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Virginia Insurance Virginia-Life-Annuities-and-Health-Insurance Exam Syllabus Topics:

Section	Objectives
Accident and Health Insurance	- Health insurance principles 1. Individual and group health plans 2. Disability and medical expense coverage
Insurance Regulatory Environment	- State insurance regulation and oversight 1. Virginia insurance laws and regulations 2. Producer licensing requirements
Life Insurance	- Life insurance fundamentals 1. Policy types and features 2. Beneficiaries and policy ownership
Annuities	- Annuity concepts 1. Fixed and variable annuities 2. Accumulation and payout options

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Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Sample Questions (Q184-Q189):

NEW QUESTION # 184
Medical expense Plan A pays up to $4,000. Plan B pays up to $3,000. If a person covered under both plans incurs $6,000 in expenses and Plan A is primary, which is true under the coordination of benefits provision?

A. Plan A pays an adjusted percentage and Plan B pays the remainder.
B. Plan A pays up to $6,000.
C. Plan A pays up to $4,000 and Plan B pays up to $2,000.
D. Plan A pays up to $3,000 and Plan B pays up to $3,000.

Answer: C

Explanation:
Under the coordination of benefits provision, when an individual is covered by more than one medical plan, the primary plan (Plan A) pays up to its limit first, and then the secondary plan (Plan B) pays any remaining covered expenses. In this case, since Plan A is primary, it will pay up to its maximum benefit of $4,000. After that, Plan B will pay up to its maximum benefit of $3,000, covering the remaining $2,000 in expenses.

NEW QUESTION # 185
All of the following factors are used to determine insurability when underwriting an individual health insurance application EXCEPT:

A. Occupation
B. Age
C. Religious preference
D. Weight

Answer: C

Explanation:
Insurers may evaluate actuarial risk factors such as age, health, weight, and occupation. Religion is never a permissible underwriting factor. Exact extract: "Underwriting practices may not discriminate based on race, color, creed, or religion." This ensures compliance with fairness standards and anti-discrimination laws.
Reference:

NEW QUESTION # 186
(Which of the following is one characteristic of a SIMPLE IRA plan?)

A. Employers do not have filing requirements
B. Employers must have a minimum of 500 employees to participate
C. Employees are vested after 10 years of service
D. Employees are mandatory contributors

Answer: A

Explanation:
A SIMPLE IRA plan is designed for small employers and is known for ease of administration. One key characteristic is that employers generally do not have complex annual filing requirements, unlike many qualified retirement plans that require detailed reporting. Employees may choose whether or not to contribute through salary deferrals, so contributions are not mandatory. SIMPLE IRA plans have immediate vesting, meaning employees are 100% vested in both employer and employee contributions right away, not after years of service. Additionally, SIMPLE IRA plans are limited to employers with 100 or fewer employees, not 500. The simplicity and low administrative burden make these plans attractive to small businesses.

NEW QUESTION # 187
Generally, an indemnity plan which covers dental expenses:

A. Only allows insureds to be treated by certain preselected providers
B. Covers preventive care for adults and children once every six months
C. Rarely requires an insured to pay a deductible or coinsurance portion for major services such as crowns
D. Covers all dependent family members living in the insured's household, including dependent parents

Answer: B

Explanation:
Dental indemnity plans reimburse insureds for covered services up to specified amounts. Preventive services such as cleanings, exams, and fluoride treatments are typically covered every six months for both adults and children. These plans generally do not limit members to a network of providers, unlike managed care dental plans, but they do require deductibles and cost-sharing for major restorative work.
Exact Extract (Virginia Dental Plan Filing Requirements): "Preventive dental services-cleanings, exams, fluoride treatments-covered once every six months." Reference (Virginia Documents / Study Guide):
- Virginia SCC Product Checklist: Individual Stand-Alone Dental Plan Organizations
- Virginia Health Insurance Study Guide, Indemnity vs. Managed Care Plans

NEW QUESTION # 188
(Life insurance death proceeds are generally:)

A. Subject to the cost recovery rule
B. Deemed to be a transfer for value
C. Subject to the interest first rule
D. Exempt from federal income tax

Answer: D

Explanation:
Under Virginia licensing standards and federal tax principles taught for the life insurance exam, life insurance death proceeds are generally exempt from federal income tax when paid to a beneficiary due to the insured's death. This long-standing rule is a fundamental advantage of life insurance and is frequently tested.
The transfer-for-value rule applies only in limited situations when a life insurance policy is sold or transferred for consideration, which is not the general rule for death benefits. The cost recovery rule and interest-first rule apply to annuities, not life insurance death proceeds. Therefore, options B, C, and D are incorrect.
This tax-free treatment allows beneficiaries to receive the full face amount without reduction for income taxes, making life insurance an effective financial protection and estate planning tool. While estate taxes may apply in certain high-value estates, income tax treatment remains favorable in most cases.

NEW QUESTION # 189
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