Xcel Final Exam Questions and answers, 2022/2023 predictor questions. Graded A+ Typically, Long-Term Disability benefits are coordinated with which benefit plan? - ✔✔Social Security The fo... cus of major medical insurance is providing coverage for - ✔✔medical and hospitalization expenses An insured under a Major Medical expense plan with a zero deductible and 80/20 coinsurance provision files a $1,000 claim. How much of this claim is the insured responsible for? - ✔✔$200 because this policy has a zero deductible, the insures is only responsible for the 20% coinsurance on this claim, or $200 An insured has a stop-loss limit of $5,000 and an 80/20 coinsurance. The insured incurs $25,000 of covered losses. How much will the insured pay? - ✔✔$5,000 Which type of plan would be the most appropriate for an individual on Medicare and concerned that Medicare will NOT pay for charges exceeding the approved amount? - ✔✔Medicare supplement Plan F When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)? - ✔✔when contribution or participation rules have been violated What does the word "level: in Level Term describe? - ✔✔the face amount A non-contributory health insurance plan helps the insurer avoid - ✔✔adverse selection because all eligible employees are usually covered, non-contributory plans are desirable from an underwriting standpoint because adverse selection is minimized. To qualify for a resident producer license in the state of Michigan, an individual - ✔✔must complete the required pre-licensing education within 12 months of license application Under an expense-incurred individual health policy, what is the MAXIMUM length of time after issuance of the policy that an insurer can exclude coverage for a pre-existing condition? - ✔✔12 months pre-existing conditions may be excluded for a maximum of 12 months from the date of enrollment. An insured has a health plan that pays established amounts in accordance with a list of injuries, surgical procedures, or other losses. This list is called a - ✔✔benefit schedule benefits schedule set predetermined limits or maximums on how much money and insured can be reimbursed for a covered loss. Who is the individual paid on a fee-for-service basis? - ✔✔Provider Which of the following is NOT an illegal inducement? - ✔✔Giving the insured an article of merchandise printed with the producer's name costing $5 $5 or less of tokens or merchandise to applicants is allowed. Making a statement that is false or maliciously critical of the financial condition of an insurer is known as - ✔✔defamation Which of the following is NOT a required provision in an accident and health insurance policy? - ✔✔change of occupation the change of occupation provision is considered an OPTIONAL provision Which of these statements about Medicaid is CORRECT? - ✔✔Funded by federal, sate, and local taxes Medicaid is funded by federal, state, and local taxes but is administered by each state. All of these are considered key factors in underwriting life insurance EXCEPT - ✔✔Marital Status Correct: tobacco use, health history, age The time limit for filing claim disputes is addressed in which provision of an accident and health policy? - ✔✔legal actions All of the following plans allow for employee contributions to be taken on a pre-tax basis EXCEPT - ✔✔Health reimbursement Arrangement plan employers contribute to health reimbursement Arrangement planz (HRA's), not employees. Which of the following gifts from a producer would NOT be considered rebating? - ✔✔$5 pen A producer quoting life insurance may give an applicant an article of merchandise having an invoice value of $5.00 or less. Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. - ✔✔20 Chris is an insured bricklayer who severed his left hand in an automobile accident. Although his primary duty cannot be performed, Chris is also a substitute high school teacher. He collects a full disability income check every month. How does his policy define total disability? - ✔✔own occupation the "own occupation" definition of total disability requires that the insured be unable to perform the insured's current occupation as a result of an accident or sickness. Which approach predicts a person's earning potential and determines how much of that amount would be devoted to dependents? - ✔✔Human life value approach The human life value approach predicts an individual's future earning potential and determines how much of that amount would be devoted to dependents. Index whole life insurance contains a securities component that acts as a(n) - ✔✔hedge against inflation Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit options would he choose? - ✔✔Guaranteed lifetime withdrawal benefit The guaranteed lifetime withdrawal benefit normally requires a fee, but it ensures that the income benefit will be paid for life without actually annuitizing the contract. Which of these factors would an insurer consider when determining whether to accept a group life plan? - ✔✔average age and insurer would consider the average age when determining whether to accept a group Life Plan. This MANDATORY health policy provision states that the policy, including endorsements and attached papers, constitutes - ✔✔the entire insurance contract between the parties The monthly benefit for an individual disability income policy is usually limited to a percentage of the insured's income in order to avoid - ✔✔over insurance When an insurance licensee changes his or her address under the Michigan Insurance Code, who MUST be notified? - ✔✔the commissioner of the Department of Insurance and financial services (DIFS) Jonas is a whole life insurance policyowner and would like to add coverage for his two children. Which of the following products would allow him to accomplish this? - ✔✔Child term rider A child term rider is a level term insurance that can be added to an existing policy. The typical long-term care insurance policy is designed to provide a minimum of __ year(s) of coverage. - ✔✔1 How many employees must an employer have for a terminated employee to be eligible for COBRA? - ✔✔20 Which of the following policies does NOT build cash value? - ✔✔Term CORRECT: straight life, endowment, variable life Which type of annuity stops all payments upon the death of the annuitant? - ✔✔Life annuity The type of annuity in which all payments cease upon the death of an annuitant is referred to as a life annuity. Under the subrogation clause, legal action can be taken by the insurer against the - ✔✔responsible third party Disability Income plans which require that the insurer can NEVER change or alter premium rates are usually considered - ✔✔Noncancellable A noncancellable policy cannot be cancelled nor can its premium rates be increased under any circumstances. Coordination of Benefits regulation applies to all of the following plans EXCEPT - ✔✔preferred provider organization plan CORRECT: group vision plan, self-funded group health plan, group health plan A spouse and child can be added to the primary insured's coverage as what kind of rider? - ✔✔Family term Amy has a group medical policy through her employer with a $500 deductible and a 90% coinsurance provision. She incurs $1,500 in covered health care services. How much will her group insurance carrier pay? - ✔✔$900 In this situation, the group insurance carrier will pay 90% of the covered loss after the deductible has been applied. In order to save on premiums, a Life Insurance policy can legally be backdated up to - ✔✔6 months [Show More]
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