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Xcel Final Exam$140
because the insured has previously met her deductible, the eligible expenses for a claim is the
entire $175. The insurance company pays 80% of $175, or $140. - ANS-A policyholder has a
major medical plan with a 80%/20% coinsurance and a deductible of $75. If the insured has
previously met her deductible and receives a bill for $175, how much will the insurer pay?
$200
because this policy has a zero deductible, the insures is only responsible for the 20%
coinsurance on this claim, or $200 - ANS-An insured under a Major Medical expense plan with a
zero deductible and 80/20 coinsurance provision files a $1,000 claim. How much of this claim is
the insured responsible for?
$4,000
In this situation, Ron may increase the face value of his policy by $4,000. $100,000 X .04 =
$4,000. - ANS-Ron has a life insurance policy with a face value of $100,000 and a cost of living
rider. If the consumer price index has gone up 4%, how much may Ron increase the face value
of the policy?
$5 pen
A producer quoting life insurance may give an applicant an article of merchandise having an
invoice value of $5.00 or less. - ANS-Which of the following gifts from a producer would NOT be
considered rebating?
$5,000 - ANS-An insured has a stop-loss limit of $5,000 and an 80/20 coinsurance. The insured
incurs $25,000 of covered losses. How much will the insured pay?
$500,000
In this situation, the death benefit would be the $500,000 face amount. - ANS-Rob purchased a
standard whole life policy with a $500,000 death benefit when he was age 30. His insurance
agent told him the policy would be paid up if he reached age 100. The present cash value of the
policy equals $250,000. Rob recently died at age 60. The death benefit would be
$700
in this situation, the insured will pay $500 deductible plus $200 coinsurance = $700.
,$1500-$500=$1000
$1000×20%=$200
$500+$200=$700 - ANS-Tim has a health insurance with a deductible of $500 and an 80/20
coinsurance. How much will she pay if she incurs a loss of $1,500?
$900
In this situation, the group insurance carrier will pay 90% of the covered loss after the deductible
has been applied. - ANS-Amy has a group medical policy through her employer with a $500
deductible and a 90% coinsurance provision. She incurs $1,500 in covered health care services.
How much will her group insurance carrier pay?
$900
in this situation, the group insurance carrier will pay 90% of the covered loss after the deductible
has been applied. - ANS-Amy has a group medical policy through him player with a $500
deductible and the 90% coinsurance provision. She encourages $1,500 in covered Health Care
Services. How much will her group insurance carrier pay?
1 - ANS-The typical long-term care insurance policy is designed to provide a minimum of __
year(s) of coverage.
100% of cost - ANS-sole Proprietors are permitted tax deductions for health costs paid from
their earnings in the amount of
12 months
pre-existing conditions may be excluded for a maximum of 12 months from the date of
enrollment. - ANS-Under an expense-incurred individual health policy, what is the MAXIMUM
length of time after issuance of the policy that an insurer can exclude coverage for a pre-existing
condition?
12 months - ANS-how long must an individual be unable to engage in any gainful activity due to
physical or mental disability in order to qualify for Social Security total disability?
12% per annum - ANS-in the state of Michigan, properly filed Health claims that are not timely
paid require the insurer to pay simple interest from a date 60 days from satisfactory proof of loss
at the rate of
15 - ANS-A producer MUST be appointed by the insurer within how many days from the date
the agency contract application is submitted?
, 15 - ANS-An insurer must furnish to a claimant forms for filing proof of loss within ___ days upon
receiving a notice of claim.
15 - ANS-an insurer must furnished to a claimant forms for filing proof of loss within _____ days
upon receiving a notice of claim.
2 to 50 employees - ANS-in Michigan, a small employer is comprised of
2 years
the contestable period for a life policy in Michigan is 2 years. - ANS-when can a life policy no
longer be canceled for non-fraudulent Miss statements after its date of issue?
2 years - ANS-when can a life policy no longer be canceled for non fraudulent statements after
its date of issue?
20 - ANS-How many employees must an employer have for a terminated employee to be
eligible for COBRA?
20 - ANS-Written notice for a health claim must be given to the insurer ___ days after the
occurrence of the loss.
3
A licensee is required to take 24 hours of continuing education every two years. Of the 24
hours, 3 must be in ethics - ANS-A licensee who is required to take continuing education MUST
include how many ethics coursework hours?
3 years - ANS-in Michigan, legal action can be taken against an insurer for fail to pay HEALTH
insurance claims for a period not to exceed
30 - ANS-the acceptance of the credit Life Application requires the submission of a Certificate of
Insurance to the insured Within ______ days.
31 - ANS-when an accident and health policy requires payment of an additional premium to
provide coverage for a newborn, how many days after the birth is the first payment due?
31 - ANS-When an accident and health policy requires payment of an additional premium to
provide coverage for a newborn, how many days after the birth is the first payment due?
6 months - ANS-In order to save on premiums, a Life Insurance policy can legally be backdated
up to
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