ILHI - Indiana Life and Health Insurance Exam

Question 21: A solo dentist wants a policy that will keep paying her office rent, utility bills, and staff wages while a disability keeps her from practicing. Which of the following policies is designed to cover those continuing business costs?

Disability buy-sell insurance

Key employee disability insurance

Group short term disability insurance

Business overhead expense insurance

Question 22: An accidental death and dismemberment benefit pays its full face amount when the insured dies in an accident, loses two limbs, or loses the sight in both eyes. Which of the following terms names that full benefit amount?

The capital sum

The indemnity limit

The principal sum

The residual amount

Question 23: A client asks whether a cancer policy she is considering will pay if she suffers a stroke instead. The policy is a specified disease contract listing cancer and heart disease. Which statement BEST describes how benefits under such a contract are limited?

Benefits cover any catastrophic illness

Benefits cover illness but not injury

Benefits cover all cardiovascular conditions

Benefits cover only diseases named

Question 24: A terminated employee elects continuation of her employer's health plan. Besides the full group premium she previously shared with her employer, the plan may add a charge for its own administrative expense. Which limit applies to that additional charge?

Two percent of the premium

Ten percent of the premium

Fifty percent of the premium

Twenty-five percent of the premium

Question 25: A disability income policy states that the insured must remain disabled for ninety days before any monthly benefit becomes payable, which functions much like a deductible measured in time rather than dollars. Which of the following names that ninety-day period?

Benefit period

Grace period

Elimination period

Recurrent disability period

Question 26: An entity contracts with a network of hospitals and physicians who agree to accept fees somewhat below the usual rate for the area, and enrollees who use those contracted providers pay a smaller share of the bill. Which arrangement is this?

A preferred provider organization

An indemnity insurance plan

A multiple employer trust

A health savings account

Question 27: Under one renewability classification the insurer may terminate an individual health policy at any time by giving the insured written notice, and any unearned premium is returned to the insured on a pro rata basis. Which classification permits that action?

Guaranteed renewable

Noncancelable

Conditionally renewable

Cancelable

Question 28: An insured with a long-term care policy wants to raise her daily benefit under the policy's guaranteed insurability option. She is currently receiving benefits in a nursing home. Which statement correctly describes her ability to exercise the option?

She may not increase it now

She may increase it without cost

She may increase it after underwriting

She may increase it at issue age

Question 29: Both long-term care policies and Medicare supplement policies must describe their renewal conditions on the first page, and regulators require a minimum renewability standard for these senior products. Which classification is the minimum these policies must carry at issue?

Cancelable

Guaranteed renewable

Optionally renewable

Conditionally renewable

Question 30: An insured satisfies the ninety day waiting period under a policy feature and benefit payments begin. Along with the benefit, the insurer stops billing premiums and refunds the premium collected during the waiting period. Which feature operates this way?

Waiver of premium

Coinsurance

Carryover deductible

Preauthorization

Question 31: A man with a diagnosed heart condition applies for a nongrandfathered individual major medical policy. He worries the insurer will refuse to pay for treatment of that condition during his first year of coverage. How does federal law treat his concern?

Exclusion allowed for twelve months

Exclusion allowed for eighteen months

Exclusion allowed only above age sixty-five

No preexisting condition exclusion permitted

Question 32: An insured is receiving benefits under a disability income policy after the insurer accepted proof of loss. Under the time of payment of claims provision, which of the following describes how often those periodic benefits must be paid?

At least once each year

Only at the disability's end

At least monthly

Whenever the insurer chooses

Question 33: Before a recommended hospital admission goes forward, an insurer requires the attending physician to submit the proposed treatment for review so the company can judge whether it is necessary and cost effective. Which cost containment measure is the insurer using?

Preauthorization

Concurrent review

Retrospective review

Coordination of benefits

Question 34: A health contract provides that the company may refuse to renew only if the insured reaches age sixty-five or leaves the occupation named in the application, and never because the insured's health has declined. Which renewability classification fits this contract?

Cancelable

Optionally renewable

Conditionally renewable

Noncancelable

Question 35: One medical plan applies its deductible once for all covered charges an insured incurs between January and December, no matter how many separate illnesses or accidents arise during those months. Which type of deductible does that plan use?

A calendar year deductible

A per cause deductible

A corridor deductible

A carryover deductible

Question 36: Three years after issuing an individual health policy, an insurer discovers an innocent misstatement in the application and wants to void the contract on that basis. Which of the following mandatory provisions determines whether the insurer may still do so?

Legal actions

Payment of claims

Change of occupation

Time limit on certain defenses

Question 37: An insured whose quarterly premium was due on the first is injured on the twelfth, still inside the grace period, and files a claim before paying. Which of the following describes how the insurer must handle that claim?

Pay it, less the premium due

Deny it; the premium was unpaid

Pay it and refund the premium

Hold it until the policy reinstates

Question 38: An insurer wishes to raise rates on a block of guaranteed renewable individual health policies because claims have been heavier than expected, and it asks whether it may single out the worst insureds. Which statement correctly states the insurer's rate authority?

Rates change only individually

Rates may never change

Rates change only with consent

Rates change only by class

Question 39: An insured with a disability income policy leaves an office job to work as a commercial roofer and does not tell the insurer. He is later injured on the roof. Under the change of occupation provision, which of the following results?

Benefits are reduced to what premiums bought

The claim is denied entirely

The insurer refunds excess premium

The policy is canceled immediately

Question 40: Two applicants compare individual health policies. One contract is guaranteed renewable and the other is noncancelable, and both must be renewed until the insured reaches age sixty-five. Which statement BEST captures the difference between the two renewability provisions?

Only one covers preexisting conditions

Only one permits premium increases

Only one may be canceled anytime

Only one requires evidence of insurability

ILHI Indiana Life and Health Insurance Exam - Set 4 - Part 2

Question 21: A solo dentist wants a policy that will keep paying her office rent, utility bills, and staff wages while a disability keeps her from practicing. Which of the following policies is designed to cover those continuing business costs?

Question 22: An accidental death and dismemberment benefit pays its full face amount when the insured dies in an accident, loses two limbs, or loses the sight in both eyes. Which of the following terms names that full benefit amount?

Question 23: A client asks whether a cancer policy she is considering will pay if she suffers a stroke instead. The policy is a specified disease contract listing cancer and heart disease. Which statement BEST describes how benefits under such a contract are limited?

Question 24: A terminated employee elects continuation of her employer's health plan. Besides the full group premium she previously shared with her employer, the plan may add a charge for its own administrative expense. Which limit applies to that additional charge?

Question 25: A disability income policy states that the insured must remain disabled for ninety days before any monthly benefit becomes payable, which functions much like a deductible measured in time rather than dollars. Which of the following names that ninety-day period?

Question 26: An entity contracts with a network of hospitals and physicians who agree to accept fees somewhat below the usual rate for the area, and enrollees who use those contracted providers pay a smaller share of the bill. Which arrangement is this?

Question 27: Under one renewability classification the insurer may terminate an individual health policy at any time by giving the insured written notice, and any unearned premium is returned to the insured on a pro rata basis. Which classification permits that action?

Question 28: An insured with a long-term care policy wants to raise her daily benefit under the policy's guaranteed insurability option. She is currently receiving benefits in a nursing home. Which statement correctly describes her ability to exercise the option?

Question 29: Both long-term care policies and Medicare supplement policies must describe their renewal conditions on the first page, and regulators require a minimum renewability standard for these senior products. Which classification is the minimum these policies must carry at issue?

Question 30: An insured satisfies the ninety day waiting period under a policy feature and benefit payments begin. Along with the benefit, the insurer stops billing premiums and refunds the premium collected during the waiting period. Which feature operates this way?

Question 31: A man with a diagnosed heart condition applies for a nongrandfathered individual major medical policy. He worries the insurer will refuse to pay for treatment of that condition during his first year of coverage. How does federal law treat his concern?

Question 32: An insured is receiving benefits under a disability income policy after the insurer accepted proof of loss. Under the time of payment of claims provision, which of the following describes how often those periodic benefits must be paid?

Question 33: Before a recommended hospital admission goes forward, an insurer requires the attending physician to submit the proposed treatment for review so the company can judge whether it is necessary and cost effective. Which cost containment measure is the insurer using?

Question 34: A health contract provides that the company may refuse to renew only if the insured reaches age sixty-five or leaves the occupation named in the application, and never because the insured's health has declined. Which renewability classification fits this contract?

Question 35: One medical plan applies its deductible once for all covered charges an insured incurs between January and December, no matter how many separate illnesses or accidents arise during those months. Which type of deductible does that plan use?

Question 36: Three years after issuing an individual health policy, an insurer discovers an innocent misstatement in the application and wants to void the contract on that basis. Which of the following mandatory provisions determines whether the insurer may still do so?

Question 37: An insured whose quarterly premium was due on the first is injured on the twelfth, still inside the grace period, and files a claim before paying. Which of the following describes how the insurer must handle that claim?

Question 38: An insurer wishes to raise rates on a block of guaranteed renewable individual health policies because claims have been heavier than expected, and it asks whether it may single out the worst insureds. Which statement correctly states the insurer's rate authority?

Question 39: An insured with a disability income policy leaves an office job to work as a commercial roofer and does not tell the insurer. He is later injured on the roof. Under the change of occupation provision, which of the following results?

Question 40: Two applicants compare individual health policies. One contract is guaranteed renewable and the other is noncancelable, and both must be renewed until the insured reaches age sixty-five. Which statement BEST captures the difference between the two renewability provisions?

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