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TN Health and Life Insurance Exam Questions and Answers Rated A+ 2025, Exams of Nursing

Florida State University (FSU)Nursing

TN Health and Life Insurance Exam Questions and Answers Rated A+ 2025

Typology: Exams

2024/2025

Available from 05/25/2025

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TN Health and Life Insurance Exam Questions and
Answers Rated A+ 2025
Which of the following reimburses its insureds for covered medical expenses?
- health maintenance organizations
- preferred provider organizations
- commercial insurers
- service providers -Answer✅ COMMERCIAL INSURERS
- Commercial insurance companies function on the reimbursement approach. Policyowners
obtain medical treatment from whatever source they feel is most appropriate and submit their
charges to their insurer for reimbursement
A business entity can be defined as a(n)
- agency that must only operate outside of TN
- agency that must only operate inside of TN
- association or a limited liability company
- business that requires approval by the Attorney General to transact business -Answer✅
ASSOCIATION OR A LIMITED LIABILITY COMPANY
- The definition of a business entity includes an association or limited liability company
Which of the following health insurance policy provisions specifies the health care services a
policy will provide?
- insuring clause
- usual, customary, and reasonable clause
- consideration clause
- benefit clause -Answer✅ INSURING CLAUSE
- The insuring clause identifies the specific type of health care services that are covered by that
policy
A Disability Income policy that only the policyowner can terminate and which the rates will
never go up is considered to be
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Download TN Health and Life Insurance Exam Questions and Answers Rated A+ 2025 and more Exams Nursing in PDF only on Docsity!

TN Health and Life Insurance Exam Questions and

Answers Rated A+ 2025

Which of the following reimburses its insureds for covered medical expenses?

  • health maintenance organizations
  • preferred provider organizations
  • commercial insurers
  • service providers - Answer✅ COMMERCIAL INSURERS
  • Commercial insurance companies function on the reimbursement approach. Policyowners obtain medical treatment from whatever source they feel is most appropriate and submit their charges to their insurer for reimbursement A business entity can be defined as a(n)
  • agency that must only operate outside of TN
  • agency that must only operate inside of TN
  • association or a limited liability company
  • business that requires approval by the Attorney General to transact business - Answer✅ ASSOCIATION OR A LIMITED LIABILITY COMPANY
  • The definition of a business entity includes an association or limited liability company Which of the following health insurance policy provisions specifies the health care services a policy will provide?
  • insuring clause
  • usual, customary, and reasonable clause
  • consideration clause
  • benefit clause - Answer✅ INSURING CLAUSE
  • The insuring clause identifies the specific type of health care services that are covered by that policy A Disability Income policy that only the policyowner can terminate and which the rates will never go up is considered to be
  • optionally renewable
  • noncancellable
  • cancellable
  • guaranteed renewable - Answer✅ NONCANCELLABLE
  • A disability income policy that only the policyowner can terminate and on which the rates will never increase is a noncancellable policy A producer may apply for one or more of the following licenses:
  • life insurance
  • personal lines property
  • accident and health or sickness insurance
  • all of the above - Answer✅ ALL OF THE ABOVE A provision in a life insurance policy that pays the policyowner an amount that does not surpass the guaranteed cash value is called the:
  • policy loan provision
  • automatic premium loan provision
  • accelerated benefits provision
  • consideration clause - Answer✅ POLICY LOAN PROVISION
  • a policy loan will pay the policyowner an amount that, with interest, does NOT exceed the guaranteed cash value Long Term Care policies will usually pay for eligible benefits using which of the following methods?
  • Delayed
  • fee for service
  • expense incurred
  • respite - Answer✅ EXPENSE INCURRED
  • Most long term care policies pay on a reimbursement (or expense-incurred) basis, up to policy limits

ONE PAYMENT PERIOD OF PURCHASE

  • an immediate annuity is designed to make its first benefit payment to the annuitant at one payment interval from the date of purchase A licensed producer can be BEST described as a(n)
  • someone who places insurance advertisements in a newspaper
  • underwriting officer of an insurance company
  • individual who places insurance on behalf of anyone seeking insurance
  • administrator answering calls for an insurance agency - Answer✅ INDIVIDUAL WHO PLACES INSURANCE ON BEHALF OF ANYONE SEEKING INSURANCE
  • A person who places insurance on behalf of anyone seeking insurance must be licensed as a producer What is the max fine that can be imposed by the Commissioner to a producer who violates an insurance law?
  • $250 per violation
  • $500 per violation
  • $1,000 per violation
  • no limit to the fine - Answer✅ $1,000 PER VIOLATION
  • If the Commissioner finds a producer to be in violation of insurance laws, the Commissioner may impose a fine of no more than $1000 per violation A father who dies within 3 years after purchasing a life insurance policy on his infant daughter can have the policy premiums waived under which provision?
  • Payor provision
  • accelerated benefits provision
  • assignment provision
  • waiver of premium provision - Answer✅ PAYOR PROVISION
  • periodical contributions begin immediately - Answer✅ BENEFIT PAYMENTS START WITHIN
  • a payor provision provides that in the event of death or disability of the adult premium payor, the premium on a juvenile policy will be waived until the insured child reaches a specified age or the maturity date of the contract Medicare part C is:
  • government insurance
  • available to those who are enrolled in a Medicare Supplement Plan with income under $12,000 per year
  • orginal part A and B medicare
  • available to those who are enrolled in Medicare Part A and Part B - Answer✅ AVAILABLE TO THOSE WHO ARE ENROLLED IN MEDICARE PART A AND PART B The Accelerated Death Benefit provision in a life insurance policy is also known as a(n):
  • 1035 exchange
  • inter vivos gift
  • non-forfeiture option
  • living benefit - Answer✅ LIVING BENEFIT
  • The accelerated death benefit provision in a life insurance policy is also known as a "living Benefit" J applies for an insurance policy. What BEST describes the particular terms of this policy?
  • AM best statement
  • policy summary
  • provisional page
  • buyers guide - Answer✅ POLICY SUMMARY
  • a policy summary describes the particular terms of the policy being applied for Which of the following consists of an offer, acceptance, and consideration?
  • warranty
  • estoppel

Who is normally considered to be the owner of a 403(b) tax-sheltered annuity?

  • the 403(b) custodian
  • the financial institution
  • the employer
  • the employee - Answer✅ THE EMPLOYEE
  • The participating employee normally applies for and owns a 403(b) tax-sheltered annuity The Automatic Premium Loan provision is designed to:
  • provide a source of revenue to the insurance company
  • avoid a policy lapse
  • allow a polocyowner to request a policy loan
  • allow a pollicyowner to take out additional coverage without evidence of insurability - Answer✅ AVOID A POLICY LAPSE
  • The purpose of the automatic premium loan is to keep the policy from lapsing An agent gives a conditional receipt to a client for an insurance policy after collecting the initial premium. When will the policy become effective?
  • when the policy is issued
  • the date of policy deliver
  • when the conditions of the receipt are met
  • the date the sales appointment was set - Answer✅ WHEN THE CONDITIONS OF THE RECEIPT ARE MET
  • A conditional receipt indicates that certain conditions must be met in order for the insurance coverage to go into effect T and S are named co-primary beneficiaries of a $500,000 Accidental Death and Dismemberment policy insuring their father. Their mother was name contingent beneficiary. Five years later, S dies of natural causes and the father is killed in a scuba accident shortly afterwards. How much of the death benefit will the mother receive?
  • $1,000,
  • $0 - Answer✅ $
  • The mother receives $0 because T is still alive and the sole primary beneficiary, while the mother is still the contingent beneficiary Q applied for life insurance and submitted the initial premium on Jan 1. The policy was issued Feb 1, but it was not delivered by the agent until Feb 7. Q is dissastisfied and return the policy on Feb 13. How will the insurer handle this situation?
  • Premium will be fully refunded minus a surrender charge
  • policy was not returned within the free-look period, premium will not be refunded
  • policy was returned within the free-look period, premium will be fully refunded
  • premium will be fully refunded minus a prorated amount for the period of Feb 7-Feb 13 - Answer✅ POLICY WAS RETURNED WITHIN THE FREE-LOOK PERIOD, PREMIUM WILL BE FULLY REFUNDED
  • free-look period begins when the policy is delivered to the policyowner After and inured gives notice of loss, what must he/she do if the insurer does not furnish forms?
  • file a lawsuit
  • contact the insurer again requesting forms
  • nothing
  • file written proof of loss - Answer✅ FILE WRITTEN PROOF OF LOSS
  • the insured may file written proof of loss in any form if the insurer does NOT furnish forms after the insured gives notice of loss How long is the typical free look period for long term care insurance policies?
  • 20 days
  • 30 days
  • 40 days
  • 50 days - Answer✅ 30 DAYS
  • provide proof of loss to an insurer within a specified time
  • notify an insurer of a claim within a specified time
  • wait 60 days after filing a claim to initiate a lawsuit against insurer
  • notify their physician of a claim within a specified time - Answer✅ NOTIFY AN INSURER OF A CLAIM WITHIN A SPECIFIED TIME Health insurance benefits NOT covered due to an act of war are:
  • excluded by the insurer in the contract provisions
  • assigned to a reinsurer
  • given a longer probationary period
  • charged a higher premium - Answer✅ EXCLUDED BY THE INSURER IN THE CONTRACT PROVISIOSNS
  • An exclusion is a provision that entirely eliminates coverage for a specified risk, such as an act of war or aviation In TN, the max fine that the Commissioner can impose on a producer is per violation
  • $
  • $
  • $
  • $2000 - Answer✅ $ Under the USA patriot act, insurers are required to report receipt of cash payments in excess of:
  • $10,
  • $7,
  • $5,
  • $2,500 - Answer✅ $10, When an insurance company sends a policy to the insured with an attached application, the element that makes the application part of the contract between the insured and the insurer is called the
  • Entire Contract Provision
  • Insuring clause
  • time limit on certain defense provision
  • legal contract clause - Answer✅ ENTIRE CONTRACT PROVISION An insurer must provide an insured with claim forms within days after receiving notice of a loss
  • 5
  • 10
  • 15
  • 20 - Answer✅ 15 All of these are considerd a producers breach of fiduciary duty EXCEPT
  • missapropration of premiums
  • conversion of premiums
  • improper withholding of premiums
  • allowing premiums to be submitted electronically - Answer✅ ALLOWING PREMIUMS TO BE SUBMITTED ELECTRONICALLY What determines the full amount of Social Security retirement benefits a qualified individual is entitled to receive?
  • Primary insurance amount (PIA)
  • total taxes paid into FICA
  • number of dependents
  • state of residence - Answer✅ PRIMARY INSURANCE AMOUNT (PIA)
  • the PIA determines the full amount of retirement benefits for an eligible person all of these settlement options involve the systematic liquidation of the death proceeds in the event of the insured's death, EXCEPT
  • fixed period
  • marital status
  • occupation - Answer✅ MARITAL STATUS With AD&D policies, what is the purpose of the Grace Period?
  • gives the policyowner additional time to pay overdue premiums
  • gives the policyowner additinal time to file a lawsuit
  • gives the policyowner additional time to file a claim
  • gives the policyowner additional time to provide proof of loss - Answer✅ GIVES THE POLICYOWNER ADDITIONAL TIME TO PAY OVERDUE PREMIUMS Which of the following is NOT a requirement to sell, solicit, or negotiate long-term care insurance?
  • be a licensed producer for life or health
  • complete a one-time 8 hours long-term care specific training course
  • complete 4 hours of long-term care continuing education
  • complete a one-time 4 hour course on estate planning - Answer✅ COMPLETE A ONE TIME 4 HOUR COURSE ON ESTATE PLANNING Which of these is a valid TN regulation for referral fees?
  • Referral fees can be unlimited in amount
  • if the referral sale involves replacement, the notice regarding replacement form is not required
  • referral fees may only be paid in the event a policy is purchased Which of the following are NOT managed care organizations?
  • POS
  • PPO
  • MIB
  • HMO - Answer✅ MIB (Medical information Bureau)
  • the commissioner may establish by rule a max amount for each referral - Answer✅ THE COMMISSIONER MAY ESTABLISH BY RULE A MAX AMOUNT FOR EACH REFERRAL

P is a producer who notices 5 questions of a life application were not answered. What actions should P take?

  • mail incomplete aplication to applicant to be completed and returned to the agent
  • submit the application as-is to the insurer
  • call the applicant and complete application over the phone
  • set up a meeting with the applicant to answer the remaining questions - Answer✅ SET UP A MEETING WITH THE APPLICANT TO ANSWER THE REMAINING QUESTIONS Which of these is an element of a Variable Life policy?
  • a fixed, level premium
  • insurer assumes the investment risk
  • no investment risk to policyowner
  • rate of returns are guaranteed - Answer✅ A FIXED LEVEL PREMIUM The AD&D provision in a life insurance policy would pay additional benefits if the insured:
  • dies of natural causes
  • becomes critically ill
  • becomes chronically ill
  • is blinded in an accident - Answer✅ IS BLINDED IN A ACCIDENT Which of these is NOT a type of agent authority?
  • express
  • implied
  • principal
  • apparent - Answer✅ PRINCIPAL
  • agent authority is what an agent is authorized to do on behalf of their company. the 3 types of agent authority include express, implied, and apparent authority

Which of the following life insurance policies combine term insurance with an investment element?

  • Increasing term life
  • Decreasing term life
  • universal life
  • graded life - Answer✅ UNIVERSAL LIFE
  • A universal life policy combines term insurance and an investment element Which of the following is the reimbursement of benefits for the treatment of beneficiary's injuries caused by a third party?
  • indemnity
  • subrogation
  • legal action
  • consideration - Answer✅ SUBROGATION According to the mandatory uniform policy provisions, what is the max amount of time after the premium due date during which the policy remains in force even though the premiums has not been paid?
  • 7 days
  • 10 days
  • 31 days
  • 60 days - Answer✅ 31 DAYS G is an accountant who has ten employees and is concerned about how the business would survive financially if G became disabled. The type of policy which BEST addresses this concern is"
  • Business Overhead Expense
  • Disability Income
  • Key employee life
  • contributory - Answer✅ BUSINESS OVERHEAD EXPENSE
  • purpose is to cover certain overhead expenses that continue when the business owner is disabled P's individual health policy is now in the grace period. P's coverage will remain in force if
  • no claim is presented
  • the premium is paid
  • the insured proves insurability
  • the insured does not leave the state - Answer✅ THE PREMIUM IS PAID If an insurance producer applicant is required to pass a written examination, what is also required?
  • a fingerprint based criminal background check
  • a college degree
  • applicant is at least 21 years old
  • the applicants credit report - Answer✅ A FINGER PRINT BASED CRIMINAL BACKGROUND CHECK T has a term policy that allows him to continue the coverage after expiration of the initial policy period. What type of term coverage is this?
  • renewable
  • increasing
  • level
  • decreasing - Answer✅ RENEWABLE insurance contract may be sold, solicited, or negotiated by an insurance producer ONLY upon
  • filing an application for licensure
  • passing the licensure exam
  • issuance of license
  • becoming an appointed producer of an insurer - Answer✅ BECOMING AN APPOINTED PRODUCER OF AN INSURER

ACCUMULATES CASH VALUE FASTER THAN STRAIGHT LIFE

Which of the following is an example of defamation?

  • making statements that encourage the purchase of term life insurance over whole life insurance
  • publishing a newsletter that makes reference to reputable brokers in the area
  • circulating brochures that falsely denounce the financial condition of an insurer Which type of renewability best describes a disability income policy that covers an individual until the age of 65, but the insurer has the right to change the premium rate for the overall risk class?
  • conditionally renewable
  • noncancellable
  • guaranteed renewable
  • optionally renewable - Answer✅ GUARANTEED RENEWABLE When a medicare supplement policy is delivered to a policyholder, which of the following MUST accompany the policy?
  • producer's address
  • outline of coverage
  • insurer's AM best rating
  • outline of policy- loss ratios - Answer✅ OUTLINE OF COVERAGE A(n) annuity pays benefits based on units rather than stated dollar amounts
  • deferred
  • variable
  • immediate
  • 20 - pay life and straight life accumulate cash value at the same rate - Answer✅ 20 - PAY LIFE
  • issuing pamphlets containing false info about term life insurance - Answer✅ CIRCULATING BROCHURES THAT FALSELY DENOUNCE THE FINANCIAL CONDITION OF AN INSURER
  • unit - Answer✅ VARIABLE the clause in an accident and health policy which defines the benefit amounts the insurer will pay is called the
  • insuring clause
  • contestable clause
  • consideration clause
  • free-look provision - Answer✅ THE INSURING CLAUSE Which of these is considered a mandatory provision?
  • payment of claims
  • insurance with other insurers
  • misstatement of age
  • change of occupation - Answer✅ PAYMENT OF CLAIMS The health insurance program which is administered by each state and funded by both the federal and state government is called
  • long term care
  • medicaid
  • medicare supplemental program
  • medicare - Answer✅ MEDICAID
  • medicaid is funded by both the federal and state governments and administered by individual states A medical care provider which typically delivers health services at its own medical facility is known as a
  • HMO
  • regional provider
  • Multiple employer trust
  • PPO - Answer✅ HMO