Supplementary questions
1.A carrier for a small group health plan may refuse to renew the plan if the employer
A. fails to pay the premium
B. exceeds a specified number of claims
C. falls below a minimum AM Best rating
D. fails to generate minimum revenues
With respect to small group health benefit plans, a carrier may discontinue coverage or may refuse to
renew such a plan if the employer fails to pay the premium prior to the end of the grace period.
2.Coverage for newborns under an accident and health plan MUST include coverage for
A. delivery costs
B. lost wages of the mother
C. birth abnormalities
D. disability of the mother
When the insured gives birth, coverage for eligible newly born children consists of coverage for injury
or sickness including birth abnormalities.
3.Which of the following is considered to be an act of misrepresentation?
A. Giving back part of a producer's commission as an incentive for a sale
B. Replacing an existing policy with a new one
C. Sharing commissions with other licensed producers
D. Falsifying the terms, benefits, advantages, or conditions of an insurance policy
Falsifying the terms, benefits, advantages, or conditions of an insurance policy is an example of
misrepresentation.
4.An alien insurer
A. is an insurer operating in the U.S. but headquartered outside the U.S.
B. is a company that was formed under the laws of another state
C. must be organized under New York insurance laws
D. writes insurance on risks located only outside of New York
An insurance company headquartered in another country is considered an alien insurer in the United
States.
5.The role of the federal government was expanded when Medicaid was established by allowing the
state to
A. receive matching funds to expand public assistance programs
B. defer all costs to the federal government for public assistance programs
C. purchase health insurance from the federal government
D. form a large PPO on a statewide level
The correct answer is "receive matching funds to expand public assistance programs". Medicaid was
created to expand the role of the federal government in health care financing by permitting the state to
receive matching funds to expand public assistance programs.
1
,6.An example of misrepresentation is
A. offering a premium rebate or a special advantage of any kind to a consumer as an inducement to
purchase a contract of insurance
B. providing incorrect, misleading, incomplete, or materially untrue information in the license
application
C. charging a different rate for someone in the same actuarial class
D. making a public statement that contains false or malicious information about an insurance
company
Providing incorrect, misleading, incomplete, or materially untrue information in the license
application is misrepresentation.
7.Which of these is NOT an Unfair Claims Settlement Practice?
A. Providing claim payments to insureds under the guidelines of the insurance contract
B. Failing to acknowledge and act promptly with respect to insurance claims
C. Refusing to pay claims without conducting a reasonable investigation
D. Compelling insureds to initiate a lawsuit by offering less on insurance claims
All of these are Unfair Claims Settlement Practices EXCEPT "Providing claim payments to insureds
under the guidelines of the insurance contract".
8.What is Medicare Part B also known as?
A. Supplementary medical insurance
B. Medicaid
C. Medicare supplement
D. Comprehensive insurance
The correct answer is "Supplementary medical insurance". Medicare Part B is also known as
supplementary medical insurance.
9.A disability policy where the premiums are due monthly require a grace period of
A. 15 days B. 20 days
B. 10 days C. 7 days
An individual accident and health insurance policy with premiums paid monthly has a minimum grace
period of 10 days.
10.An individual who has a contract with an insurance company to represent it is called a(n)
A. administrator
B. representative
C. agent
D. Superintendent
"Insurance agent" or "agent" is a person required to be licensed pursuant to the laws of this state to
sell, solicit, or negotiate insurance.
2
,11.An insurance company that has qualified and received a Certificate of Authority from the
Superintendent to sell insurance in this state is called a(n)
A. admitted insurer
B. unauthorized insurer
C. fraternal organization
D. nonadmitted insurer
An insurance company that has qualified and received a Certificate of Authority from the
Superintendent to sell insurance in this state is known as an admitted insurer.
12.Charles is an agent who is licensed in New York but resides in New Jersey. Charles is considered
to be a(n)
A. admitted agent
B. nonresident agent
C. reciprocal agent
D. foreign agent
An agent who is licensed in another state as a resident and solicits insurance in New York is called a
nonresident agent.
13.The required grace period for an accident and health policy is ___ days for weekly premium
policies.
A. 7 B. 3
B. 9 C. 5
The grace period for a health policy is no less than 7 days for weekly premium policies.
14.Which of the following is Medicare Part B also known as?
A. Medigap
B. Hospital insurance
C. Long-term care insurance
D. Medical insurance
Medicare Part B covers most medically necessary doctors’ services, preventive care, durable medical
equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home
health and ambulance services. You pay a monthly premium for this coverage.
15.The Right-to-Examine period is ___ days for all Long-Term Care Policies sold in New York.
A. 10 B. 30
C 60 D. 45
In New York, the free-look period for Long-Term Care policies is 30 days.
16.Group accident and health insurance policies issued in New York must generally include an
unmarried dependent child who is ___ years old or younger.
A. 20 B. 18
B. 19 C. 21
3
, A family group accident and health insurance policy must continue coverage for each unmarried child
at least until the child turns 19 years old.
17.To be classified as a small employer in New York, an employer must employ
A. 2-50 employees
B. 1-10 employees
C. 2-25 employees
D. 1-100 employees
A small employer is defined as one that employed between 2-50 employees the preceding calendar
year.
18.Which of these may NOT be used in a health insurance advertisement?
A. An insurance company's trademark instead of the company's actual name
B. A celebrity endorsement
C. A statement that highlights coverage amounts
D. A paid testimonial
The name of an insurance company shall be clearly identified in any advertisement.
19.The _______ is responsible for determining the appropriateness of a Medicare Supplement policy
for an applicant.
A. applicant
B. agent
C. insurer
D. underwriter
In New York, the agent who solicits the application is primarily responsible for determining the
appropriateness of a Medicare Supplement policy for a proposed insured.
20.XYZ Corp was issued a group health policy for its employees. Under this plan a
A. policy must be issued to XYZ, and a certificate must be issued to each employee
B. certificate must be issued to XYZ and each employee
C. policy must be issued to XYZ and each employee
D. certificate must be issued to XYZ, and a policy must be issued to each employee
With a group health policy, a policy must be issued to the employer and a certificate must be issued to
each employee.
21.A life insurance policy becomes incontestable after it has been in force for:
A. 1 year
B. 2 years
C. 4 years
D. 3 years
The contestable period in Pennsylvania for life insurance policies is 2 years.
4
1.A carrier for a small group health plan may refuse to renew the plan if the employer
A. fails to pay the premium
B. exceeds a specified number of claims
C. falls below a minimum AM Best rating
D. fails to generate minimum revenues
With respect to small group health benefit plans, a carrier may discontinue coverage or may refuse to
renew such a plan if the employer fails to pay the premium prior to the end of the grace period.
2.Coverage for newborns under an accident and health plan MUST include coverage for
A. delivery costs
B. lost wages of the mother
C. birth abnormalities
D. disability of the mother
When the insured gives birth, coverage for eligible newly born children consists of coverage for injury
or sickness including birth abnormalities.
3.Which of the following is considered to be an act of misrepresentation?
A. Giving back part of a producer's commission as an incentive for a sale
B. Replacing an existing policy with a new one
C. Sharing commissions with other licensed producers
D. Falsifying the terms, benefits, advantages, or conditions of an insurance policy
Falsifying the terms, benefits, advantages, or conditions of an insurance policy is an example of
misrepresentation.
4.An alien insurer
A. is an insurer operating in the U.S. but headquartered outside the U.S.
B. is a company that was formed under the laws of another state
C. must be organized under New York insurance laws
D. writes insurance on risks located only outside of New York
An insurance company headquartered in another country is considered an alien insurer in the United
States.
5.The role of the federal government was expanded when Medicaid was established by allowing the
state to
A. receive matching funds to expand public assistance programs
B. defer all costs to the federal government for public assistance programs
C. purchase health insurance from the federal government
D. form a large PPO on a statewide level
The correct answer is "receive matching funds to expand public assistance programs". Medicaid was
created to expand the role of the federal government in health care financing by permitting the state to
receive matching funds to expand public assistance programs.
1
,6.An example of misrepresentation is
A. offering a premium rebate or a special advantage of any kind to a consumer as an inducement to
purchase a contract of insurance
B. providing incorrect, misleading, incomplete, or materially untrue information in the license
application
C. charging a different rate for someone in the same actuarial class
D. making a public statement that contains false or malicious information about an insurance
company
Providing incorrect, misleading, incomplete, or materially untrue information in the license
application is misrepresentation.
7.Which of these is NOT an Unfair Claims Settlement Practice?
A. Providing claim payments to insureds under the guidelines of the insurance contract
B. Failing to acknowledge and act promptly with respect to insurance claims
C. Refusing to pay claims without conducting a reasonable investigation
D. Compelling insureds to initiate a lawsuit by offering less on insurance claims
All of these are Unfair Claims Settlement Practices EXCEPT "Providing claim payments to insureds
under the guidelines of the insurance contract".
8.What is Medicare Part B also known as?
A. Supplementary medical insurance
B. Medicaid
C. Medicare supplement
D. Comprehensive insurance
The correct answer is "Supplementary medical insurance". Medicare Part B is also known as
supplementary medical insurance.
9.A disability policy where the premiums are due monthly require a grace period of
A. 15 days B. 20 days
B. 10 days C. 7 days
An individual accident and health insurance policy with premiums paid monthly has a minimum grace
period of 10 days.
10.An individual who has a contract with an insurance company to represent it is called a(n)
A. administrator
B. representative
C. agent
D. Superintendent
"Insurance agent" or "agent" is a person required to be licensed pursuant to the laws of this state to
sell, solicit, or negotiate insurance.
2
,11.An insurance company that has qualified and received a Certificate of Authority from the
Superintendent to sell insurance in this state is called a(n)
A. admitted insurer
B. unauthorized insurer
C. fraternal organization
D. nonadmitted insurer
An insurance company that has qualified and received a Certificate of Authority from the
Superintendent to sell insurance in this state is known as an admitted insurer.
12.Charles is an agent who is licensed in New York but resides in New Jersey. Charles is considered
to be a(n)
A. admitted agent
B. nonresident agent
C. reciprocal agent
D. foreign agent
An agent who is licensed in another state as a resident and solicits insurance in New York is called a
nonresident agent.
13.The required grace period for an accident and health policy is ___ days for weekly premium
policies.
A. 7 B. 3
B. 9 C. 5
The grace period for a health policy is no less than 7 days for weekly premium policies.
14.Which of the following is Medicare Part B also known as?
A. Medigap
B. Hospital insurance
C. Long-term care insurance
D. Medical insurance
Medicare Part B covers most medically necessary doctors’ services, preventive care, durable medical
equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home
health and ambulance services. You pay a monthly premium for this coverage.
15.The Right-to-Examine period is ___ days for all Long-Term Care Policies sold in New York.
A. 10 B. 30
C 60 D. 45
In New York, the free-look period for Long-Term Care policies is 30 days.
16.Group accident and health insurance policies issued in New York must generally include an
unmarried dependent child who is ___ years old or younger.
A. 20 B. 18
B. 19 C. 21
3
, A family group accident and health insurance policy must continue coverage for each unmarried child
at least until the child turns 19 years old.
17.To be classified as a small employer in New York, an employer must employ
A. 2-50 employees
B. 1-10 employees
C. 2-25 employees
D. 1-100 employees
A small employer is defined as one that employed between 2-50 employees the preceding calendar
year.
18.Which of these may NOT be used in a health insurance advertisement?
A. An insurance company's trademark instead of the company's actual name
B. A celebrity endorsement
C. A statement that highlights coverage amounts
D. A paid testimonial
The name of an insurance company shall be clearly identified in any advertisement.
19.The _______ is responsible for determining the appropriateness of a Medicare Supplement policy
for an applicant.
A. applicant
B. agent
C. insurer
D. underwriter
In New York, the agent who solicits the application is primarily responsible for determining the
appropriateness of a Medicare Supplement policy for a proposed insured.
20.XYZ Corp was issued a group health policy for its employees. Under this plan a
A. policy must be issued to XYZ, and a certificate must be issued to each employee
B. certificate must be issued to XYZ and each employee
C. policy must be issued to XYZ and each employee
D. certificate must be issued to XYZ, and a policy must be issued to each employee
With a group health policy, a policy must be issued to the employer and a certificate must be issued to
each employee.
21.A life insurance policy becomes incontestable after it has been in force for:
A. 1 year
B. 2 years
C. 4 years
D. 3 years
The contestable period in Pennsylvania for life insurance policies is 2 years.
4
