Aflac Insurance Practice Exam

These questions are part of the practice quiz. Start practicing

• Which statement best describes experience rating in large-group premium determinations?
• Which of the following is typically regarded as a major treatment in an indemnity dental plan?
• In a group accident and health contract, which party is not directly involved?
• Non-occupational disability coverage is designed for employees who suffer non-work related disabilities, since work-related disabilities are covered by Workers' Compensation.
• Medicare SELECT plans require insureds to use which providers in exchange for lower premiums?
• When COBRA benefits have expired, a fully insured group policy can be converted to a(n)
• Which action by a producer could lead to imprisonment under federal law?
• According to Wisconsin law, intermediaries must retain policyholder records for at least how many years after termination or lapse?
• The Change of Occupation provision in a Disability Income policy states that, in the event the insured changes to a less hazardous occupation, which of the following may apply?
• What benefit is available only when coverage is purchased through the health insurance exchange?
• Which of the following LTC policy features typically covers care in a nursing facility?
• In a concurrent care setting, what aspect is commonly monitored?
• Disability benefits are typically how compared to pre-disability earnings?
• Which statement describes the coverage for the Medicare Part B coinsurance in the context of Medicare Supplements?
• All of these are used to prevent adverse selection in a group dental plan EXCEPT
• Medicare Supplements, sold to individuals to fill gaps in Medicare, are provided by
• Starting in 2016, businesses with up to how many employees will be defined by the ACA as a small business?
• The phrase entire contract in an insurance policy consists of which items?
• A major medical expense plan typically includes coverage for hospital room and board. Which item is normally covered under this category?
• Which statement about the regulation of long-term care and Medicare supplement products is true?
• Health plans must provide coverage for newborns for how many days?
• During an insurer's examination, the insurer is expected to do what?
• Medicare is described as which?
• Nonqualified distributions from a health savings account (HSA) have a tax penalty of
• Which entity regulates the sale of Medicare Supplements?
• A family counseling benefit is typically offered under which of these coverages?
• Underwriting considers marital status to determine dependent coverage eligibility.
• During the grace period, when a health insurance claim is filed, what happens to any unpaid premium?
• Which statement describes how a major medical expense policy typically pays surgeon fees?
• A policyowner's statement that promotes an insurance company and its policy by describing the policy's benefits is called what?
• What type of employee welfare plans are not subject to ERISA regulations?
• Which statement describes the condition under which an intermediary may receive a commission on business written on the intermediary's own life?
• Which of the following is NOT typically classified as an ADL in long-term care coverage?
• Which of the following is NOT a violation of the Federal Fraud and False Statements Act?
• How long must all health plans provide coverage for newborn children?
• Which provision would permit an insurer to delay a covered disability policy claim?
• John has a criminal record in which he was convicted of a felony that involved dishonesty. Under Federal law, how would John be able to engage in insurance transactions?
• The Wisconsin Insurance Security Fund was established to protect consumers in the event of an insurer's
• A Medicare Supplement policy is required to do which of the following?
• An insurer may cancel a policy midterm for all of the following reasons EXCEPT which?
• Dividends from a mutual insurance company are paid to which party, as reflected in typical mutual company practice?
• Which of the following is a typical elimination period length in long-term care policies?
• An insured, age 67, is covered under a disability income policy. What will the insurer require in order for the insured to continue coverage?
• When an intermediary has a change of mailing address, the intermediary MUST notify the Office of the Commissioner of Insurance in writing of the address change within a maximum of thirty days
• A limited accident and health policy covers what?
• An example of the unfair restraint of competition would be
• In an accident and health policy, which provision addresses premium requirements?
• Emergency health care coverage for Medicare enrollees traveling abroad is an example of which kind of benefit?
• Which incident would NOT be covered by an Accidental Death and Dismemberment policy?
• A Medicare Supplement insurance policy may EXCLUDE coverage for preexisting conditions for a maximum period of how many months after the policy goes into effect?
• Which statement regarding an examination of an insurer's books and records by the Commissioner is true?
• Which of the following would NOT have a restricted ability to enter into a contract?
• Which statement is true regarding replacement of Medicare Supplement coverage?
• Lamont has a point-of-service plan and seeks health services outside the network. What will likely be the end result?
• Which statement would allow an intermediary to receive compensation for insuring the intermediary's own life?
• Which statement is CORRECT about an insured's failure to report a claim in a timely manner based on the advice of an intermediary?
• Which entity administers approval for Medicare Supplement advertisements?
• Who reports an intermediary's termination of appointment to the Commissioner?
• In long-term care insurance, the term describing the duration during which claims are paid is called the
• If an intermediary's license was revoked for nonpayment of fees, what is the earliest time the intermediary may apply for reinstatement?
• Lead poisoning screening requirements apply to disability policies for children under which age?
• Which statement is true regarding the exchange of consideration among parties involved in an insurance contract?
• Which federal agency enforces securities laws?
• Which feature is commonly included in long-term care policies to keep pace with rising costs?
• The 'insurance with other insurers' provision states an insurer can pay benefits on a pro-rata basis if what condition is met?
• The term used to describe a statement of an insured's policy benefits used in marketing materials is
• Who regulates an insurer's claim settlement practices?
• The amount of disability income payments for an on-the-job injury may be reduced by which benefits already paid?
• Which policy would a disabled business owner use to cover ongoing payroll and other overhead expenses if the owner becomes disabled?
• In an accident and health policy, which documents constitute the entire contract?
• Readmission testing is described as a measure that generally results in which outcome?
• Major Medical policies are typically characterized by which of the following?
• Travel abroad emergency care for Medicare enrollees is included as what kind of benefit?
• Long-term care policies normally cover expenses associated with
• Which statement is NOT true concerning the relationship between group health insurance plans and Medicare for a business with more than 20 employees?
• Qualified long-term care premiums are tax-deductible to the extent they exceed what percentage of AGI?
• An accident and health insurance policy's premium requirements are set forth in which provision?
• In a cancelable health policy, who may terminate coverage?
• Who determines the suitability of a disability (accident & health) policy to a potential insured?
• An insured's statement of a policy's benefits which is to be used in marketing materials is called a(n)
• In the Jonas disability scenario, what percentage of the premium is paid by Jonas?
• What type of doctor-ordered care assists an individual with performing basic daily activities such as bathing, dressing, and eating?
• When does the producer give a premium receipt for an accident and health insurance application?
• Inflation protection in long-term care policy is designed to
• Medicaid will pay for nursing home expenses under what condition?
• Who typically initiates the initial premium for an accident and health policy?
• Which term best describes employer-supported programs within an HMO that promote health, such as stress reduction and smoking cessation?
• In a disability policy with employer-paid premiums (employer pays 75%, employee pays 25%), which portion of the benefits is subject to income taxes?
• Which statement best describes defamation in the context of insurance?
• What is to be expected with the Mandatory Second Surgical Opinion provision in place?
• Which method is commonly used by insurers to set premiums for large groups?
• Which practice is prohibited in marketing Medicare Supplements?
• Medigap open enrollment period lasts six months when you are 65 or older and enrolled in Part B. During this period, insurers cannot require medical underwriting.
• What policy feature delays eligibility for disability benefits after a disabling event?
• Hospice care is included in some standard Medicare Supplement policies. Which option best reflects this benefit?
• The 'other insurance with this insurer' provision protects which party?
• What term describes a renewable provision where premiums can increase only within rate classes?
• Which statement accurately describes the financial impact of total disability?
• In long-term care insurance, the length of time for which claims will be paid is called the
• How do birthing centers reduce medical costs?
• If a policyholder experiences a covered loss while a policy is in force and proof of loss is submitted after cancellation, how is the claim handled?
• In a long-term care policy, the benefit period refers to
• Making a statement that is false or maliciously critical of the financial condition of an insurer is known as what?
• What do Limited accident and health policies normally cover?
• The initial premium for an accident and health insurance policy is typically paid in what way?
• In long-term care insurance, the period during which benefits are paid is called the
• When issuing disability income coverage on a substandard risk, an insurer may
• Risk ____ is the process of analyzing exposures that create risk and designing programs to handle them.
• Which statement correctly describes a noncancelable policy?
• During open enrollment for Laura obtaining non-contributory group Major Medical insurance, what action must she take?
• In the context of group disability coverage, continuation privileges allow up to eighteen months of coverage under which option?
• Which entity has the power to revoke an intermediary's license?
• An intermediary must complete how many hours of approved training to sell long-term care products?
• A false statement made by an applicant that would influence an insurer in determining whether or not to accept the risk is
• In travel accident insurance, a double indemnity clause results in benefits being doubled when conditions described in the policy are met.
• Which plan name is a standard Medicare Supplement plan offering standardized benefits across insurers?
• Which parties are directly involved in a group accident and health insurance contract?
• Which coverage would be considered standard in disability policies for adults?
• How long is individual medical expense insurance normally written for?
• Is group health coverage available to an employee's spouse that is Medicare-eligible?
• Under federal law, pregnancy must be treated the same as which of the following by employers?
• When an intermediary's license is revoked for failure to meet continuing education requirements, the intermediary CANNOT
• An intermediary may receive compensation for insuring the intermediary's self ONLY if
• The purpose of licensing insurance intermediaries is to show to the satisfaction of the Commissioner all of the following EXCEPT that the applicant
• Tonya has been diagnosed with kidney failure and has group accident and health insurance through her large employer. Which plan will be primary during the months following her diagnosis?
• Which option lists activities that are typically classified as ADLs in long-term care coverage?
• Which of the following is available ONLY if the consumer purchases coverage in the health insurance exchange?
• The benefit period for Medicare Part A begins on which event?
• Which statement correctly describes a reinsurance contract?
• Which option best describes a Cancer plan?
• An autopsy may be requested by an accident and health insurer under which circumstance?
• An insurer has a contractual agreement which transfers a portion of its risk exposure to another insurer. What type of contractual arrangement is this?
• The Mandatory Second Surgical Opinion provision is intended to reduce what?
• All newly issued group disability policies must provide coverage for which of the following?
• Which of the following is true about the major treatment in indemnity dental plans?
• Which of the following is available ONLY if the consumer purchases coverage in the health insurance exchange?
• Which term describes paying part of the commission to the buyer as an incentive?
• Group accident and health insurance may be offered by an insurer when the sponsoring group provides what type of relationship?
• Under Federal Law, which action may result in imprisonment for a producer?
• Which of the following does NOT meet the requirements of 'skilled nursing care'?
• CE revocation true/false: If an intermediary's license is revoked for failure to meet continuing education requirements, the intermediary can still be present during the sale of insurance by another intermediary.
• Nonqualified distributions from a health savings account (HSA) have a tax penalty of?
• Who determines the suitability of a disability (accident & health) policy to a potential insured?
• A disabled business owner who has payroll and business expenses paid for has what kind of insurance policy?
• Long-term care policies normally cover expenses associated with
• Qualified long-term care policies must include all of the following provisions EXCEPT
• For group health plans covering employees in more than one state, the state regulatory jurisdiction established for the plan may affect any of the following aspects EXCEPT
• Which type of facility would Julie be eligible for if she needs assistance with one or more activities of daily living?
• Death benefits paid from a health insurance policy to a named beneficiary are generally:
• What is the daily coinsurance amount for skilled nursing facility services covered by Medicare after 100% coverage ends?
• Medicare Part B excess charges are covered by
• A disability income policy provides only nonoccupational coverage. Which scenario would likely not be covered?
• A preferred provider plan and an indemnity plan are similar in what way?
• Under standard accident and health policy provisions, the policy, endorsements, and attached papers constitute the what?
• Splitting the commission with the buyer on an insurance sale is known as what?
• With a point-of-service plan, obtaining services outside the network typically results in what for the member?
• Which type of coverage is designed for employees who suffer disabilities not related to work because workers' compensation covers work injuries?
• Which of the following is NOT a valid reason for midterm cancellation?
• All of the following are covered under most dental plans EXCEPT for
• Which statement is NOT a requirement for licensure as an insurance intermediary?
• Jill has a group health plan with an employer that covers employees in more than one state. Which of the following is NOT affected by the state regulatory jurisdiction established for this plan?
• Who is protected with the "other insurance with this insurer" provision?
• If a policyowner cannot perform one or more important job duties due to an injury, under which provision would the decreased income be paid?
• Which of these is NOT a factor that influences group health insurance underwriting?
• In coordination with Medicare for a business with more than 20 employees, which statement is true regarding active employees' group plans and Medicare?
• Which entity is primarily responsible for regulating how insurers settle claims?
• Which of the following is NOT typically included in a health maintenance organization wellness program?
• Readmission testing affects hospital stay by which of the following?
• In insurance contracts, the exchange of consideration can be unequal.
• Claims settlement practices of insurers are regulated by which entity?
• Periodic health claim payments must be made at least how often?
• Which of the following types of insurers limits the exposures it writes to those of its owners?
• What triggers pro-rata payment under the 'insurance with other insurers' provision?
• Which item is not typically covered by most dental plans?
• The Insurance Commissioner has the right to issue which of the following orders?
• In underwriting, how is the cost of insuring a substandard risk most commonly adjusted?
• Which noncontributory group plan would a claim likely result in the payment of federal income taxes?
• Which statement is true regarding hospital preadmission certification for emergency situations?
• A Guaranteed Renewable provision allows premiums which can only be increased per rate class.
• If the intermediary's biennial license fee is not paid by the expiration date, the intermediary's license
• Kelly purchases a health insurance policy issued on a conditionally renewable basis. The insurance company has a right to decline renewal of the policy for
• Which scenario illustrates a Change of Occupation that would typically be considered a movement to a less hazardous job under a Disability Income policy?
• The PRIMARY purpose of the replacement rule is to
• Under the Pregnancy Discrimination Act of 1978, employers must treat pregnancy in the same manner as which of the following?
• Which type of policy pays benefits to a policyholder covered under a Hospital Expense policy?
• Who may terminate coverage under a cancelable health insurance policy?
• All of the following are typically covered under dental insurance EXCEPT
• What is a typical result of a concurrent review in health care management?
• Which statement best describes the role of probationary periods in a group dental plan?
• Which individual would be best suited for Medicare Supplement insurance?
• Which of the following statements BEST describes a double indemnity provision in travel accident insurance?
• Which statement about expense incurred method for Long Term Care benefits is correct?
• Continuation privileges under group disability insurance allow coverage to continue for up to how many months?
• Which statement about church plans is true?
• Medicare SELECT is characterized by requiring the insured to use which providers to obtain lower premiums?
• When a health insurance policy includes a Mandatory Second Surgical Opinion provision, the insured must
• How does marital status affect underwriting in relation to dependent coverage?
• A pre-existing condition exclusion pertains to
• Disability (accident and health) policies that cover hospital expenses for adults MUST include coverage for
• Which statement best describes a Cancer plan in the context of health insurance?
• Which of these would NOT likely qualify as a presumptive disability?
• Which organization is a syndicate established by a group of insurers to share underwriting duties?
• Which event would not be covered by an AD&D policy?
• A pre-existing condition exclusion in an accident and health insurance policy pertains to
• What is the primary purpose of the concept 'material misrepresentation' in underwriting?
• With a deductible of $200 and an 80/20 coinsurance, if the remaining eligible expenses after deductible are $600, how much does the insurer pay?
• In dual coverage scenarios, pro-rata payments occur if no notification of other coverage before claim is given.
• Under the carryover provision, with a deductible of $200 and an 80/20 coinsurance, total expenses of $100 in November and $400 in January amount to what the insurer will pay?
• An example of the unfair restraint of competition would be
• A copy of all Medicare Supplement advertisements must be submitted for approval to
• The family counseling benefit is typically offered under Hospice Care. Which of the following options best reflects this relationship?
• Some standard Medicare Supplement policies include which benefit?
• The major medical deductible carryover period normally applies to expenses incurred during the last ___ months of the plan year.
• What is the federal income tax liability of a death benefit paid from a health insurance policy to a named beneficiary?
• An insurance company's failure to enforce a contract's provision is called a(n)
• Which statement is INCORRECT about why the government provides insurance?
• Terry receives long-term physical therapy at her residence. What type of insurance would cover this service?
• Employees age 65 or older are typically required to be offered the same group health benefits as younger employees.
• Which individual is the best candidate for Medicare Supplement insurance?
• Which type of private insurance covers the cost-sharing amounts under Medicare?
• How long can pre-existing conditions be excluded in long-term care policies?
• Where is the difference between a standard risk and a substandard risk reflected?
• Which statement is NOT true regarding the ability of an insured to return a disability (accident & health) policy?
• In Wisconsin, intermediaries must retain policyholder records for at least how long after lapse?
• In a long-term care policy, the elimination period is best described as
• The marketing of Medicare Supplements is regulated to prevent all of the following EXCEPT
• Which statement about the major medical plan's deductible carryover provision is accurate?
• What is the maximum fine for someone who intentionally commits a criminal violation of an insurance law?
• Continuation privileges under group disability policies are designed to allow coverage for up to how many months?
• The insurer is legally protected against actions in which an intermediary and a policyholder did what?
• A policy issued on a conditionally renewable basis allows the insurer to decline renewal for reasons stated in the contract. This renewal type is known as?
• According to the Affordable Care Act, coverage may be rescinded
• Greg applies for insurance and makes a false statement on the application that will influence whether or not the insurer will accept the risk. Greg's false statement is called a(n)
• All Medicare Supplement advertisements must be submitted for approval to which official?
• What is evidence of insurability primarily used for in group plans?
• In disability policy terms, which action best describes the effect of misrepresentation or false statements?
• Custodial care is care that assists with activities of daily living and is typically prescribed by a physician. Which of the following best describes custodial care?
• A licensee whose name or address changes must notify the Commissioner within how many days by written notice?
• Which of the following describes the act of insuring a risk against possible loss?
• Which of the following is NOT one of the 10 essential health benefits required by a comprehensive ACA plan?
• A licensee must respond to the Commissioner's information request in what manner?
• Medicare is
• Under a disability (accident and health) policy, which statement about coverage for a physically or mentally handicapped child who has reached the policy's limiting age is correct?
• Dividends from a mutual insurance company are paid to whom?
• What is the earliest time an intermediary may apply for reinstatement after revocation for nonpayment of fees?
• The process of evaluating and addressing risk by analyzing exposures and designing protective programs is called what?
• Under an employer-sponsored disability income policy, the employee pays the portion of the premium attributable to residual disability benefits and the employer pays the remainder. What are the tax implications of residual disability benefits?
• To which of the following group plans do HIPAA rules NOT apply?
• Tim has an accident and health insurance policy that may not be changed by the insurer up to a stated age, as long as the premiums are paid. What type of policy is this?
• Which term describes the elimination of a hazard?
• HIPAA rules NOT apply to which type of group plan?
• In the context of small business health insurance, what is the maximum number of employees that defines a small business?
• Wisconsin insurance law requires intermediaries to keep policyholder records for at least how many years after termination or lapse of the policy?
• When the Insurance Commissioner requests information from an intermediary or other licensed individual, what is required?
• A temporary license may be issued to
• What is covered under a limited accident and health insurance policy?
• Which BEST describes a 'partial disability'?
• Which term describes the start of Medicare Part A's benefit period?
• Under what circumstance does an accident and health insurer have the right to request an autopsy?
• Under Medicare Supplement marketing regulations, which practice is allowed?
• In an employer-sponsored policy, who pays the portion of the premium attributable to the cost of residual disability benefits?
• The right to return period begins with policy delivery.
• During open enrollment, which action is necessary to complete enrollment?
• Under a group accident and health policy, after termination notice, how many days does the insured have to apply for a converted policy?
• In health insurance terminology, what does field underwriting refer to?
• Jim is covered under a disability income policy. He is hurt while engaged in an occupation that is more hazardous than the occupation he specified in the policy. What action will the insurer likely take?
• Long Term Care policies will usually pay for eligible benefits using which of the following methods?
• Limited accident and health policies normally cover
• Screening for lead poisoning is required for disability policies for children under