During the underwriting process for a group health policy, it was discovered that 15 out of 50 members of the group have major health issues. How would the insurer handle this?
-Accept or reject the whole group
-Accept the 35 insurable individuals while rejecting the remaining 15
-Charge a higher premium to the 15 unhealthy individuals
-Assign the group to a reinsurer
Accept or reject the whole group
What percentage of eligible employees must participate in a noncontributory group health plan before it can be put in effect?
-0%
-25%
-50%
-100%
Who is financially liable for the payment of covered claims in a fully insured group health plan?
-Insurer
-Group member
-Health
provider
-Guaranty Association
Minimum participation standards exist for group health insurance plans in order to...
-cover the agent's commission
-prevent adverse selection
-avoid treating benefits as taxable income
-meet state requirements
prevent adverse selection
Business Overhead Expense Insurance pays for...
-business expenses when a business owner becomes disabled
-a business owner's salary in the event of the owner's disability
-any loss in value of a business if the owner becomes disabled
-business expenses during an economic downturn
business expenses when a business owner becomes disabled
A policy that covers an NFL quarterback's arm or a singer's voice may not be covered by an AD&D Policy or a health policy is a...
-limited risk policy
-optional policy
-special risk policy
-private policy
Which of the following is NOT typically covered under vision care insurance?
-Retina surgery
-Eyeglasses
-Examinations
-Contacts
The problem of overinsurance is addressed in which health insurance provision?
-Entire contract
-Suitability
-Reinstatement
-Coordination of benefits
Buy-sell plans are typically funded by which two types of insurance?
-Life insurance and disability insurance
-Annuities and disability insurance
-Modified endowment contracts and Long-term care insurance
-Life insurance and Long-term care
insurance
-Life insurance and disability insurance
Coverage is limited for vision and dental insurance in all of the following ways EXCEPT...
-Number of teeth cleanings per year
-Dollar amount for eyeglass frames
-Number of X-rays performed per year
-Specific dollar amount for examinations
Specific dollar amount for examinations
Which of the following statements pertaining to health insurance policy premium factors is CORRECT?
-A "policy fee" is another term for policy premium.
-A policyowner has an individual health plan. Therefore, the policy is most likely a participating policy.
-Age and sex of the individual insureds would have the most influence on a
group health insurance policy's experience rating refund credit.
-Health insurance policies are paid for on a year-by-year basis and are subject to periodic increases.
Health insurance policies are paid for on a year-by-year basis and are subject to periodic increases.
An employee for XYZ Corp is injured on the job. Where does coverage for the employee's injuries come from?
-Employer's group health plan
-Employer's self-insured fund
-Workers' Compensation
-Employee's individual health policy
Medicare Part B has an initial enrollment period. How many months after an individual's 65th birthday month does this enrollment period end?
-1 months
-3 months
-6 months
-8 months
Coverage for care received from a network provider pays more than care received from a non-network provider in what type of health plan?
-Hospital indemnity
-Self-insured plan
-Preferred Provider Organization (PPO)
-Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
At age 65, which of the following is available at no cost to all individuals?
-Medicare
Select
-Medicare Part A
-Medicare Part B
-Medicare Supplemental insurance
Which statement is TRUE regarding Workers' Compensation coverage...
-Negligence is a factor in determining the employer's liability
-Workers' Compensation benefits are usually received in a lump sum
-Employer pays the entire premium for Workers' Compensation coverage
-The amount received from workers'
compensation is usually greater than the employee might receive if he or she sued a negligent employer
Employer pays the entire premium for Workers' Compensation coverage
How is a Medicare claim submitted?
-Expenses are submitted to Medicare by the Commissioner
-Expenses are submitted to Medicare by the health provider
-Expenses are
submitted to Medicare by the patient
-Expenses are submitted to Medicare by an arbitrator
Expenses are submitted to Medicare by the health provider
Which statement about Health Maintenance Organizations is NOT true?
-Members minimize out-of-pocket expenses by using HMO network providers
-Subscribers pay a fixed periodic fee to the
HMO
-HMOs are known for stressing preventive care
-When a member uses out-of-network providers, a higher monthly fee is charged
When a member uses out-of-network providers, a higher monthly fee is charged
Which of the following does Medicare Part A NOT provide coverage for?
-Doctor's services
-Hospice
-Hospitalization
-Inpatient care
Which statement regarding Medicare is true?
-Nursing home coverage is covered by Part B
-Benefits for prescription drugs are covered by Part A
-Medicare is available only to individuals age 60 and older
-Benefits for diagnostic tests and X-rays performed on an outpatient basis are provided by Part B
Benefits for diagnostic tests and X-rays performed on an outpatient basis are provided by Part B
Who acts as the gatekeeper in a Health Maintenance Organization (HMO)?
-Policyowner
-HMO Arbritrator
-Primary care physician
-Insurance company
Individuals become eligible for Medicare Part A benefits at what age?
-50
-59 1/2
-62
-65
Disabled workers are covered under Workers' Compensation medical expense benefits for how long?
-6 months
-3 years
-10 years
-No limit
Medicare Part A covers what type of care?
-Skilled nursing facility care
-Major Medical facility care
-Custodial facility care
-Respite facility care
Skilled nursing facility care
Basic Medical Expense policies generally begin to pay benefits...
-on day 1
-on the 5th day in the hospital
-after 10 days
-after 45 days
Which of the following does specified disease insurance NOT cover?
-costs covered by medical expense insurance
-medical expenses that are noncovered
-incidental costs
-out-of-pocket expenses
costs covered by medical expense insurance
Allen has a disability income policy with a $2,500 monthly benefit and a 30-day elimination period. He is unable to work 90 days following an automobile accident. What will the policy pay?
-$0
-$2,500
-$5,000
-$7,500
-$5,000
[90 days - 30 day elimination period is 60 days (2 months). 2 months X $2,500/month benefit = $5,000 total benefit paid]
Which of the following is NOT included in comprehensive major medical plans?
-Maximum coverage limits
-Coinsurance
-First-dollar coverage
-Deductibles
Medical expense policies will typically cover which of the following?
-Injuries caused by accidents
-Routine dental care
-Prescription eyeglasses
-Voluntary cosmetic procedures
Injuries caused by accidents
When does an insured qualify for stop-loss coverage?
-When the insured reaches an age stated in the policy
-When claims exceed a specified limit in a set period of -time
When claims exceed
the policy's maximum lifetime benefit limit
-When the average claim amount exceeds the limit stated in the policy
When claims exceed a specified limit in a set period of -time
Which of these statements is NOT true concerning recurrent disabilities?
-The insurer continues coverage after a new elimination period
-The recurrence of a
disability must occur within a specified time period after the prior disability
-A recurrent disability is considered to be a continuation of the prior disability
-The recurrent disability must be caused from the original disability
The insurer continues coverage after a new elimination period
What does a Hospital Confinement indemnity policy pay for?
-Pays for the entire cost of the hospital stay
-Pays for the deductible and coinsurance of the hospital stay
-Pays for cost of the hospital stay after the deductible and coinsurance has been met
-Pays a specified daily amount while the insured is confined to a hospital
Pays a specified daily amount while the insured is confined to a hospital
Which of the following terms is NOT associated with a Major Medical policy?
-Stop-loss
-Comprehensive
-Deductible
-Capitation
What does the term coinsurance refer to?
-The stated initial dollar amount that the individual insured is required to pay before insurance benefits are paid
-The amount the Federal government pays after the deductible is met
-A situation where two insurance
policies cover the same claim
-After the deductible is satisfied, the percentage paid by the insured for the remaining covered expenses
After the deductible is satisfied, the percentage paid by the insured for the remaining covered expenses
Which of the following riders guarantees the insured the option of purchasing additional amounts of disability income coverage at predetermined times without requiring the insured to provide evidence of insurability?
-Guaranteed insurability rider
-Lifetime maximum benefit rider
-Extended purchase rider
-Additional insurance rider
Guaranteed insurability rider
In what form do disability income policies typically pay benefits?
-Lump sum
-Periodic
income
-Tax credit
-Annuity
Which type of disability would be less than total impairment and equal to permanent impairment?
-Partial total disability
-Permanent partial disability
-Residual partial disability
-Temporary partial disability
Permanent partial disability
What is the elimination period of an individual disability policy?
-Time period an insured must wait before coverage begins
-Time period a disabled person must wait before benefits are paid
-Time period after the policy issue date in which the provisions are still contestable
-The point in time when benefits are no longer payable
Time period a disabled person must wait before benefits are paid
The factor used most often when underwriting a disability income policy is...
-annual earnings
-sex of the insured
-marital status
-occupation
Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this?
-Guaranteed insurability rider
-Additional coverage rider
-Paid-up option rider
-Extended insurability rider
Guaranteed insurability rider
A disability policyowner is injured and becomes totally disabled. The benefits pay for 2 years, starting from the date of the injury. What is this time period called?
-Recurrent
period
-Probationary period
-Benefit period
-Elimination period
What is the primary factor that determines the benefits paid under a disability income policy?
-Education level
-Wages
-Type of occupation
-Age
Coming from an insurance point of view, which of the following is the main risk associated with disability?
-Loss of limbs
-Loss of
income
-Decreased work skills
-Decreased mobility
A disability income policy can prevent an insured from earning a higher income than if he/she were working by utilizing...
-elimination periods
-probationary periods
-benefit limits
-deductibles
Frank is shopping for a disability income policy. Which of the following would have the HIGHEST premium?
-14 day waiting period / 5 year benefit period
-14 day waiting period / 10 year benefit period
-28 day waiting period / 5 year benefit period
-28 day waiting period / 10 year benefit period
14 day waiting period / 10 year benefit period
What portion does an insured pay for covered expenses under Medicare Part B after the deductible?
-20%
-50%
-75%
-100%
Which of the following would be considered an activity of daily living under a long term care policy?
-Bathing
-Running
-Working
-Breathing
Periodic increases in policy benefits are allowed in which long-term care policy provision?
-Entire contract
-Nonforfeiture
-Deflation protection
-Inflation protection
All of these statements concerning Medicare are true EXCEPT...
-Medicare is primarily funded by Federal payroll and self-employment taxes
-Long-term care is covered by Medicare Part C
-Hospice is covered by Medicare Part A
-Doctors' services are covered by Medicare Part B
Long-term care is covered by Medicare Part C
Which of the following plans will cover medical costs that Medicare doesn't cover?
-Major medical
-Indemnity
-Medi-Cal
-Medicare supplement
Which of the following is NOT a required uniform provision in individual health policies?
-Change of occupation
-Legal Actions
-Notice of claim
-Reinstatement
The misstatement of age provision in a health policy states that if an insured gives the wrong age at the time of application, what action can the insurance company take?
-Reissue the policy
-Policy cancellation
-Benefits can be adjusted
-Premiums can be adjusted
The conditions, times, and circumstances under which an insured is NOT covered by a health policy are called...
-reinstatements
-deductibles
-inclusions
-exclusions
Under a health insurance policy, the provision that states the kind of benefits provided and the circumstances under which they will be paid is called the...
-payment of claims provision
-entire contract provision
-insuring clause
-benefit clause
In what situation does a waiver of premium provision keep a health insurance policy in force without premium payments?
-When an insured becomes
unemployed
-When an insured is involved in an accident at work
-When an insured is confined in a hospital
-When an insured becomes totally disabled
When an insured becomes totally disabled
Under the Payment of Claims provision, when are benefits typically payable after proof of loss is received?
-within 60 days
-Within 30 days
-Immediately
-By the end of
the calendar year
The insurer has the option of terminating a health insurance policy on a date stated in the contract. What type of policy is this?
-Optionally renewable
-Renewable
-Conditionally renewable
-Cancellable
Which type of health insurance policy cannot be canceled by the insurer nor increase the premiums?
-Renewable
-Noncancellable
-Guaranteed
renewable
-Conditionally renewable
Christine has a health insurance policy that has been in force beyond the incontestable period. The insurer has discovered that a fraudulent statement was made on the application. What would the insurer have to pay on a claim, assuming this wasn't a guaranteed renewable policy?
-Nothing
-50% of the claim's amount
-75% of the claim's amount
-100% of the claim's amount
A health insurance policy paid on a quarterly basis has a grace period of...
-7 days
-10 days
-31 days
-60 days
What type of changes can be made to a guaranteed renewable health insurance policy?
-The policy's provisions
-The grace period
-The premium rates of the policyowner
-The incontestability period
The premium rates of the policyowner
Assume the following individuals are issued health insurance policies with varying renewability provisions. All other factors being equal, who would pay the highest premium?
-Dana-cancellable
-Chris-optionally renewable
-Pam-conditionally renewable
-Jack-noncancellable
What is the effect of an impairment rider attached to a health insurance policy?
-To increase the premium rate charged
-To decrease the amount of benefits provided
-To exclude from coverage losses resulting from specified conditions
-To increase the policy's waiting period
To exclude from coverage losses resulting from specified conditions
Each of the following is a significant consideration in the underwriting of individual health insurance risks except...
-Occupation
-Age of applicant
-Geographic location
-Physical condition
If a health insurance policy has lapsed and it is later reinstated, the reinstated policy will cover only sickness that begins...
-After the date of reinstatement
-At
least 10 days after the date of reinstatement
-At least 20 days after the date of reinstatement
-At least 30 days after the date of reinstatement
At least 10 days after the date of reinstatement
An increase in which factor will decrease the disability insurance premium?
-Expenses used
-Benefit level
-Interest rate
-Morbidity figures
Which of these factors do NOT affect the rates of medical insurance?
-Health
-Race
-Occupation
-Gender
Which of the following is NOT considered to be insurer expenses?
-Maintenance costs
-Policy premiums
-Employees' salaries
-Utilities
Which of the following is NOT a factor in determining the morbidity of a group of individuals?
-Health
-Occupation
-Age
-Race
What is the term used to describe the frequency and severity of certain illnesses and accidents?
-Morbidity
-Mortality
-Malaise
-Insurability
Jim is the insured on a health insurance policy and holds 2 jobs. If "occupation" is used to classify the risk, the insurer will most likely classify Jim according to the occupation that...
-is most hazardous
-pays the lowest wage
-pays the highest wage
-he has worked at the longest
Which of the following is the purpose of medical cost management?
-To influence hospital charges and doctors' fees
-To discourage individuals from utilizing health care services
-To control health claim expenses
-To encourage individuals to seek medical help only as a
last resort
To control health claim expenses
Which of the following statements most aptly describes health insurance benefits?
-Each policy offers a single type of benefit.
-Claims, not benefits, affect premium rates.
-Policyowners who have policies with identical benefits pay the same premiums.
-
The greater the benefits, the higher the premium.
One technique that helps to control health care costs is a requirement for...
-Preexisting conditions
-Second surgical opinions
-Waiver of premiums
-Optional benefit riders
Which of the following is considered a moral hazard in health insurance underwriting?
-Morbid
obesity
-Alcoholism
-High blood pressure
-Skydiving
The cost of services charged by the Health Insurance Counseling Advocacy Program (HiCap) is...
-$25 per appointment
-$50 per appointment
-$75 per appointment
-no cost
Which of the following is NOT covered by the Family and Medical Leave Act (FMLA)?
-Pregnancy
-Adoption
-Traveling
overseas with a spouse
-Attending to the serious health condition of a parent
Traveling overseas with a spouse
The California Insurance Code allows an individual how many days to cancel a life policy for a full-refund?
-Up to 10 days
-Between 15 and 20 days
-Between 10 and 30 days
-Between 30 and 45 days
MRMIP is a...
-state program that offers health coverage to California residents who are not able to obtain coverage due to pre-existing conditions
-state program that assists single parents obtain affordable health coverage for their children
-Federal program that offers health coverage to California residents who are not able to obtain coverage due to pre-existing conditions
-Federal program that gives tax credits to help offset the cost of health
insurance
state program that offers health coverage to California residents who are not able to obtain coverage due to pre-existing conditions
Both the Federal and state governments jointly finance which health insurance entitlement program?
-Medi-Cal
-MRMIP
-Medicare
-Social Security
Where must you specifically reside to qualify for MRMIP?
-North America
-United States
-California
-California and its reciprocal states
MRMIP stands for...
-Minor Risk Medical Insurance Program
-Major Risk Medical Insurance Program
-Major Rehabilitation Medical Indemnity Plan
-Minor Rehabilitation Medical Insurance Plan
Major Risk Medical Insurance Program
Which of the following does the California Department of Insurance (CDI) have NO jurisdiction over?
-Medicare
-Health Maintenance Organizations
-Preferred Provider Organizations
-Life and health insurance companies
Term
According to PPACA, what is a health benefits exchange?
-An entity to which individuals and small
businesses can have access to affordable health coverage
-An entity where existing policies can be converted to newer policies
-An entity that provides tax credits to employers for providing health insurance to their employees
-An entity that offers affordable health coverage to only those with low incomes
An entity to which individuals and small businesses can have access to affordable health coverage
Who does a life settlement broker represent?
-Insurance company
-Life agent
-Private firm
-Individual wanting to sell their life policy to a third party
Individual wanting to sell their life policy to a third party
Before an insurer is allowed to test an individual for HIV, what must be completed?
-Consent form
-Policy summary
-Buyer's Guide
-Certification form
What is an insurance solicitor authorized to do?
-Settle life insurance claims
-Manage an insurance agency
-Solicit insurance
-Help an agent or broker sell insurance
Help an agent or broker sell insurance
What does the term "illustration" mean when used in the phrase "life insurance policy illustration", according to the California Insurance Code?
-Publication designed to help an applicant reach an informed decision about which coverage is appropriate
-A copy of the sales materials used in an insurance transaction
-A copy of the terms given for the free-look period
-Presentation of policy features that includes non-guaranteed
elements
Presentation of policy features that includes non-guaranteed elements
An individual who transacts life, disability, or life and accident and health insurance on behalf of an insurer is called a(n)...
-adjuster
-analyst
-life agent
-insurance solicitor
What is the insurance term the State of California uses for an insurer that is eligible to transact business in this state?
-Admitted
-Eligible
-Authorized
-Valid
How many "activities of daily living" must an insured be UNABLE to perform in order to meet the chronically ill requirement of a Long-Term Care policy?
-Minimum of one activity of daily living
-Minimum of two activities of daily living
-Minimum of three activities of daily
living
-Minimum of four activities of daily living
Minimum of two activities of daily living
A person who asserts a right of recovery under an insurance policy is called...
-tertiary
-claimant
-insured
-agent
What is required after a life agent sells an insurance policy to an applicant without being appointed by the insurer?
-Notice of appointment must be submitted to the Commissioner
-Notice of appointment must be submitted to the insurer
-Penalty is assessed to the insurer and life agent
-Application is automatically turned away
Notice of appointment must be submitted to the Commissioner
Which of the following does NOT have to be included on life insurance policy illustrations?
-Age of the insured
-Name of the agent
-Statement that all values and benefits are guaranteed
-Name of the insurer
Statement that all values and benefits are guaranteed
Pete is a life agent who has misappropriated fiduciary funds to his own use. What is Pete guilty of?
-Fiduciary
misappropriation
-Rebating
-Mishandling
-Theft
According to the PPACA, an adult can be covered by a parent's health care plan until what age?
-Age 18
-Age 21
-Age 25
-Age 26
What does the term "indemnity" mean as it pertains to insurance?
-To overinsure
-To award punitive damages
-To make whole
-To assume risk
The free-look period for life insurance policyowners age 60 or older is...
-10 days
-15 days
-30 days
-60 days
In California, the elderly can receive information about health related issues from...
-Medi-Cal
-Medicare
-Major Risk Medical Insurance Program (MRMIP)
-Health Insurance Counseling and Advocacy Program (HiCAP)
Health Insurance Counseling and Advocacy Program (HiCAP)
According to PPACA, how long can an adult be covered as a dependent under their parents' insurance plan?
-Up to age 18
-Up to age 21
-Up to age 26
-Up to age 30
Kimberly is an employee on leave under the Family and Medical Leave Act (FMLA). What will happen to her group health coverage?
-She will have to purchase short-term health coverage through the State while on leave
-Her coverage will be temporarily suspended while she is on leave
-She continues to be enrolled during the leave
-She will be forced to convert her group plan to an individual plan
She continues to be enrolled during the leave
The California Insurance Code requires that an insurer must have enough assets to cover its liabilities and for reinsurance of all outstanding risks. To remain solvent, it must also possess additional assets equal to what amount?.
-50% of its stock value
-Its paid-in capital
-$10,000,000
-Amount determined by the Insurance Guarantee Association
Jim is applying to become an insurance agent and has a past misdemeanor conviction that was later expunged due to California Penal Code 1203.4. Which of the following statements is correct?
-Jim is not required to disclose the conviction on his insurance license application
-Jim must still disclose the conviction on his insurance license application
-Only convictions that have been expunged within the last 3 years need to be reported on an insurance license application
-Only expunged felonies are required to be reported on an
insurance license application
Jim must still disclose the conviction on his insurance license application
How long must life agents keep their transaction records?
-3 years
-4 years
-5 years
-6 years
Life insurance surplus must be distributed to policyowners at what frequency?
-Monthly
-Quarterly
-Semi-annually
-Annually
The California Insurance Code defines "policy" as a(n)...
-accepted offer
-promissory arrangement
-written contract
-written quotation
Which of the following acts is NOT a Federal offense committed by an insurance agent?
-Embezzlement
-Insurance fraud
-Misrepresentation on an insurance application
-Falsify records
Misrepresentation on an insurance application
Which of the following is NOT a primary objective of insurance regulation?
-Insurance Code enforcement
-Licensing agents
-Protect policyowners
-Interpret policy provisions
Interpret policy provisions
In what order are people on the MRMIP waiting list allowed to enroll?
-Based on the date an individual's application is received
-Priority is given to California residents
-Based on the individual's date of birth
-Priority is given to those with the most serious health issues
Based on the date an individual's application is received
What type of license is required for an individual who charges a fee to review an insured's existing life insurance policy?
-Adjuster
-Life and disability counselor
-Life and disability analyst
-Life agent
Life and disability analyst
In California, an insurer organized under the state laws of Oregon is called a(n)...
-unauthorized insurer
-foreign insurer
-alien insurer
-domestic insurer
What is an insurance solicitor authorized to do?
-Settle life insurance claims
-Manage an insurance agency
-Solicit insurance
-Help an agent or broker sell insurance
Help an agent or broker sell insurance
An insurance company entitled to transact business in California is called a(n)...
-authorized carrier
-permitted carrier
-admitted carrier
-valid carrier
Which word implies permissiveness according to the California Insurance Code?
-May
-Indemnity
-Admitted
-Shall
Which of the following is NOT considered to be an unfair claims settlement practice?
-Advising a claimant to hire an attorney
-Failing to provide a reasonable basis for the denial of a claim upon request
-Failing to adopt and implement reasonable standards for prompt investigation and processing of insured’s claims
-Misrepresenting to insureds pertinent facts or policy provisions relating to coverage at issue
Advising a claimant to hire an attorney
When intentional concealment is involved, what course of action is the injured party entitled to?
-Rescission of the contract
-Punitive damages
-Reduction in premium
-Nothing
Rescission of the contract
Which of the following is NOT protected under the California Life and Health Guarantee Association?
-Policyowners
-Insureds
-Primary beneficiaries
-Insurers
According to the California Insurance Code, what term is used to describe a fact so important it could affect the policy premium?
-Guarantee
-Materiality
-Absolute
-Warranty
According to the California Insurance Code, what is "insurance"?
-A
contract
-A transfer
-A hazard
-An agreement
People with low income can be provided with medical assistance through which program?
-Medi-Cal
-Social Security
-HSA
-Medicare
How long must a policy be in force before an insurer is prohibited from denying claims based on misstatements made on the health policy application?
-1 year
-2 years
-3 years
-4
years
Paul has an existing annuity and is sold a new one, in which the new policy holds no greater financial benefit to him than the existing contract. This is considered a(n)...
-illegal transaction
-immediate annuity
-fraudulent act
-unnecessary replacement
When an insurer has met the qualifications necessary to transact business in California, it is said to be...
-admitted
-valid
-authorized
-qualified
Anyone employed in California to assist an insurance agent in transacting insurance is called an insurance...
-assistant
-solicitor
-manager
-consultant
The California Life and Health Insurance Guarantee Association covers all of these types of policies EXCEPT...
-Whole life
-Immediate annuities
-Disability
-Self-funded plans
Which type of jurisdiction requires an insurer to have its rates accepted by the Insurance Department prior to using them?
-Prior acceptance
-File and use
-Prior approval
-State approval
What is the purpose of the Pre-Existing Condition Insurance Plan (PCIP)?
-PCIP was created by the PPACA for people rejected by private health insurers due to pre-existing
conditions
-PCIP was created by the State of California for people rejected by private health insurers due to pre-existing conditions
-PCIP was created by the PPACA for low income individuals hoping to obtain health insurance
-PCIP was created by the State of California for low income individuals hoping to obtain health insurance
PCIP was created by the PPACA for people rejected by private health insurers due to pre-existing conditions
What effect did the Pregnancy Discrimination Act have on the health industry?
-Pregnancy qualifies a woman for paid leave from work
-Pregnancy must be treated as any other medical condition
-Pregnancy benefits can no longer be forced on employers
-No effect on the health industry
Pregnancy must be treated as any other medical condition
How is an agent's first year commission calculated for a replacement long-term policy?
-Based on the new policy's annual premium
-Based on the original policy's annual premium
-Based on the difference between the new and original policy annual premiums
-The new policy's commission minus a penalty
Based on the difference between the new and original policy annual premiums
According to the California Insurance Code, how is the word "may" interpreted?
-Irrevocable
-Mandatory
-Voluntary
-Permissive
According to the California Insurance Code, what is the maximum penalty per violation for anyone who unwillfully commits an unfair method of competition?
-$1,000
-$5,000
-$7,000
-$10,000
An agent's attempt to stop the replacement of an existing life insurance policy is known as...
-preservation
-prevention
-conservation
-concealment
In what situation does a waiver of premium provision keep a health insurance policy in force without premium payments?
-When an insured becomes unemployed
-When an insured is involved
in an accident at work
-When an insured is confined in a hospital
-When an insured becomes totally disabled
When an insured becomes totally disabled
Which of the following is NOT an accurate description of Access for Infants and Mothers Program (AIM)?
-Eligibility is based on income
-Low-cost health care coverage for pregnant
women
-Only women who have private insurance plans with a maternity-only deductible or copayment greater than $500 are eligible
-Only women who have private insurance plans with a maternity-only deductible or copayment greater than $1,500 are eligible
Only women who have private insurance plans with a maternity-only deductible or copayment greater than $1,500 are eligible
Which of the following actions is NOT allowed by Health Insurance Counseling and Advocacy Program (HiCAP) counselors?
-Medical record keeping assistance
-Charge a fee
-Assist in policy evaluation
-Assist in understanding Medicare Supplements
According to the PPACA, the medical enrollment tier that has 80% actuarial value is called...
-platinum
-gold
-silver
-bronze