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- Major medical
- Health insurance subject to a deductible
- which of the following stements regarding disclosure requirements for medicare is untrue?
- the producer must tell the prospective buyer that return of the policy and full refund of the premium can be made within 10 days
- Number of uniform provisions
- 23
- Non-admitted Company
- Not licensed to do business in a given state
- Fixed Amount Option
- Where beneficary recieves fixed amount for period of time
- Policy
- Contract of insurance including all applicable papers
- Master policy
- Issued to employers with certifacate to empolyees
- comprehensive major medical policies may provide 100% payment of the cobered expenses after the insured's out-of-pocket payment reach a specified level. thius provision is the
- stop loss
- Comprehensive Medical
- Combines Basic medical and major medical coverages
- Dismemberment
- Loss of specified members of the body
- Cobra Coverage Ends After
- 18 Months
- Controlled Business
- Insurance written for producer or producers spouse
- Commission
- Portion of premium retained by producer as compensation
- the director has issued a cease and desist order. if the person violates this order they may be fined not more than
- 5,000
- Disability Benefits
- Benefits paid because of disabilty
- medicare part D has a deductible of
- $250
- Cancelable
- Insurance contract that may be terminated by either party( Producer or insured )
- each fo the following is a function of accident insurance except
- to probide benefits for the loss of time away from the job as a result of sickness
- stock company
- own by stock holders
- Whole life insurance
- Pernament insurance on which premiums are paid for life of insured
- Lapses
- Termination because of failure to pay premiums
- License renew every
- 2 years
- Master Policy
- Issued to employers with certificate of employers
- if a group insurance contract is discontinued which of the following is an obligation of the group holder?
- the holder must notify enrolled individuals within 10 working days
- Non-Resident Producer
- A producer licensed in a state that is not the producers resident state
- Unilateral
- only one party to the contract makes any kind of enforceable agreement
- Providing a claim form by insured
- 15 days
- Eliminaion Period
- Period of time between beginning of disability and the date the benefits begin
- all of the following staements regarding long term care are true except
- long term care policies can provide coberage only for skilled nursing care
- which of the following miscellaneous expenses would not be covered under a basic medical policy?
- prescriptions
- which of the following statements about a Nonresident licensee is untrue?
- if a licensee holds a valid license from another state, there is nothing they need to do
- Premium Refunds to insured within
- 15 days
- under medigap policy plan C, which of the following would be excluded?
- part B excess
- medicare part A covers which of the following
- hospice care
- Competency
- Legally qualified by reason of age
- M.I.B
- collects medical billing
- under the rights of renewability an insurer can cancel the policy at any time by probiding written notification to the policyowner. this is
- cancelable
- Inpatient
- Person admitted in hospital
- prior to obtaining an insurance producers license a person can obtain a temporary license for
- 90 days
- Probationary Period
- Period time before benefits are paid due to illness
- Accumulate at interest
- Divided option that allows them to accumulate with interest
- under a LHSO which of the following are covered?
- ambulance, dental care, vision care, clinical laboratory services
- Beneficary Change
- Done in writing to new beneficary
- Installment annuity
- Beneficiary recieves balance of annuity payments
- the period of time that must elapse following the effective date of the policy before sickness benefits are paid is the
- probationiary period
- which of the following stements pertaining to the blue plans is untrue?
- payments for services are made directly to the subscriber
- Mortgage Insurance
- Policy pays balance of mortgage if death
- the clause that states the amount and frequency of premium payment is the
- consideration clause
- Conditionally Renewable
- Contract that can be renewed by insured to a date, insurer can cancel by written notice to insured
- Reciprocal Agreement
- Agreement between 2 states where license testing are waived
- convertible term
- temp. insurance that can be converted to permanant insurance
- Claim
- Request for benefits
- Uniform Provision
- Provision in health insurance related to operating condition that are specified by law
- guaranteed insurability
- rider given the insured choice of purchasing additional insurance
- Domestic Company
- Company formed under laws of the state in and the location of the home office
- a warrant could be best described as
- an absolute truth
- fraternal insurance
- social insurance organization to its members
- Mutual Company
- Company owned by policy holders
- Mandated Provisions
- 12
- Concealment
- With holding of fact by applicant
- which of the following stements regarding taxes on accident/health premiums and benefits are untrue?
- disability benefits are always subject to tax.
- Mode
- Frequency of pemium payment
- Conversion option provision
- 31 days
- if an examinee disagrees witht the examination they can request a hearing. after a hearing is completed, a wretten order from the director will be issued within how many days?
- 90 days
- incontestability clause
- policy endows when insured hits a certain age
- Primary Beneficiary
- First named to recieve procleds
- Consideration
- The premium and statements made on an application
- loading
- amount added to cost insurance cover insurer's endoment of operations
- Lapses
- Termination because of failure to pay premiums
- Absoulute Assignment
- Assignment of a policy owners right to another
- which of the following statements regarding HIV testing is untrue?
- notice of testing will be sent to the insured
- Arrears
- Premium Payments past due within grace period
- Immediate annuity
- Payments begin immediately
- Double Indemnity
- Twice the amount of basic benefits when loss results due to an accident
- Group Contract
- Written on members of entire group
- Spend thrift
- Proceeds annot be taken settle debts
- Settlement Opions
- Paying life insurance other than one lump some
- Return of proof of loss to insurer
- 90 days
- consideration clause
- specifies premium due & frequency of payment
- accidental death benefits
- additional death benefit if death happen by an accident
- Legal Reserve
- Money hel moratality & Interest Rate
- Authorized Company
- Permitted to sell insurance within a state
- Unauthorized Company
- Company not permitted to sell insurance within a given state
- Grace period
- 31 days
- Contributory Contract
- Insured pays part of premium
- dividend option
- ways insured may recieve dividends
- under the rights of renewability an insurer has the option to renew a policy but only on the anniversary dates or premium due dates. this is
- optionally renewable
- Foreign Company
- Organized in a state other than the one where insurance is written
- authorized company
- pemitted to sell insurance within a state
- Foreign Company
- Organized in a state other than one where the insurance is written
- cash surrender balue option
- insurer takes cash accumalation in a lump sum
- Non forfeiture option
- Can take accumalated values in reduced paid up, extended term insurance or cash value
- by illinois law which of the following will need a license issued by the division of insurance?
- broker
- an HMO can exclude an preexisting condition for no more than
- 12 months
- Fraud
- False statements
- the specified period of time, immediately following the start of disability, when loss of income benefits are not paid is the
- elimination period
- Reciprocal Agreement
- Agreement between 2 states where testing license requrirments are waived producers to sell in each states
- part of the legal consideration of an accident/health policy consists of statements by the applicant and payment of the premium. this is found in the
- consideration clause
- Certificate
- Statement of coverages used with group coverage
- Mutual Company
- Company owned by poicy holders
- an insurance producer cannot
- issue policies
- Insurable Interest
- Interest life where there will be loss of death occurs
- if a group insurance contract is discontinued for failure to pay premiums, which of the following is true?
- claims will be paid if they occur prior to the end of the grace period
- usual, reasonable and customary charges sert the amount the health carrier will pay based on
- based on local average for that service
- all of the following stements are true except
- long term care policies cannot include benefits for care and treatment in accordance with the practices of an established church that teaches reliance on spiritual treatment through prayer for healing
- under group insurance definitions, accrued liability means which of the following?
- liabilities established on the date an injury is sustained or the beginning of an illness
- Cobra Applied To Companies With
- 20 Employees
- which of the following would be eligible for social security benefis under worker's benefits?
- child disabled before age 22
- Number of ADLs to trigger benefits under a long term policy
- 2
- level premiums
- premiums cannot change during perium paying period
- under part B of medicare which of the following services is not covered?
- hospice care
- Return license to director of insurance
- Immediately
- Participating Policy
- A policy that pays dividends
- Concealment
- With holding of facts of applicant
- which of the following would not be a source for insurablility?
- multiple employer welfare association
- Pre-Existing Condition
- Health condition existing before policy is issued
- deferred annuity
- payments to annuitant delays until future date
- Contiditionally Renewable
- Contract the can be renewed be insured to state age & date
- if a physician certifies the need for hospice care, medicare will pay?
- 100% with a limit to the amount for outpatient drugs
- which of the follwoing plan uses the primary physicaian to be the gatekeeper of added medical services?
- POS.
- Alien Company
- Company located in a country other the united states
- the director of insurance suspects an insurance producer of being in violation of the insurance code and appoints a group of examiners to do an examination. a wretten notice of the examination will be given to participants involved in the examination within
- 10 days
- claim
- request for benefits
- Grace Period
- Specified period of time after premium is due during which coverage continues
- Group Life
- Member of a group
- non participating policy
- doesnot pay dividends
- which of the following provide a reduced rate for specified doctors and hospitals?
- preferred provider organizations
- most persons are covered under medicare part A
- when they reach 65
- Permant &Toatal diability
- Does not recover from disability
- rider
- modifying benefits of policy by adding or excluding benefits
- Family Plan option
- Covers all family members pemanent & term
- Automatic Premium Loans
- Allows the company to pay premium from the cash value so it dont lapse policy
- Free look for long term care
- 30 days
- Double Indemnity
- Twice amount of basic benefit when loss result specified circumstances
- Free look for life
- 10 days
- Stock Company
- Owned by stock holders
- Accident
- An unforeseen
- Individual Contract
- Any policy except group or blanket insurance
- Group Contract
- Payments to 2 annuities for only as long as both are alive
- Admitted company
- Does not recover from disability
- Occupation accident
- Job related accident
- Clause
- Term used to identify a particular provision in a policy
- a limited representative can sell all fo the following except
- property insurance
- License License Suspension
- 2years
- adhesion
- contract is not negotiable
- actuary
- person who calculates risk of premiums
- Domestic Company
- Company formed under laws of the state where insurance is written
- commission
- portioin of premium retained by producer as compensation
- Legal action after filling prooff of loss
- 60 Days
- controlled business
- written on insurers own life
- which of the following stements about medicaid is untrue
- it is not abailable to any governemment workers
- noncontributory
- plan of insurance for which employer pays premium
- Standard Risk
- Risk that meets same conditions of underwriting with no exra premium charge
- License Revocation
- 3 years
- prior to making an application for a new health policy debra had been treated for a medical condition. if the new insurer wants to limit coverage for this condition it will require the use of which of the following?
- impairment rider
- A producer (respondent) has how many days to respond to a complaint filed with the division of insurance against of LHSO?
- no later than 21 days
- Master Policy
- Issued to employers with certificate to empolyes
- Other Insurance
- Provisions in health insurance stated what is to be done in case of duplication of coverage
- Primary Beneficiary
- First named to recieve death benefits
- Representation
- insurance used for a trip by commercial carrier
- flexible spending accounts offer all the following benefits except
- employee gets a refund of unused money at the end of the year
- Corridor Deductible
- Deductible paid basic medical plan is exhausted and before the major medical plan pays
- amendment
- changes terms of policy to fit special circumstances
- Buisness Insurance
- Written to coer key people
- Contesable period
- 2 years
- Coinsurance
- a provision that both insured/ insurer will share in the loss by a specific percentage
- certificationstatement of coverages used with group coberagethe clause that specifies the conditioins under which the insurer will pay-benefits is the
- insuring clause
- limited life pay
- permanent policy premiums paid for # of years
- Notice of claim by insured
- 20 Days
- Pre-Existing limits for LTC
- 6 Months
- death benifits
- predetermination amount payable upon death
- Contingent Beneficiary
- Recieves benefits if primary beneficianry is dead
- a person holding a temporary insurance producer's license issued due to the death of an insurance producer can do all of the following except
- write new business
- a spouse of a disabled worker is eligible for medicare benefits under which condition?
- at age 65
- certificate
- statement of coverages used with group coverage
- which of the following modes of premium payment would generate the lowest premium?
- annual
- Non-Admitted Company
- Not licensed in given state
- the $ amount to be paid by the insured before a health policy starts paying a percentage of benefits is the
- deductible
- which of the following statements regarding health maintenance organization is untrue?
- a grievance committee can have up to 100 days to respond to a complaint
- Twisting
- Trying to get the policyowener to get rid of one for a new one
- Cabcelable
- Insurance contract the may be terminated by either party
- under the rights of renewability an insurer is allowed to refuse to renew a policy on the basis of specified conditions stated in the policy. this is
- conditionally renewable
- Medical Expense insurance
- Health insurance that pays medical expenses
- Admitted Company
- Licensed to do buisness in any state
- Notice of address change to department
- 30 days
- Alien Company
- Company located in a country other than united states
- Optionally Renewable
- Contract where insured reserves right to terminate coverage on anniversary date
- Time limit on certain defenses
- After a number of years. No statements made on the application can be used to deny payments of coverd claim
- Misstatement of age clause
- Company can adjust face amount of policy or premium on correct age
- Rated
- Policy issued with an extra premium charge due to increased physically occupation hazards
- Accidental Death Benefit
- Additional benefit if death results from accident
- Capital sum
- Specified sum paid for dismemberment
- conditional
- the insurer's promise to pay benefits dependent on the occurrence of the risk insured against
- Guarented Renewable
- Insured has the right to continue insurance the premium may be raised class basis
- An LHSO contract and long term care policy must provide coverage for no less than
- 12 months
- Warranty
- Statement that is believed to be true
- Extended term Policy
- Nonforfeiture option