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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Life Insurance Products and Provisions | 30% | - Types of Life Insurance Policies
|
| Topic 2: Accident and Health Insurance | 35% | - Health Insurance Basics
|
| Topic 3: Insurance Regulation and General Principles | 20% | - Insurance Concepts
|
| Topic 4: Underwriting, Marketing and Sales Practices | 15% | - Sales and Customer Service
|
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NEW QUESTION # 28
Which of the following is a basic benefit of Medicare Supplemental insurance?
Answer: B
Explanation:
Medicare Supplement insurance (Medigap) is designed to fill gaps in Original Medicare (Parts A and B) by paying certain out-of-pocket expenses that Medicare does not pay in full. A commonly tested basic Medigap benefit is coverage for the first 3 pints of blood each year . Under Original Medicare, a beneficiary may be responsible for the cost of the first three pints of blood in a calendar year (unless replaced or covered under specific circumstances). Medigap policies include this "first three pints" coverage as part of the standardized core benefits, helping reduce the beneficiary's exposure to unexpected hospital or outpatient blood costs.
The other choices are not considered standard "basic" Medigap benefits. "At-home recovery" and certain
"preventive care" enhancements have been associated with limited or older plan designs rather than being universally basic. "Basic drugs limit of $1,250" reflects older outpatient prescription concepts that are largely associated with pre-Part D benefit structures and not a core Medigap basic benefit in the way the blood coverage is. Therefore, the correct basic benefit is the first 3 pints of blood each year .
NEW QUESTION # 29
According to the Affordable Care Act, a child can remain on a parent ' s health benefit plan until the child
Answer: B
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 # 30
An insured wants to purchase a policy with three key elements: flexible premium, death benefit, and the choice of how the cash value will be invested. The insured should purchase
Answer: C
Explanation:
The correct answer is variable universal life . This policy combines the core features of universal life and variable life . From universal life, it provides flexible premiums and the ability to adjust the death benefit within policy limits. From variable life, it gives the policyowner the choice of how the cash value will be invested , typically through separate account investment options. This makes variable universal life the only option listed that includes all three elements named in the question.
An adjustable life policy allows changes in features such as premium, face amount, or period of protection, but it does not give the owner direct control over investment of the policy's cash value in separate accounts.
Universal term life is not a standard policy form used to describe investment-directed permanent cash value coverage. Graded premium whole life involves premiums that start lower and increase later, but it does not offer flexible premium design combined with investment choice.
Because the question specifically requires flexible premium , adjustable death benefit , and investment control over cash value , the correct answer is C. variable universal life .
NEW QUESTION # 31
When a provider does NOT have an agreement with the insurer for payment, they will be reimbursed
Answer: B
Explanation:
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.
NEW QUESTION # 32
Which of the following statements BEST describes a disability elimination period?
Answer: B
NEW QUESTION # 33
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