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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Underwriting, Marketing and Sales Practices | 15% | - Application and Underwriting Procedures
|
| Topic 2: Insurance Regulation and General Principles | 20% | - New York Insurance Code and Laws
|
| Topic 3: Accident and Health Insurance | 35% | - Government Health Programs
|
| Topic 4: Life Insurance Products and Provisions | 30% | - Types of Life Insurance Policies
|
>> New NY-Life-Accident-and-Health Dumps Questions <<
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NEW QUESTION # 30
Which of the following is described when a selected group of practitioners, in a certain area, agrees to provide services at a pre-arranged cost on a fee-for-service basis?
Answer: A
Explanation:
The correct answer is A. preferred provider organization. A Preferred Provider Organization (PPO) is a health care arrangement in which an insurer or plan contracts with a selected network of doctors, hospitals, and other providers in a geographic area to deliver medical services at negotiated or reduced charges . Federal and New York sources describe PPOs as networks of participating providers that agree to furnish care at discounted rates, while patients generally retain the flexibility to use non-network providers at a higher cost. That matches the question's description of a selected group of practitioners agreeing to provide services at a pre- arranged cost on a fee-for-service basis . ( HealthCare.gov ) The other options do not fit this definition. An indemnity organization traditionally reimburses covered losses and does not depend on a contracted provider network with prearranged fees. A risk purchasing group is associated with liability insurance purchasing arrangements, not standard health provider networks. Coalition group is not the recognized term for this managed care structure. Therefore, the correct description is a preferred provider organization . ( Department of Financial Services )
NEW QUESTION # 31
Intentionally withholding information that should be provided to an insurer is known as
Answer: B
Explanation:
The correct answer is A. concealment . In insurance, concealment means an applicant or insured intentionally fails to disclose a material fact that should be made known to the insurer. A material fact is any information that would affect the insurer's decision to issue the policy, set the premium, or determine the scope of coverage. Because insurers rely on full and truthful disclosure during underwriting, concealment can be treated as a form of misrepresentation and may give the insurer grounds to deny a claim or rescind the policy, depending on the circumstances and applicable law.
The other choices do not match this definition. Estoppel is a legal principle that can prevent a party from asserting a right when its own actions have caused another to rely to their detriment. Remission is not the standard insurance term for withholding information in underwriting. Twisting is an unfair trade practice involving inducing a policyowner to replace existing insurance using misleading comparisons. Since the question asks specifically about intentionally withholding information from an insurer, the correct term is concealment .
NEW QUESTION # 32
Long-term care policies MUST cover which of the following conditions?
Answer: B
Explanation:
Long-term care (LTC) insurance is intended to cover services needed when an insured cannot perform activities of daily living (ADLs) or suffers a cognitive impairment that requires substantial supervision for health and safety. A core regulatory and policy design principle is that LTC benefits must be available for qualifying impairments regardless of whether the cause is physical or cognitive . Alzheimer's disease is a leading cause of cognitive impairment and is specifically recognized in LTC training materials as a condition LTC policies must cover when it results in the required level of functional or cognitive limitation. In practice, Alzheimer's often triggers eligibility through the cognitive impairment standard, even when the insured can still perform some ADLs, because supervision is needed to protect the individual from threats to health and safety.
The other options are commonly associated with policy exclusions rather than required coverage. LTC policies frequently exclude losses related to war or acts of war , and they may exclude intentionally self- inflicted injuries . Alcoholism or drug addiction is not treated as a mandatory covered condition in the same way; coverage depends on policy terms and is often limited or excluded. Therefore, the condition LTC policies must cover is Alzheimer's disease .
NEW QUESTION # 33
A Section 457 Deferred Compensation plan is provided specifically for employees of
Answer: C
Explanation:
A Section 457 Deferred Compensation Plan is a type of retirement savings program established under Section
457 of the Internal Revenue Code. It is primarily designed for employees of state and local governments , including workers employed by states, counties, cities, and municipalities , as well as certain governmental agencies. These plans allow employees to defer a portion of their salary into a retirement account on a pre-tax basis , meaning the contributions are not included in taxable income until the funds are withdrawn, usually during retirement.
Section 457 plans are similar in concept to other tax-deferred retirement plans such as 401(k) or 403(b) plans, but they are specifically intended for public sector employees . One of the distinctive features of a governmental 457 plan is that withdrawals can often be taken without the early withdrawal penalty typically applied before age 59½ , provided the participant separates from service.
Options such as sole proprietorships or religious organizations typically use other retirement arrangements (like SEP, SIMPLE IRA, or 403(b) plans ). Therefore, the correct answer is that Section 457 plans are intended for employees of states, counties, or municipalities .
NEW QUESTION # 34
An insured wants to purchase a policy with three key elements: flexible premium, death benefit, and the choice of how the cash value will be invested. The insured should purchase
Answer: D
Explanation:
The correct answer is variable universal life . This policy combines the core features of universal life and variable life . From universal life, it provides flexible premiums and the ability to adjust the death benefit within policy limits. From variable life, it gives the policyowner the choice of how the cash value will be invested , typically through separate account investment options. This makes variable universal life the only option listed that includes all three elements named in the question.
An adjustable life policy allows changes in features such as premium, face amount, or period of protection, but it does not give the owner direct control over investment of the policy's cash value in separate accounts.
Universal term life is not a standard policy form used to describe investment-directed permanent cash value coverage. Graded premium whole life involves premiums that start lower and increase later, but it does not offer flexible premium design combined with investment choice.
Because the question specifically requires flexible premium , adjustable death benefit , and investment control over cash value , the correct answer is C. variable universal life .
NEW QUESTION # 35
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