OHIO LIFE AND HEALTH INSURANCE LATEST 2025 EXAM COMPREHENSIVE QUESTIONS WITH 100_ VERIFIED, Exams of Health sciences

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OHIO LIFE AND HEALTH INSURANCE

2025 EXAM COMPREHENSIVE

QUESTIONS WITH 100% VERIFIED

SOLUTIONS- GRADED A+

According to the law of large numbers, how would losses be affected if the number of similar insured units increases? Predictability of losses will be improved Which of the following can be defined as "the potential for loss"? Risk An insurer has a contractual agreement which transfers a portion of its risk exposure to another insurer. What type of contractual arrangement is this? Reinsurance contract Which of these statements regarding insurance is false? As the number of insured units increases, the number of losses decreases The powers directly given to an agent in an agency contract are called express Which of these is true regarding the exchange of consideration among parties involved in an insurance contract? Can be unequal What is the reason that insurance companies require a minimum number of employees participating in a group insurance plan? Adverse selection is minimized What type of policy can group term life insurance normally be converted to? An individual permanent life insurance policy Any employee insured under a group life insurance plan is normally protected by term life insurance Which of these is NOT relevant when determining the amount of personal life insurance needed? Local unemployment rates What is considered a valid reason for small businesses to insure the lives of its major shareholders? Fund a buy-sell agreement Employers often purchase life insurance on a key employee in order to help offset the cost of finding and training a replacement if the employee dies Which of the following is NOT considered to be an expense for surviving family members of a deceased wage earner? Unemployment tax expenses

Life insurance premiums are based on what three factors? Mortality, interest, expenses Which settlement option makes minimum guaranteed dollar payments over a stated number of years? Fixed-Period Which life insurance settlement option pays lifetime benefits to two or more people? Joint and survivor What is considered a valid reason for an insurer's refusal to pay policy proceeds directly to a minor? Minors are normally not capable of handling money in a reasonable manner Which statement regarding the life insurance premium for a children's term rider is true? Premium remains the same no matter how many children A life insurance policy provision that has the potential to reduce the death benefit is called the accelerated (living) benefit Which statement regarding the waiver of premium rider is accurate? Cash payment is not directly provided to the policyowner How long can an insurer legally defer paying the cash value of a surrendered life insurance policy? 6 months Which of these would NOT be a valid reason to add the waiver of premium rider to a life insurance policy? Allows a policyowner to take out a policy loan to cover premium payments in the event of total disability A life insurance policy that includes a return of premium rider will pay the beneficiary how much upon the insured's death? Total premiums paid plus the policy face amount Which life insurance policy option allows the policyowner to have coverage equal to the net death benefit of the lapsed policy? Extended term nonforfeiture option A policyowner has a life insurance policy where she had listed her age on the application as 5 years younger than her actual age. If she dies and the insurer discovers the misstatement of age, how much will the insurance company pay? Less than the face amount What happens to the death benefit of a life insurance policy if the insured elects a partial payment from the accelerated (living) benefit provision?

Reduced The absolute assignment of a life insurance policy results in the assignee receives all incidents of ownership Which of the following is NOT subject to the promise to pay in an insuring clause? How the premium is calculated A life insurance policyowner would like a dividend option that results in a limited current outlay of funds. Which dividend option would be chosen? Reduction of premium payment What kind of life policy typically offers mortgage protection? Decreasing term When would evidence of insurability be required for a person already covered with a variable universal life policy? The death benefit is increased A survivorship life insurance policy usually covers how many lives? 2 At what point are death proceeds paid in a joint life insurance policy? When the first insured dies What kind of life insurance policy allows a policyowner the choice of investments along with flexible premium payments? Variable universal life All of these statements concerning group credit life insurance are false EXCEPT The face amount is determined by the outstanding loan balance Which statement concerning an adjustable life insurance policy is FALSE? Evidence of insurability is required when there is a change in premium An advantage of owning a flexible premium life insurance policy would be The policyowner can make policy changes without difficulty The insurance coverage in a variable life insurance policy may vary based on the value of its underlying investments Which of these is NOT an allowable deduction made from premium payments of the cash value of a variable life insurance policy?

Employer contributions are deductible An accident and health insurance policy defines an injury as "bodily injury by accidental means". For an injury to be covered on this policy, what is required? Both the cause and resultant injury must be accidental Pete is covered by a group health insurance plan which covers employees in multiple states. This plan is governed by the laws of which state? Where the master contract was issued Trade association groups that are eligible for group medical benefits normally are in the same industry Bert's spouse passed away recently. Bert was covered under his spouse's group family health insurance plan but now is covered under COBRA. How much of the active-employee cost may be passed on to Bert for continued coverage? Maximum of 102% What type of employee welfare plans are not subject to ERISA regulations? Church plans In regards to health insurance, employees age 65 or older are typically required to be offered the same group health benefits offered to the younger employees ABC Partnership is a business with a limited number of partners. Which disability buy-sell agreement is best suited for this business? Cross purchase agreement Individuals covered with employer-paid group health plans will normally receive tax-free benefits under all of these plans EXCEPT Disability income How are benefit payments from individually-owned medical expense policies treated for tax purposes? Exempt from income taxes Mary is the sole proprietor of her business and has a family health plan. She would like to deduct the premiums from her taxes. What percentage of her premiums are tax deductible? 100%

Which of the following situations would a medical exam NOT be required for an individual health insurance applicant? Applicant's family members have a history of cancer The disability income policy most likely to have been issued on a substandard basis is Non-cancelable with a health condition exclusion rider Which of the following is NOT a basic underwriting action for accident and health insurance? Removing uniform policy provisions Which of these noncontributory group plans would a claim likely result in the payment of federal income taxes? Disability income An applicant for accident and health insurance has a risk factor that is similar to a majority of the insurer's other applicants. What will be the likely outcome of this applicant? Issued with a standard premium rate Which of the following are used by most insurers when determining the premiums for large groups? Experience rating Which individual would be best suited for Medicare Supplement insurance? Medicare enrollee Terry receives long-term physical therapy at her residence. What type of insurance would cover this service? Home health care Mary has a Health Savings Account (HSA). Distributions that have been made for anything other than qualified medical expenses are considered taxable and subject to a penalty of 20% Which of these statements regarding Major Medical Expense insurance is NOT true? Benefits are paid on a capitation basis Major Medical policies are typically characterized by which of the following? Flat deductible

To resolve written grievances received, each HIC specialty plan must establish a complaint system The main purpose of an Ohio health insuring corporation (HIC) solicitation document is to provide a detailed medical plan description All of the following statements about HICs are true EXCEPT: Benefits are usually provided on a reimbursement basis In Ohio, health insuring corporation (HIC) complaint responses must include a notice of the right to appeal the HIC's decision to The HIC's complaint system administrator What action can an insurer take to discourage malingering and false disability claims? When an insured has two disability policies with the same insurer, the insurer sets limits on the amount of benefits an insured can collect Which of the following is NOT true of a preferred provider plan? Hospitals can only initiate preferred provider plans The courts will normally interpret a policy in favor of the insured when the meaning of the policy is not clear. This is because an insurance policy is a(n) contract of adhesion A group-owned insurance company that is formed to assume and spread the liability risks of its members is known as a(n) risk retention group Which of the following does medical expense insurance NOT typically cover? Treatment in a government facility An enrollee in an HIC may have her coverage cancelled for all of the following reasons EXCEPT excessive illnesses If an agent misleads or fails to adequately disclose the title and true nature of a policy offered to a potential insured, it may be considered Misrepresentation In Ohio, what must an HIC establish and maintain to provide reasonable procedures for the resolution of written complaints initiated by subscribers concerning services provided? complaint system With whom may the subscriber of an HIC file an appeal regarding the resolution of a complaint concerning services provided?

Peer Review Committee A Keogh plan is a(n) qualified retirement plan for the self employed Tori has an annuity that pays her a $500 per month income benefit for life or for ten years, whichever is longer. What kind of annuity is this? Fixed life annuity with period certain What is covered under a limited accident and health insurance policy? Limited perils and amounts Kyle is an insured who disregarded an accident and health insurance policy provision that requires him to seek a second surgical opinion. What will the end result be? He may be reimbursed for the surgical procedure at a reduced benefit level Some standard Medicare Supplement policies include which benefit? Hospice care Which of the following best describes the tax treatment of medical expense policies for the selfemployed? 100% of medical expense plan premiums are tax deductible In long-term care insurance, what is the length of time for which claims will be paid? Benefit period Assets that back the non-guaranteed values of variable life insurance products are held in which account? Separate account set up by the insurer Which of the following is a syndicate established by a group of insurers to share underwriting duties? Lloyd's organization When a ten-year renewable term life insurance policy issued at age 45 is renewed, the premium rate will be the current rate for

When group benefits under COBRA have expired, a fully insured group policy can be converted to a(n) individual health policy Mary is an employee who is covered with a disability income policy through her employer. She pays for the portion of the premium attributable to the cost of residual disability benefits, while her employer pays for the remainder. What are the tax implications of this policy? Residual benefits will be received income tax-free The major medical deductible carryover period normally applies to expenses incurred during the last ___ months of the plan year. 3 How does an underwriter take into account an applicant's marital status? When determining who is eligible for dependent coverage Andy is in need of health care performed by skilled medical practitioners, but only on an intermittent basis. What level of care will his doctor likely prescribe? Intermediate care Which of the following statements regarding hospital pre-admission authorization is NOT true? It encourages weekend admission ABC Corporation purchases and is beneficiary of an individual disability income insurance policy on a key employee. Which of the following statements is true? Benefits are received tax-free by the company Patrick purchased a long-term care policy. He has a health condition for which medical treatment was recommended by a physician within 6 months prior to the policy's effective date. This condition is called a(n) pre-existing condition Christopher is issued an insurance policy that contains an attached agreement which alters the terms of the policy. This attached agreement is called a(n) endorsement An employer pays the accident and health insurance premiums for its employees. The premiums paid by the employer are deductible to the business Which of the following is a true statement regarding a Medicare Supplement policy purchased during the open enrollment period? The policy will be issued regardless of health Which of the following describes the act of insuring a risk against possible loss? Risk transfer

An agreement is reached when an insurance contract is formed. Which of the following is NOT considered to be an element of an agreement? Equity An insured, age 67, is covered under a disability income policy. What will the insurer require in order for the insured to continue coverage? The insured must work for a stated number of hours per week Under an adjustable life insurance policy, which of the following may NOT be changed without further underwriting? The person insured According to the IRS, a company may NOT do which of the following in regards to funds in a qualified retirement plan? Repossess the funds for business purposes Which of the following is NOT a dividend option for a life insurance policy? Surrender the policy's cash value A life insurance beneficiary died after receiving only six payments under the policy's life income settlement option. What happens with the remaining balance of the death proceeds? Kept by the insurance company