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Which of these is NOT a fair marketing practice when an existing insurance policy is being replaced - ✔✔reduce the cost by lowering the commission J applies for an insurance policy. What BEST describes the particular terms of this policy? - ✔✔Policy summary Which mode of payment is NOT used by health insurance policies? - ✔✔Single Premium XYZ Corp was issued a group Accident and Health policy for its employees. Under this plan a - ✔✔policy must be issued to XYZ, and a certificate must be issued to each employee Which of the following statements about a Guaranteed Renewable Health Insurance policy is CORRECT? - ✔✔Premiums normally increase at time of renewal In Tennessee, the MAXIMUM fine that the Commissioner can impose on a producer is _ per violation - ✔✔$1, What authority does the Commissioner have over Tennessee producers? - ✔✔the commissioner may establish guidelines for continuing education as a part of the producer license renewal procedure C is the policy owner of a Comprehensive individual Major Medical policy. C pays an annual premium which is due September 1. If C forget to pay the premium and is hospitalized
September 10, how will the insurer handle the claim? - ✔✔Pay the claim in full minus the premium due (Because the grace period is 31 days for Individual Accident and Health policies paid annually, this claim will be paid minus the premium due) What is the initial requirement for an insured to become eligible for benefits under the Waiver of Premium provision? - ✔✔Insured must be under a physician's care Medicare Part C is: - ✔✔Available to those who are enrolled in Medicare part A and B A(n) _ of benefits of a Health Policy transfers payments to someone other than the policyowner
- ✔✔assignment Insurance contracts may be sold, solicited, or negotiated by an insurance producer ONLY upon - ✔✔becoming an appointed producer of an insurer Before a health insurance policy is issued, which of these components of the contract is required? - ✔✔Applicant's signature on application Which of the following actions will an insurance company most likely NOT take if an applicant, who has diabetes, applies for a Disability Income policy? - ✔✔Issue the policy with an altered Time of Payment of Claims provision The insurance Commissioner is REQUIRED to do which of the following before holding a hearing that could lead to the suspension of a producers license. - ✔✔give written notice to the producer
D the agent met with a prospect and ended up selling an insurance policy. While filling out the insurance application, D makes a mistake. In this situation, D MUST - ✔✔Correct the information and have the prospect initial the change Which of the following is the purpose of the Tennessee Guaranty Association? - ✔✔all of the above Which of the following actions may NOT be taken by an insurance company to insure a substandard applicant for disability income coverage? - ✔✔Lengthen the contestability period An insurance producer could be found guilty of rebating by - ✔✔sharing commissions with a client who has purchased insurance Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures? - ✔✔Commercial insurer Who determines the education credits needed for a producer's continuing education? - ✔✔Commissioner of Commerce and insurance Dental care coverage is designed to cover the costs of all of the following EXCEPT: - ✔✔loss of income P is self-employed and owns an Individual Disability Income policy. He becomes totally disabled on June 1 and receives $2,000 a month for the next 10 months. How much of this income is subject to federal income tax? - ✔✔$
Which of the following types of health coverage frequently uses a deductible? - ✔✔Major Medical policy P is a producer who notices 5 questions on a life application were not answered. What actions should P take? - ✔✔Set up a meeting with the applicant to answer the remaining questions An insured covered by a group Major Medical plan is hospitalized after sustaining injuries that resulted from an automobile accident. Assuming the plan had a $1,000 deductible and an 80/ Coinsurance clause, how much will the INSURED be responsible to pay with $11,000 in covered medical expenses? - ✔✔$3, The Tennessee Guaranty Association is subject to review and regulation by the Commissioner. A financial statement must be submitted no later than of each year - ✔✔March 30th The Tennessee Insurance Guaranty Association - ✔✔Protects Tennessee insurance policy owners in the event an insurance company becomes insolvent When must insurable interest exist for a life insurance contract to be valid? - ✔✔Inception of the contract Which of these is a valid Tennessee regulation for referral fees? - ✔✔The Commissioner may establish by rule a maximum amount for each referral All of these insurance subjects qualify for continuing education credits in Tennessee EXCEPT: - ✔✔Motivating producers Medicare Part B does NOT cover - ✔✔inpatient hospital services
Qualified Long-Term Care policies may take into consideration an applicant's pre-existing conditions for a maximum of not more than month(s) prior to the effective date of coverage.
- ✔✔ 6 The Commissioner notifies the association of an insolvent insurer no later than _ days after receiving notice of the insurer's insolvency. - ✔✔ 3 What should an insured do if the insurer does not send claims forms within the time period set forth in a health policy's Claims Forms provision? - ✔✔Submit the claim in any form Which of the following would best describe the actions of an insurer who promises the cheapest premium rates in the United States? - ✔✔false advertising Which of the following is NOT a requirement to sell, solicit, or negotiate Long-Term Care insurance? - ✔✔complete a one-time 4 hour course on estate planning M's insurance company denied a reinstatement application for her lapsed health insurance policy. The company did not notify M of this denial. How many days from the reinstatement application dates does the insurance company have to notify M of the denial before the policy will be automatically placed back in force? - ✔✔45 days Generally, how long is a benefit period for a Major Medical Expense Plan? - ✔✔one year When engaged in an insurance transaction in Tennessee, the producer represents the - ✔✔insurer Unfair discrimination is BEST described as - ✔✔charging a different rate for someone in the same actuarial class
What action should a producer take if the initial premium is NOT submitted with the application? - ✔✔Forward the application to the insurer without the initial premium In order to establish a Health Reimbursement Arrangement (HRA), it MUST: - ✔✔be established by the employer When does a Probationary Period provision become effective in a health insurance contract? - ✔✔At the policy's inception M has a Major Medical insurance policy with a $200 flat deductible and an 80% Coinsurance clause. If M incurs a $2,200 claim for an eligible medical expense, how much will M receive in payment for this claim? - ✔✔$1, A Long-Term Care policy sold in Tennessee MUST be - ✔✔Guaranteed renewable In Major Medical Expense policies, what is the objective of a Stop Loss provision? - ✔✔Limits an insured's out-of-pocket medical expenses If a producer commits an act of coercion or intimidation, how would the producer's insurance company be held responsible for this act? - ✔✔If the insurer approves of the act Why is an applicant's signature required on a life insurance application? - ✔✔To attest that the statements on the application are accurate to the best of the applicant's knowledge
What is the maximum fine that can be imposed by the Commissioner to a producer who violates an insurance law? - ✔✔$1,000 per violation Which of the following BEST describes a warranty? - ✔✔Statement guaranteed to be true Which of these actions should a producer take when submitting an insurance application to an insurer? - ✔✔Inform insurer of relevant information not included on the application Which statement is TRUE regarding a group accident & health policy issued to an employer? - ✔✔The employer receives the policy and each employee is issued a certificate B is an insurance producer who occasionally engages in financial planning. If B sells an insurance policy during the course of a financial planning seminar, B must disclose to the client - ✔✔that a commission will be earned in addition to any fee charged for financial planning All of these are powers of the Commissioner EXCEPT - ✔✔incarcerate a producer Which of the following is NOT a limited benefit plan? - ✔✔life insurance policy Which statement is true regarding a minor beneficiary - ✔✔Normally, a guardian is required to be appointed in the Beneficiary clause of the contract Which of these is NOT a legitimate insurance marketing practice for obtaining business from a competitor? - ✔✔Reducing commissions in order to make a sale
A Disability Income policyowner recently submitted a claim for a chronic neck problem that has now resulted in total disability. The original neck injury occurred before application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of application. How will the insurer handle this claim? - ✔✔Claim will be paid and coverage will remain in force Which of the following medical expenses does Cancer insurance NOT cover? - ✔✔arthritis T was insured under an individual Disability Income policy and was severely burned in a fire. As a result, T became totally disabled. The insurer began making monthly benefit payments, but later discovered that the fire was set by T in what was described as arson. What actions will the insurer take? - ✔✔The insurer will rescind the policy, deny the claim, and recover all payments made Which of the following BEST describes a Hospital Indemnity policy? - ✔✔Coverage that pays a stated amount per day of a covered hospitalization Why must an accident & health insurance applicant answer all questions on the application? - ✔✔Statements and representations on the application are part of the consideration for issuing a policy The Health Insurance Portability and Accountability Act (HIPAA) gives privacy protection for: - ✔✔health information Which of the following statements is true about most Blue Cross/Blue Shield organizations? - ✔✔They are nonprofit organizations A provision that the policy, application, and all attachments shall constitute the _ between the parties. - ✔✔Entire Contract
An individual health insurance policy is REQUIRED to contain a(n) - ✔✔Payment of Claims provision
