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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. Gatekeeper Model

2. Pro Rata Cancellation
A provision that helps determine the primary provider in situations where an insured is covered by more than one policy - thus avoiding claims overpayments.
An entity certified by the insured's health plan that provides health care services under contract.
Termination of an insurance policy - with an adjustment of the premium charge in proportion to the exact coverage that has been in force.
A selection of health care benefits from which an employee may choose the ones that he/she needs.

3. Workers Compensation
The date when the face amount of the life insurance becomes payable.
A type of individual or group insurance that provides coverage for illness until the insured reaches age 65 and for life in the case of an accident.
An amount representing actual or potential liabilities kept by an insurer in a separate account to cover debts to policyholders.
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.

4. Nonrenewal
A rider attached to a life insurance policy that provides LTC benefits or benefits for the terminally ill by using available life insurance benefits.
A contract whereby one party (insurer) agrees to indemnify or guarantee another party (insured) against a loss by a specified future contingency or peril in return for payment of a premium.
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 termination of a policy by an insurer on the anniversary or renewal date.

5. Annual Statement
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
An act of giving up a life policy - in which the insurer will pay the insured the cash value the policy has built up.
A detailed financial report that an insurance company must submit every year to the insurance department of state(s) in which it conducts business.
The portion of premium for which policy protection has not yet been given.

6. Underwriter
A person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
An infectious and incurable disease caused by the human immunodeficiency virus (HIV).
A percentage of the principal amount of a policy paid to the insured if he/she suffered the loss of an appendage.
A situation in which two parties provide the same help or advantages to each other (for example - Producer A living in State A can transact business as a nonresident in State B if State B's resident producers can transact business in State A).

7. Consumer Reports

8. Contract
The reduction - decrease - or disappearance of value of the person or property insured in a policy - by a peril insured against.
The amount of money an insured can borrow using the cash value of his/her life insurance policy as collateral.
Care that is rendered to help an insured complete his/her activities of daily living.
An agreement between two or more parties enforceable by law.

9. Rebating
Withdrawing the money from a qualified plan and placing it into another qualified plan.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.
Any inducement offered in the sale of insurance products that is not specified in the policy.
The amount a physician or supplier actually bills for a particular service or supply.

10. Qualified Plan
Insurance agent or broker.
A retirement plan that meets the IRS guidelines for receiving favorable tax treatment.
The binding force in a contract that requires something of value to be exchanged for the transfer of risk. The consideration on the part of the insured is the representations made in the application and the payment of premium; the consideration on th
An insurance company that is incorporated in another state.

11. Reduction
A policy premium that remains the same over the period of time premiums are paid.
Lessening the possibility or severity of a loss.
The length of time over which the insurance benefits will be paid for each illness - disability or hospital stay.
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.

12. Insured
A practice in which a person in a fiduciary capacity illegally mixes his/her personal funds with funds he/she is holding in trust.
A professional liability insurance that protects the insurer from claims by the insured for errors or oversights on the part of the insurer.
The person or organization that is protected by insurance; the party to be indemnified.
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

13. Home Health Care
An excessive amount of insurance that would result in overpayment to the insured in the event of a loss.
An insurance company that conducts business in the state of incorporation.
Type of care in which part-time nursing or home health aide services - speech therapy - physical or occupational therapy services are given in the home of the insured.
Policies which replace a certain percentage of the insured's pure loss of income due to a covered accident or sickness.

14. Intentional Injury
A policy with a high maximum limit that covers certain diseases named in the contract (such as polio and meningitis).
An act that is intended to cause injury. Self- inflicted injuries are not covered under accident insurance; intentional injuries inflicted on the insured by another are covered.
A basic principle of insurance under which the risk of financial loss is assigned to another party.
An entity certified by the insured's health plan that provides health care services under contract.

15. Standard Risk
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.
A type of life insurance that features a level premium and a death benefit that decreases each year over the duration of the policy.
An applicant or insured who is considered to have an average probability of a loss based on health - vocation and lifestyle.
The effect of a person's reputation - character - living habits - etc. on his/her insurability.

16. Payment of Claims
A mortality table used in life insurance that mathematically predicts the likelihood of death.
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 specifies to whom claims payments are to be made.
An information database that stores the health histories of this database for underwriting purposes.individuals who have applied for insurance in the past. Most insurance companies subscribe to

17. Policyholder
The person who has possession of the policy - usually the insured.
An insurance classification for applicants who have a lower expectation of incurring loss - and who - therefore - are covered at a reduced rate.
The effect a person's indifference concerning loss has on the risk to be insured.
Care that is rendered to help an insured complete his/her activities of daily living.

18. Home Health Agency

19. Administrator
Requirements approved by state law that must appear in all insurance policies.
An individual appointed by a court as a fiduciary to settle the financial affairs and estate of a deceased person.
The tendency of risks with higher probability of loss to purchase and maintain insurance more often than the risks who present lower probability.
A life or health insurance policy that is underwritten based on the insured's statement of health rather than a medical examination.

20. Hazard
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.
To reach the maturity date or time at which the face amount equals cash values.
An agent licensed in a state in which he or she is not a resident.
A circumstance that increases the likelihood of a loss.

21. Extended Care Facility
A fee or commission charged at the time of purchase of an annuity or a security.
The method of premium payment - whether annually - semiannually - quarterly - or monthly.
A facility which is licensed by the state to provide 24 hour nursing care.
An insurance sales office or company.

22. Annuity
A contract that provides income for a specified period of years - or for life.
An information database that stores the health histories of this database for underwriting purposes.individuals who have applied for insurance in the past. Most insurance companies subscribe to
An insurance company that conducts business in the state of incorporation.
Insurance that pays over and above or in addition to basic policy limits.

23. Law of Large Numbers
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 statement (or booklet) that confirms that a policy has been written and that describes the coverage in general.
An insurance policy that provides payment if the insured's death is the result of an accident.
A physical illness - disease - or pregnancy - but not a mental illness.

24. Home Health Services
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 unit of measure used to determine rates charged for insurance coverage.
A life insurance policy designed to provide a level death benefit to the insured's age 100 for a one-time - lump sum payment.
A covered expense under Part A of Medicare in which a licensed home health agency provides home health care to an insured.

25. Tertiary Beneficiary
Insurance that does not pay dividends.
A waiting period that is imposed on the insured from the onset of disability until benefit payments begin.
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.
The third in line to receive the benefits of a life insurance policy.

26. Partial Disability

27. Multiple-Employer Trust (MET)
A group of small employers who do not qualify for group insurance individually - formed to establish a group health plan or self-funded plan.
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 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.
An organization that is formed by - or on behalf of - a group of insurers to develop rates for those insurers - and to file the rates with the insurance department on behalf of its members. They may also act as a collection point for actuarial data.

28. Contributory
A group insurance plan that requires the employees to pay part of the premium.
The inclusion of causes of loss (perils) which are covered within a scope of a policy.
The full face value of a policy.
An arrangement that allows someone living with a life threatening condition to sell their existing life insurance policy and use the proceeds when and where they are most needed - before death.

29. Convertible
The third in line to receive the benefits of a life insurance policy.
The person who has possession of the policy - usually the insured.
A policy that may be exchanged for another type of policy by contractual provision - at the option of the policyowner - and without evidence of insurability (i.e. term life changed to a form of permanent life).
A type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable.

30. Explanation of Medicare Benefits
A life or health insurance policy that is underwritten based on the insured's statement of health rather than a medical examination.
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 group of small employers who do not qualify for group insurance individually - formed to establish a group health plan or self-funded plan.
A statement sent to a Medicare patient indicating how the Medicare claim will be settled.

31. Dual Choice
A provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.
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 federal requirement that employers who have 25 or more employees - who are within the service area of a qualified HMO - who pay minimum wage - and offer a health plan - must offer HMO coverage as well as an indemnity plan.
A contract that legally binds only one party to contractual obligations after the premium is paid.

32. Provider
A physical illness - disease - or pregnancy - but not a mental illness.
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 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).
Any group or individual who provides health care services.

33. Health Maintenance Organization (HMO)
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 person who evaluates and classifies risks to accept or reject them on behalf of the insurer.
Activities individuals must do every day such as moving about - getting dressed - eating - bathing - etc.
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.

34. Subrogation
The payment made by insurers to agents or brokers for the sale and service of policies.
An annuity that offers fixed payments and guarantees a minimum rate of interest to be credited to the purchase payment or payments.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
The legal process by which an insurance company seeks recovery of the amount paid to the insured from a third party who may have caused the loss.

35. Waiver of Premium
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.
Amounts an insured must pay for coinsurance and deductibles before the insurer will pay its portion.
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.
The reduction - decrease - or disappearance of value of the person or property insured in a policy - by a peril insured against.

36. Accident
An unplanned - unforeseen event which occurs suddenly and at an unspecified place.
The uncertainty or chance of a loss occurring in a situation that can only result in a loss or no change.
Organizations that process inpatient and outpatient claims on individuals by hospitals - skilled nursing facilities - home health agencies - hospices and certain other providers of health services.
Unplanned - unforeseen traumatic injury to the body.

37. Group Life
The age of the insured at a determined date.
Life insurance provided for members of a group.
An unfair trade practice in which one person refuses to do business with another until he or she agrees to certain conditions.
A request for payment of the benefits provided by an insurance contract.

38. Risk - Speculative
The acceptability of an applicant who meets an insurance company's underwriting requirements for insurance.
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.
The United States federal government plan for paying certain hospital and medical expenses for persons who qualify.
The uncertainty or chance of a loss occurring in a situation that involves the opportunity for either loss or gain.

39. Lloyd's Associations
The head of the state department of insurance.
Organizations that provide support facilities for underwriters or groups of individuals that accept insurance risk.
An insurance classification for applicants who have a lower expectation of incurring loss - and who - therefore - are covered at a reduced rate.
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.

40. Benefit Period
The length of time over which the insurance benefits will be paid for each illness - disability or hospital stay.
The individual's age when a policy is issued.
Organizations that process claims and pay benefits in an insurance policy
The first page of a policy.

41. Back-End Load
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 provision that spells out an insured's duty to provide the insurer with reasonable notice in the event of a loss.
A fee charged at the time of a sale - transfer or withdrawal from an annuity or a life insurance policy.
Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.

42. Death Benefit
The amount payable upon the death of the person whose life is insured.
A practice in which a person in a fiduciary capacity illegally mixes his/her personal funds with funds he/she is holding in trust.
A rider that is added to a life insurance policy to pay log-term care benefits. The amount of benefits available for LTC depends upon the life insurance benefits available; however - the benefits paid toward LTC will reduce the life insurance policy'
A clause that defines the insurance company's and the insured's right to cancel or renew coverage.

43. Single Premium Whole Life (SPWL)

44. Cash Value
Coverage that provides benefits for room - board and miscellaneous hospital expenses for a certain number of days during a hospital stay.
An unfair trade practice in which one agent or insurer makes an injurious statement about another with the intent of harming the person's or company's reputation.
A ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and nonguaranteed elements.
The amount to which a policyowner is entitled if the policy is surrendered before maturity.

45. Multiple Employer Welfare Association (MEWA)
A contract which has not yet been fulfilled by one or both parties that promises action in the event of a specified future occurrence.
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.
A choice of ways of receiving policy dividends - nonforfeiture values - death benefits - or cash values.
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.

46. Residual Disability
A legal contract that determines what will be done with a business in the event that an owner dies or becomes disabled.
Type of disability income policy that provides benefits for loss of income when a person returns to work after a total disability - but is still not able to perform at the same level as before becoming disabled.
The act that stipulates federal standards for private pension plans.
The amount a physician or supplier actually bills for a particular service or supply.

47. Commission
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.
The payment made by insurers to agents or brokers for the sale and service of policies.
A temporary contract that puts an insurance policy into force before the premium has been paid.
A clause that defines the insurance company's and the insured's right to cancel or renew coverage.

48. Joint Life
A form of insurance whereby one insurance company (the reinsurer) in consideration of a premium paid to it - agrees to indemnify another insurance company (the ceding company) for part or all of its liabilities from insurance policies it has issued.
The reduction - decrease - or disappearance of value of the person or property insured in a policy - by a peril insured against.
A single policy that is designed to insure two or more lives.
A statement usually obtained from the applicant's doctor.

49. Medigap
Medicare supplement plans issued by private insurance companies that are designed to fill some of the gaps in Medicare.
A single policy that is designed to insure two or more lives.
Special powers granted to an agent by his or her agency contract.
A group insurance plan that requires the employees to pay part of the premium.

50. Adult Day Care
The length of time over which the insurance benefits will be paid for each illness - disability or hospital stay.
A program for impaired adults that attempts to meet their health - social - and functional needs in a setting away from their homes.
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.
Type of disability income policy that provides benefits for loss of income when a person returns to work after a total disability - but is still not able to perform at the same level as before becoming disabled.