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Life And Health Insurance Exam

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. Fair Credit Reporting Act
The act that stipulates federal standards for private pension plans.
An entity that indemnifies against losses - provides benefits - or renders services (also known as "company" or "insurance company").
A federal law that established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential - accurate - relevant and properly used.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.

2. CSO Table (The Commissioner's Standard Ordinary Table)
A basic - fundamental insurance policy which pays first with respect to other outstanding policies.
A mortality table used in life insurance that mathematically predicts the likelihood of death.
A provision that allows an insurer - at its own expense - to have an insured physically examined when a claim is pending or to have an autopsy performed where not prohibited by law.
An agreement between an insurer and insured in which both parties are expected to pay a certain portion of the potential loss and other expenses.

3. Custodial Car
Care that is rendered to help an insured complete his/her activities of daily living.
A model of HMO and PPO organizations that uses the insured's primary care physician (the gatekeeper) as the initial contact for the patient for medical care and for referrals.
An entity that obtains and possesses a license solely for the purpose of writing business on the owner - immediate family - relatives - employer and employees.
An unincorporated group of individuals who mutually insure one another - each separately assuming a share of each risk.

4. Endodontics
Plans designed to help individuals save for qualified health expenses.
An area of dentistry that deals with diagnosis - prevention and treatment of the dental pulp within natural teeth at the root canal.
The inclusion of causes of loss (perils) which are covered within a scope of a policy.
To restore the insured to the same condition as prior to loss with no intent of loss or gain.

5. Risk Retention Group
A contract which has not yet been fulfilled by one or both parties that promises action in the event of a specified future occurrence.
An act of identifying the name of the producer - representative or firm - limited insurance representative - or temporary insurance producer on any policy solicitation.
The amount payable upon the death of the person whose life is insured.
A liability insurance company owned by its members - which are exposed to similar liability risks by virtue of being in the same business or industry.

6. Endow
A policy premium that remains the same over the period of time premiums are paid.
A type of benefit plan that may discriminate - is not required to be filed with the IRS - and does not provide a current tax deduction for contributions.
To reach the maturity date or time at which the face amount equals cash values.
A patient who is expected to die within an amount of time specified in the policy.

7. Standard Provisions
A statement that outlines what services were rendered - how much the insurer paid - and how much the insured was billed.
The person who is entitled to exercise the rights and privileges in the policy. This person may or may not be the insured.
Requirements approved by state law that must appear in all insurance policies.
A method of dealing with risk by deliberately keeping away from it (e.g. if a person wanted to avoid the risk of being killed in an airplane crash - he/she might choose never to fly in a plane).

8. Deductible
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
A general term used to refer to various forms of whole life insurance policies that remain in effect to age 100 so long as the premium is paid.
A rider found in juvenile policies which waives the premiums if the person paying them (often the parent) is disabled or dies while the child is still a minor.
The portion of the loss that is to be paid by the insured before any claim benefits may be paid by the insurer.

9. Misrepresentation
A false statement or lie that can render the contract void.
A selection of health care benefits from which an employee may choose the ones that he/she needs.
A prepaid medical service plan in which specified medical service providers contract with the HMO to provide services. The focus of the HMO is preventive medicine.
A claim to a provider or medical supplier to receive payments directly from Medicare.

10. Insolvent organization
The payment made by insurers to agents or brokers for the sale and service of policies.
A member organization which is unable to pay its contractual obligations and is placed under a final order of liquidation or rehabilitation by a court of competent jurisdiction.
The tendency or likelihood of insurance policies not lapsing or being replaced with insurance from another insurer.
The effect a person's indifference concerning loss has on the risk to be insured.

11. Disability
Care that is rendered to help an insured complete his/her activities of daily living.
A physical or mental impairment - either congenital or resulting from an injury or sickness.
Period of time after the premium due date during which premiums may still be paid - and the policy and its riders remain in force.
A method of dealing with risk by intentionally or unintentionally keeping a portion of it for the insured's account; the amount of responsibility assumed but not reinsured by the insurance company.

12. Comprehensive Policy
A liability insurance company owned by its members - which are exposed to similar liability risks by virtue of being in the same business or industry.
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
A plan that provides a package of health care services - including preventive care - routine physicals - immunization - outpatient services and hospitalization.
Insurance organizations that have no capital stock - but are owned by the policyholders.

13. Morbidity Table
An arrangement in which an insured must pay a specified amount for services "up front" and the provider pays the remainder of the cost.
A table showing the incidence of sickness at specified ages.
The law that provides for the continuation of group health care benefits for the insured for up to 18 months if he/she terminates employment or is no longer eligible - and for the insured's dependents for up to 36 months in cases of loss of eligibili
A provision that allows coverage to continue beyond the policy's expiration date for employees who are not actively at work due to disability or who have dependents hospitalized on that date. This coverage continues only until the employee returns to

14. Hazard - Physical
A type of hazard that arises from the physical characteristics of an individual - such as a physical disability due to either current circumstance or a condition present at birth.
The maximum amount a physician may charge a Medicare beneficiary for a covered service if the physician does not accept assignment of the Medicare approved amount.
Plans that allow employers to set aside funds for reimbursing employees for qualified medical expenses.
The accounting measurement of an insurer's future obligations to pay claims to policyowners.

15. Annual Statement
A detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business.
A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.
An employer-funded account linked to a high deductible medical insurance plan.
A representative of an insurance company who investigates and acts on the behalf of the company to obtain agreements for the amount of the insurance claim.

16. Acquired Immunodeficiency Syndrome (AIDS)
A claim to a provider or medical supplier to receive payments directly from Medicare.
An employer-funded account linked to a high deductible medical insurance plan.
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).
The fair and equal bargaining by both parties in forming the contract - where the applicant must make full disclosure of risk to the company - and the insurance company must be fair in underwriting the risk.

17. Permanent Life Insurance
A general term used to refer to various forms of whole life insurance policies that remain in effect to age 100 so long as the premium is paid.
Insurance which can - at the election of the policyowner - be renewed at the end of a term without evidence of insurability.
The portion of premium for which policy protection has not yet been given.
Organizations that process claims and pay benefits in an insurance policy

18. Buyer's Guide
An insurance company that is incorporated in another state.
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
The tendency of risks with higher probability of loss to purchase and maintain insurance more often than the risks who present lower probability.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.

19. Death Benefit
A rider found in juvenile policies which waives the premiums if the person paying them (often the parent) is disabled or dies while the child is still a minor.
A condition which does not allow a person to perform the duties of any occupation for payment as a result of injury or sickness.
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.
The amount payable upon the death of the person whose life is insured.

20. Limiting Charge
A disability rider - found in Universal Life Insurance - that waives the cost of the insurance but does not waive the cost of premiums necessary to accumulate cash values.
A document that authorizes a company to start conducting business and specifies the kind(s) of insurance a company can transact. It is illegal for an insurance company to transact insurance without this certificate.
The maximum amount a physician may charge a Medicare beneficiary for a covered service if the physician does not accept assignment of the Medicare approved amount.
The reduction - decrease - or disappearance of value of the person or property insured in a policy - by a peril insured against.

21. Personal Contract

22. Director (Commissioner - Superintendent)
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
A method of dealing with risk for a group of individual persons or businesses with the same or similar exposure to loss who share the losses that occur within that group.
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
The head of the state department of insurance.

23. Application
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
A liability insurance company owned by its members - which are exposed to similar liability risks by virtue of being in the same business or industry.
A booklet that describes insurance policies and concepts - and provides general information to help an applicant make an informed decision.
A document that provides information for underwriting purposes. After the policy is issued - any unanswered questions are considered waived by the insurer.

24. Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986

25. Broker
An individual who represents an insured in the process of purchasing and negotiating a contract of insurance.
Special powers granted to an agent by his or her agency contract.
A general statement that identifies the basic agreement between the insurance company and the insured - usually located on the first page of the policy.
A circumstance that increases the likelihood of a loss.

26. Warranty
A provision that specifies to whom claims payments are to be made.
A material stipulation in the policy that if breached may void coverage.
Average number of years remaining for a person of a given age to live - as shown on the mortality table.
An insurance policy that provides payment if the insured's death is the result of an accident.

27. Employee RetirementIncome Security Act (ERISA)
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
Benefits required by state law to be paid to an employee by an employer in the case of injury - disability - or death as the result of an on-the-job hazard.
The act that stipulates federal standards for private pension plans.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.

28. Back-End Load
A fee charged at the time of a sale - transfer or withdrawal from an annuity or a life insurance policy.
A legal impediment to denying a fact or restoring a right that has been previously waived.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
The date when an insurance policy begins (also known as the inception date). The period of time in which an employee may enroll in a group health care plan without having to provide evidence of insurability.

29. Explanation of Benefits (EOB)
A statement that outlines what services were rendered - how much the insurer paid - and how much the insured was billed.
A policy rider that states that the cause of death will be analyzed to determine if it complies with the policy description of accidental death.
The withholding of known facts which - if material - can void a contract.
Any entity of at least two employers - other than a duly admitted insurer - that establishes an employee benefit plan for the purpose of offering or providing accident and sickness or death benefits to the employees.

30. Illustration
A physical or mental impairment - either congenital or resulting from an injury or sickness.
A type of insurance that pays benefits for medical - surgical - and hospital costs.
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
A facility which is licensed by the state to provide 24 hour nursing care.

31. Cash Value
The appearance or the assumption of authority based on the actions - words - or deeds of the principal or because of circumstances the principal created.
An agreement between two or more parties enforceable by law.
The amount to which a policyowner is entitled if the policy is surrendered before maturity.
The period of time between the effective date of a health insurance policy and the date coverage for all or certain conditions begins.

32. Flexible Premium
A policy feature that allows the policyholder to vary premium payments in the amount and/or timing.
An insurance company that has not applied for - or has applied and been denied a Certificate of Authority and may not transact insurance in a particular state.
A contract that provides income for a specified period of years - or for life.
The full face value of a policy.

33. Alien Insurer
The ratio of the incidence of sickness to the number of well persons in a given group of people over a given period of time.
A period of time - usually required by law - during which a policyowner may inspect a newly issued individual life or health insurance policy for a stated number of days and surrender it in exchange for a full refund of premium if not satisfied for a
A level of care that is one step down from skilled nursing care; provided under the supervision of physicians or registered nurses.
An insurance company that is incorporated outside the United States.

34. Nonqualified Pla
To reach the maturity date or time at which the face amount equals cash values.
A type of benefit plan that may discriminate - is not required to be filed with the IRS - and does not provide a current tax deduction for contributions.
A circumstance that increases the likelihood of a loss.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.

35. Authorized (Admitted) Insurer
An insurance company authorized and licensed to transact business in a particular state.
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.
A method of dealing with risk for a group of individual persons or businesses with the same or similar exposure to loss who share the losses that occur within that group.
A disease that causes the victim to become dysfunctional due to degeneration of brain cells causing severe memory loss.

36. Implied Authority
Authority that is not expressed or written into the contract - but which the agent is assumed to have in order to transact the business of insurance for the principal.
The termination of an insurance contract due either to material misrepresentation by the insured or by fraud - misrepresentation - or duress on the part of the agent/insurer.
A principle stating that the larger the number of similar exposure units considered - the more closely the losses reported will equal the underlying probability of loss.
A patient who is expected to die within an amount of time specified in the policy.

37. Payment of Claims
A form of misrepresentation in which an agent persuades an insured/owner to cancel - lapse - or switch policies - even when it's to the insured's disadvantage.
A provision that specifies to whom claims payments are to be made.
Insurance whereby premiums are paid for protection in the event of death or disability - not for cash value accumulation.
Any group or individual who provides health care services.

38. Morbidity Rate
The ratio of the incidence of sickness to the number of well persons in a given group of people over a given period of time.
A basic principle of insurance under which the risk of financial loss is assigned to another party.
The appearance or the assumption of authority based on the actions - words - or deeds of the principal or because of circumstances the principal created.
A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.

39. Binder (Binding Receipt)
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
A temporary contract that puts an insurance policy into force before the premium has been paid.
Insurance that is kept in force for a person's entire life and pays a benefit upon the person's death - whenever that may be.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.

40. Co-Pay
An arrangement in which an insured must pay a specified amount for services "up front" and the provider pays the remainder of the cost.
The date specified in the policy as the date of termination.
An area of dentistry that deals with diagnosis - prevention and treatment of the dental pulp within natural teeth at the root canal.
A type of temporary health or medical care provided either by paid workers who come to the home or by a nursing facility where a patient stays to give a caregiver a short rest.

41. Skilled Nursing Care
Termination of a policy because the premium has not been paid by the end of the grace period.
Daily nursing care or skilled care - such as administration of medication - diagnosis - or minor surgery that is performed by or under the supervision of a skilled professional.
A policy that provides benefits for all medical costs - including doctor visits - hospitalization - and drugs.
The first page of a policy.

42. Actual Charge
A combination of basic coverage and major medical coverage that features low deductibles - high maximum benefits - and coinsurance.
The amount a physician or supplier actually bills for a particular service or supply.
A detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.

43. Proof of Loss
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
A statement that outlines what services were rendered - how much the insurer paid - and how much the insured was billed.
A variation of whole life insurance that charges a level annual premium and provides a level - guaranteed death benefit to the insured's age 100 and will endow for the face amount if the insured lives to age 100. Limited-pay life is designed so that
A claim form that a claimant must submit after a loss occurs.

44. Pro Rata Cancellation
A method of dealing with risk for a group of individual persons or businesses with the same or similar exposure to loss who share the losses that occur within that group.
A combination of basic coverage and major medical coverage that features low deductibles - high maximum benefits - and coinsurance.
A condition which does not allow a person to perform the duties of any occupation for payment as a result of injury or sickness.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.

45. Group Life
A rule that states a contract may not be altered without written consent of both parties; in other words - the contract may not be altered by an oral agreement.
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
Insurance furnished by nongovernmental insuring organizations.
Life insurance provided for members of a group.

46. Emergency
A rider attached to a life insurance policy that provides LTC benefits or benefits for the terminally ill by using available life insurance benefits.
An injury or disease which occurs suddenly and requires treatment within 24 hours.
An agreement between an insurer and insured in which both parties are expected to pay a certain portion of the potential loss and other expenses.
Period of time after the premium due date during which premiums may still be paid - and the policy and its riders remain in force.

47. Foreign Insurer
The fair and equal bargaining by both parties in forming the contract - where the applicant must make full disclosure of risk to the company - and the insurance company must be fair in underwriting the risk.
The third in line to receive the benefits of a life insurance policy.
An insurance company that is incorporated in another state.
Choices available to the insured/owner for distribution of insurance proceeds.

48. Accumulation Period
The time over which the annuitant makes paymenrs or investments in an annuity - and when those payments earn interest tax deferred.
Insurance agent or broker.
An amount representing actual or potential liabilities kept by an insurer in a separate account to cover debts to policyholders.
An agent/broker who handles insurer's funds in a trust capacity.

49. Benefit Period
The length of time over which the insurance benefits will be paid for each illness - disability or hospital stay.
Health coverage provided to members of a group.
A patient who is expected to die within an amount of time specified in the policy.
Insurance that pays benefits for inability to work because of disability resulting from accidental bodily injury or sickness.

50. Valued Contract
Disability from which the insured does not recover.
The authority granted to an agent by means of the agent's written contract.
A provision that states that the insurer and the insured will share the losses covered by the policy in a proportion agreed upon in advance.
A contract that pays a stated amount in the event of a loss (disability insurance/life insurance).