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Final Exam - California Life and Health Question & Answers 2025
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Employer-provided group term life insurance is exempt from income taxation up to - CORRECT ANSWERS ✔✔$50, Medicare Part B has an initial enrollment period. How many months after an individual's 65th birthday month does this enrollment period end? - CORRECT ANSWERS ✔✔3 months Which statement is true regarding policy dividends? - CORRECT ANSWERS ✔✔A dividend option is selected by the insured at the time of policy purchase What does the insurance term "indemnity" refer to? - CORRECT ANSWERS ✔✔Make whole What is a common reason people purchase an annuity? - CORRECT ANSWERS ✔✔To protect against the risk of outliving their financial resources The importance of a representation is demonstrated in what rule? - CORRECT ANSWERS ✔✔Materiality of concealment
Who does a life settlement broker represent? - CORRECT ANSWERS ✔✔Individual wanting to sell their life policy to a third party Who is financially liable for the payment of covered claims in a fully insured group health plan? - CORRECT ANSWERS ✔✔Insurer The Human Life Value concept is based on - CORRECT ANSWERS ✔✔income Business Overhead Expense Insurance pays for - CORRECT ANSWERS ✔✔business expenses when a business owner becomes disabled At what point does a self-insured group qualify for stop-loss coverage? - CORRECT ANSWERS ✔✔When claims exceed a specified limit in a set period of time What percentage of eligible employees must participate in a noncontributory group health plan before it can be put in effect? - CORRECT ANSWERS ✔✔100% A life insurance policy where the insured can choose where the cash value can be invested is called - CORRECT ANSWERS ✔✔variable life
Cindy buys a 10-year certain annuity with an installment refund. After receiving monthly payments for 5 years, Cindy dies. How many remaining payments will the insurer make to her beneficiary? - CORRECT ANSWERS ✔✔60 payments he free-look period for life insurance policyowners age 60 or older is - CORRECT ANSWERS ✔✔30 days What is considered to be the definition of disability, according to Social Security? - CORRECT ANSWERS ✔✔Unable to engage in any substantial gainful activity "Life insurance creates an immediate estate". This phrase means: - CORRECT ANSWERS ✔✔when the insured dies, a death benefit is paid How are death benefits that are received by a beneficiary normally treated for tax purposes? - CORRECT ANSWERS ✔✔Exempt from federal income taxes Exempt from federal income taxes - CORRECT ANSWERS ✔✔Payment for services goes directly to the provider
When an insurance company requests an attending physician's report, the request must be accompanied by a - CORRECT ANSWERS ✔✔copy of the signed authorization Which policy provision protects the policyowner from unintentional lapse of the contract? - CORRECT ANSWERS ✔✔Grace period What kind of annuity pays income to two annuitants until their deaths?
Which of the following is a contract that involves one party which indemnifies another when a loss arises from an unknown event? - CORRECT ANSWERS ✔✔Insurance policy Which of the following is a situation where there is a possibility of either a loss or a gain? - CORRECT ANSWERS ✔✔Speculative risk An agent's attempt to stop the replacement of an existing life insurance policy is known as - CORRECT ANSWERS ✔✔conservation Who would be most likely to submit a Medicare Part A claim? - CORRECT ANSWERS ✔✔Hospital In California, an insurer organized under the state laws of Oregon is called a(n) - CORRECT ANSWERS ✔✔foreign insurer Under a health insurance policy, the provision that states the kind of benefits provided and the circumstances under which they will be paid is called the? - CORRECT ANSWERS ✔✔insuring clause What distinguishes a deferred annuity from an immediate annuity? - CORRECT ANSWERS ✔✔The time at which benefit payments start
The elimination period in a disability income policy serves the same purpose as - CORRECT ANSWERS ✔✔a deductible Which of the following is NOT a common life insurance policy rider? - CORRECT ANSWERS ✔✔extended term When an accidental death benefit is added to a whole life policy, how does this affect the policy's cash value? - CORRECT ANSWERS ✔✔Policy's cash value is not affected An insured is protected from the expense of a catastrophic illness by which of the following health insurance provisions? - CORRECT ANSWERS ✔✔Stop-loss A hazard can be best described as - CORRECT ANSWERS ✔✔a condition that may increase the likelihood of a loss occuring Which of the following is NOT a true description of non-medical life insurance? - CORRECT ANSWERS ✔✔Applicants are not required to answer medical questions on the application
How does underwriting differ between group life and individual life insurance? - CORRECT ANSWERS ✔✔Medical questions must be answered on individual life insurance The risk selection process is primarily given to which insurance company department? - CORRECT ANSWERS ✔✔Underwriting Which of the following describes the increase in the probability of a loss due to an insured's dishonest tendencies? - CORRECT ANSWERS ✔✔Moral hazard he California Insurance Code defines "policy" as a(n) - CORRECT ANSWERS ✔✔written contract Who is NOT eligible for Social Security survivor benefits? - CORRECT ANSWERS ✔✔A deceased worker's dependent parents of any age How are acts of war and aviation treated under a group life insurance policy? - CORRECT ANSWERS ✔✔Policy exclusion
How are acts of war and aviation treated under a group life insurance policy? - CORRECT ANSWERS ✔✔Policy exclusion Which of the following is NOT an important reason for a life insurance application? - CORRECT ANSWERS ✔✔The beneficiary must sign the application before the insurer will issue the policy Coverage for care received from a network provider pays more than care received from a non-network provider in what type of health plan?
Bruce is involved in an accident and becomes totally and permanently disabled. His insurance policy continues in force without payment of further premiums. Which policy provision is responsible for this? - CORRECT ANSWERS ✔✔Waiver of premium provision A unilateral contract is one in which - CORRECT ANSWERS ✔✔only one party (the insurer) makes any kind of legally enforceable promise The problem of overinsurance is addressed in which health insurance provision? - CORRECT ANSWERS ✔✔Coordination of benefits What prevents a life insurance policy from being rescinded by the insurer after being in force for two years? - CORRECT ANSWERS ✔✔Incontestability clause Which of the following is NOT included under long-term care insurance?
The misstatement of age provision in a health policy states that if an insured gives the wrong age at the time of application, what action can the insurance company take? - CORRECT ANSWERS ✔✔Benefits can be adjusted Which of the following is NOT a risk classification that an underwriter would use? - CORRECT ANSWERS ✔✔Dividend risk Pete is a life agent who has misappropriated fiduciary funds to his own use. What is Pete guilty of? - CORRECT ANSWERS ✔✔Theft An insurer that has been found using higher rates based on race, religion, or ethnicity is said to be engaging in - CORRECT ANSWERS ✔✔unfair discrimination During the underwriting process for a group health policy, it was discovered that 15 out of 50 members of the group have major health issues. How would the insurer handle this? - CORRECT ANSWERS ✔✔Accept or reject the whole group
Who is issued a certificate of insurance with a group insurance policy? - CORRECT ANSWERS ✔✔Participant John owns an insurance policy that gives him the right to share in the insurer's surplus. What kind of policy is this? - CORRECT ANSWERS ✔✔Participating Which of the following is NOT a benefit of insurance? - CORRECT ANSWERS ✔✔Losses due to fraud are eliminated Which statement regarding Medicare is true? - CORRECT ANSWERS ✔✔Benefits for diagnostic tests and X-rays performed on an outpatient basis are provided by Part B What is the price of insurance for each exposure unit? - CORRECT ANSWERS ✔✔Rate Which of the following risk classifications charges the lowest premium?
According to the California Insurance Code, what is the maximum penalty per violation for anyone who unwillfully commits an unfair method of competition? - CORRECT ANSWERS ✔✔$5, Jim is applying to become an insurance agent and has a past misdemeanor conviction that was later expunged due to California Penal Code 1203.4. Which of the following statements is correct? - CORRECT ANSWERS ✔✔Jim must still disclose the conviction on his insurance license application Which of the following are two examples of activities of daily living (ADL's) used in qualifying for long-term care benefits? - CORRECT ANSWERS ✔✔Eating and dressing Which of the following is NOT typically covered under vision care insurance? - CORRECT ANSWERS ✔✔Eye surgery The "blackout period" affects whose benefits? - CORRECT ANSWERS ✔✔Surviving spouse The insurer has the option of terminating a health insurance policy on a date stated in the contract. What type of policy is this? - CORRECT ANSWERS ✔✔Optionally renewable
Which word implies permissiveness according to the California Insurance Code? - CORRECT ANSWERS ✔✔May What does the term coinsurance refer to? - CORRECT ANSWERS ✔✔After the deductible is satisfied, the percentage paid by the insured for the remaining covered expenses Which of the following is any situation that presents the possibility of a loss? - CORRECT ANSWERS ✔✔Loss exposure The conditions, times, and circumstances under which an insured is NOT covered by a health policy are called? - CORRECT ANSWERS ✔✔exclusions Medical expense policies will typically cover which of the following? - CORRECT ANSWERS ✔✔Injuries caused by accidents Any changes in background information that occur after a producer application has been submitted or a license has been issued MUST be reported to the Insurance Commissioner within - CORRECT ANSWERS ✔✔30 days
Which of the following would NOT be accomplished with the purchase of an insurance policy? - CORRECT ANSWERS ✔✔Risk is eliminated Paul has an existing annuity and is sold a new one, in which the new policy holds no greater financial benefit to him than the existing contract. This is considered a(n) - CORRECT ANSWERS ✔✔unnecessary replacement Mark, age 45, has a Modified Endowment Contract (MEC). What is the tax penalty for taking a loan against this policy prior to age 59 1/2? - CORRECT ANSWERS ✔✔10% Which of the following best describes the statement "The more times an event is repeated, the more predictable the outcome becomes"? - CORRECT ANSWERS ✔✔Law of large numbers When an applicant applies for insurance, the process by which the insurer determines whether to issue a policy is called - CORRECT ANSWERS ✔✔underwriting In regards to a group health insurance plan, which statement is CORRECT? - CORRECT ANSWERS ✔✔A non-contributory group health plan must cover all eligible members