TLAHI Tennessee Life and Accident and Health Insurance Exam - Set 4 - 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 insurer wants to prevent a disabled insured from receiving more in benefits than she earned while working, so a provision can reduce benefits to match her actual prior income. A producer names this provision. Which optional provision is being described?

Change of occupation

Misstatement of age

Relation of earnings to insurance

The illegal occupation provision

Question 42: A large employer wants to protect itself financially against the loss of a highly valuable executive whose disability would disrupt operations and profits. A producer names the coverage that insures the business against that loss. Which coverage is being described?

Business overhead expense

A disability buyout policy

Group disability income

Key person disability insurance

Question 43: A health insured surrenders his right to sue the insurer for a claim until sixty days after proof of loss, and no later than three years afterward, under a standard timing rule. A producer names this uniform provision. Which provision is being described?

Time of payment of claims

The legal actions provision

Notice of claim

Physical examination and autopsy

Question 44: During a pending disability claim, the insurer wants the right to have the insured examined by a physician of the insurer's choice at reasonable intervals, and to order an autopsy where allowed in case of death. A producer names this provision. Which provision is described?

Physical examination and autopsy

Proof of loss

The grace period

Change of beneficiary

Question 45: A health insured who missed a premium can restore a lapsed policy under a provision, but a producer explains that after reinstatement, sickness is typically covered only if it begins a certain number of days later, while injury is covered immediately. Which provision is being described?

The grace period

Notice of claim

The reinstatement provision

Time limit on certain defenses

Question 46: An employer pays the full premium for a group health plan covering its employees, and a producer explains the general federal tax treatment of that arrangement for the business and the workers. How is employer-paid group health coverage generally treated for tax?

Nondeductible and taxable to workers

Taxable to the employer only

Deductible only if employees contribute

Deductible to employer, tax-free to employees

Question 47: A worker enrolling in group health coverage does not have to undergo a medical exam or answer detailed health questions, because the insurer evaluates the group as a whole rather than each person. A producer names this feature of group underwriting. Which feature is being described?

No individual medical underwriting

Mandatory individual exams

Postclaim underwriting

Guaranteed premium refunds

Question 48: A managed care plan controls costs by requiring approval before certain nonemergency hospital admissions or expensive procedures, confirming in advance that they are truly medically necessary. A producer names this cost-control step. Which utilization tool is being described?

Coordination of benefits

Subrogation

Preauthorization

An elimination period

Question 49: A person shopping on the health insurance marketplace with a modest income may receive federal help that lowers the monthly premium she pays for a qualified plan. A producer names this Affordable Care Act assistance. Which form of help is being described?

A health savings account

A premium tax credit or subsidy

A guaranteed insurability rider

A coordination of benefits payment

Question 50: A group health plan continues coverage for an employee's newborn from the moment of birth, but the plan generally requires the parent to notify the insurer and pay any added premium within a set number of days. A producer names this provision. Which provision is being described?

The coordination of benefits provision

The change of occupation provision

The relation of earnings provision

The newborn coverage provision

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