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Texas life and health FINAL EXAM REVIEW Study Guide.pdf, Exams of Nursing

Keele University Nursing

Texas life and health FINAL EXAM REVIEW Study Guide.pdf

Typology: Exams

2023/2024

Available from 07/02/2024

samuel-waweru-1 🇬🇧

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Texas life and health FINAL EXAM

REVIEW Study Guide

If, at the time of an insured's death, the insurance company discovers that the

insured's age was misstated on the application for life insurance, the company will

most likely -

✅ pay the policy proceeds in the amount the premiums would have purchased at

the insured's actual age

The provision in a health insurance policy that suspends premiums being paid to the

insurer while the insured is disabled is called the: -

✅ Waiver of Premium

P and Q are married and have three children. P is the primary beneficiary on Q's

Accidental Death and Dismemberment (AD&D) policy and Q's sister R is the

contingent beneficiary. P, Q, and R are involved in a car accident and Q and R are

killed instantly. The Accidental Death benefits will be paid to: -

✅ P only

Which of these statements accurately describes the Waiver of Premium provision in

an Accident and Health policy? -

✅ *Premiums are waived after the insured has been totally disabled for a specified

time period

(The Waiver of Premium provision waives the payment of premiums after the insured

has been totally disabled for a specified period of time.)

All of the following provisions must be included in life insurance policies EXCEPT -

✅ All of the following provisions must be included in life insurance policies

EXCEPT

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? -

✅ olicy was returned within the free-look period, premium will be fully refunded

Who can purchase a plan through the Marketplace? -

✅ Any legal resident except those incarcerated

A major medical policy typically: -

✅ provides benefits for reasonable and necessary medical expenses, subject to

policy limits

Which of the following BEST describes a short-term medical expense policy? -

✅ Nonrenewable

Partial preview of the text

Download Texas life and health FINAL EXAM REVIEW Study Guide.pdf and more Exams Nursing in PDF only on Docsity!

Texas life and health FINAL EXAM

REVIEW Study Guide

If, at the time of an insured's death, the insurance company discovers that the insured's age was misstated on the application for life insurance, the company will most likely - ✅ pay the policy proceeds in the amount the premiums would have purchased at the insured's actual age The provision in a health insurance policy that suspends premiums being paid to the insurer while the insured is disabled is called the: - ✅ Waiver of Premium P and Q are married and have three children. P is the primary beneficiary on Q's Accidental Death and Dismemberment (AD&D) policy and Q's sister R is the contingent beneficiary. P, Q, and R are involved in a car accident and Q and R are killed instantly. The Accidental Death benefits will be paid to: - ✅ P only Which of these statements accurately describes the Waiver of Premium provision in an Accident and Health policy? - ✅ *Premiums are waived after the insured has been totally disabled for a specified time period (The Waiver of Premium provision waives the payment of premiums after the insured has been totally disabled for a specified period of time.) All of the following provisions must be included in life insurance policies EXCEPT - ✅ All of the following provisions must be included in life insurance policies EXCEPT 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? - ✅ olicy was returned within the free-look period, premium will be fully refunded Who can purchase a plan through the Marketplace? - ✅ Any legal resident except those incarcerated A major medical policy typically: - ✅ provides benefits for reasonable and necessary medical expenses, subject to policy limits Which of the following BEST describes a short-term medical expense policy? - ✅ Nonrenewable

A Whole Life Insurance Policy endows when the - ✅ Cash value equals the death benefit The insuring clause - ✅ States the scope and limits of the coverage An insurer must provide an insured with claim forms within __ days after receiving notice of a loss. - ✅ 15 A Family Income Policy is a combination of Whole Life and - ✅ Decreasing term insurance T and S are named co-primary beneficiaries on a $500,000 Accidental Death and Dismemberment policy insuring their father. Their mother was named contingent beneficiary. Five years later, S dies of natural causes and the father is killed in a scuba accident shortly afterwards. How much of the death benefit will the mother receive? - ✅ $ Which of these statements describe a Modified Endowment Contract (MEC)? - ✅ Exceeds the maximum amount of premium that can be paid into a policy and still have it recognized as a life insurance contract What group term life feature permits an individual to depart from the group and continue to be covered without providing evidence of insurability? - ✅ conversion An insurance company may be judged guilty of false advertising if it - ✅ exaggerates its dividends in a newspaper advertisement A policy of adhesion can only be modified by whom? - ✅ the insurance company Variable Whole Life Insurance can be described as: - ✅ both an insurance and securities product Which type of contract liquidates an estate through recurrent payments? - ✅ annuity Many small business owners worry how their business would survive financially if the owner becomes disabled. The policy which BEST addresses this concern is: - ✅ business overhead expense What is the elimination period of an individual disability policy? - ✅ time period a disabled person must wait before benefits are paid

Quarterly premium payments increase the annual cost of insurance because - ✅ Interest to the insurer is decreased while the administrative costs are increased An agent whose license has been revoked is required to - ✅ wait at least five years before applying for a new license The individual who provides general medical care for a patient as well as the referral for specialized care is known as a: - ✅ primary care physician The agreement in a life insurance contract that states a specific sum of money will be paid to a designated person upon an insured's death is called a(n): - ✅ insuring agreement A Business Disability Buyout plan policy is designed - ✅ To pay benefits to the corporation or other shareholders Information obtained from a phone conversation to the proposed insured can be found in which of these reports? - ✅ inspection report A creditor who requires a debtor to obtain insurance from a particular company or agent as a condition for a loan is guilty of - ✅ coercion Group life insurance policies are generally written as: - ✅ annually renewable term An enrollee of a Health Maintenance Organization (HMO) may be cancelled or nonrenewed for which of the following reasons? - ✅ failure to pay for coverage Which of the following does Social Security NOT provide benefits for? - ✅ dismemberment Which of these types of coverage is best described as a short term medical policy? - ✅ interim coverage Which of the following correctly explains the actions an agent should take if a customer wants to apply for an insurance policy? - ✅ Complete the application and review the information with the customer prior to obtaining the customer's signature, then send the application off to the insurance company Which of these statements about a Guaranteed Insurability Option rider is NOT TRUE? - ✅ Evidence of insurability is required when the option is exercised

The clause in an Accident and Health policy which defines the benefit amounts the insurer will pay is called the: - ✅ insuring clause An insured is past due on his life insurance premium, but is still within the Grace Period. What will the beneficiary receive if the insured dies during this Grace Period?

✅ Full face amount minus any past due premiums The first portion of a covered Major Medical insurance expense that the insured is required to pay is called the: - ✅ initial deductible 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? - ✅ 31 days Which of the following BEST describes a Hospital Indemnity policy? - ✅ coverage that pays a stated amount per day of a covered hospitalization Which of these is NOT relevant when determining the amount of personal life insurance needed? - ✅ local unemployment rate Under which of the following circumstances will the benefits under COBRA continuation coverage end? - ✅ all group health plans are terminated by the employer What is the consideration given by an insurer in the Consideration clause of a life policy? - ✅ promise to pay a death benefit to a named beneficiary Nursing home benefits must be provided for at least 12 consecutive months in which of the following types of policies? - ✅ long term care Which of the following services is NOT covered under a hospitalization expense policy? - ✅ surgeons fees Which of these life insurance riders allows the applicant to have excess coverage? - ✅ term rider A CEO's personal assistant suffered injuries at home and as a result, was unable to work for four months. Which type of policy will pay a monthly benefit to the personal assistant? -

What kind of life insurance starts out as temporary coverage but can be later modified to permanent coverage without evidence of insurability? - ✅ convertible term Which of these do NOT constitute policy delivery? - ✅ policy issued with a rating Taking receipt of premiums and holding them for the insurance company is an example of: - ✅ fiduciary responsibility Under what system do a group of doctors and hospitals in a designated area contract with an insurer to provide services at a prearranged cost to the insured? - ✅ PPO When does a Probationary Period provision become effective in a health insurance contract? - ✅ at the policies inception An individual life insurance policy issued in Texas MUST have a grace period for premium payment of how many days? - ✅ 31 T took out a $50,000 life insurance policy with an Accidental Death and Dismemberment rider. Five years later, T commits suicide. How much will the insurer pay? - ✅ $50, Why is an applicant's signature required on a life insurance application? - ✅ to attest that the statements on the application are accurate to the best of the applicants knowledge Which of the following types of care is typically not covered in a Long-Term Care policy? - ✅ acupuncture A student pilot can pay regular premium costs for her life insurance policy with the addition of which of the following? - ✅ aviation exclusion With Optionally Renewable Health policies, the insurer may: - ✅ review the policy annually and determine whether or not to renew it After the initial enrollment period, an HMO must hold an open enrollment period of how many days at LEAST once in every 12-month period? - ✅ 31

To be eligible for Social Security disability benefits, an employee must be unable to perform: - ✅ any occupation Insurance company agent appointments remain in force for which of the following maximum periods of time, if any? - ✅ until terminated or withdrawn In a qualified retirement plan, the yearly contributions to an employee's account: - ✅ as restricted to maximum levels set by the IRS J, an Accidental Death and Dismemberment (AD&D) policy holder, dies after injuries sustained in an accident. J's age as stated on the application five years ago was found to be understated by ten years. Which of the following actions will the insurance company take? - ✅ the insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age Which of these circumstances is a Business Disability Buy-Sell policy designed to help in the sale of a business? - ✅ business owner becoming disabled Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract? - ✅ entire contract A certificate of authority does which of the following? - ✅ permits an insurance company to transact business in Texas What is being delivered during a policy delivery? - ✅ insurance contract to the proposed insured S is employed by a large corporation that provides group health coverage for its employees and their dependents. If S dies, the company must allow his surviving spouse and dependents to continue their group health coverage for a maximum of how many months under COBRA regulations? - ✅ 36 Under Texas insurance law, the term "transacting business" includes - ✅ collecting premiums Which of these provisions require proof of insurability after a policy has lapsed? - ✅ Reinstatement J has a Disability Income policy that does NOT provide benefits for losses occurring as the result of his employment. What kind of coverage is this? - ✅ nonoccupational coverage

✅ coercion In health insurance policies, a waiver of premium provision keeps the coverage in force without premium payments: - ✅ after an insured has become totally disabled as defined in the policy A newly licensed General Lines agent must complete a MINIMUM of how many hours of continuing education within 24 months after initial license? - ✅ 24 Information obtained from a phone conversation to the proposed insured can be found in which of these reports? - ✅ inspection report A stock insurance company is owned by it's - ✅ stockholders Insurance contracts are known as ____ because certain future conditions or acts must occur before any claims can be paid. - ✅ conditional An agent may legally share commissions only with - ✅ another agent who is licensed in the same line of insurance From what authority derives the requirement that an insurance application contains a disclosure stating that an investigative consumer report may be obtained on an applicant? - ✅ Fair credit reporting act Which of the following health insurance policy provisions specifies the health care services a policy will provide? - ✅ Insuring clause Which of the following circumstances would cause a Medicare Supplement policy to be cancelled? - ✅ the insured fails to pay the premium T owns an Accident & Health policy and notifies her insurance company that she has chosen a less hazardous occupation. Under the Change of Occupation provision, which of the following actions may her insurance company take? - ✅ increase her policy's coverage amount When an insurance company sends a policy to the insured with an attached application, the element that makes the application part of the contract between the insured and the insurer is called the: - ✅ Entire contract provision

An agent MUST give a prospective insured an Outline of Coverage when taking an application for a - ✅ Medicare supplement policy M purchased an Accidental Death and Dismemberment (AD&D) policy and named his son as beneficiary. M has the right to change the beneficiary designation at anytime. What type of beneficiary is his son? - ✅ Revocable Insurance agent licenses normally must be renewed every - ✅ two years A Return of Premium life insurance policy is - ✅ whole life and increasing term Which of the following statements about Health Reimbursement Arrangements (HRA) is CORRECT? - ✅ If the employee paid for qualified medical expenses, the reimbursements may be tax-free M purchased an Accidental Death and Dismemberment (AD&D) policy and named his son as beneficiary. M has the right to change the beneficiary designation at anytime. What type of beneficiary is his son? - ✅ Revocable Which of these is NOT a type of agent authority? - ✅ Principal Life insurance that covers an insured's whole life with level premiums paid over a limited time is called: - ✅ Limited pay life An insurance company may NOT reject a prospective insured's life application on the basis of which of the following factors? - ✅ Gender The type of annuity that can be purchased with one monetary deposit is called a(n): - ✅ immediate annuity Benefits for drug and alcohol treatment under a group health policy must include all of the following services EXCEPT - ✅ transportation to and from an outpatient facility Boycott, coercion, and intimidation that result in the unreasonable restraint of trade are prohibited under the Texas Insurance Code covering - ✅ unfair methods of competition Which type of policy is considered to be overfunded, as stated by IRS guidelines? -

✅ Insurance issued on a debtor to cover outstanding balances on installment loans What does the ownership clause in a life insurance policy state? - ✅ Who the policyowner is and what rights the policyowner is entitled to returning a portion of a premium as inducement to purchase insurance - ✅ Which of the following is an example of rebating? All of these Settlement options involve the systematic liquidation of the death proceeds in the event of the insured's death, EXCEPT: - ✅ interest only Which of these factors does NOT influence an applicant's need for life insurance? - ✅ self-maintenance expenses According to the Time Limit of Certain Defenses provision in an Individual Health Insurance Policy, nonfraudulent misstatements first become incontestable: - ✅ two years from the date of the policy was issued Which of the following will a Long Term Care plan typically provide benefits for? - ✅ home health care

Texas life and health FINAL EXAM REVIEW Study Guide.pdf, Exams of Nursing

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Partial preview of the text

Download Texas life and health FINAL EXAM REVIEW Study Guide.pdf and more Exams Nursing in PDF only on Docsity!

Texas life and health FINAL EXAM

REVIEW Study Guide