Exam (elaborations)
Life, Accident, and Health Questions and Answers
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Life, Accident, and Health
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Life, Accident, and HealthIn Major Medical Expense policies, what is the objective of a Stop Loss provision? -
answer Limits an insured's out-of-pocket medical expenses
Which of the following policy features allows an insured to defer current health charges
to the following year's deductible instead of the current year's deductible? - answer
Carryover provision
P is an employee who quits her job and wants to convert her group health coverage to
an individual policy. After the expiration of COBRA benefits, which of the following
statements is TRUE? - answer She DOES need to provide evidence of insurability
What provision in a life insurance policy state that the application is considered part of
the contract? - answer Entire Contract Provision
Generally, how long is a benefit period for a Major Medical Expense Plan? - answer
One Year
Under the Affordable Care Act (ACA), health coverage is provided for dependents up to
the age of - answer26
Agent J takes an application and initial premium from an applicant and sends the
application and premium check to the insurance company. The insurance company
returns the check back to J because the check is made out to J instead of the insurance
company. What action should J take? - answerReturn to the customer, collect a new
check made out to the insurance company, and send the new check out to the
insurance company
The commissioner of Insurance has notified an insurer that an Individual Health Policy
form does not comply with North Carolina laws. the insurer may - answernot issue the
form in connection with any new application
An individual has a Major Medical policy with a $5,000 deductible and an 80/20
coinsurance clause. How much with the INSURED have to pay if a total of $15,000 in
covered medical expenses are incurred? - answer$7000
$5,000 + 20% of the remaining bill= $7,000
Which of these actions is NOT considered an act of rebating? - answerSharing
commissions with other licensed and appointed agents
Which of these is NOT an element of Life insurance premiums? - answerMorbidity rate
,A license may be denied, suspended, or revoked if the licensee - answeris found guilty
of misrepresentation
A group life insurance policy can be converted to an individual whole life policy under
which circumstances? - answerEmployment termination
A proof of loss is required to be submitted within ________ days after the date of loss -
answer180
K pays on a $20,000 20-Year Endowment policy for 10 years and dies from an
automobile accident. How much will the insurance company pay the beneficiary? -
answer$20,000 death benefit
An individual who purchases a Life annuity is given protection against: - answerthe risk
of living longer than expected
Life insurance that covers an insured's whole life with level premiums paid over a limited
time is called: - answerLimited Pay Life
If a dispute arises over an insurance contract, the agent who sold the policy is
considered to represent the - answercompany
What is North Carolinas definition of Life insurance replacement ? - answerA
transaction in which a new policy is bought and an old policy is terminated
Which type of plan allows an employer to give money to an employee for buying a life
insurance policy and also permits the employee to select the beneficiary? - answerSplit-
Dollar
If an insurance applicant is being investigated into his/her personal character and mode
of living, the applicant MUST be notified of this investigation. Which of the following
makes this a requirement? - answerInsurance Information and Privacy Protection Act
Which of these are NOT an example of a Nonforfeiture option? - answerLife Income
A Health Insurance Policy Applicant unintentionally fails to list a previous visit to a
neurologist. If the policy is issued and the insurer later decides to contest the policy, it
must do so - answerwithin 2 years from the date of issue
An example of unfair discrimination would be - answeroffering different terms of
coverage for different policyowners having the same risk classification
a terminated employee must have been covered for at LEAST ___ month(s) under a
Group Health Insurance policy immediately prior to termination in order to be eligible for
continuation of coverage - answer3 months
, What is the purpose of the Time of Payment Of Claims provision? - answerPrevents
delayed claim payments made by the insurer
Q applied for life insurance and submitted the initial premium on January 1. The policy
was issued February 1, but it was not delivered by the agent until February 7. Q is
dissatisfied and returns the policy February 13. How will the insurer handle this
situation? - answerPolicy was returned within the free-look period, premium will be fully
refunded
A Business Overhead Expense policy would cover which of the following if a business
owner becomes disabled? - answerUtilities and office rent
Disability policies do NOT normally pay for disabilities arising from which fo the
following? - answerWAR
An insurance applicant was recently denied insurance coverage. The applicant is
requesting access from the insurer to recorded personal information regarding this
decision. Under the Information and Privacy Protection Act, the insurer MUST make the
information available within_____ business days - answer30
Which of the following is considered an element of a Variable Life Policy? -
answerUnderlying equity investment
Which of the following statements describes what an Accident and Health policy owner
may NOT do? - answerAdjust the premium payments
An agent soliciting insurance policies in North Carolina MUST be - answerappointed by
an authorized insurer in North Carolina
All are true statements regarding the underwriting process, EXCEPT - answerAIDS and
HIV virus exams can be conducted in a discriminatory fashion
Chemical dependency treatment under a Group Health policy MUST include (over the
life of the contract) a minimum benefit of - answer$16,000
An agent who solicits applications for life insurance in North Carolina is considered to
represent the - answerinsurance company
a level premium indicates: - answerthe premium is fixed for the entire duration of the
contract
According to the Mandatory Uniform Policy Provisions, what is the maximum amount of
time after the premium due date during which the policy remains in force even though
the premium has not been paid? - answer31 days
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