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CA Life Agent Exam
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Subject
:
certifications
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Reappearance of disability w/in 6 mth. period after "recovery" from same disability is considered recurrence - not new disability.
Recurrent disability clause/provision
Occupational Disability policy
Blackout Period
Proof of Loss provision
2. Level - fixed death benefit - premium fixed until renewal; Decreasing - death benefit decreases over term - premium fixed until renewal; Increasing - death benefit increases over term - premium fixed until renewal.
Medical cost containment (aka Managed care)
Types of hazards
Types of Term Life policies
COBRA Time Limitations
3. Intentional deception; grounds for rescission.
Adjustable Whole Life policy
Medicaid/Medi-Cal
Fraud
Tax implications of an Estate
4. Policy owner must notify Insurer of loss either in writing - in person or by phone w/in 20 days.
Waiver of Premium (Waiver of Cost of Insurance) rider
Notice of Claim provision
Graded Premium Whole Life policy
Concealment
5. Hybrid of HMO & PPO w/ greater flexibility on choosing specialists outside network w/ benefits still provided but @ higher co-pay.
Total disability (any-occupational definition)
Guaranteed Insurability Life rider
Point of Service plan
Dividends
6. Federally-funded but state-run program for truly indigent individuals & families providing medical care at Federal clinic.
Medicaid/Medi-Cal
Common Disaster (Simultaneous Death Act) clause/provision
Adjustable Whole Life policy
1035 Exchange
7. Pre-existing illness/injury; Waiting period; Elimination period; Probationary period; Benefits - Exclusions - Limitations; Underwriting reqs.
24 Hour Coverage (CA)
Payor (aka Waiver of Payor's Premium) rider
Employer Liability
Considerations in replacing Health insurance
8. Covers entire family w/ WL for breadwinner & (convertible) Level Term for spouse & children (until certain age).
Family policy
Non-Occupational Disability policy
Renewability provision
Annuity Classifications (5 of 5): # of lives
9. Agents - represent Insurer; Brokers - represent themselves & Insured; Solicitors - represent one agent to solicit leads.
Types of Licensed Producers
Partial disability rider
Variable Universal Life policy
Accidental Death & Dismemberment (AD&D) Disability rider
10. Conditional - coverage is conditional; Personal - parties are people; Good faith - honesty/integrity; Fiduciary - req's financial trust.
Rescission
Insurance contract characteristics (2 of 2)
Loss of Earnings Test
Presumptive disability
11. Policy owner has 90 days from date of loss to submit proof of loss to Insurer; valid claim must be paid immediately upon receipt.
Types of hazards
Proof of Loss provision
Total disability (any-occupational definition)
Transplant/Cosmetic Surgery rider
12. An attempt to contain costs by employing various strategies - including wellness programs - preventative testing - outpatient & alternative procedures.
7 Pay Test
Employee Retirement Income Security Act (ERISA)
Medical cost containment (aka Managed care)
Conformity with State Statute provision
13. Same as WL but death benefit increases annually - linked to Consumer Price Index; premium increases annually OR is set high from start.
Notice of Claim provision
Family policy
Equity Index Whole Life policy
Indemnify
14. Allows policy owner to w/draw set % of death benefit upon verification of terminal illness w/ expectancy 12-24 mths.; generally tax-free.
Accelerated Benefits (aka Terminal Illness or Living Benefits) rider
Guaranteed Insurability (aka Additional Purchase or Future Increase) Disability rider
Underwriting risk categories
Key Employee Disability policy
15. 1: Tax-free lump sum; 2: Monthly pay-outs for fixed time; 3: Fixed monthly payments until depleted.
Health Insurance Portability and Accountability Act (HIPAA)
Concealment exceptions
Claim Form (aka Proof of Loss Form) provision
Settlement options for Life policy (1 of 2)
16. 1: mortality probability charge; 2: Insurer's investment return; 3: expenses (admin costs - commissions). 1 - 2 = net; 1 - 2 + 3 = gross.
Medical cost containment (aka Managed care)
Accelerated Benefits (aka Terminal Illness or Living Benefits) rider
Age Discrimination in Employment Act (ADEA)
Factors that determine premium
17. Monthly; Quarterly; Semi-annually; Annually (cheapest due to less admin cost).
Types of Insurers (by ownership)
Social Security Benefit (Supplement) rider
Premium modes
Non-Occupational Disability policy
18. Taxable income (unlike individual plans); can be either short-term - 13-52 wks. max. or long-term - longer than 52 wks.
Group Disability plan
Current Assumption (aka Interest-Sensitive) Whole Life policy
Grace Period provision
Modified Endowment Contract (MEC)
19. Govt. organization providing health care benefits for dependents of military personnel.
CHAMPUS (aka TriCare)
Types of Term Life policies
Comprehensive Major Medical plan
Phases of an annuity
20. 1: Surrender for cash value (taxable); 2: Buy equal-benefit paid-up Level Term policy; 3: Buy reduced-benefit paid-up WL policy.
Medi-Cal Share Cost plan
Non-forfeiture options for WL policy
Insurer (as defined by CIC)
Preferred Provider Organization (PPO)
21. If Insured changes to: more hazardous job - benefits reduced; less hazardous job - premiums reduce.
Change of Occupation provision
Cost of Living Adjustment (COLA) Life rider
Exclusions for Major Medical plan
Types of Medical Plans
22. Extreme form of Limited Pay Whole Life whereby entire premium is paid in a single payment.
Misstatement of Age/Sex provision
CHAMPUS (aka TriCare)
Modified Endowment Contract (MEC)
Single Pay Whole Life policy
23. Policyholders - Mutual (participating) co. - may pay dividends; Stockholders - Stock (non-participating) co. - no dividends.
Binding receipt (aka Temporary Insurance Agreement)
Types of Insurers (by ownership)
Incontestability clause/provision
Rehabilitation rider
24. Specialized policy covering diagnostic & preventative dental care; often no deductible; co-insurance; expensive; may be included w/ medical plan.
Common Life Exclusions
Binding receipt (aka Temporary Insurance Agreement)
Dental Plan
Total disability (as commonly defined)
25. Employer w/ 25 or less employees must offer all eligible employees @ least 2 medical plan options where pre-existing conditions can't be excluded more than 1 yr.
Concealment exceptions
Small Employer Medical Expense plan
Impairment (Exclusion) rider
Premium modes
26. Insurer has right to adjust (+ or -) death benefit if age or sex is misstated but normally doesn't void policy.
Trusts
Misstatement of Age/Sex provision
Return of Premium rider
Cash value
27. Authorized (admitted) - can conduct business in state; Unauthorized (non-admitted) - cannot conduct business in state (w/ one exception).
Elimination (aka Waiting) period
Types of Insurers (by authorization)
Tax implications of Death Benefit & Cash Value
Policy delivery
28. Plan A is the CORE benefit & is least expensive; All other plans include Plan A + additional benefits. Plans F & J are high deductible. K & L are both deductible & co-pay plans.
Entire Contract provision
Reinsurance
Plans A-L of Medical Supplement or Medigap
Medicare Part C (aka Medicare Advantage)
29. No-charge annuity w/drawals allowed up to 10% of total - THEN penalized on sliding scale based on # policy yrs.; conditionally waived.
Annuity surrender charges
Business Overhead Expense (BOE) Disability policy
Trial Application (aka Request for Offer)
Types of Accident & Health insurance
30. Disability income is based on "earned income" (salary - bonus - commission) - not unearned income (interest - investment - rents).
Types of hazards
Policy delivery
Total disability (more restrictive definition)
Loss of Earnings Test
31. Prevents overinsuring in order to profit from disability by coordinating benefits between Insurers.
Relation of Earnings to Insurance provision
Experience vs. Community rating in Group Health plan
Incontestability clause/provision
Concealment exceptions
32. Group plan initially self-funded by employer (like SIR); after which - group plan Insurer covers (up to policy limit); requires TPA.
Limited Pay Whole Life policy
Trusts
Annuity Classifications (3 of 5): Source of income
Employer-Administered plan
33. Provides % of monthly income benefit if Insured becomes disabled due to illness or accident.
Disability Income policy
Elements to contract
Revocable vs. Irrevocable beneficiary
Supplemental Major Medical plan
34. Peril is the CAUSE of loss. Hazard is a condition that increases LIKELIHOOD of loss.
Peril vs. Hazard
Key Employee policy
Survivorship (aka "Last to die") policy
Tax implications of an Annuity (1 of 2)
35. Accumulation or "pay-in" - contributions & interest earned are tax-deferred; Annuity or "pay-out" - monthly annuity (taxable) paid.
Split Dollar Plan
Current Assumption (aka Interest-Sensitive) Whole Life policy
Phases of an annuity
Policy delivery
36. 1: Skilled nursing care; 2: Intermediate care; 3: Custodial care; 4: Home health care.
Risk management
Needs approach (most common)
Levels of Long Term Care provided
Family Maintenance policy
37. Guaranteed min. interest rate on cash value buildup but possible higher rate if short-term investment returns higher than expected.
Entire Contract provision
Universal (aka Flexible Premium Adjustable) Life policy (3 of 4)
Medi-Cal Share Cost plan
Total disability (more restrictive definition)
38. 1: Straight aka Pure Life - lifetime income but no survivorship refund; 2: Life w/ Period Certain - lifetime income w/ death benefit of monthly annuity for remaining predetermined term. 3: Annuity Certain - monthly income paid for predetermined term
Multiple Employer Trust (MET) aka Multiple Employer Welfare Association (MEWA)
Experience vs. Community rating in Group Health plan
Annuity Classifications (4 of 5): Disposition "pay-out" of proceeds
Settlement options for Life policy (1 of 2)
39. Compensates business for loss due to disability of key employee; premiums not deductible but benefits tax-free.
Rescission
Types of Agency Authority
Key Employee Disability policy
Insurer (as defined by CIC)
40. Fraternal - non-profit - members only; Reciprocal - unincorp'd org. - members insure each other; Lloyd's Assoc. - groups sharing risks; Surplus lines - special market risks.
CHAMPUS (aka TriCare)
Total disability (as commonly defined)
Types of Insurers (miscellaneous)
Modified Endowment Contract (MEC)
41. War - 2 types; Suicide (1st 2 yrs.); Aviation (non-commercial); Hazardous hobbies; Criminal acts; Alcohol/Drug influenced.
Reinstatement provision
Common Life Exclusions
Modified Premium Whole Life policy
Relation of Earnings to Insurance provision
42. Part A - Inpatient hospital deductibles vary on # of days; limited reserve days; finite benefit; 1st 3 pints blood; Part B - 20% co-payment.
Insurer (as defined by CIC)
Medicare Part A & B "Gaps"
Comprehensive Major Medical plan
Pure risk vs. Speculative risk
43. Time extension of benefits based on "qualifying" event. 18 mth. extension if laid off or fired; 36 mth. extension if death - divorce or child leaves home.
COBRA Time Limitations
Common Life Exclusions
Enhanced Ordinary (aka Extraordinary) Whole Life policy
Tax implications of Disability policy
44. The state in which the contract is accepted or delivered is the state that possesses regulatory jurisdiction over Group plan.
Doctrine of Comity
Employee Retirement Income Security Act (ERISA)
Peril vs. Hazard
Medicare Part C (aka Medicare Advantage)
45. Beneficiary has right to leave death benefits / Insurer to protect $ from creditors; interest (taxable) paid on retained funds.
Guaranteed Insurability (aka Additional Purchase or Future Increase) Disability rider
Spendthrift provision
Insurable interest
Waiver of Premium (Waiver of Cost of Insurance) rider
46. Upon notice - Insurer must provide Claim Form (Proof of Loss Form) to Insured w/in 15 days.
Exclusions for Major Medical plan
Claim Form (aka Proof of Loss Form) provision
Employer-Administered plan
Parole Pardon Rule
47. 'The inability to perform your OWN normal occupation or daily duties'.
Group Disability plan
Total disability (as commonly defined)
Approval Type Conditional receipt
Medicare Part B (aka Supplemental Medical Insurance or SMI)
48. Qualified Annuity - Tax-deductible contributions & tax-deferred growth but fully taxable w/drawals.
Tax implications of an Annuity (1 of 2)
Adjustable Whole Life policy
Return of Cash Value rider
Pure risk vs. Speculative risk
49. Palliative - treatment to manage pain; Curative - treatment to cure illness/condition.
Indeterminate Premium Whole Life policy
Risk management
Palliative vs. Curative care
Non-forfeiture options for WL policy
50. Agreement - Offer & acceptance; Consideration - application + premium; Legal capacity - licensed &/or competent; Legal purpose - public good.
Elements to contract
Group Disability plan
Small Employer Medical Expense plan
Change of Occupation provision
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