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| Section | Weight | Objectives |
|---|---|---|
| Insurance Regulation and General Principles | 20% | - Insurance Concepts
|
| Accident and Health Insurance | 35% | - Government Health Programs
|
| Life Insurance Products and Provisions | 30% | - Policy Provisions, Riders and Options
|
| Underwriting, Marketing and Sales Practices | 15% | - Application and Underwriting Procedures
|
>> NY-Life-Accident-and-Health참고덤프 <<
Insurance Licensing인증 NY-Life-Accident-and-Health시험을 등록했는데 마땅한 공부자료가 없어 고민중이시라면Itcertkr의Insurance Licensing인증 NY-Life-Accident-and-Health덤프를 추천해드립니다. Itcertkr의Insurance Licensing인증 NY-Life-Accident-and-Health덤프는 거의 모든 시험문제를 커버하고 있어 시험패스율이 100%입니다. Itcertkr제품을 선택하시면 어려운 시험공부도 한결 가벼워집니다.
질문 # 31
Which premium payment mode typically results in the lowest overall cost for a life insurance policy?
정답：C
설명：
The correct answer is D. Annually. Life insurance premiums may be paid using several payment modes, including monthly, quarterly, semi-annually, or annually . Although the total annual premium for a policy is based on the insurer's underwriting calculations, insurers typically apply modal factors when premiums are paid more frequently than once per year. These modal factors slightly increase the cost to cover administrative expenses and the loss of investment income that the insurer would otherwise receive if the premium were paid in one lump sum.
Because of these additional charges, paying premiums monthly, quarterly, or semi-annually usually results in a higher total cost over the course of the year compared to paying the full premium at once. When the premium is paid annually , the policyowner generally avoids these additional modal charges, making it the least expensive payment mode overall .
For this reason, insurance licensing materials and life insurance training commonly explain that while more frequent payment modes may be more convenient for budgeting purposes, annual premium payments provide the lowest total cost for the policyholder over time.
질문 # 32
A Medicare Supplement policy must NOT contain benefits which
정답：C
설명：
A Medicare Supplement policy (Medigap) is designed specifically to fill the gaps in coverage left by Medicare Parts A and B . These policies are standardized and regulated to ensure that they supplement, rather than replace or duplicate, Medicare benefits. The purpose of Medigap coverage is to help pay for certain out- of-pocket expenses , such as deductibles, copayments, coinsurance, and other costs that original Medicare does not fully cover. Because of this purpose, Medicare Supplement policies are not allowed to duplicate benefits that Medicare already provides . If a benefit were duplicated, it would violate the fundamental principle that Medigap policies are intended only to supplement existing Medicare coverage , not provide overlapping payments for the same services.
Option A is incorrect because insurers may charge premiums for the coverage provided under the policy.
Option C is incorrect because Medigap plans may include benefits that help pay expenses beyond Medicare's basic coverage limits (such as additional hospital days). Option D is incorrect because Workers' Compensation operates separately and is not the defining restriction placed on Medigap benefits. Therefore, Medicare Supplement policies must not duplicate Medicare benefits .
질문 # 33
When a buyer is considering a long-term care policy, they are encouraged to review carefully all policy
정답：A
설명：
The correct answer is limitations . When evaluating a long-term care policy , applicants are strongly encouraged to review all policy limitations, exclusions, waiting periods, benefit triggers, and conditions of coverage before purchasing the contract. Long-term care insurance can vary significantly from one policy to another, so understanding what the policy does not cover is just as important as understanding the benefits it provides.
Policy limitations may affect the types of care covered, such as nursing home care, assisted living care, home health care, adult day care, or custodial care . They may also define when benefits begin, how long they continue, whether preexisting conditions are restricted, and what eligibility standards must be met before benefits become payable. Because long-term care policies often involve substantial premiums and are intended for future healthcare needs, buyers must carefully examine these details to avoid unexpected gaps in coverage.
The other choices are incorrect because although facilities, carriers, and agents may all be important considerations, the standard warning in long-term care insurance education is to review the policy limitations carefully. Therefore, A. limitations is the correct answer.
질문 # 34
When a provider does NOT have an agreement with the insurer for payment, they will be reimbursed
정답：B
설명：
When a medical provider does not have a contract or payment agreement with an insurer (often called a nonparticipating or out-of-network provider), the insurer generally does not pay based on a negotiated contract rate. Instead, reimbursement is commonly determined using a UCR methodology- Usual, Customary, and Reasonable charges. "Usual" refers to the typical charge a provider makes for a service;
"customary" reflects what providers in the same geographic area commonly charge for that service; and
"reasonable" considers whether the charge is appropriate given the circumstances and local market norms.
Under many major medical plans, the insurer pays a percentage of the UCR amount (subject to deductibles and coinsurance), and the patient may be responsible for any difference between the provider's billed charge and the insurer's allowed UCR amount (often referred to as balance billing , where permitted).
The other choices do not match standard insurer payment terminology: "absolute" and "relative" fee are not the typical reimbursement basis described for noncontracted providers, and "non-scheduled plan customary fee" is not the recognized standard method used in these plan provisions.
질문 # 35
At the time of an insured ' s death, a per capita distribution of policy proceeds are paid to
정답：A
설명：
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.
질문 # 36
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