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Ohio Health and Life Insurance Practice 2025
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The type of policy where the insurer can send a notice to the insured that the policy has been cancelled in the middle of the term is called - ✔✔cancelable Krissa purchases a 10 - year level term life insurance policy that has a death benefit of $200,000. Which of these statements is true? The policy automatically converts to whole life after the 10-year period - ✔✔The face amount and premium will remain constant over the 10 year period Which of the following provides Medicare supplement policies? - ✔✔Private insurance companies Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the - ✔✔employee's waiting period for coverage of a preexisting condition can be reduced under the new employer's health plan Which of the following is typically NOT eligible for the coverage in a group health policy? - ✔✔Temporary employee Which of the following is a reinstatement condition? - ✔✔Proof of insurability Ohio requires that a licensee complete hours of continuing education on the subject of ethics every reporting period. - ✔✔ 3
Carole is a licensed agent who lives in Michigan and transacts insurance in Ohio. In Ohio, Carole is considered to be a - ✔✔nonresident agent Long- term care insurance applications must contain plain and unambiguous health questions. The exception to this rule would be applications for - ✔✔guaranteed issue Continuous 24- hour care provided by licensed medical professionals under the direct supervision of a physician is called - ✔✔skilled nursing care The entire contract includes the actual policy and the - ✔✔application The branch of dentistry which deals with the replacement of missing parts is called - ✔✔Prosthodontics An agent's license has been suspended for non-renewal. The agent my apply for reinstatement
- ✔✔within 12 months of the license renewal date Which of the following is an annuity that is linked to a market-related index? - ✔✔Equity- indexed annuity A closed network plan offers a a primary physician copay of $25. If a subscriber chooses a primary care physician outside of the network, the subscriber will likely pay - ✔✔100% of the billed amount An accident and health insurer has just received written proof of loss from one of its insureds. The insured must now wait 60 days before - ✔✔bringing legal action against the insurer
A spouse and child can be added to the primary insured's coverage as what kind of rider? - ✔✔Family Term What is known as the immediate specific event causing loss and giving rise to risk? - ✔✔Peril Insurance agent Kelly offers a prospect a $1,000 shopping card if an insurance policy is purchased through her. What illegal activity is this an example of? - ✔✔Rebating A provision that allows a policyowner to withdraw a policy's cash value interest free in a - ✔✔partial surrender An employee has days after the date of marriage to add a new spouse to a small group health plan. - ✔✔ 30 days All of these are considered forms of advertising EXCEPT - ✔✔An insurer's AM Best rating A Medicare supplement plan can be canceled by the insurer - ✔✔for nonpayment of premiums Which of these preventative care services is NOT provided by health insuring corporation (HIC) primary care physicians? - ✔✔Hearing screenings Under group health insurance, a certificate of coverage is issued to the - ✔✔employee
Preferred risk policies with reduced premiums are issued by insurance companies because the insured has - ✔✔better than average mortality or morbidity experience An insurer may refuse to renew an employer's small group health plan due to - ✔✔nonpayment of premium Which of these is a method of determining the level of funds required for ongoing support in the event of the breadwinner's death? - ✔✔Human Life Value A Long-term care policy typically provides all of the following levels of care EXCEPT - ✔✔acute care Pre-death distributions from a modified endowment contract (MEC) receive different tax treatment than other life insurance policies because - ✔✔the MEC tends to be an investment vehicle An employer with under 20 employees must allow a terminated employee to continue accident and health coverage for a MINIMUM of months. - ✔✔ 12 How does one become eligible for Part D: Prescription Drug coverage? - ✔✔must have Medicare Which of these is NOT a legal reason for an HIC to release a subscriber's confidential health information? - ✔✔Public interest
Which of the following is NOT a common exclusion for a medical expense policy? - ✔✔Physical therapy Which of the following is required for an insurer to conduct business in this state? - ✔✔Certificate of authority is NOT an element of a valid contract - ✔✔countersignature If an agent is believed to be causing considerable harm, the superintendent - ✔✔may issue a cease and desist order against the agent The factor used most often when underwriting a disability income policy is - ✔✔annual earnings Which contract element is insurable interest a component of? - ✔✔Legal purpose The free- look provision gives the policyowner - ✔✔the right to return the policy for a full refund within a specified number of days A business will typically use which type of life insurance to cover their employees? - ✔✔Group policy An insurance company has just received a request for verification from a viatical settlement provider. The insurer is required to respond within calendar days of this request. - ✔✔ 30 Which of these annuities require premium payments that vary from year to year? - ✔✔flexible premium deferred annuity
Under a Modified Endowment Contract, what are the likely tax consequences? - ✔✔Pre-death destructions will become taxable A dread disease policy is considered to be a type of - ✔✔limited health insurance policy Which of the following statements is CORRECT regarding an individual applying for life or health insurance? - ✔✔The applicant's medical history may be analyzed and reported All of these are valid policy dividend options for a life insurance policyowner EXCEPT - ✔✔accumulate without interest A life insurance policyowner is allowed days upon policy delivery to return the policy for a full premium refund - ✔✔ 10 All of the following are considered to be nonforfeiture options available to a policyowner EXCEPT - ✔✔Reduction of premium An interest-sensitive life insurance policyowner may be able to withdraw the policy's cash value interest free. The provision that allows this is called - ✔✔Partial Surrender A life insurance applicant in Ohio may backdate the application for up to month(s) - ✔✔ 3
Sole proprietors are permitted tax deductions for health costs paid from their earnings in the amount of - ✔✔100% of costs Unmarried children who are incapable of self support and have proof of incapacity are included under their parent's health coverage until - ✔✔policy termination Kristi purchases an annuity that will pay her husband an income for 15 years. If he dies, this income will become payable to their children for the remainder of the period. Kristi has what kind of annuity? - ✔✔Temporary annuity certain Which type of coverage pays an amount per day for hospitalization directly to the insured regardless of the insured's other health insurance? - ✔✔Hospital indemnity Shawn, Mike, and Dave are brothers who have a $100,000 "first to die" joint life policy covering all three of their lives. If Mike dies first, the policy proceeds - ✔✔will no longer provide insurance protection A 70 - year old insured indiviual has suffered from a kidney failure for the past 24 months. She is covered by her spouse's large- group employer plan. How will Medicare be utilized in this situation? - ✔✔Will be the secondary insurer and pay for claims not fully covered by the group plan In an employer- sponsored contributory group Disability income plan, the employer pays 60% of the premium and each employee pays 40% of the premium. Any income benefits paid are taxed to the employee at - ✔✔60% of the benefit When calculating the amount of life insurance needed for an income earner, what has to be determined when using the Needs Approach? - ✔✔The family's financial objectives if the income earner were to die or become disabled
"Maximum benefits" refer to the - ✔✔upper limit of the total lifetime benefits the insurance company will pay When a decreasing term policy is purchased, it contains a decreasing death benefit and - ✔✔level premiums What is a corridor in relation to a Universal Life insurance policy? - ✔✔The gap between the total death benefit and the policy's cash value An insurer can exclude coverage for a preexisting condition on a Medicare Supplement policy for up to - ✔✔ 6 months An insurer must furnish to a claimant forms for filing proof of loss within days upon receiving a notice of claim. - ✔✔ 15 An example of a health insuring corporation (HIC) specialty care provider is a(n) - ✔✔neurologist Insurance represents the process of risk - ✔✔transference Premiums paid that exceed 7 1/2% of an insured's Adjusted Gross Income (AGI) are tax- deductible when paid for which of the following plans? - ✔✔Qualified Long- Term Care plan Sharon is the policyowner of a $50,000 life insurance policy. Her son, Mike, is the beneficiary. If Sharon MUST obtain Mike's signature in order to change the beneficiary, what kind of beneficiary designation is this? - ✔✔Irrevocable
In group health care, what is the purpose of the coordination of benefits provision? - ✔✔Determines what is paid by the primary and secondary insurers in the event of a claim Mortality is calculated by using a large risk pool of - ✔✔people and time Frank is shopping for a disability income policy. Which of the following would have the HIGHEST premium? - ✔✔ 14 day waiting period/ 10 year benefit period What is considered to be the primary reason for buying life insurance? - ✔✔Provide death benefits An insurance producer is often responsible for field underwriting during the application process. All of these are possible field underwriting roles EXCEPT - ✔✔providing commission information to the applicant What is involved when a life insurance policy has been backdated? - ✔✔Making the policy effective on an earlier date than the present Which of the following is NOT typically included under "hospital care" for the most health insuring corporation (HIC) plans? - ✔✔Private duty nursing An agent has committed an insurance crime that violates US Code 1033 (interstate commerce). Who would be responsible for the prosecution of this crime? - ✔✔US Attorney General Which disability policy provision would address any concerns of the value of the benefits decreasing over time? - ✔✔Cost of living benefit
How soon can the benefit payments begin with a deferred annuity? - ✔✔A minimum of 12 months after date of purchase Which of these factors is NOT taken into consideration when determining the cost of a long- term care policy? - ✔✔Personal income An agent is legally permitted to share his/her commissions - ✔✔with another licensed agent The waiver of premium does NOT include which provision? - ✔✔All future premiums are waived if the insured recovers from the disability An employer is issued a group medical insurance policy. This single contract is known as a(n) - ✔✔Master policy Who is the individual paid on a fee-for-service basis - ✔✔Provider Which type of plan would be most appropriate for an individual on Medicare and is concerned that Medicare will NOT pay for charges exceeding the approved amount? - ✔✔Medicare supplement Plan F Lisa has recently bought a fixed annuity. Which of these is considered to be a disadvantage of owning this type of annuity? - ✔✔During periods of inflation, annuitants will experience a decrease in purchasing power of their payments Long- Term care policies may provide coverage for claims arising from - ✔✔senile dementia
When an insured has a major medical plan with first dollar coverage, how does this impact the benefits paid? - ✔✔No deductible payment is required A rehabilitation benefit is intended to - ✔✔prepare the insured to return to employment James is the insured on a life insurance policy where his age was misstated on the application. Which of the following is CORRECT regarding the death benefit amount? - ✔✔The death benefit paid will be what the premium would have purchased at the correct age According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual - ✔✔is eligible for coverage upon hire An agent's renewal date for his/her license is on or before - ✔✔the last day of the licensee's birth month Which situation accurately describes a reduced paid- up nonforfeiture option? - ✔✔Policy has a decreased face amount Under the Affordable Care Act, a large employer that does NOT provide health insurance and owes an employer mandate penalty MUST pay an annual penalty, which is calculated by multiplying $2,000 by - ✔✔the number of full time employees minus 30 Which of these is a TRUE statement regarding HIC's - ✔✔HIC's operate on a prepayment basis
A clause that allows an insurer the right to terminate coverage at any anniversary date is called a(n) - ✔✔optional renewability clause Who provides all preventative and routine medical care given to a health insuring corporation (HIC) member? - ✔✔Primary care physician Coverage for newborns under an accident and health plan MUST include coverage for - ✔✔birth abnormalities A minor may receive a life insurance policy's death benefit ONLY - ✔✔if the minor has an appointed guardian A disability elimination period is best described as a - ✔✔time deductible All of the following plans allow for employee contributions to be taken on a pre- tax basis EXCEPT - ✔✔Health Reimbursement Arrangement Plan The Superintendent determines an examination of an insurer's books and records is necessary. After receiving the notification, the insurer - ✔✔must not impede the examination An attending physician's statement would be appropriate for which of the following life insurance purpose? - ✔✔At the request of the insurer to assist in the underwriting decision An agent's license may only be suspended or revoked if the agent - ✔✔has been afforded a right to a hearing An example of endodontic treatment is a - ✔✔root canal
