SDLAHP South Dakota Life Accident and Health Producer - Set 1 - Part 3

Test your knowledge of technical writing concepts with these practice questions. Each question includes detailed explanations to help you understand the correct answers.

Question 41: An insured's adult child has an intellectual disability but is fully self-supporting through steady employment, pays all of her own living expenses, and no longer relies on her parent financially. Which outcome follows for continued coverage past the policy's dependent limiting age under South Dakota law?

coverage continues due to the disability alone

coverage continues if proof is filed anytime

coverage terminates because chief dependency is absent

coverage ends automatically at the limiting age

Question 42: An issuer discontinues a Medicare supplement policy and does not renew it, and a different Medicare supplement policy from another issuer takes effect for the same insured. Under South Dakota law, within what period after the discontinued date must the new policy's effective date fall to count as a replacement?

ten days after the old policy ends

sixty days after the old policy ends

ninety days after the old policy ends

thirty days after the old policy ends

Question 43: An individual on South Dakota group continuation coverage is determined disabled under the applicable Social Security Act provisions during the first sixty days after that continuation coverage began. Which total continuation period does that disability determination make available under state law?

twenty-nine months of continuation coverage

eighteen months of continuation coverage

thirty-six months of continuation coverage

continuation ends at the disability finding

Question 44: A long-term care claimant cannot perform daily tasks without substantial assistance from another person due to a loss of functional capacity. Under South Dakota rule, how many of the six defined activities of daily living must be affected, and for how long, to meet this part of the benefit trigger?

three ADLs for ninety days

two ADLs for ninety days

two ADLs for thirty days

four ADLs for sixty days

Question 45: A parent asks a South Dakota producer why one insurer told them a dependent child's coverage must end at age nineteen while a different plan keeps the same child covered until age twenty-six. Which explanation correctly accounts for this apparent conflict?

one of the two insurers is wrong

the state law was recently repealed

state and federal dependent-age rules differ

age twenty-six applies only to Medicaid

Question 46: A long-term care claimant appears to meet the activities-of-daily-living trigger, but no licensed health care practitioner has documented that status. Under South Dakota rule, what additional requirement must be satisfied before the claimant is considered chronically ill for benefit purposes?

certification within the preceding six months

certification by two separate practitioners jointly

certification renewed every ninety days

certification within the preceding twelve months

Question 47: An employee's spouse remains covered as a qualified beneficiary after the employee's divorce is finalized, and the employee stays actively employed and insured under the same group plan. Which continuation period applies to the divorced spouse under South Dakota's qualified beneficiary provision?

thirty-six months of continuation coverage

eighteen months of continuation coverage

twenty-nine months of continuation coverage

coverage ends immediately upon the divorce

Question 48: A South Dakota life insurance policy includes a long-term care rider, and the insurer that issued it later becomes impaired. Under the guaranty association statute, against which set of coverage limits are the benefits provided by that long-term care rider actually measured?

a separate long-term care guaranty limit

same limits as the base life policy

the health benefit plan guaranty limit

no guaranty coverage applies to the rider

Question 49: A policyholder's baby is born while the family health policy is in force, and the policyholder has not yet notified the insurer or paid any additional premium for the child. From what point does the newborn's coverage under South Dakota law actually begin?

after an automatic thirty-one-day waiting period

only once notice is given

from the moment of birth

once the insurer underwrites the child

Question 50: A long-term care claimant does not meet the activities-of-daily-living portion of the benefit trigger, but a licensed health care practitioner has documented that the claimant needs substantial supervision to stay safe. Under South Dakota rule, which condition allows this claimant to still qualify as chronically ill?

any chronic illness diagnosis by itself

confinement to a hospital for observation

a family member's written request for benefits

severe cognitive impairment requiring substantial supervision

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