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200 QUESTION PA LIFE AND HEALTH STATE EXAM
SIMULATOR
Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -100 Questions and Answers
-Format: Multiple-choice / Flashcard
Question 1: In which of the following situations would the insurer be liable for a loss?
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The insured suffered an injury as an innocent bystander during a bank robbery Question 2: Which of the following employers is required to follow ERISA regulations?
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A local electrical supply company with 12 employees Question 3: Under Pennsylvania statute, first year commissions for long-term care insurance may not be greater than
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50% of the first year premium Question 4: This MANDATORY health policy provision states that the policy, including endorsements and attached papers, constitutes
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the entire insurance contract between the parties
Question 5: All of the following riders can increase the death benefit amount EXCEPT
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Waiver of Premium Question 6: An individual can enroll in a Part C Medicare Advantage Plan at what time?
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When becoming eligible for Medicare Question 7: A producer who offers 10% of his commission to a potential client as an inducement to purchase an insurance policy is committing the act of
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inducement Question 8: Loans obtained by a policy owner against the cash value of a life insurance policy
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would not be treated as taxable income Question 9: According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual
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is eligible for coverage upon hire Question 10: Which of the following best describes a conditional insurance contract?
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A contract that requires certain conditions or acts by the insured individual
Question 11: Which of these statements about Medicaid is CORRECT?
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Funded by federal, state, and local taxes
Question 12: Which of the following does Coordination of Benefits allow?
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Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid
Question 13: When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPPA)?
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When contribution or participation rules have been violated Question 14: Insurance companies determine risk exposure by which of the following?
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Law of large numbers and risk pooling Question 15: All of the following are considered to be nonforfeiture options available to a policy owner EXCEPT
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Reduction of premium
Question 16: What is the elimination period of an individual disability policy?
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Time period a disabled person must wait before benefits are paid
Question 17: During the accumulation period, who can surrender an annuity?
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Policyowner
Question 18: An example of a presumptive disability would be
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deafness Question 19: A type of group that has a constitution and bylaws and has been organized for purposes other than obtaining insurance is called a(n)
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association or labor group Question 20: States that have "no loss no gain" laws require a replacing policy to
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pay for ongoing claims under the policy it replaces
Question 21: Producer commissions may NOT be paid to
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licensed producers not appointed by an insurer Question 22: Upon policy delivery, which of the following must a producer have an applicant sign if no initial premium was collected with the life insurance application?
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A good health statement Question 23: A policyholder has a major medical plan with a 80%/20% coinsurance and a deductible of $75. If the insured has previously met her deductible and receives a bill for $175, how much will the insurer pay?
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$140 Question 24: When a preferred provider organization (PPO) insured goes out-of-netnetwork, which of the following actions occur?
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The insurer will pay a reduced amount Question 25: Major medical insurance will typically cover medical expenses that result from
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a negative reaction to prescribed medication
Question 26: The authority granted to a licensed producer is produced via the
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Law of Agency Question 27: All of the following are included as part of a contract in the entire contract provision EXCEPT the
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changes made by the producer