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Xcel Final Exam 1. Typically, Long-Term Disability benefits are coordinated with which benefit plan?: Social Security 2. The focus of major medical insurance is providing coverage for: medical and hospitalization expenses€11,78
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Xcel Final Exam 1. Typically, Long-Term Disability benefits are coordinated with which benefit plan?: Social Security 2. The focus of major medical insurance is providing coverage for: medical and hospitalization expenses
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Xcel
Xcel Final Exam
1. Typically, Long-Term Disability benefits are coordinated with which benefit
plan?: Social Security
2. The focus of major medical insurance is providing coverage for: medical and
hospitalization expenses
1. Typically, Long-Term Disability benefits are coordinated with which benefitplan?ANS
Social Security
2. The focus of major medical insurance is providing coverage forANS
medical andhospitalization expenses
3. An insured under a Major Medical expense plan with a zero deductible and80/20 coinsurance provision
files a $1,000 claim. How much of this claim is the insured responsible for?ANS
$200
because this policy has a zero deductible, the insures is only responsible for the 20%coinsurance on this claim, or $200
4. 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?ANS
-
$5,000
5. Which type of plan would be the most appropriate for an individual on Medicare and concerned that
Medicare will NOT pay for charges exceedingthe approved amount?ANS
Medicare supplement Plan F
6. When can a group health policy renewal be denied according to the HealthInsurance Portability and
Accountability Act (HIPAA)?ANS
when contribution or participation rules have been violated
7. What does the word "levelANS
in Level Term describe?ANS
the face amount
8. A non-contributory health insurance plan helps the insurer avoidANS
adverseselection
because all eligible employees are usually covered, non-contributory plans are desirable from an underwriting
standpoint because adverse selection is minimized.
9. To qualify for a resident producer license in the state of Michigan, an individualANS
must complete the required pre-licensing education within 12 monthsof license application
10. 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?ANS
12 months
pre-existing conditions may be excluded for a maximum of 12 months from the dateof enrollment.
11. An insured has a health plan that pays established amounts in accordancewith a list of injuries, surgical
procedures, or other losses. This list is called aANS
benefit schedule
, Xcel Final Exam
benefits schedule set predetermined limits or maximums on how much money andinsured can be reimbursed for a
covered loss.
12. Who is the individual paid on a fee-for-service basis?ANS
Provider
13. Which of the following is NOT an illegal inducement?ANS
Giving the insured anarticle of merchandise printed with the producer's name costing $5
$5 or less of tokens or merchandise to applicants is allowed.
14. Making a statement that is false or maliciously critical of the financialcondition of an insurer is
known asANS
defamation
15. Which of the following is NOT a required provision in an accident andhealth insurance policy?ANS
change of occupation
the change of occupation provision is considered an OPTIONAL provision
16. Which of these statements about Medicaid is CORRECT?ANS
Funded by fed-eral, sate, and local taxes
Medicaid is funded by federal, state, and local taxes but is administered by eachstate.
17. All of these are considered key factors in underwriting life insuranceEXCEPTANS
Marital Status
CorrectANS
tobacco use, health history, age
18. The time limit for filing claim disputes is addressed in which provision ofan accident and health
policy?ANS
legal actions
19. All of the following plans allow for employee contributions to be taken ona pre-tax basis EXCEPTANS
Health reimbursement Arrangement plan
employers contribute to health reimbursement Arrangement planz (HRA's), notemployees.
20. Which of the following gifts from a producer would NOT be consideredrebating?ANS
$5 pen
A producer quoting life insurance may give an applicant an article of merchandisehaving an invoice value of $5.00 or
less.
21. Written notice for a health claim must be given to the insurer days afterthe
occurrence of the loss.ANS
20
22. Chris is an insured bricklayer who severed his left hand in an automobileaccident. Although his primary
duty cannot be performed, Chris is also a substitute high school teacher. He collects a full disability income
check every
, Xcel Final Exam
month. How does his policy define total disability?ANS
own occupation
the "own occupation" definition of total disability requires that the insured be unableto perform the insured's current
occupation as a result of an accident or sickness.
23. Which approach predicts a person's earning potential and determines how much of that amount would be
devoted to dependents?ANS
Human life valueapproach
The human life value approach predicts an individual's future earning potential anddetermines how much of that amoun
would be devoted to dependents.
24. Index whole life insurance contains a securities component that acts asa(n)ANS
hedge against inflation
25. Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits.Which of these benefit
options would he choose?ANS
Guaranteed lifetimewithdrawal benefit
The guaranteed lifetime withdrawal benefit normally requires a fee, but it ensures that the income benefit will be paid
for life without actually annuitizing the contract.
26. Which of these factors would an insurer consider when determiningwhether to accept a group life
plan?ANS
average age
and insurer would consider the average age when determining whether to accept agroup Life Plan.
27. This MANDATORY health policy provision states that the policy, includingendorsements and attached
papers, constitutesANS
the entire insurance contract between the parties
28. The monthly benefit for an individual disability income policy is usually limited to a percentage of the
insured's income in order to avoidANS
over insurance
29. When an insurance licensee changes his or her address under the Michi- gan Insurance Code, who MUST
be notified?ANS
the commissioner of the Depart-ment of Insurance and financial services (DIFS)
30. Jonas is a whole life insurance policyowner and would like to add coveragefor his two children. Which of the
following products would allow him to accomplish this?ANS
Child term rider
A child term rider is a level term insurance that can be added to an existing policy.
31. The typical long-term care insurance policy is designed to provide a mini- mum of year(s) of
coverage.ANS
1
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