Best PA Practice Exam

A temporary license may be issued without state examination to all of the following EXCEPT

1. A prospective producer who is currently enrolled in a pre-licensing insurance class

In Pennsylvania, a Specified disease accident and health plan must provide a minimum benefit in the amount of

1. 5000

According to Pennsylvania law, which of the following is NOT considered to be personally identifiable financial information? Blind trust data that does not include names and addresses

According to Pennsylvania law, group life insurance conversion privileges must NOT

1. require evidence of insurability

In Pennsylvania, accident and health plans are required to provide mammograms for women starting at age: 40

All of these are considered a form of advertising EXCEPT

1. an insurer's A.M. Best rating

Advertising material for a life insurance policy does NOT need to contain which of the following?

1. Producer's commission rate

In Pennsylvania, an employee must request spousal coverage under a group sponsored accident and health plan within ___ days of marriage.

1. 60

In Pennsylvania, HIPAA laws require that an individual's prior creditable coverage may reduce the maximum pre-existing condition exclusion period that a new group health plan can apply. This rule is applicable as long as there has been no gap in creditable coverage for a period greater than

1. 63 days

Advertising regulations exist in order to

1. demonstrate full and truthful disclosures to the public

All statements in an insurance application, in the absence of fraud, are considered representations

In Pennsylvania, the definition of total disability changes from one's "own occupation" to "any occupation" by reason of one's education, training, and experience after what period of time?

1. 24 months

In Pennsylvania, the Time Limit on Certain Defenses provision provides that no misstatements (EXCEPT fraud) made by the applicant on a health insurance application can be used to void the policy or deny coverage after the expiration of 3 years

After an annuity has been in force for ___ year(s), it becomes incontestable.

1. 2

Charging a client less premium than what is stated in their insurance policy is called: a rebate

Long-Term Care policies must provide coverage for claims arising from

1. Senile dementia

Carmen's individual life insurance policy has recently lapsed. She may reinstate her policy within ___ year(s). 3 years

No Long-Term Care policy may exclude pre-existing conditions for a period of more than 6 months

ommissions may be shared by

1. licensed and appointed Producers

The branch of dentistry which deals with the replacement of missing parts is called: Prosthodontics

Greg has recently been terminated from his job that covered him for group life insurance. How long does he have to convert his coverage to an individual policy?

1. 31 days

For licensing purposes, if an applicant has a home or office location in the state of Pennsylvania, this would be consistent with which of the following?

1. Home state

The document that describes policy features, benefits, exclusions and riders in a Long-Term Care policy is known as the

1. Outline of Coverage

For Pennsylvania Insurance Code violations, the Commissioner may assess a(n)

1. administrative penalty

The Medicare Supplement open enrollment period is the

1. 6 month period that begins with the month in which enrollment in Part B Medicare occurred, typically at age 65

Under Pennsylvania statute, first year commission for long-term care insurance may not be greater than, 50% of the first year premium

Holding premium funds for timely submission to the insurer is an example of

1. acting in a fiduciary capacity

What are the levels of coverage as defined by the Affordable Care Act?

1. Bronze, Silver, Gold, and Platinum

Maria the producer would like to advertise an annuity product on a highway billboard. Which of the following must be included in the advertisement?

1. Her name

If the Insurance Department determines that the issuance of a temporary producer license serves in the public's best interest, the license may be issued to

1. an executor of a deceased producer's estate

What is the difference between a Long-Term Care Partnership Plan and a Non-Partnership Plan?

1. Asset protection

In order to solicit insurance in Pennsylvania, all of the following is required EXCEPT

1. be at least 21 years of age

Which accident and health policy provision allows the policyowner a stated amount of time to return a newly-delivered policy for a full refund of premiums if not satisfied for any reason?

1. Right to examine

On occasion, insurable interest may exist in the absence of economic interest. Which of the following examples does this pertain to?

1. A husband and wife

In Pennsylvania, a producer may have their license revoked for which of the following acts?

1. Signing a prospect's name without their knowledge or presence

The Pennsylvania Life and Health Guaranty Association protects life insurance death benefit claims up to

1. $300,000

Which of these is NOT considered a form of life insurance advertisement?

1. Buyer's Guide

In Pennsylvania, an insurance producer license can be denied for failure to pay each of the following EXCEPT?

1. Property tax

A life insurance illustration showing future premiums being paid out of nonguaranteed values must disclose that

1. The policyowner may need to resume premium payments depending on actual results

In Pennsylvania, which of the following is NOT something a licensee must do to renew their insurance license?

1. Confirm previous exam scores

A life insurance policy becomes incontestable after it has been in force for

1. 2 years

In Pennsylvania, who is responsible for Continuing Education (CE) course content approval?

1. Commissioner

A life insurance producer licensed in the Commonwealth of Pennsylvania is authorized to

1. Solicit, receive and forward applications to the insurer

Producers must complete a total of ___ Continuing Education credits for each two-year licensing period.

1. 24

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

1. Replacement

Sharing 50% of a producer's commission with the insured is an example of illegal inducement

Agreements made by terminally ill persons to sell their life insurance policies at a discount in order to pay medical expenses are called

1. Viatical settlements

The Commissioner has the right and duty to

1. audit insurer financial reports and conduct market studies

An Accelerated Death Benefit in Pennsylvania must be at least what percentage of the total death benefit?

1. 25%

The Commissioner is responsible for all of the following EXCEPT

1. Recommending insurers

The Commissioner is responsible for all of the following

1. Regulate premium rates

2. Issue cease and desist orders

3. Conduct hearings

A Medicare Supplement policy may be cancelled by an insurer for which of the following reason: Material misrepresentation

Any of the following may be an unfair claims practice EXCEPT

1. Refusing to pay persons bringing false or fraudulent claims

The Pennsylvania Department of Insurance may take each of the following actions EXCEPT

1. Incarceration

A Medicare Supplement policy's outline of coverage MUST include a(n)

1. description of policy benefits

The Pennsylvania Insurance Department is responsible for each of the following EXCEPT

1. Shareholders

A newborn is required to be covered for ___ days from the moment of birth.

1. 31

Acme Corporation recently purchased a group health plan for its employees. Who would receive a certificate of coverage?

1. Employees

Violating Pennsylvania insurance law may result in which of the following Insurance Department actions?

1. Issuance of a cease and desist order after a hearing

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

1. Fine and/or imprisonment and up to 50,000 for violaiton and a maximum of 15 years in prison

During the first two years a life insurance policy is in force, the insurer may contest a policy for all of the following reasons EXCEPT

1. Misstatement of age in the application

An insured dies from what appears to be accidental causes. When confirming the cause of death, which of these actions by the insurer takes precedence?

1. Autopsy

What is required before an insurance producer can act as a representative of an insurer?

1. Producer needs to be appointed by that insurer

What is the purpose of the Pennsylvania Life and Health Insurance Guaranty Association?

1. Provide policyowner protection if an insurer becomes insolvent

In Pennsylvania, an insurer may backdate policy issue not more than how many months from the date of a life insurance application?

1. Six months

An insured may return their accident and health policy within ___ days of policy delivery.

1. 10

An insurer is REQUIRED to offer which of the following to each long-term care applicant at the time of purchase?

1. Inflation protection

What is the required action to be taken by a Pennsylvania licensee before operating under an assumed business name?

1. Notify Commissioner

In Pennsylvania, what's the requirement for a minor to receive proceeds from a death benefit?

1. A guardian must be appointed

Benefits for a Medicare Supplement policy: must not duplicate Medicare benefits

Life insurance may make an immediate benefit payment before the insured dies in which transaction?

1. Viatical Settlement

Proceeds of a viatical settlement contract could be subject to the claims of

1. Creditors

When a producer offers something of value in return for the purchase of an insurance policy, which prohibited sales practice has been committed?

1. Inducement

Coverage for newborns under an accident and health plan MUST include coverage for

1. birth abnormalities

When an applicant for a producer's license has a principal place of residence or business location in Pennsylvania, for licensing purposes the State of Pennsylvania is known as the

1. home state

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

1. 10 days

When an insurance company consistently fails to provide reasonable explanations for the denial of a claim, this is called a(n)

1. unfair claim settlement

Health insurance advertisements that mention statistical information are required by Pennsylvania law to

1. accurately convey all pertinent facts

Viatical settlement brokers are permitted to do all of the following EXCEPT

1. Make the first transaction up to 30 days before approved for a license

When collecting insurance premiums from a client, a producer MUST

1. forward premiums to the insurer on a timely basis

When soliciting insurance, a producer CANNOT: emphasize Guaranty Association benefits

Health insurance policies that provide maternity benefits must provide for a minimum of ___ hours of inpatient care following a Caesarean delivery.

1. 96

Viatical settlement brokers send packets of information to potential viatees. These information packets normally include existing policy terms and which of the following?

1. Viator's medical prognosis

Which of the following statements about the contestability of a life insurance policy is true?

1. The policy can be contested by the insurer only during the first two years of the contract

Which of following provisions protects a Pennsylvania policyowner from an innocent mistake made on the application over 2 years ago?

1. Incontestability provision

If a health policy is reinstated after it had lapsed for nonpayment, there is a waiting period of ___ days before a claim covering sickness will be covered.

1. 10

Which of the following constitutes grounds for suspending a Pennsylvania producer's license?

1. Felony conviction

Which of the following is a person who negotiates an insurance contract on behalf of an insurer?

1. Producer

Which of the following is a violation of Pennsylvania insurance law?

1. Offering insurance contracts through unlicensed entities

Which of the following is required to maintain a producer's license in Pennsylvania?

1. Field underwriter, who solicits insurance and earns a commission

In Pennsylvania, a Long-Term Care policy must be _______ renewable.

1. Guaranteed

In Pennsylvania, health insurance advertisements are required to contain the

1. insurance company's name

Long-term care insurance provides

1. one or more diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services in a setting other than an acute care unit of a hospital

Which of the following is the Pennsylvania Insurance Department NOT responsible for?

1. Shareholders

Which prohibited act involves a producer spending a client's insurance premiums for his/her own personal use?

1. Embezzlement

Who can receive an insurance commission?

1. Producer

Within how many days must a producer report to the Commissioner any charges made against him/her?

1. 30

Long-term care policies sold in Pennsylvania may exclude coverage related to

1. substance addictions

In Pennsylvania, no legal action may be taken against an insurer for failure to honor a valid claim after the expiration of how many years from the time proof of loss is furnished?

1. Three years

Once the insurance company receives a notice of claim, they have ___ days to send the claim form.

1. 15

A Long-Term Care plan must provide which of the following options for coverage in the state of Pennsylvania?

1. Inflation protection rider

According to Pennsylvania law, postnatal care must be delivered within how many days of discharge?

1. 2 days

Proof of loss on a health insurance claim must be submitted to an insurer within ___ days after the insured's date of loss.

1. 90

The _______ is responsible for determining the appropriateness of a Medicare Supplement policy for an applicant.

1. producer

An accident and health Major Medical plan would provide coverage for

1. Accidental overdose of a prescription drug

The free look period in Pennsylvania for individual health insurance policies is ___ days.

1. 10

If a health insurance claim is not promptly paid, legal action may be taken against the insurer after

1. 60 days from the date proof of loss is furnished

If a Medicare Supplement policy replaces another that had been in effect for at least 6 months, the replacing policy may impose which of the following time exclusions for pre-existing conditions?

1. 0 months

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

1. insurer

In Pennsylvania, completion of continuing education is required  upon license renewal for which of the following?

1. Licensed individuals qualified in major lines of insurance

In a Long-Term Care policy, the right-to-examine period is

1. 30 days

What is the MINIMUM benefit period that must be offered by a Long-Term Care policy?

1. 12 months

In accident and health plans, premiums paid less frequent than monthly require a minimum grace period of at least

1. 31 days

Pennsylvania law requires that an insurer must notify the Commissioner of a producer appointment termination: within 30 days of termination

What is the required renewability status of all Medicare supplement policies?

1. Guaranteed renewable

When a Medicare Supplement insurance policy is being replaced, who must sign the notice of replacement?

1. The producer and the applicant

When is a Group Accident and Health policy required to provide coverage for a newborn child?

1. At the moment of birth

 Every Pennsylvania insurer, upon receiving notification of a claim, must acknowledge receipt of the notice within

1. 10 days

Which of the following is included in the entire contract according to the entire contract provision?

1. Application

A licensed producer must report any administrative action taken against the licensee in another jurisdiction or by another agency department in Pennsylvania within how many days of the final disposition?

1. 30 days

Which of these may NOT be used in a health insurance advertisement?

1. An insurance company's trademark instead of the company's actual name

A licensee can have his/her license denied or revoked by the Commissioner if

1. the licensee has committed insurance-related fraud or dishonesty

Who issues Medicare Supplement policies?

1. Insurance companies

A licensee may only sell, solicit, and negotiate insurance contracts on behalf of the

1. appointing insurer

A Pennsylvania temporary producer license may be issued for a period not to exceed

1. 180 days

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

1. 30

A producer that willfully violates any provision of Pennsylvania Insurance law may be imposed to a maximum penalty set by the Commissioner at

1. $5,000 per violation

Written notice of a health insurance claim should be given to the insurer within __ days after the occurrence of any loss covered by the policy: 20

A producer who offers 10% of his commission to a potential client as an inducement to purchase an insurance policy is committing the act of

1. inducement

A producer who sells insurance in Pennsylvania but resides in another state is called a(n)

1. nonresident producer

A producer 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?

1. Financial objectives

A producer's license CANNOT be revoked without

1. a hearing given to the producer

A producer who sells an individual life insurance policy in Pennsylvania MUST deliver to the policyowner a(n)

1. Policy Summary and Buyer's Guide

A resident producer license requires each of the following EXCEPT

1. Insurer appointment

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

1. March 23, 2010

Under the Affordable Care Act, which of these plans is designed to provide coverage that is actuarially equivalent to 80% of the full actuarial value of the benefits provided under the plan?

1. Gold

Which of the following is NOT an eligible dependent on an Accident and Health policy?

1. 27 year old married child, covered only up to 26 as a dependednt

According to the Affordable Care Act, what metal tier is required to have an actuarial value of 70% with covered individuals paying 30% through deductibles, co-pays, and other cost sharing features?

1. Silver Plan

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

1. 70% actuarial level of coverage provided

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

1. Bronze, Silver, Gold, Platinum

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

1. the number of full time employees minus 30

What are the levels of coverage as defined by the Affordable Care Act?

1. Bronze, Silver, Gold, and Platinum

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

1. $2,500

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.

1. 50%

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

1. preventative health services

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

1. preventative and diagnostic services

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

1. 25

A common exclusion or limitation on a dental policy is

1. Endodontics

Under the Affordable Care Act, how would a grandfathered health plan lose its grandfathered status?

1. The insurer significantly raises co-insurance charges, deductibles, or co-payment charges

Group dental plans will frequently place a limit on annual benefits in order to minimize

1. adverse selection

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

1. Dental treatment is needed to repair an injury

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

1. coinsurance

With a scheduled dental policy, how are covered expenses paid?

1. Benefits are limited to a specific maximum dollar amount per procedure

An example of endodontic treatment is a

1. root canal

A form of medical health insurance covering the treatment and care of gum disease is called

1. Dental expense insurance

The branch of dentistry which deals with the replacement of missing parts is called

1. Prosthodontics

Which of the following does restorative dental treatment cover?

1. Crowns