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Life & Health Insurance Oklahoma Study
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In Oklahoma, a life insurance policy loan may NOT exceed an interest rate of - ✔✔8% Under HIPAA requirements, eligibility for the pre-existing conditions exclusion waiver under new coverage is lost if - ✔✔there is a break in coverage of more than 63 days Which of the following health insurance provisions requires that the application becomes part of the policy? - ✔✔Entire Contract clause impatient psychiatric care is covered under Part A Medicare for 190 days per - ✔✔lifetime What happens when a policyowner borrows against the cash value of his life insurance policy? - ✔✔The policy proceeds would be reduced by the outstanding loan balance ABC Corporation purchases and is beneficiary of an individual disability income insurance policy on a key employee. Which of the following statements is true? - ✔✔Benefits are received tax- free by the company All parts of the Medicare program (except for public information and enrollment) are administered by which federal agency? - ✔✔The Centers of Medicare and Medicaid Services Which of the following is NOT an intended use of an annuity? - ✔✔Create new funds upon the death of wage-earner
Part A Medicare includes coverage for all of the following services EXCEPT - ✔✔ 120 days of Skilled Nursing Facility care Which of these factors does NOT affect the life insurance premium rates? - ✔✔Producer Certification A license is NOT required when you are - ✔✔providing referrals Producers must complete a total of Continuing Education credits for each two-year licensing period. ✔✔ 24 Which life insurance policy would be eligible to include an automatic premium loan provision? - ✔✔Whole life A Guaranteed Renewable provision allows - ✔✔premiums which can only be increased per rate class An insurance producer is BEST defined as - ✔✔a person who has a contract with an insurance company to represent it If a new policy is replacing an existing one, the insured is given the right to return for a full refund of at least how many days after policy delivery. - ✔✔ 20
How long does one premium payment cover in a single premium whole life policy? - ✔✔full life of the policy The interest credited to the cash values of personally-owned non-qualified annuities is considered - ✔✔tax-deferred Which of the following statements accurately describes the "time limit on certain defenses"? - ✔✔After a stated period of time, claims cannot be denied due to material misrepresentation on the application Producers must complete how many hours of continuing education biannually. - ✔✔ 24 Who may terminate coverage under a cancelable health insurance policy? - ✔✔the insurer or the insured The amount of a covered loss to be paid by the insured before a major medical expense policy begins to pay is called the - ✔✔deductible amount What could be the potential result of taking out a cash value loan under a life insurance policy?
- ✔✔Reduces the amount receivable upon surrender of the contract Which of these statements regarding the extended term insurance nonforfeiture option in a life policy is accurate? - ✔✔The premium to purchase the coverage comes from the policy's cash value Which statement concerning the Entire Contract provision in an individual accident and health insurance policy is TRUE? - ✔✔The agent doesn't have the authority to change the policy or waive its provisions
What must be given to a life insurance applicant when the agent receives an application and the initial premium? - ✔✔Conditional receipt A medical expense health plan claim may be denied due to material misrepresentation within how many years of issue. - ✔✔two A preferred provider plan and an indemnity plan are similar in what way? - ✔✔Both pay on a fee-for-service basis Who is required to notify the producer in the event of appointment termination? - ✔✔Insurer What kind of arrangement gives the policyowner the right to change the beneficiary? - ✔✔Revocable designation Proceeds payable under a life insurance contract to a policyowner in anticipation of death are called - ✔✔accelerated benefits The automatic premium loan provision can be accurately described as a - ✔✔provision that provides a policy loan to pay any premiums by the end of the grace period Which statement concerning a decreasing term life policy is accurate? - ✔✔face amount decreases over the policy period
Jerry is a resident producer who has moved to another city in Oklahoma. How long does he have to notify the Insurance Commissioner of the change of address? - ✔✔30 days Omar is covered by a disability income policy. He is hurt while performing an occupation more hazardous than the occupation listed in his policy. The policy's change of occupation provision will have what effect? - ✔✔reduce the benefit level Peter, age 50, surrenders his modified endowment contract (MEC). How is the gain treated in terms of federal income taxes? - ✔✔The gain is treated as taxable income and a penalty tax is imposed on the gain. Before emailing a client an insurance document during a transaction, what must the client provide before the producer can send the document? - ✔✔consent to receive the email Some standard Medicare Supplement policies include which benefit? - ✔✔Hospice care An insured has a $25,000 whole life insurance policy with $6,000 cash value available. Under the extended term nonforfeiture option, what is the amount of insurance available to the insured?
- ✔✔$25, Twisting is - ✔✔replacing an insurance policy from one insurer to another based on misrepresentation A survivorship life insurance policy usually covers how many lives? - ✔✔ 2
If an insured dies during the grace period without having paid the premium, how much will the insurer pay? - ✔✔policy's face amount minus any premiums due An insured files for an accident and health insurance policy claim eight days after the premium due date. The benefit payable is $500 and the overdue premium is $200. Assuming that the policy pays on a first-dollar basis and contains the unpaid premium provision, how much will the insurer pay? - ✔✔$ What is considered a valid reason for an insurer's refusal to pay policy proceeds directly to a minor? - ✔✔Minors are normally not capable of handling money in a reasonable manner Third-part administration has become fairly common in accident and health insurance due to the growth of - ✔✔self funding of benefits Disability income insurance normally excludes coverage for disabilities that arise from - ✔✔active military duty The Fair Credit Reporting Act protects consumers - ✔✔with guidelines regarding credit reporting and distribution Which of these statements regarding Major Medical Expense insurance is NOT true? - ✔✔Benefits are paid on a capitation basis
Which of the following is NOT a condition that must be met for an accidental death benefit to be paid? - ✔✔Cause of death must be from a job-related injury What is the name of the period of time during which a new employee is ineligible for group Health insurance coverage? - ✔✔Probationary period An individual whose producer's license had been suspended continues to perform insurance transactions illegally. This individual could be charged with a felony and fined up to - ✔✔$5, When dealing with long-term care coverage, which of the following are classified as ADLs? - ✔✔Eating, bathing, dressing, and mobility All individual and group health insurance policies that provide coverage for a newborn child require that the insurer be notified of a child's birth. Any additional premium due must be paid within how many days of the child's birth. - ✔✔ 31 What effect can a long-term care benefit rider have on a life insurance policy? - ✔✔reduced death benefit K is an agent who takes an application for individual life insurance and accepts a check from the client. He submits the application and check to the insurance company, however the check was never signed by the applicant. If the application is approved, when will coverage be effective? - ✔✔the date the agent delivered the policy, collected the initial premium, and obtained a good health statement from the insured How long do most states allow an insurance company to delay the payment of a cash surrender under the Delayed Payment provision? - ✔✔6 months
Larry has a Major Medical Expense policy for his family with a $1,000 per family/per year deductible and an 80/20 coinsurance provision. If Larry's family files four claims of $400, $800, $100, and $700 in one year, how much will the insurance company pay? - ✔✔$ The Change of Occupation provision in a Disability Income policy states that, in the event the insured changes to a less hazardous occupation, which of the following may apply? - ✔✔benefits can be increased in the event of a covered claim If an employee loses employment, how long does the employee have to apply for COBRA (continuation of coverage)? - ✔✔60 days What does the rehabilitation benefit cover in a disability income policy? - ✔✔covers the approved cost of the rehabilitation necessary to help a disabled insured return to work Which of these statement is NOT true regarding a cash value loan against a life insurance policy? - ✔✔interest payments made by policyowner are deductible Which of the following does a Medicare Advantage enrollee typically pay for? - ✔✔Small co-pay per visit or per service In Oklahoma, how many hours of impatient care must be provided for an insured mother and her newborn following delivery? - ✔✔ 48 hours for vaginal birth; 96 hours for caesarean section In the event of employment termination, a person covered by a group life policy also has the right to convert such coverage to an individual policy within how many days without proving insurability. - ✔✔ 31
Which of these procedures is NOT designed for ambulatory care centers? - ✔✔Impatient surgery A health insurer MUST provide a proof of loss from - ✔✔within 15 days of receipt of the notice of loss Which of these is a valid reason for an insurer's cancellation of a Medicare Supplement policy? - ✔✔Non-payment of premium How can a group dental insurer discourage adverse selection? - ✔✔limit the duration of coverage Which of these life insurance policies does NOT contain a cash value provision? - ✔✔decreasing term life Which statement is NOT true regarding health insurance policies that provide limited benefits?
- ✔✔only persons under the age of 65 are eligible How is an insured's accident and health claim handled by an insurer if occurs during the policy's grace period? - ✔✔the unpaid premium may be subtracted from the reimbursement Which of the following is NOT subject to the promise to pay in an insuring clause? - ✔✔how the premium is calculated Which of these statements reflects an accurate portrayal of Medicare SELECT? - ✔✔Insured uses preferred providers in exchange for paying lower premiums
Which is an accurate description of the premium in a graded premium life insurance policy? - ✔✔Annual increases in premium for a stated number of years then remains level The Medical Information Bureau consists of members from which group? - ✔✔Insurance companies Which of these is NOT considered the responsibility of a producer during the underwriting process? - ✔✔selecting the final approval date Medicaid will pay for nursing home expenses under what condition? - ✔✔Must have financial need Which of these statements is FALSE regarding immunization benefits for dependent children? - ✔✔Must not be subject to a schedule The health insurance premiums paid for by each partner in a partnership is considered to be - ✔✔100% tax deductible Failing to promptly provide a reasonable explanation for the denial of a claim is considered to be a(n) - ✔✔unfair claim settlement practice Rick owns a variable universal life policy and chooses a variable death benefit option. What will typically happen to the death benefit as a result of this selection? A. Remain the same B. Decrease but never increase
A licensee MUST notify the Commissioner of an address change within how many days of the change. - ✔✔ 30 What type of life insurance is designed to pay the balance of a loan if the insured dies before the loan has been repaid. - ✔✔credit Medicare Part A does NOT provide coverage for - ✔✔the first 3 pints of blood Insurance producer Karey offers clients a $250 shopping card if they purchase an insurance product through her. What is an example of? - ✔✔Rebating Which health policy clause specifies the amount of benefits to be paid? - ✔✔insuring What is payable to the policyowner if a whole life policy is surrendered prior to its maturity date? - ✔✔the cash value Which of the following is generally a form of group credit life insurance? - ✔✔decreasing term insurance Periodic health claim payments MUST be made at least - ✔✔monthly What happens to the death benefit of a life insurance policy if the insured elects a partial payment from the accelerated (living) benefit provision? - ✔✔reduced An accident and health insurance policy's premium requirements are set forth in which of the following provisions? - ✔✔consideration clause
Which of the following statements BEST describes employer contributions for employer provided health insurance? - ✔✔employer contributions are deductible These are all accurate statements regarding universal life insurance EXCEPT - ✔✔policy loans are not permitted The standard provisions of an accident and health insurance policy require that the - ✔✔policy, endorsements, and attached papers constitute the "entire contract" Larry wants to purchase an individual disability income policy to ensure that he will not experience a lapse in income should he become disabled. He has a two-month wage continuation benefit from his employer. What should the policy elimination period be for his individual policy? - ✔✔60 days James is covered with health insurance by two different insurers. The "insurance with other insurers" provision in an individual health insurance policy allows an insurer to pay benefits to the insured on a pro-rata basis when - ✔✔the insurer was not notified prior to the claim that the insured has other health coverage Which of these must be disclosed in a universal life policy? - ✔✔The policy's surrender charges A policyowner has just borrowed from a life insurance policy's cash value. Which of these statements is true? - ✔✔In the event of death, the loan amount is deducted from the policy proceeds An insured is covered with a health insurance policy. If the insured would like to cancel the policy, he/she must - ✔✔notify the insurance company in writing
An insured must provide written proof of loss to the insurer within how many days from the date of loss. ✔✔ 60 Group life plans sold in Oklahoma typically contain a conversion option. If the insured elects this option, the new policy - ✔✔does NOT require evidence of insurability A producer who is licensed in Oklahoma but resident in another state is called a - ✔✔nonresident producer How long must a life insurance policy be in effect before the policyowner may use the nonforfeiture provision? - ✔✔3 years An insurer may pay a commission in which of the following scenarios? - ✔✔To a licensed producer who is appointed with the insurer To be classified as a small employer in Oklahoma, an employer must employ how many eligible employees? - ✔✔1 to 50 Which of the following Long-term care benefits would NOT encourage home health care? - ✔✔Custodial facility care A life insurance policy becomes incontestable after it has been in force for - ✔✔ 2 years
How often must the Commissioner examine each domestic insurance company? - ✔✔Every 5 years An example of an Unfair Claims Settlement Practice is - ✔✔Misrepresenting policy provisions affecting a loss Oklahoma requires that a licensee completes how many hours of continuing education on the subject of ethics every reporting period. - ✔✔ 3 Under the Unfair Claims Settlement Practice Act, the insurer may coup overpaid claims within how many months after payment was made. - ✔✔ 24 Which of the following is a TRUE statement regarding universal life insurance? - ✔✔Policy indicates how much of each premium is used toward company expenses Which statement regarding the cash value of a whole life insurance policy is correct? - ✔✔Available to the policyowner when policy has been surrendered The absolute assignment of a life insurance policy results in - ✔✔all incidents of ownership transferred to the assignee What happens to a life insurance policy when the policy loan balance exceeds the cash value? - ✔✔Policy will no longer be in force Which of the following is NOT guaranteed in a whole life policy? - ✔✔Dividend scale
