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| Section | Objectives |
|---|---|
| Topic 1: State Regulations (New York) | - Ethics and compliance
|
| Topic 2: Insurance Fundamentals | - Principles of insurance and risk management
|
| Topic 3: Accident and Health Insurance | - Health insurance products
|
>> NY-Life-Accident-and-Health Reliable Test Objectives <<
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NEW QUESTION # 13
If a partner of a company becomes permanently disabled, which type of plan will allow the other partner to acquire the disabled partner's interest in the company?
Answer: C
Explanation:
A disability buy-sell agreement (often funded with disability buyout insurance) is specifically designed to address the business ownership problem created when an owner/partner becomes totally and permanently disabled . The agreement establishes, in advance, the terms under which the non-disabled partner(s) can purchase the disabled partner's ownership interest , providing an orderly transfer of control and a fair method to determine the buyout price. The insurance component supplies the cash needed to complete the purchase so the remaining partner is not forced to borrow, liquidate assets, or disrupt operations to raise funds. By contrast, long-term disability and employee disability coverage are aimed at replacing personal income for the disabled individual, not transferring ownership interests. Business overhead expense insurance reimburses ongoing fixed business expenses (rent, utilities, certain salaries) during the owner's disability; it helps keep the business running but does not create a mechanism for one partner to acquire the other partner's share.
Therefore, the provision that enables acquisition of the disabled partner's interest is the disability buy-sell agreement.
NEW QUESTION # 14
Which of the following is NOT an Essential Health Benefit Category under the Affordable Care Act?
Answer: D
Explanation:
The Affordable Care Act (ACA) requires non-grandfathered individual and small group health plans to cover Essential Health Benefits (EHBs) -a defined set of benefit categories that must be included to ensure comprehensive coverage. The EHB categories include, among others, emergency services , laboratory services , and maternity and newborn care , all of which are explicitly listed as required categories. These categories ensure access to critical care such as emergency treatment, diagnostic testing and screenings through lab services, and prenatal, delivery, and newborn-related services.
" Alternative Medicine " is not one of the ACA's EHB categories. While some plans may choose to cover certain alternative or complementary treatments (for example, limited chiropractic or acupuncture benefits), such services-when covered-are typically plan-specific design choices or may be addressed under broader categories only if the state's EHB benchmark defines them that way. The ACA does not mandate "Alternative Medicine" as a standalone essential benefit category in the way it mandates emergency, lab, and maternity
/newborn coverage. Therefore, the option that is NOT an Essential Health Benefit Category is Alternative Medicine .
NEW QUESTION # 15
The cause of a loss is called
Answer: B
Explanation:
In insurance terminology, the cause of a loss is known as a peril . A peril is the specific event or cause that results in damage, injury, or financial loss. Common examples of perils include fire, theft, accident, illness, disability, or death . In life and health insurance, the insured event-such as death in life insurance or sickness and accidental injury in health insurance-is considered the peril that triggers the insurer's obligation to pay benefits under the policy. Insurance policies are designed to provide financial protection against losses that result from covered perils.
It is important to distinguish a peril from other related insurance concepts. A hazard is a condition or situation that increases the likelihood or severity of a loss caused by a peril. Hazards are typically categorized as physical hazards (such as icy roads or faulty wiring), moral hazards (dishonesty or fraudulent behavior), and morale hazards (carelessness because of insurance coverage). An exposure refers to the possibility of loss, while risk refers to the uncertainty regarding the occurrence of a loss. Therefore, the term that specifically describes the direct cause of a loss is a peril .
NEW QUESTION # 16
Which of the following products is designed to pay benefits that can provide a stream of retirement income to the purchaser?
Answer: C
Explanation:
An annuity contract is a financial product specifically designed to provide a steady stream of income , typically during retirement. Annuities are issued by insurance companies and are commonly used as part of retirement planning. The purchaser (annuitant or owner) contributes funds either through a lump-sum payment or periodic premiums during the accumulation phase , where the money grows on a tax-deferred basis . Later, during the annuitization phase , the accumulated value is converted into a series of regular payments that may last for a specified period or for the lifetime of the annuitant.
These payments can be structured in several ways, such as life-only, life with period certain, joint and survivor, or fixed period payments , allowing flexibility depending on the annuitant's retirement needs.
Option B, tax-deferred growth , is a feature of certain financial products, not a product itself. Option C, variable life insurance , is primarily designed to provide a death benefit with an investment component rather than retirement income. Option D, modified endowment contract (MEC) , is a tax classification for certain life insurance policies that exceed premium limits and is not designed primarily to provide retirement income streams.
NEW QUESTION # 17
Intentionally withholding information that should be provided to an insurer is known as
Answer: D
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 # 18
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