Xcel Final Exam
Typically, Long-Term Disability benefits are coordinated with which benefit plan? - Answer-Social
Security
The focus of major medical insurance is providing coverage for - Answer-medical and hospitalization
expenses
An insured under a Major Medical expense plan with a zero deductible and 80/20 coinsurance provision
files a $1,000 claim. How much of this claim is the insured responsible for? - Answer-$200
because this policy has a zero deductible, the insures is only responsible for the 20% coinsurance on this
claim, or $200
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? - Answer-$5,000
Which type of plan would be the most appropriate for an individual on Medicare and concerned that
Medicare will NOT pay for charges exceeding the approved amount? - Answer-Medicare supplement
Plan F
When can a group health policy renewal be denied according to the Health Insurance Portability and
Accountability Act (HIPAA)? - Answer-when contribution or participation rules have been violated
What does the word "level: in Level Term describe? - Answer-the face amount
A non-contributory health insurance plan helps the insurer avoid - Answer-adverse selection
,because all eligible employees are usually covered, non-contributory plans are desirable from an
underwriting standpoint because adverse selection is minimized.
To qualify for a resident producer license in the state of Michigan, an individual - Answer-must complete
the required pre-licensing education within 12 months of license application
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? - Answer-12 months
pre-existing conditions may be excluded for a maximum of 12 months from the date of enrollment.
An insured has a health plan that pays established amounts in accordance with a list of injuries, surgical
procedures, or other losses. This list is called a - Answer-benefit schedule
benefits schedule set predetermined limits or maximums on how much money and insured can be
reimbursed for a covered loss.
Who is the individual paid on a fee-for-service basis? - Answer-Provider
Which of the following is NOT an illegal inducement? - Answer-Giving the insured an article of
merchandise printed with the producer's name costing $5
$5 or less of tokens or merchandise to applicants is allowed.
Making a statement that is false or maliciously critical of the financial condition of an insurer is known as
- Answer-defamation
,Which of the following is NOT a required provision in an accident and health insurance policy? - Answer-
change of occupation
the change of occupation provision is considered an OPTIONAL provision
Which of these statements about Medicaid is CORRECT? - Answer-Funded by federal, sate, and local
taxes
Medicaid is funded by federal, state, and local taxes but is administered by each state.
All of these are considered key factors in underwriting life insurance EXCEPT - Answer-Marital Status
Correct: tobacco use, health history, age
The time limit for filing claim disputes is addressed in which provision of an accident and health policy? -
Answer-legal actions
All of the following plans allow for employee contributions to be taken on a pre-tax basis EXCEPT -
Answer-Health reimbursement Arrangement plan
employers contribute to health reimbursement Arrangement planz (HRA's), not employees.
Which of the following gifts from a producer would NOT be considered rebating? - Answer-$5 pen
A producer quoting life insurance may give an applicant an article of merchandise having an invoice
value of $5.00 or less.
, Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. -
Answer-20
Chris is an insured bricklayer who severed his left hand in an automobile accident. Although his primary
duty cannot be performed, Chris is also a substitute high school teacher. He collects a full disability
income check every month. How does his policy define total disability? - Answer-own occupation
the "own occupation" definition of total disability requires that the insured be unable to perform the
insured's current occupation as a result of an accident or sickness.
Which approach predicts a person's earning potential and determines how much of that amount would
be devoted to dependents? - Answer-Human life value approach
The human life value approach predicts an individual's future earning potential and determines how
much of that amount would be devoted to dependents.
Index whole life insurance contains a securities component that acts as a(n) - Answer-hedge against
inflation
Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit
options would he choose? - Answer-Guaranteed lifetime withdrawal 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.
Which of these factors would an insurer consider when determining whether to accept a group life
plan? - Answer-average age
and insurer would consider the average age when determining whether to accept a group Life Plan.
Typically, Long-Term Disability benefits are coordinated with which benefit plan? - Answer-Social
Security
The focus of major medical insurance is providing coverage for - Answer-medical and hospitalization
expenses
An insured under a Major Medical expense plan with a zero deductible and 80/20 coinsurance provision
files a $1,000 claim. How much of this claim is the insured responsible for? - Answer-$200
because this policy has a zero deductible, the insures is only responsible for the 20% coinsurance on this
claim, or $200
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? - Answer-$5,000
Which type of plan would be the most appropriate for an individual on Medicare and concerned that
Medicare will NOT pay for charges exceeding the approved amount? - Answer-Medicare supplement
Plan F
When can a group health policy renewal be denied according to the Health Insurance Portability and
Accountability Act (HIPAA)? - Answer-when contribution or participation rules have been violated
What does the word "level: in Level Term describe? - Answer-the face amount
A non-contributory health insurance plan helps the insurer avoid - Answer-adverse selection
,because all eligible employees are usually covered, non-contributory plans are desirable from an
underwriting standpoint because adverse selection is minimized.
To qualify for a resident producer license in the state of Michigan, an individual - Answer-must complete
the required pre-licensing education within 12 months of license application
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? - Answer-12 months
pre-existing conditions may be excluded for a maximum of 12 months from the date of enrollment.
An insured has a health plan that pays established amounts in accordance with a list of injuries, surgical
procedures, or other losses. This list is called a - Answer-benefit schedule
benefits schedule set predetermined limits or maximums on how much money and insured can be
reimbursed for a covered loss.
Who is the individual paid on a fee-for-service basis? - Answer-Provider
Which of the following is NOT an illegal inducement? - Answer-Giving the insured an article of
merchandise printed with the producer's name costing $5
$5 or less of tokens or merchandise to applicants is allowed.
Making a statement that is false or maliciously critical of the financial condition of an insurer is known as
- Answer-defamation
,Which of the following is NOT a required provision in an accident and health insurance policy? - Answer-
change of occupation
the change of occupation provision is considered an OPTIONAL provision
Which of these statements about Medicaid is CORRECT? - Answer-Funded by federal, sate, and local
taxes
Medicaid is funded by federal, state, and local taxes but is administered by each state.
All of these are considered key factors in underwriting life insurance EXCEPT - Answer-Marital Status
Correct: tobacco use, health history, age
The time limit for filing claim disputes is addressed in which provision of an accident and health policy? -
Answer-legal actions
All of the following plans allow for employee contributions to be taken on a pre-tax basis EXCEPT -
Answer-Health reimbursement Arrangement plan
employers contribute to health reimbursement Arrangement planz (HRA's), not employees.
Which of the following gifts from a producer would NOT be considered rebating? - Answer-$5 pen
A producer quoting life insurance may give an applicant an article of merchandise having an invoice
value of $5.00 or less.
, Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. -
Answer-20
Chris is an insured bricklayer who severed his left hand in an automobile accident. Although his primary
duty cannot be performed, Chris is also a substitute high school teacher. He collects a full disability
income check every month. How does his policy define total disability? - Answer-own occupation
the "own occupation" definition of total disability requires that the insured be unable to perform the
insured's current occupation as a result of an accident or sickness.
Which approach predicts a person's earning potential and determines how much of that amount would
be devoted to dependents? - Answer-Human life value approach
The human life value approach predicts an individual's future earning potential and determines how
much of that amount would be devoted to dependents.
Index whole life insurance contains a securities component that acts as a(n) - Answer-hedge against
inflation
Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit
options would he choose? - Answer-Guaranteed lifetime withdrawal 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.
Which of these factors would an insurer consider when determining whether to accept a group life
plan? - Answer-average age
and insurer would consider the average age when determining whether to accept a group Life Plan.
