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An insured has a stop-loss limit of $5,000, a deductible of $500, and an 80/20 coinsurance. The insured incurs $25,000 of covered losses. How much will the insured have to pay? $ $5, $5, $5,600 - ✔✔$5, Which of these is NOT subject to income taxation under Modified Endowment Contract (MEC) Loan against the cash value Policy withdrawal Policy Dividend Death Benefit - ✔✔Death benefit An indemnity plan Pays both the insured and health care provider Provides the insured a specific dollar amount for services
Pays the health care provider directly for services rendered Is typically issued as a group plan - ✔✔provides the insured a specific dollar amount for services Chris is an insured bricklayer who severed his left hand in an automobile accident. Although his primary duty cannot be performed, Chris is also a substitute high school teacher. He collects a full disability income check every month. How does his policy define total disability? Recurrent Any occupation Own occupation Presumptive - ✔✔Own occupation A policyowner can receive an immediate payment before the insured dies by using a(n) viatical settlement contract buy-sell arrangement adhesion agreement spendthrift plan - ✔✔viatical settlement contract
Interest only - ✔✔Fixed amount Term insurance is appropriate for someone who Seeks living benefits for themselves Seeks a policy that builds cash value Seeks temporary protection and lower premiums Seeks permanent protection and higher premiums - ✔✔Seeks temporary protection and lower premiums Sole proprietors are permitted tax deductions for health cost paid from their earnings in the amount of cost that exceed 7 1/2 % of AGI cost that exceed 10% of AGI 100% of cost no deduction permitted - ✔✔ 100 % of cost If an agent is believed to be causing considerable harm, the superintendent may incarcerate the agent may suspend the agent's license without a hearing
may issue a cease and desist order against the agent may take away the agent's appointment - ✔✔may issue a cease and desist order against the agent A medical provider that accepts medicare assignment must - ✔✔accept payment based upon a defined medicare schedule as payment in full Under group health insurance, a certificate of coverage is issued to the employer employee producer sponsor - ✔✔employee A spouse and child can be added to the primary insured's coverage as what kind of rider? Dependent term Guaranteed insurability primary term family term - ✔✔Family term When a decreasing term policy is purchased, it contains a decreasing death benefit and
A beneficiary change can occur - ✔✔normally at any time during the policy term A life insurance applicant in Ohio may backdate the application for up to ___ month(s) - ✔✔ 3 Which of these is NOT a qualifying event for Medicare On Social Security disability for over 2 years- Kidney failure- Age 65 or older- Falling below the federal poverty level - ✔✔Falling below the federal poverty level An agent's license has been suspended for non-renewal. The agent may apply for reinstatement
- ✔✔the 12 month period following the date when the license should have been renewed Craig submits a $500 claim for medical expenses. With a past due premium of $100, the insurer pays $400. Which of the Uniform Optional Provisions covers this situation? - ✔✔Unpaid premium An insurance producer is often responsible for field underwriting during the application process. All of these are possible field underwriting roles EXCEPT - ✔✔providing commission information to the applicant An insurance company advertises an accident and health insurance product in a local Ohio newspaper and refers to dollar amount benefits. This insurer must also disclose which of the following in the advertisement? - ✔✔Any applicable benefit reduction A Renewable Term Life Insurance policy can be renewed - ✔✔at a predetermined date or age, regardless of the insured's health
As of January 1, 2014, an employer with up to 25 full time equivalent (FTE's) with average annual wages of less than $50,000 may be eligible for a tax credit of of the premiums paid by the employer. 30% 4 0% 50% 60% - ✔✔50% Respite care is able to provide: permanent relief to the patient's primary caregiver health care to the patient's primary caregiver weekly benefit payments to supplement the primary caregiver's income temporary relief to the patient's primary caregiver - ✔✔temporary relief to the patient's primary caregiver Jonas has disability insurance through his employer. The employer pays 75% of the premium, and Jonas pays the other 25%. What is Jonas's tax liability for any benefits paid from the disability plan? - ✔✔Taxes must be paid on 75% of the benefits received Which market index is normally associated with an indexed annuity's rate of return? - ✔✔S &P 500 Barbara's policy includes a rider which allows her to purchase additional insurance at specific dates or events without evidence of insurability. This rider is called a(n) - ✔✔Guaranteed insurability rider
A beneficiary has just received a claim payment fora life insurance policy. Which of the following is TRUE regarding the federal income tax liability owed? - ✔✔No federal income tax is owed on life insurance proceeds An order issued by the superintendent that prohibits practice listed in the order is called a(n) - ✔✔cease and desist order Pete the agent recently had his license suspended because he was found to be in violation of state insurance law. Due to this suspension, Pete - ✔✔may be assessed the administrative costs sustained by the department Bill requires some nursing care and supervision but NOT full-time care. Which of these nursing home options would best serve him? Nursing home Assisted living Congregate housing Custodial residence - ✔✔Assisted living A common exclusion with Vision plans is - ✔✔lasik surgery A limited payment whole life policy provides - ✔✔lifetime protection An insured has a health plan that pays established amounts in accordance with a lit of injuries, surgical procedures, or other losses. This list is called - ✔✔benefit schedule
The two major actions required for a policyholder to comply with the Reinstatement Clause are provide evidence of insurability, agree to a new incontestable period provide evidence of insurability, pay past due premiums pay past due premiums, agree to a new incontestable period pay past due premiums, agree to a reduction in coverage - ✔✔provide evidence of insurability, pay past due premiums Which of the following is considered to be an event or condition that increases the probability of an insured's loss? Risk Hazard Indemnity Peril - ✔✔Harzard A dread disease policy is considered to be a type of - ✔✔limited health insurance policy
Which situation would qualify an individual for receiving benefits from a qualified long-term care policy - ✔✔becoming cognitively impaired (mentally ill) The legal action provision in a health contract is limited to no more than years 2 3 4 5 - ✔✔ 5 years In an insurance contract, the applicant's "consideration" is the offer and acceptance premium only statements made in the application and the premium statements made in the application only - ✔✔statements made in the application and the premium When the principal gives the agent authority in writing, it's referred to as - ✔✔express authority Which of these is a TRUE statement regarding HIC's? - ✔✔HIC's operate on a prepayment basis An insurer can exclude coverage for a preexisting condition on a Medicare Supplement policy for up to - ✔✔6 months
Written notice for a health claim must be given to the insurer days after the occurrence of the loss. 10 20 31 60 - ✔✔ 20 A life insurance policyowner is allowed days upon policy delivery to return the policy for a full premium refund. 7 10 14 30 - ✔✔ 10 Which of the following decisions would a Health Savings Account (HSA) owner NOT be able to make? The amount contributed by the employer The amount contributed by the owner The underlying account investments used
What is the nonforfeiture value of an annuity before annuitization? - ✔✔All premiums paid, plus interest, minus any withdrawals and surrender charges. An advertisement for an insurance product may contain - ✔✔the insurer's name All of these statements concerning whole life insurance are false EXCEPT - ✔✔When a whole life policy is surrendered, income taxes may be owed All of these are responsibilities of the superintendent except - ✔✔Endorsing Insurers Pat owns a 20 - pay life policy with a paid-up dividend option. Which of the following statements is true? - ✔✔The policy may be paid up early by using policy dividends In what part of an insurance policy are policy benefits found? - ✔✔Declarations". Essentially, the insurance declaration page is like a quick guide to the insurance policy, providing all of the basic information the policyholder needs to know All of the following are examples of pure risk EXCEPT - ✔✔Losing money at a casino Which of the following is a requirement for ANY change in an insurance application? - ✔✔Change must be initialed by the applicant An insurance company has just received a request for verification from a viatical settlement provider. The insurer is required to respond within _ calendar days to this request. - ✔✔ 30
A life insurance policy that is subject to a contract interest rate is referred to as - ✔✔Universal Life Which of these is NOT a legal reason for an HIC to release a subscriber's confidential health information - ✔✔public interest How much does Medicare Part B pay for physician fees? - ✔✔ 80 % What type of injury would NOT be covered under a health insurance policy - ✔✔work related An employee has days after the day of marriage to add a new spouse to a small group plan
- ✔✔ 30 Which of the following is required for an insurer to conduct business in this state - ✔✔certificate of authority Bob and Tom start a business. Since each partner contributes an important element to the success of the business, they decide to take life insurance policies out on each other, and name each other as beneficiaries. Eventually, they retire and dissolve the business. Bob dies 12 months later. The policies continue in force with no change. Both partners are still married at the time of Bob's death. In this situation, who will receive Bob's policy proceeds? - ✔✔tom How many employees must an employer have for a terminated employee to be eligible for COBRA? - ✔✔ 20
during the last 6 months - ✔✔minus indebtedness and without interest The branch of dentistry which deals with the replacement of missing parts is called - ✔✔prosthodontics Which of the following statements regarding Group Disability Income insurance is TRUE? - ✔✔It provides benefits for nonoccupational illnesses and injuries All of the following plans allow for employee contributions to be taken on a pre-tax basis EXCEPT - ✔✔Health Reimbursement Arrangement Plan A group Disability Income plan that pays tax-free benefits to covered employees is considered - ✔✔Fully contributory The entire contract includes the actually policy and the - ✔✔application An individual most likely will have an insurable interest in insuring a person's life if - ✔✔an economic interest exists for the continuance of the insured's life Carole is a licensed agent who lives in Michigan and transacts insurance in Ohio. In Ohio, Carole is considered to be a(n) - ✔✔nonresident agent A nonparticipating company is sometimes called a(n) - ✔✔stock insurer
Which of the following does Coordination of Benefits allow? - ✔✔Coordination of benefits allows the secondary payor to reduce their benefit payments so that no more than 100% of the claim is paid When screening an applicant for HIV, the insurer - ✔✔may require a blood test for HIV A health care provider claim may be settled using which of the following payment methods - ✔✔fee-for-service Which of the following is NOT included under a health benefit plan? - ✔✔Hospital indemnity plan An agent's license may only be suspended or revoked if the agent - ✔✔has been afforded a right to a hearing Ohio requires that licensee complete hours of CE on the subject of ethics every reporting period. - ✔✔ 3 Which of the following is NOT typically included under "hospital care" for most health insuring corporation (HIC) plans - ✔✔Private Duty Nursing Under a non-qualified annuity, interest is taxed after the - ✔✔exclusion ratio has been calculated(The taxable and non-taxable portions of annuity payments are determined by the exclusion ratio.) Which of these do NOT provide primary care to HIC members - ✔✔surgeon
