Insurance Licensing NY-Life-Accident-and-Health Latest Pass Exam

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Insurance Licensing NY-Life-Accident-and-Health Exam Syllabus Topics:

SectionWeightObjectives
Accident and Health Insurance25-30%- Long-term care insurance basics
- Major medical coverage
- Disability income insurance
- Health insurance policy types (individual, group, HMOs)
- Medical expense coverage
- Dental and vision insurance basics
Life Insurance Fundamentals25-30%- Beneficiary designations
- Dividends and nonforfeiture options
- Policy reinstatement
- Policy types and provisions
- Policy riders and endorsements
New York State Regulations20-25%- Consumer protection regulations
- Licensing requirements and procedures
- Replacement and churn rules
- Fiduciary responsibilities
- NYS Insurance Law requirements
- Advertising regulations
General Insurance Principles15-20%- Agent/broker duties and ethics
- Fair claims settlement practices
- Underwriting principles
- Insurance contract fundamentals
- Ethical sales practices

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Insurance Licensing New York Life, Accident and Health Insurance Agent/Broker Examination Series 17-55 Sample Questions (Q59-Q64):

NEW QUESTION # 59
The difference between the face value of a life insurance policy and its cash value is the

Answer: A

Explanation:
The correct answer is C. net amount. In life insurance, the difference between a policy's face amount and its cash value is commonly referred to in licensing terminology as the net amount at risk , and exam questions often shorten that phrase to net amount . This represents the portion of the death benefit the insurer is actually risking at a given time because the cash value already belongs to the policyowner and offsets part of the insurer's exposure. As cash value increases over the life of a permanent policy, the insurer's net amount at risk generally decreases. NAIC life insurance regulatory material describes the amount subtracted from the policy's face value to determine the net amount at risk , which is consistent with this concept. ( NAIC ) The other options are not correct insurance terms for this relationship. Market value applies more to investments or securities. Assumed amount is not the standard term used in life insurance contract analysis.
Term value is also incorrect because term insurance generally does not build cash value. Therefore, the recognized answer is net amount , meaning the policy's net amount at risk . ( NAIC )


NEW QUESTION # 60
According to the Affordable Care Act, a child can remain on a parent ' s health benefit plan until the child

Answer: A

Explanation:
The correct answer is reaches age 26 . The Affordable Care Act (ACA) introduced a major change in health insurance dependent coverage rules by requiring most health insurance plans that provide dependent coverage to allow children to stay on their parent's health insurance policy until they reach age 26 . This rule applies to both individual and employer-sponsored health plans .
One important feature of this regulation is that eligibility does not depend on the child's marital status, student status, financial independence, or residence . This means a young adult may still remain covered under the parent's plan even if the child is married, living independently, or no longer attending school. The goal of this provision is to reduce the number of uninsured young adults who may otherwise lose coverage after finishing school or aging out of traditional dependent eligibility requirements.
The other options are incorrect because dependent coverage does not automatically end when the child marries, graduates from college, or turns age 19 . The ACA clearly sets the maximum age for dependent coverage at 26 years old , making Option C the correct answer.
Because the owner's physician, accountant, and insurance consultant are all specifically barred from receiving such referral compensation, the only correct option is D. life settlement broker .


NEW QUESTION # 61
At the time of an insured ' s death, a per capita distribution of policy proceeds are paid to

Answer: D

Explanation:
The correct answer is the named living primary beneficiaries . In life insurance beneficiary designations, per capita means "by the head," or equally among the living members of the named class or group . When policy proceeds are distributed per capita, each living beneficiary at the same beneficiary level receives an equal share of the death benefit. If one of the named primary beneficiaries dies before the insured, that deceased beneficiary's share is not passed to that beneficiary's estate or descendants unless the policy specifically provides otherwise. Instead, the proceeds are divided equally among the remaining living primary beneficiaries .
This is what distinguishes per capita from per stirpes . Under per stirpes, the share of a deceased beneficiary would pass down to that beneficiary's descendants. But under per capita, only the surviving named beneficiaries in the class receive the proceeds.
The other options are incorrect because a deceased beneficiary's estate does not automatically receive the share, the children of a deceased primary beneficiary are not paid under per capita unless specifically named, and contingent beneficiaries are paid only if no primary beneficiaries survive. Therefore, D is correct.


NEW QUESTION # 62
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 # 63
With respect to a life settlement contract, no person shall directly or indirectly pay a referral or finders fee to any person other than the

Answer: C

Explanation:
The correct answer is life settlement broker . Under New York Insurance Law Article 78 , the life settlement rules prohibit paying a referral or finder's fee to most persons connected with the policyowner, including the owner's physician, attorney, accountant, insurance producer, insurance consultant, or other person providing medical, legal, or financial planning services . The statute specifically states that such compensation may not be paid to any of those persons, or to any other person representing the owner, other than a life settlement broker .
This rule is designed to prevent conflicts of interest and to ensure that recommendations about life settlements are not improperly influenced by side compensation. New York permits compensation only where it is paid in connection with the role of a licensed life settlement broker , because that person is regulated under the state's life settlement framework. The broker is the recognized professional authorized to represent the owner in the transaction and receive compensation in that capacity.


NEW QUESTION # 64
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