In accordance with New Jersey law, a Producer must remit health insurance premiums to the insurer within what period? If a subscriberchooses a primary care physician outside of the network, the subscriber willlikely pay, Medicareprovides coverage for each of the following EXCEPT. How many months can a life insurance policy normally be backdated from the date of application? A producer's secretary who solicits prospects on the telephone Must be licensed as a producer Which of the following is a requirement for ANY change in an insurance application? A medicare supplement plan can be canceled by the insurer, Small employers who are sponsored by an insurer to provide group benefits to its employees are called, Health insurance involves two perils, accident and _____. An insurance producer who replaces an existing policy by making false written or oral statements is committing the act of, A license MUST notify the Commissioner of an address change with ___ Days of the change. The time limit for filing claim disputes is addressed in which provision of an accident and health policy? Kathysannuity is currently experiencing tax-deferred growth until she retires. A Medicare Supplement policy may exclude coverage fora preexisting condition for up to __months. Underthe Maryland health insurance plan, comprehensive health benefits are providedto. C) Unintentionally misrepresented a material fact on the application. Claims for a Long-Term Care policy MUST be paid for which of the following conditions? \text{Total assets} & \underline{\underline{\hspace{3pt}\$244,000}} & \underline{\underline{\hspace{3pt}\$256,000}} \\ visas, binomial trials. To be classified as a small employer, an employer must NOT have more than _________ eligible employees, The _______ is responsible for determining the appropriateness of a Medicare Supplement policy for an applicant, During the examination of an insurer's books and records by the Commissioner, the insurer, remain in effect until a new one is issued, John the insurance producer has an insurance license that expires in 6 months. In what form do disability income policies typically pay benefits? Which of the following is true concerning the proceeds of a life insurance policy? May an insurance producer licensed in New Jersey but not in New York sell a life insurance policy to a New York resident while in New Jersey? Whichof the following is Medicare Part B also known as? Afterwards, she deposits the check into her personal account. Actively solicits increases in limits and/or coverages or rounding out accounts through sales to clients at every service contact. What would be an expense factor in a insurance program? \text{Inventory} & \underline{\hspace{13pt}55,000} & \underline{\hspace{13pt}50,000} \\ Which of the following would disqualify a company's retirement plan from receiving favorable tax treatment? A. A minimum of 12 months after date of purchase. In order for the producer's insurance business to continue, the Commissioner may issue to the producer's spouse a has a mental or physical handicap and remains dependent on the parent A dependent child may remain on a parent's health insurance plan beyond age 26 if the child 60 Converting a group plan to permanent lifeinsurance requires: D. The conversion being applied for within 31 daysof termination. A _______ negotiates an insurance contract on behalf of an insurer, The Entire Contract provision states that an entire contract consists of the actual policy and the, the last day of the licensee's birth month (every two years), A producer's renewal date for his/her resident insurance license is on or before. A prorated death benefit based on the amount of insurance the insured's premiums would have been if purchased at the correct age, A guaranteed issue insurance policy has no, A single premium cash value policy can be described as, A policy that is paid up after only one payment. Ron has a life insurance policy with a face value of $100,000 and a cost of living rider. a producer's secretary who solicits prospects on the telephone. Mariais a preferred provider organization (PPO) subscriber and received care from anout-of-network provider. Registered for the state insurance examination. All of these are valid options for an Adjustable Life Policy EXCEPT, A nonforfeiture option can be used to increase the death benefit. \text{Total current assets} & \underline{\hspace{8pt}144,000} & \underline{\hspace{8pt}151,000} \\ \end{array} A producer's secretary who solicits prospects on the telephone, When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT, In Maryland, a full-time employee of a small employer MUST work an average of at least _____ per week, A producer may begin to solicit insurance ONLY when. Upon delivery, she may be expected to collected all of the followingEXCEPT a(n), B. Signedimpairment rider acknowledgement, C. Modifiedapplication with a new signature, Oneof the most important considerations when replacing health insurance would bethe. Doctor cannot charge more than Medicare's scheduled coverage, Health insurance advertisements that mention statistical information are required by New Jersey law to. by recommending insurers with good AM Best ratings, C.) With guidelines regarding credit reporting and distribution. 14 day waiting period / 10 year benefit period. 1. Any decrease in income resulting from this injury would make him eligible for benefits under which provision? A type of group that has a constitution and bylaws andhas been organized for purposes other than obtaining insurance is called awhat? In the event of employment termination, group insurance can be kept if the employee pays the premiums. If she dies 15 years after the policy's inception date, how much will her beneficiary receive? We'll bring you back here when you are done. Failingto promptly provide a reasonable explanation for the denial of a claim isconsidered to be a (n). Where would policy proceeds be paid if both the insured and primary beneficiary were killed in the same accident? D. Coverage includes compulsory hospital andvoluntary supplementary medical insurance. Maria has committed what crime? Which of the following would have the HIGHEST premium? a)When the policy owner notifies the insurance company, c.)When the required additional premium is paid, d.) No more than 10 days after date of birth, The double indemnity provision in a life insurance policy pertains to an insured's death caused by a(n), A) the policy would be payable, minus the premium amount, B) the policy would be payable only after the beneficiary makes past due premium payment, C) all past premiums will be refunded with interest, An insurance producer agrees to pay the first monthly premium for an insurance applicant. Which entity is responsible for processing insurance advertising in New Jersey? This agreement is called an, Upon receiving a producer complaint, the Commissioner may immediatley, ABC Insurance Company transfers part of their risk to XYZ Insurance Company. \text{Net property, plant, and equipment} & \underline{\hspace{8pt}100,000} & \underline{\hspace{8pt}105,000} \\ In the advertising of Individual Life Insurance policies, an "introductory" or "special enrollment" may not be made available until any previous enrollment period for the same policy has been closed for at least how long? Who is the individual paid on a fee-for-service basis? Please upgrade to Cram Premium to create hundreds of folders! How soon can the benefit payments begin with a deferred annuity? Whowere Keogh Plans designed to provide pension benefits for? What is the purpose of having an accelerated death benefit on a life insurance policy? Which of the following is NOT part of an insurance contract? All of these are standard exclusions found in a life insurance policy EXCEPT. Submit to the replacing insurer a list of the policies to be replaced. who would be responsible for the prosecution of this crime? Under a disability income policy, which provision would be payable if the cause of an injury is unexpected and accidental? XZY company has applied for group health insurance for its employees. B. Anytimewithin 12 months after date of purchase, C. Aminimum of 6 months after date of purchase, D. Aminimum of 12 months after date of purchase. the daily amount paid for nursing home care, All long-term care policies sold in North Dakota are REQUIRED to pay the SAME daily benefit amount for "at home" care as paid for. A. Thepolicys elimination period is waived, B. Thetime frame for reinstating a lapsed policy is extended, C. Thepolicys probation period is earlier than the present, D. Thepolicy effective date is earlier than the present, D. The policy effective date is earlier than thepresent, Premiummode is a term used to describe the. The exceptions, reductions, and limitations affecting the basic provisions of the policy, Any advertisement that mentions a dollar amount, period of time for which any benefit is payable, cost of policy, policy benefit, or the loss for which the benefit is payable MUST disclose. What amount will be paid under a policy where the insured misstated his/her age? B. Paul has an, An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called. Ifan insurer refuses to pay a claim, how many days must the insured wait to takelegal action against a health insurer after submitting written proof of loss? Which of these gaps in Medicare coverage is addressed with Medicare Supplemental Insurance? This change is called a(n). The entity which issues the certificate of authority is the, A policyowner has _____ days after policy delivery to return a major medical policy for a full refund, make any transactions before being approved for a licence, counsels and advises the Governor on all matters assigned to the Maryland Insurance Administration, A Maryland insurance producer solicits an insurance policy. C.) Unintentionally misrepresented a material fact on the application. 1. Within how many days must a producerreport to the commissioner any administrative actions made against him/her? What will the beneficiary receive if an annuitant dies during the accumulation period? A licensed producer is required to file notice of any change of address within how many days? Changing from one occupation to another at the same general status is called _____. Philsshopping for an annuity that guarantees he CANNOT outlive the benefits. In Maryland, an insurance producer cannot sell, solicit, or negotiate policies for an insurer unless there is an agreement in place between the producer and insurer. B.Change must be initialed by the applicant. A Long-Term Care policy may only exclude pre-existing conditions for up to _____ months, The identity of the ____ must be made clear in every health insurance advertisement, _______________ is the authority given to a producer to sell, solicit, or negotiate insurance on behalf of the insurer, Pre-existing conditions may only be excluded from coverage for a maximum of 6 months. Whichof these will have the highest monthly payout upon Annuitization? The benefit can be offered as a rider at a specific extra cost or may be at no cost, All of the following are included as part of a contract in the entire contract provision EXCEPT the. Pre-existing conditions may only be excludes from coverage for a maximum of 6 months, The reinstatement provision in a health insurance policy is, 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, Naming a contingent beneficiary as "all surviving children" is describing by which term, The entire contract includes the actual policy and the. Which of the following actions is REQUIRED by an agent who is replacing an existing life insurance policy? An attending physician's statement would be appropriate for which life insurance purpose? Whatis the elimination period of an individual disability policy? In which of the following relationship would there NOT be an insurable interest? Their offer/administration. Sonya applied for a health insurance policy on April 1. If an insured's age on a life insurance policy has been misstated, what is the insurer's liability if the insured dies? B. Recieve a tax credit to help offset the cost of health insurance. As of January 1, 2014, small group health insurance can be rated on the basis of. Please sign in to share these flashcards. What does the consolidated Omnibus Budget Reconciliation ACT (COBRA) of 1985 allow an employee to do? B. Guaranteedlifetime withdrawal benefit, D. Guaranteedminimum accumulation benefit. a producers secretary who solicits prospects on the telephonecrumbl cookies franchise applicationcrumbl cookies franchise application (To help answer this question, create an Accounts Receivable T-account and insert the beginning and ending balances.) On which date would Sonya have coverage? Maria would like an annuity that provides a guaranteed accumulation or payout. The Office of General Counsel issued the following opinion on April 25, 2005, representing the position of the New York State Insurance Department. C. Funded by federal, state, and local taxes. Long-term care insurance and Medicare Supplementplan have a free-look period of__ days. The replacing policy may only impose a ____ month time exclusion for pre-existing conditions, forward premiums to the insurer on a timely basis, When collecting insurance premiums from a client, a producer MUST, Once a health insurance policy has been in force for _______ years, the policy may NOT be contested by the insurer, cancelling a term life policy to buy a whole life policy, All of these types of benefits may be covered by a nonprofit health service plan EXCEPT, have it's content approved by the commissioner. Unit 4 Assign Rubric Impact of Colonial Experience (2).pdf, 0B1FC21B-547A-410E-8D8F-64E2A8C35084.jpeg, My Path Assessment Editor _ WorldQuant University.pdf, Oral liquid 50 microgramsml Tablet 625 micrograms 250 micrograms epinephrine, spirit its source is what constitutes religion This can be traced to the, Write in a brief description for the bubbles with underlined words 2 Choose a, BUS 1021 Organizational Behavior (OB) Consulting Assignment.edited11.docx, lOMoARcPSD11771818 True or False The above plot shows clear evidence that the, 2 Non tariff barriers which are further classified into two categories a, CTS115 - Chapter 5 - Case Study - Denial of Service -Moss.docx, The fallacy described as a red herring is most similar to a False cause b, Copy of Algebra Unit 2, Concepts 1, 2, 3.pdf, The model is used to describe the interaction of external forces that affect an, EVM Presentation - Project Management .pptx, What is the shape usually used to refer to the curve that illustrates. The insurer's obligation to pay a death benefit upon an approved death claim, Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. At minimum, a carrier is required to offer which of the following health benefit plans to small employers? A. According to HIPPA, this tax will not be applied if the withdrawal is used for medical expenses that exceed _____ of the individual's adjusted gross income. The ________ has the right to renew a small employer health plan. The standard grace period for a life insurance policy sold in Maryland is. An applicant's character and personal habits can be obtained for underwriting purposes from which source? It is administrated by the federal government, C. It is funded by federal, state, and local taxes. \text{Cash and cash equivalents} & \$\ \hspace{5pt}48,000 & \$\ \hspace{5pt}57,000 \\ Since each partner contributes an important element to the success of the business, they decide to take life insurance policies out on each other, and name each other as beneficiaries. The coverage, condition, and limitations in the master policy of a group contract can be found in which document? Producers must complete a total of ____ continuing education credits for each two-year licensing period. by geriford27, Whichtype of injury would NOT be covered under a health insurance policy? The waiting period for a disability insurance policy, Excludes payments for a short term illness or injury. Insurable interest can be established sufficiently by sentimental attachment alone, A life insurance policy written on one contract for two people in which it is payable upon the first death is called. b. Pat the client interest on any monies held. In the event of the employment termination, group health insurance can be kept if the EMPLOYEE pays the premiums, A health insurer must be provided with written proof of loss _____ days after the date of loss, A producer must notify the Commissioner within _____ days of a felony conviction. As beneficiary, he will pay__taxeson any money withdrawn. a. Oneor more diagnostic, preventive, therapeutic, rehabilitative, maintenance orpersonal care services in a setting other than an acute care unit of ahospital. These rights are called, A producer who intentionally makes an untrue or incomplete statement in the course of an insurance transaction may be guilty of. A producer has committed an insurance crime that violates US code 1033 (interstate commerce). \\ Determine whether the discriminant is positive, negative, or zero. A master contract and certificate of coverage can be found in which type of policy? Duringthe accumulation period, who can surrender an annuity? The policies continue in force with no change. What kind of insurance provides coverage for one or more necessary or appropriate diagnostic, preventative, therapeutic, rehabilitative, maintenance, or personal care services in a setting other than an acute care unit of a hospital? A licensee MUST notify the Commissioner of an address change within _______ days of the change, Violations of US Code Title 18 section 1033 may result in, In the state of Maryland, a licensed producer, sharing commissions with other licensed and appointed agents, All of the following actions are considered rebating EXCEPT, Under the Maryland Health Insurance Plan, comprehensive health benefits are provided to, A producer who knowingly submits a false statement in support of a claim. A. Toaccept or decline insurance applicants, B. Toset the premium rates for insurers, D. Toperform physical examination on applicants. Provides the insured a specific dollar amount for services, An example of an unfair method of competition is, Overstating the benefits of an insurance policy, A pharmacy benefit covers prescription drugs derived from a list called, The type of policy which pays on the death of the last person is called, Converting a group plan to permanent life insurance requires, The conversion being applied for within 31 days of termination, Ownership of a life insurance policy may be temporarily transferred with a(n).

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