life insurance

An agent does NOT have a fiduciary responsibility to

• the New York Guaranty Association

an insurance agency has fiduciary responsibilities to insurers, applicants, and insureds

All Medicare Supplement policies MUST contain which provision?

Pre-existing conditions may be excluded from coverage for a maximum of 6 months

Benefits for a Medicare Supplement policy

must not duplicate Medicare benefits

Which of the following is considered to be an act of misrepresentation?

Falsifying the terms, benefits, advantages, or conditions of an insurance policy

If a new enrollee to a group health plan has had previous creditable coverage for up to ___ days prior to enrollment, the Pre-existing Condition Provision will apply.

63

Which of the following is NOT a duty of the Superintendent?

Establish rates for the insurers

If an insurer refuses to pay a claim, how many days must the insured wait to take legal action against a health insurer after submitting written proof of loss?

60

Which of the following is required for an insurer to conduct business in this state?

Certificate of authority

A disability policy where the premiums are due monthly require a grace period of

10 days

The required grace period for an accident and health policy is ___ days for weekly premium policies

no less than 7 days

Every agent licensed in New York must notify the Superintendent within __ days of any change of address

30

The Right-to-Examine period is ___ days for all Long-Term Care Policies sold in New York

30 days

The identity of the ___ must be made clear in every health insurance advertisement

insurer

An agent is meeting with a client to determine whether an annuity would be suitable for purchase. Which of the following topics needs to be discussed with the client?

Financial objectives

An example of replacement is

canceling a term life policy to buy a whole life policy

roles of the Superintendent is to

• enforce state insurance laws

The promise of a discount in premium as an inducement to purchase insurance is known as

rebating

Life insurance replacement can be best defined as

a transaction in which a new life insurance policy is purchased and an existing life insurance policy is surrendered

The amount received for a life insurance policy in a life settlement is ______ than the death benefit.

less

Within ___ days after policy delivery, both Medicare Supplement and Long-Term Care policies can be returned for a 100% premium refund.

30 days

A life insurance agent is required to give a disclosure notice about information practices to an applicant or proposed insured

prior to or at the time of signing the application

A medical provider that accepts Medicare Assignment must

accept payment based upon a defined Medicare schedule as payment in full

The free look period provided in a life insurance policy is usually

10 days

Violations of US Code Title 18 section 1033, may result in

Fine and/or imprisonment

The standard grace period for a life insurance policy sold in New York is:

31 days

An individual can enroll in a Part C Medicare Advantage Plan at what time?

When becoming eligible for Medicare

A life settlement broker is someone who is

licensed to negotiate a life settlement contract

A life settlement intermediary is a(n)

association which maintains a facility that displays offers and counteroffers for purchasers or sellers of life settlement contracts

Which of the following is NOT information found in a life insurance buyer's guide?

How to take legal action against an insurance company

When screening an applicant for HIV, the insurer

may require a blood test for HIV

All of these are responsibilities of the Superintendent EXCEPT

Endorsing insurers

Which of the following is an example of an agent's fiduciary duty?

Collecting premiums and remitting them to the insurer

How is Medicare Part B funded?

General tax revenue and user premiums

Which of the following statements regarding the Fair Credit Reporting Act is TRUE?

An insurer does NOT need to discuss any credit history inconsistencies with the applicant

Medicaid is a government-funded program designed to provide health care to

low-income individuals

Which type of annuity guarantees a stated number of income payments, whether or not the annuitant is still alive to receive them?

Life annuity certain

What is the primary reason for buying an annuity?

Provide future economic security

Which type of annuity stops all payments upon the death of the annuitant?

Life annuity

Which settlement option pays a stated amount to an annuitant, but no residual value to a beneficiary?

Life income

What is considered to be the primary reason for buying life insurance?

Provide death benefits

A policyowner suffers an injury that renders him incapable of performing one or more important job duties. Any decrease in income resulting from this injury would make him eligible for benefits under which provision?

Partial disability

What percentage of a participant's income are group long-term disability benefit amounts typically limited to?

60%

Which of the following is NOT considered advertising?

A rating from a rating service company, such as A.M. Best

According to the Affordable Care Act, any plan in existence prior to which date is considered a grandfathered plan?

March 23, 2010

A non-contributory health insurance plan helps the insurer avoid

adverse selection

When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?

Change of occupation provision

What is the purpose of a Disability Income Benefit?

Provide money for living expenses

As classified by the Affordable Care Act (ACA), a Silver Plan offers

70% actuarial level of coverage provided

How are health plans classified according to the Affordable Care Act?

Bronze, Silver, Gold, Platinum

Which clause defines total disability as being unable to perform the major duties of the insured's regular occupation?

Own occupation clause

Under a group life policy, the insurer will issue an individual _____ to the policyowner for delivery to each person insured.

certificate

Under the Affordable Care Act, a large employer that does NOT provide health insurance and owes an employer mandate penalty MUST pay an annual penalty, which is calculated by multiplying $2,000 by

the number of full time employees minus 30

What is the contract called that is issued to an employer for a Group Medical Insurance plan?

Master policy

A type of group that has a constitution and bylaws and has been organized for purposes other than obtaining insurance is called a(n)

association or labor group

This MANDATORY health policy provision states that the policy, including endorsements and attached papers, constitutes

the entire insurance contract between the parties

What is the elimination period of an individual disability policy?

Time period a disabled person must wait before benefits are paid

Karen is a producer who has obtained personal information about a client without having a legitimate reason to do so. Under the McCarran-Ferguson Act, what is the maximum penalty for this?

a fine of $10,000 or up to one year in jail is the penalty

All of the following are characteristics of a Group Life Insurance Plan EXCEPT

Individual underwriting

According to the Affordable Care Act, what is the maximum amount an individual can contribute to a Flexible Savings Account?

$3,400

How are annuities given favorable tax treatment?

Gains are taxed at distribution

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.

50%

A common exclusion with Vision plans is

Lasik surgery

Ken is a producer who has obtained Consumer Information Reports under false pretenses. Under the Fair Credit Reporting Act, what is the maximum penalty that may be imposed on Ken?

$5,000

All Health Benefit Plans issued after January 1, 2014 must provide

preventative health services

A group Disability Income plan that pays tax-free benefits to covered employees is considered

fully contributory

All of these are considered key factors in underwriting health insurance EXCEPT

Marital status

The Do Not Call Registry offers exemptions for calls placed from all of the following EXCEPT

insurance sales calls

In most dental plans, a deductible typically is NOT applied to

preventative and diagnostic services

Legal purpose is a term used in contract law meaning

there must be legal reasons for entering into the contract

An example of a presumptive disability would be

deafness

An employer may qualify for health care tax credits through SHOP Marketplace if that employer has fewer than how many employees?

25 full-time employees

Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n)

conversion

Who assumes the investment risk with a fixed annuity contract?

The insurer

A life insurance policy that is subject to a contract interest rate is referred to as

universal life

An annuity is primarily used to provide

retirement income

The policyholder for a group health benefit plan is considered to be the

Employer

A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance?

Dental treatment is needed to repair an injury

Group health plans may deny participation based upon the

member' part-time employment status

Coming from an insurance point of view, which of the following is the main risk associated with disability?

Loss of income

The power given to an individual producer that is not specifically addressed in his/her contract is considered what type of authority?

implied

The taxable portion of each annuity payment is calculated using which method?

Exclusion Ratio

Converting a group plan to permanent life insurance requires

the conversion being applied for within 31 days of termination

A renewable Term Life insurance policy allows the policyowner the right to renew the policy

without producing proof of insurability

What happens to interest earned if the annuitant dies before the payout start date?

It is taxable

The term which describes the fact that both parties of a contract may NOT receive the same value is referred to as

Aleatory

An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called

coinsurance

A nonparticipating company is sometimes called a(n)

stock insurer

A Modified Endowment Contract (MEC) is best described as

A life insurance contract which accumulates cash values higher than the IRS will allow

Where would policy proceeds be paid if both the insured and primary beneficiary were killed in the same accident?

contingent beneficiary

A Renewable Term Life insurance policy can be renewed

at a predetermined date or age, regardless of the insured's health

During the accumulation period, who can surrender an annuity?

Policyowner

The coverage, conditions, and limitations in the master policy of a group contract can be found in which document?

Certificate of coverage and benefits

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 interest-sensitive life insurance policyowner may be able to withdraw the policy's cash value interest free. The provision that allows this is called

Partial Surrender

A beneficiary has just received a claim payment for a 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

Donald is the primary insured of a life insurance policy and adds a children's term rider. What is the advantage of adding this rider?

Can be converted to permanent coverage without evidence of insurability

A spouse and child can be added to the primary insured's coverage as what kind of rider?

Family term

A master contract and certificate of coverage can be found in which type of policy?

Group

Which type of disability would be less than total impairment and equal to permanent impairment?

Permanent partial disability

Which annuity payout option allows the policyowner to choose a pre-determined number of benefit payments?

Period certain