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Texas Insurance Regulations and Policies, Exams of Personal Health

A comprehensive overview of various insurance regulations and policies in the state of texas. It covers a wide range of topics, including insurance company licensing, agent responsibilities, policy provisions, insurance types (life, health, disability, etc.), and relevant laws and regulations. Likely intended for insurance professionals, such as agents, brokers, and underwriters, as well as individuals interested in understanding the insurance landscape in texas. The level of detail and technical terminology suggest that this document would be most useful for university-level insurance or risk management courses, as well as for insurance industry professionals seeking to stay up-to-date on the latest regulations and best practices.

Typology: Exams

2024/2025

Available from 09/29/2024

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Texas Life, Health Insurance
Examination
1. A certificate of authority does which of the following? - ✔✔Permits
an insurance company to transact business in Texas
2. A creditor who requires a debtor to obtain insurance from a
particular company or agent as a condition for a loan is guilty of -
✔✔coercion
3. 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 the 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
4. A foreign insurance company is one that is incorporated - ✔✔under
the laws of another state
5. A Health Maintenance Organization (HMO) may issue an Evidence of
Coverage form after it has been approved by the - ✔✔Commissioner
of Insurance
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Texas Life, Health Insurance

Examination

  1. A certificate of authority does which of the following? - ✔✔Permits an insurance company to transact business in Texas
  2. A creditor who requires a debtor to obtain insurance from a particular company or agent as a condition for a loan is guilty of - ✔✔coercion
  3. 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 the 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
  4. A foreign insurance company is one that is incorporated - ✔✔under the laws of another state
  5. A Health Maintenance Organization (HMO) may issue an Evidence of Coverage form after it has been approved by the - ✔✔Commissioner of Insurance
  1. A Key Employee policy is taken out by Company X on its vice president. Ten years later, this employee leaves Company X and begins working for Company Y. If this individual were to die and the policy is still in force and unchanged, where would the death proceeds be directed? - ✔✔Company X
  2. A level premium indicates - ✔✔the premium is fixed for the entire duration of the contract
  3. A life insurance illustration is NOT required to include the - ✔✔company's mortality table
  4. A life policy with a death benefit that can fluctuate according to the performance of its underlying investment portfolio is referred to as - ✔✔Variable Life
  5. A Long-Term Care policy must offer a MINIMUM benefit period of how many months? - ✔✔ 12
  6. A newly licensed General Lines agent must complete a MINIMUM of how many hours of continuing education within 24 months after initial license? - ✔✔24 hours
  7. A noncontributory group term life plan is characterized by - ✔✔the entire cost of the plan is paid for by the employer
  1. All students attending a large university could be covered by - ✔✔a blanket policy
  2. An agent is an individual that represents whom? - ✔✔Insurer
  3. An agent may legally share commissions only with - ✔✔another agent who is licensed in the same line of insurance
  4. An agent who tells a client that dividends are guaranteed may be guilty of - ✔✔misrepresentation
  5. An agent who tells claimants that their rights may be impaired if they fail to complete a release form within a given period of time could be guilty of - ✔✔coercion
  6. An agent whose license has been revoked is required to - ✔✔wait at least five years before applying for a new license
  7. An enrollee of a Health Maintenance Organization (HMO) may be cancelled or nonrenewed for which of the following reasons? - ✔✔Failure to pay for coverage
  8. An individual life insurance policy issued in Texas MUST have a grace period for premium payment of how many days? - ✔✔ 31
  1. An insurance agent does NOT have fiduciary responsibilities to - ✔✔other agents
  2. An insurance company may NOT reject a prospective insured's life application on the basis of which of the following factors?
    • Height
    • Weight
    • Gender
    • Medical history - ✔✔gender
  3. An insurance company must do which of the following to terminate an agent's appointment? - ✔✔Send notice of the termination to the Texas Department of Insurance
  4. An insurance company normally has 2 years to contest information provided on an accident and health application. This 2 year period begins on the date that the - ✔✔insurer dates the policy
  5. An insured is past due on his life insurance premium, but is still within the Grace Period. What will the beneficiary receive if the insured dies during this Grace Period? - ✔✔Full face amount minus any past due premiums
  6. An insurer must provide an insured with claim forms within __ days after receiving notice of a loss. - ✔✔ 15

dies. Although E was married with three children at the time of death, the primary beneficiary is still F. However, an insurable interest no longer exists. Where will the proceeds from E's life insurance policy be directed to? - ✔✔In this situation, the proceeds from E's life insurance policy will go to F.

  1. F needs life insurance that provides coverage for only a limited amount of time with a death benefit that changes regularly according to a schedule. What kind of policy is needed? - ✔✔Decreasing term policy
  2. G purchased a Family Income policy at age 40, The policy has a 20- year rider period. If G were to die at age 50, how long would G's family receive an income? - ✔✔10 years
  3. How long does the coverage normally remain on a limited-pay life policy? - ✔✔age 100
  4. How long is the typical free look period for Long Term care insurance policies? - ✔✔30 days
  5. If a retiree on Medicare required five hospital stays in one year, which policy would provide the best insurance for excess hospital expenses? - ✔✔Medicare Supplement
  1. If an insurance company is organized under the laws of New Jersey and licensed to do business here, it is considered which of the following in Texas? - ✔✔a foreign company
  2. If an insured sustains a loss on a policy sold by an agent through an insurance company that is not authorized to do business in Texas, which of the following would be liable? - ✔✔The agent and the company
  3. In general, what percent of personal health insurance premiums is deductible for federal income tax purposes? - ✔✔100%
  4. In order for coverage on a non-medical insurance application to take effect the same day, the producer must collect a signed application and - ✔✔the initial premium
  5. In order to establish a Health Reimbursement Arrangement (HRA), it MUST - ✔✔be established by the employer
  6. In Texas, a domestic insurance company is defined as a company that - ✔✔is incorporated and formed in Texas
  7. Insurance agent licenses normally must be renewed every - ✔✔ 2 years
  1. K has a life insurance policy where her husband is beneficiary and her daughter is contingent beneficiary. Under the Common Disaster clause, if K and her husband are both killed in an automobile accident, where would the death proceeds be directed? - ✔✔daughter
  2. K is the insured and P is the sole beneficiary on a life insurance policy. Both are involved in a fatal accident where K dies before P. Under the Common Disaster provision, where will the money go? - ✔✔To P's estate
  3. Life insurance that covers an insured's whole life with level premiums paid over a limited time is called - ✔✔Limited-Pay Life
  4. M purchased an Accidental Death and Dismemberment (AD&D) policy and named his son as beneficiary. M has the right to change the beneficiary designation at anytime. What type of beneficiary is his son? - ✔✔revocable
  5. Medicaid was designed to assist individuals who are - ✔✔below a specific income limit
  6. Medicare - ✔✔is a hospital and medical expense insurance program
  1. On a life insurance policy, who is qualified to change the beneficiary designation? - ✔✔Policyowner
  2. One becomes eligible for Social Security disability benefits after having been disabled for - ✔✔5 months
  3. P is looking to purchase a life insurance policy that will pay a stated monthly income to his beneficiaries for 20 years after he dies and a lump sum of $20,000 at the end of that 20 year period. What type of policy should P purchase? - ✔✔Family Maintenance policy
  4. P, age 50, purchased an annuity that P will fund with $500/ month for 15 years. The annuity will then pay P retirement payments after the 15 years. Which type of annuity did P purchase? - ✔✔Deferred
  5. Q is severely injured in an automobile accident and becomes totally disabled. How many months must Q be disabled before being able to apply for Social Security disability benefits? - ✔✔ 5
  6. Statements made on an insurance application that are believed to be true to the best of the applicant's knowledge are called - ✔✔representations
  1. The health insurance program which is administered by each state and funded by both the federal and state governments is called - ✔✔Medicaid
  2. The individual who provides general medical care for a patient as well as the referral for specialized care is known as a - ✔✔Primary Care Physician
  3. The most important factor to consider when determining whether to convert term insurance at the insured's attained age or the insured's original age is - ✔✔the cost
  4. The part of a life insurance policy guaranteed to be true is called a(n) - ✔✔warranty
  5. The stated amount or percent of liquid assets that an insurer must have on hand that will satisfy future obligations to its policyholders is called - ✔✔reserves
  6. Under an individual life insurance policy, an insured may assign a MAXIMUM of what percentage of policy ownership? - ✔✔100%
  7. Under Texas insurance law, the term "transacting business" includes - ✔✔collecting premiums
  1. Under the Texas insurance code, an insurance company must pay death benefits for suicide if the policy has been in force for a MINIMUM of - ✔✔2 years
  2. W is a 39-year old female who just purchased an annuity to provide income for life starting at age 60. All of these would be acceptable annuity choices EXCEPT a(n)
    • Flexible Premium Deferred annuity
    • Variable annuity
    • Immediate annuity
    • Straight Life annuity - ✔✔Immediate annuity
  3. What does a Face Amount Plus Cash Value Policy supposed to pay at the insured's death? - ✔✔Face amount plus the policy's cash value
  4. What does Medicare Parts A and B cover? - ✔✔Part A covers hospitalization; Part B covers doctor's services
  5. What is Old Age and Survivors Health Insurance (OASDHI) also known as? - ✔✔Social Security
  6. What kind of life insurance product covers children under their parent's policy? - ✔✔Term rider
  1. When a policy owner exchanges a term policy for a whole life policy without providing proof of good health, which of these apply?
- ✔✔Conversion provision 
  1. When an insurer issues a policy that refuses to cover certain risks, this is referred to as a(n) - ✔✔exclusions
  2. When can a policyowner change a revocable beneficiary? - ✔✔anytime
  3. When does Term Life expire? - ✔✔At the end of the policy period
  4. When third-party ownership is involved, applicants who also happen to be the stated primary beneficiary are required to have - ✔✔insurable interest
  5. Which of the following actions require a policy owner to provide proof of insurability in an Adjustable Life policy? - ✔✔increase face amount
  6. Which of the following are NOT managed care organizations? - ✔✔Medical Information Bureau (MIB)
  1. Which of the following does Social Security NOT provide benefits for?
    • Survivorship
    • Dismemberment
    • Disability
    • Retirement - ✔✔Dismemberment
  2. Which of the following health policy provisions states that the producer does NOT have the authority to change the policy or waive any of its provisions? - ✔✔Entire Contract
  3. Which of the following is an example of rebating? - ✔✔returning a portion of a premium as inducement to purchase insurance
  4. Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures? - ✔✔Commercial insurer
  5. Which of the following statements about a Variable Whole Life policy is CORRECT?
    • It provides a minimum guaranteed Death benefit
- It is a combination of a Limited Period Endowment and a Decreasing Term policy - Its premiums and benefits are variable - It has a guaranteed rate of return - ✔✔It provides a minimum guaranteed Death benefit 
  1. acceptance
  2. negotiating
  3. consideration - ✔✔negotiating
  4. Which of these require an offer, acceptance, and consideration? - ✔✔Contract
  5. Which of these statements about a Guaranteed Insurability Option rider is NOT TRUE?
    • Coverage can be added at specific events such as marriage or having a child
    • Evidence of insurability is not required when the option is exercised
    • Evidence of insurability is required when the option is exercised
    • Coverage can be added at specific ages - ✔✔Evidence of insurability is required when the option is exercised
  6. Which of these statements concerning an Individual Straight Life annuity is accurate? - ✔✔Payments are made to an annuitant for life
  7. Which policy requires an agent to register with the National Association of Securities Dealers (NASD) before selling? - ✔✔Variable Life
  1. Which product would best serve a retired individual looking to invest a lump-sum of money through an insurance company? - ✔✔Annuity
  2. Which statement regarding the Misstatement of Age provision is considered to be true?
    • Coverage will be adjusted to reflect the insured's true age if a misstatement of age is discovered
    • Requires that a new policy must be applied for if a misstatement of age is found on the current policy
    • Misstatement of Age provision is valid only during the contestable period
    • Insurer may void the policy if a misstatement of age is discovered
- ✔✔Coverage will be adjusted to reflect the insured's true age if a misstatement of age is discovered 
  1. Which term defines the legally enforceable promise in an insurance contract by the insurer? - ✔✔Unilateral
  2. Which type of contract liquidates an estate through recurrent payments? - ✔✔Annuity
  3. Which type of provider is known for stressing preventative medical care? - ✔✔Health Maintenance Organizations (HMO's)