as the policy is in force.D) premiums are uniformly lower during the early years of the contract.
    B) it is basically an endowment policy.
  63. Which of the following statements regarding experience versus community rating by group health insurance plans is CORRECT?A) Experience rating is based on past and projected medical costs of the group.B) Community rating is more cost effective and competitive.C) Premiums for group insurance are typically not based on experience rating.D) Community rating takes the group's previous claims experience into account.
    A) Experience rating is based on past and projected medical costs of the group.
  64. Persons who are otherwise considered unacceptable health insurance risks can obtain coverage if an insurer issues a policy with a(n)A) Waiver of impairments rider.B) Nondisabling injury rider.C) Multiple indemnity rider.D) Optional exclusion rider.
    A) Waiver of impairments rider.
  65. Which of the following statements pertaining to limited pay life policies is CORRECT?A) The total premium cost for a single-premium life policy is more than the total premium cost for a policy with premiums spread over a period of years.B) A limited pay life policyowner pays premium of variable amounts during the life of the policy.C) Insurance protection exists only during the time premiums are actually paid.D) Both limited pay life and whole life policies endow at age 100.
    D) Both limited pay life and whole life policies endow at age 100.
  66. An impaired insurer is a company that:A) is not authorized to do business in the state.B) has only interim agents and apprentice brokers in its marketing force.C) has products which are not competitive in the state.D) is potentially unable to fulfill its contractual obligations.
    D) is potentially unable to fulfill its contractual obligations.
  67. What is the initial period of time specified in a disability income policy that must pass, after a policy is in force, before a loss due to sickness can be covered?A) Temporary interval.B) Elimination period.C) Probationary period.D) Preexisting term.
    C) Probationary period
  68. Which of the following terms relates to disability income insurance?A) Service basis.B) Residual basis.C) Coinsurance.D) First dollar.
    B) Residual basis.
  69. Mary has lost both legs as the result of complications caused by diabetes. Previously a horse trainer, she has taken a position as a computer programmer. Nonetheless, her insurance company pays her benefits under her disability income insurance policy under which of the following provisions?A) The partial disability provision.B) The presumptive disability provision.C) The flat amount benefit provision.D) The own occupation provision.
    B) The presumptive disability provision.
  70. The probationary period in disability income policies usually lasts:
    C) two weeks to one month.
  71. Benefit periods for short-term disability income policies typically vary from:A) one to five years.B) six months to two years.C) three months to three years.D) one to 12 months.
    B) six months to two years.
  72. What disability policy can be used to fund buy-sell agreements between partners or stockholders in a closely held corporation?A) Business overhead expense policy.B) Key-person disability policy.C) Long-term care disability policy.D) Disability buy-out policy.
    D) Disability buy-out policy.
  73. Which kind of insurance company is owned by individuals who buy shares but are not entitled to receive policy dividends? A)Reciprocal insurance company. B)Fraternal insurance company. C)Stock insurance company. D)Mutual insurance company.
    C)Stock insurance company.
  74. Which of the following statements regarding representations is CORRECT? A)Only written statements are considered representations. B)If a representation is false on a material point, the insurer may alter the contract but may not rescind it. C)A representation is guaranteed to be true. D)A representation may not be altered after the insurance is in effect.
    D)A representation may not be altered after the insurance is in effect.
  75. If an insurance producer violates any section of the insurance code, what can the Commissioner issue to stop the producer from committing the violation? A)Notice of a hearing. B)Notice of violation. C)Suspension order. D)Cease and desist order.
    D)Cease and desist order.
  76. A group of individuals who agree to share each others' losses is known as:A) a mixed group.B) a reinsurer.C) a reciprocal exchange.D) a service organization.
    C) a reciprocal exchange.
  77. Which of the following would not be required of a producer who wants to sell variable annuities?A) Successfully passing the required exams.B) Registration with the National Association of Insurance and Financial Advisors.C) Having a valid producer life insurance license.D) Registration with the Financial Industry Regulatory Authority.
    B) Registration with the National Association of Insurance and Financial Advisors.
  78. Which of the following period certain income options would call for the highest payment rate per $1,000 of life policy proceeds?A) 15-year period certain.B) 10-year period certain.C) 20-year period certain.D) 5-year period certain.
    D) 5-year period certain.
  79. The risk that involves the chance of both loss and gain is:A) impure risk.B) whole risk.C) pure risk.D) speculative risk.
    D) speculative risk
  80. Concerning Mutual Insurers, which of the following is a CORRECT statement?A) Policyholders participate in dividends.B) In a mutual company, there are stockholders.C) In a mutual company, there are shareholders.D) Mutual companies are sometimes referred to as non-participating companies.
    A) Policyholders participate in dividends.
  81. Regular notices sent to policyowners for payment of their life insurance policy premiums reflect:A) net level premium.B) gross single premium.C) gross premium.D) net single premium.
    C) gross premium.
  82. All of the following statements about mutual insurance companies are correct EXCEPT:A) they are unincorporated.B) they do not have capital stock.C) they charge a fixed premium.D) they must maintain the same reserves as a stock company.
    A) they are unincorporated.
  83. Doreen is appointed by an insurance company to transact insurance on its behalf. She collects her clients premiums and has them sign paperwork. By what authority can she do so?A) Apparent.B) Express.C) Fiduciary.D) Implied.
    D) Implied.
  84. A person authorized by an agent or broker to solicit insurance applications and collect premiums is called a(n):A) adjutant agent.B) auxiliary broker.C) solicitor.D) adjuster.
    C) solicitor.
  85. Under HIPAA regulations, a health insurer can refuse to renew coverage for all of the following reasons EXCEPT:A) the employer failed to pay premiums in a timely manner.B) the employer required new group members to wait 6 months before entry to the plan based on pre-existing conditions.C) the employer denied an employee's entry into the plan based on evidence of uninsurability.D) the employer excluded certain group members in a contributory plan.
    B) the employer required new group members to wait 6 months before entry to the plan based on pre-existing conditions.
  86. Medicare supplement (Medigap) policies are designed to pay:A) most or all of Medicare's deductibles.B) benefits provided under Medicare Part A.C) medical costs associated with extended custodial (nursing home) care.D) benefits to those who cannot afford Medicare Part B coverage.
    A) most or all of Medicare's deductibles
  87. For how many days of care in a skilled nursing facility will Medicare pay benefits?A) 100 days.B) 60 days.C) 75 days.D) 20 days.
    A) 100 days
  88. None of the following can be considered qualifying expenses for purposes of determining an individual's medical tax deduction EXCEPT:A) premium contributions paid by an employer to a group medical expense plan.B) premium contributions paid by an individual to a group disability plan.C) premium contributions paid by an employer to a group disability plan.D) premium contributions paid by an individual to a group medical expense plan
    B) premium contributions paid by an individual to a group disability plan.
  89. A health insurance plan would require the naming of a beneficiary in order to:A) indicate who is to receive benefits if the insured becomes disabled.B) identify supplemental assets upon the termination of benefits.C) reallocate unused funds in a medical savings account (MSA) or health savings account (HSA).D) identify the recipient of the Social Security death benefit.
    C) reallocate unused funds in a medical savings account (MSA) or health savings account (HSA).
  90. Lisa is in the hospital awaiting surgery. The doctors meet in the morning to discuss the best way to proceed as a routine procedure in their PPO. This is an example of:A) provider credentialing.B) retrospective review.C) gatekeeping.D) concurrent review.
    D) concurrent review.
  91. Which of the following accurately describes the service approach used by Blue Cross and Blue Shield?A) Blue Cross and Blue Shield are for-profit organizations run by insurance companies.B) Both Blue Cross and Blue Shield plans do not reimburse for covered expenses, but pay health care providers directly.C) Blue Shield plans provide prepayment coverage for hospital expenses; Blue Cross plans provide prepayment coverage for medical and surgical services.D) Both Blue Cross and Blue Shield reimburse their subscribers for covered medical and hospital expenses.
    B) Both Blue Cross and Blue Shield plans do not reimburse for covered expenses, but pay health care providers directly.
  92. Credit health insurance:A) provides payments on loans if the debtor dies.B) covers both debtors and creditors.C) provides payments on loans that become due while the debtor is disabled.D) covers creditors only.
    C) provides payments on loans that become due while the debtor is disabled.

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