Correct Answers
Which of the following reimburses its insureds for covered medical
expenses?
- health maintenance organizations
- preferred provider organizations
- commercial insurers
- service providers Correct Answer-COMMERCIAL INSURERS
- Commercial insurance companies function on the reimbursement
approach. Policyowners obtain medical treatment from whatever source
they feel is most appropriate and submit their charges to their insurer for
reimbursement
A business entity can be defined as a(n)
- agency that must only operate outside of TN
- agency that must only operate inside of TN
- association or a limited liability company
- business that requires approval by the Attorney General to transact
business Correct Answer-ASSOCIATION OR A LIMITED LIABILITY
COMPANY
- The definition of a business entity includes an association or limited
liability company
Which of the following health insurance policy provisions specifies the
health care services a policy will provide?
,- insuring clause
- usual, customary, and reasonable clause
- consideration clause
- benefit clause Correct Answer-INSURING CLAUSE
- The insuring clause identifies the specific type of health care services
that are covered by that policy
A Disability Income policy that only the policyowner can terminate and
which the rates will never go up is considered to be
- optionally renewable
- noncancellable
- cancellable
- guaranteed renewable Correct Answer-NONCANCELLABLE
- A disability income policy that only the policyowner can terminate and
on which the rates will never increase is a noncancellable policy
A producer may apply for one or more of the following licenses:
- life insurance
- personal lines property
- accident and health or sickness insurance
- all of the above Correct Answer-ALL OF THE ABOVE
A provision in a life insurance policy that pays the policyowner an
amount that does not surpass the guaranteed cash value is called the:
,- policy loan provision
- automatic premium loan provision
- accelerated benefits provision
- consideration clause Correct Answer-POLICY LOAN PROVISION
- a policy loan will pay the policyowner an amount that, with interest,
does NOT exceed the guaranteed cash value
Long Term Care policies will usually pay for eligible benefits using
which of the following methods?
- Delayed
- fee for service
- expense incurred
- respite Correct Answer-EXPENSE INCURRED
- Most long term care policies pay on a reimbursement (or expense-
incurred) basis, up to policy limits
Which of the following is NOT a limited benefit plan?
- Dental policy
- life insurance policy
- critical illness policy
- cancer policy Correct Answer-LIFE INSURANCE POLICY
- is not a limited benefit plan
, In TN, the definition of "individual" may include which of the
following?
- The individual's children
- the individual's business associates
- the individuals legal representative
- the individuals financial accounts Correct Answer-THE
INDIVIDUALS LEGAL REPRESENTATIVE
- The term "individual" can be associated with an individuals legal
representative
What is the purpose of the Time of Payment Claims Provision?
- Requires the insured to wait 60 days after submitting Proof of Loss
before filing a lawsuit
- prevents delayed claim payments made by the insurer
- requires a probation period for each claim filed by the insured
- protects the insurer from frivolous lawsuits Correct Answer-
PREVENTS DELAYED CLAIM PAYMENTS MADE BY THE
INSURER
- The purpose of the Time of Payment of Claims provision is to prevent
the insurance company from delaying claim payments
What is considered to be a characteristic of an immediate annuity?
- Benefit payments start within one payment period of purchase
- benefit payments start within 5 years of initial purchase
- normally tied to a specific equity or stock index