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

Topic	Details
Topic 1	Qualified Plans: This domain addresses employer-sponsored retirement plans including qualification requirements, tax advantages, and various plan types such as SEPs, 401(k)s, and 403(b) plans.
Topic 2	Individual Health Insurance Policy General Provisions: This domain covers uniform required and optional provisions in individual health policies including contract terms, claims procedures, grace periods, renewability classifications, and the free look period.
Topic 3	Medical Plans: This domain examines medical insurance delivery systems including major medical, HMOs, PPOs, and POS plans, along with cost containment strategies, Virginia eligibility requirements, HIPAA provisions, and HSAs.
Topic 4	Life Insurance Policy Provisions, Options and Riders: This domain addresses standard contract provisions, beneficiary designations, settlement options, nonforfeiture provisions, policy loans, dividend options, and riders including disability benefits and accelerated death benefits.
Topic 5	Federal Tax Considerations for Health Insurance: This domain examines federal tax treatment of personally-owned and employer-provided health insurance, business disability insurance, and tax-advantaged accounts including HSAs, HRAs, and FSAs.
Topic 6	General Insurance: This domain introduces fundamental insurance concepts including risk management methods, types of insurers, agent authority, and the essential elements and characteristics of insurance contracts including legal doctrines governing agreements.
Topic 7	Group Health Insurance: This domain covers group health insurance characteristics, eligible groups, underwriting criteria, employee and dependent eligibility, continuation of coverage under COBRA, and small employer plan requirements.
Topic 8	Federal Tax Considerations for Life Insurance and Annuities: This domain examines federal tax treatment of life insurance and annuities including death benefits, policy loans, modified endowment contracts, non-qualified annuities, IRAs, and Section 1035 exchanges.
Topic 9	Health Insurance Basics: This domain introduces health insurance fundamentals including covered perils, types of benefits, policy classifications, limited policies, common exclusions, agent responsibilities, underwriting processes, and replacement considerations.

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Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Sample Questions (Q235-Q240):

NEW QUESTION # 235
(Under a twenty-payment whole life insurance policy, the insured stops paying premiums:)

A. When the cash value exceeds the premium
B. At the later of date of death or 20 years after policy inception
C. At the earlier of date of death or 20 years after policy inception
D. When the policy matures at its face amount

Answer: C

Explanation:
A twenty-payment whole life insurance policy is a limited-pay whole life policy that requires premiums to be paid for only 20 years. If the insured survives the 20-year payment period, the policy becomes fully paid-up and remains in force for the insured's lifetime without any further premium payments. If the insured dies before the 20-year payment period ends, premium payments stop at death, and the death benefit is paid to the beneficiary. Therefore, premium payments cease at the earlier of the insured's death or the end of the 20-year payment period. The policy does not require premium payments until maturity or until cash value exceeds premiums. The correct definition focuses on the limited premium payment structure of the policy.

NEW QUESTION # 236
An individual covered under a disability income policy is injured while engaged in an occupation that is more hazardous than the occupation stated in the policy. What is the effect of the policy's change of occupation provision?

A. The benefit level is reduced.
B. The premium rate is increased.
C. The policy is cancelled.
D. The policy limits are increased.

Answer: A

Explanation:
If an individual covered under a disability income policy is injured while engaged in an occupation that is more hazardous than the one stated in the policy, the policy's change of occupation provision typically results in the benefit level being reduced. This provision allows the insurer to adjust the benefits based on the new, more hazardous occupation, reflecting the increased risk.

NEW QUESTION # 237
At the request of a small group medical plan policyholder the insurer must disclose all of the following EXCEPT:

A. The insurer's right to increase premium rates
B. The renewability provisions
C. All available benefits
D. The insurer's expenses

Answer: D

Explanation:
Virginia small-group medical insurance disclosure rules require insurers to inform policyholders of renewability provisions, available benefits, and rights related to premium rate increases. However, insurers are not required to disclose their business operating expenses. Exact extract: "At the request of the policyholder, the insurer shall disclose the insurer's right to increase premium rates, the renewability provisions, and all available benefits." Reference:

NEW QUESTION # 238
The insurance with other insurers provision in an individual health insurance policy allows an insurer to pay benefits to the insureds on a pro-rata basis when the:

A. Insured has submitted claims in excess of $2,000 during the policy year
B. Insurer was not notified prior to the claim that the insured has other health coverage
C. Policy has entered into the grace period for premium payment
D. Policy is within 31 days of the renewal date

Answer: B

Explanation:
The "insurance with other insurers" provision, addressed in Virginia Code § 38.2-3514, is a coordination of benefits (COB) mechanism in individual health insurance policies designed to prevent over-insurance and duplicate payments when an insured has multiple policies covering the same loss. This provision allows the insurer to prorate benefits-paying a share based on the total coverage-when certain conditions are met. Option C states that the insurer wasn't notified prior to the claim of other coverage, which triggers proration. This aligns with standard COB rules: if the insurer isn't informed of other policies, it may assume primary liability initially but adjust to a pro-rata share upon discovery, ensuring equitable payment across insurers. Option A (within 31 days of renewal) is irrelevant; renewal proximity doesn't affect benefit coordination. Option B (grace period) relates to premium payment timing, not other insurance, and doesn't trigger proration. Option D ($2,000 claim threshold) is arbitrary and not a standard condition in Virginia law or study materials for this provision. The study guide likely emphasizes notification as key to COB, as Virginia follows NAIC model regulations requiring disclosure of other coverage (e.g., via application or claim forms). Without prior notice, the insurer applies proration retroactively, making C the correct choice.

NEW QUESTION # 239
A juvenile life insurance policy is:

A. Available only as decreasing term insurance for a minor
B. Available only for children who are less than five years old
C. Designed to insure the lives of a juvenile's parents
D. A life insurance policy that insures the life of a minor

Answer: D

Explanation:
A juvenile life insurance policy is a life insurance policy that insures the life of a minor (a child). These policies are typically purchased by a parent or guardian, and the intent is to provide coverage for the child at a young age. These policies are not limited to children under five years old, nor are they necessarily available only as decreasing term insurance.

NEW QUESTION # 240
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