NY-Life-Accident-and-Health Lernhilfe, NY-Life-Accident-and-Health Schulungsunterlagen

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Insurance Licensing NY-Life-Accident-and-Health Exam Syllabus Topics:

SectionObjectives
Accident and Health Insurance- Health insurance products
  • 1. Disability income insurance
    • 2. Hospital and medical expense coverage
      - Policy features and provisions
      • 1. Coordination of benefits
        • 2. Elimination periods and benefit limits
          Insurance Fundamentals- Principles of insurance and risk management
          • 1. Insurable interest and indemnity concepts
            • 2. Risk classification and pooling of risk
              - Insurance contract law basics
              • 1. Policy provisions and clauses
                • 2. Elements of a valid contract
                  State Regulations (New York)- Ethics and compliance
                  • 1. Unfair trade practices
                    • 2. Producer responsibilities and conduct
                      - Licensing requirements
                      • 1. Pre-licensing education requirements
                        • 2. Application and background checks

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                          NY-Life-Accident-and-Health Schulungsunterlagen & NY-Life-Accident-and-Health Ausbildungsressourcen

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                          Insurance Licensing New York Life, Accident and Health Insurance Agent/Broker Examination Series 17-55 NY-Life-Accident-and-Health Prüfungsfragen mit Lösungen (Q58-Q63):

                          58. Frage
                          If a policyowner surrenders a policy for its cash value, when is a tax liability incurred?

                          Antwort: D

                          Begründung:
                          A tax liability is incurred upon surrender of a life insurance policy when the cash surrender value received exceeds the total premiums paid into the policy , excluding any amounts previously withdrawn tax-free. In life insurance taxation, the policyowner's cost basis is generally the sum of premiums paid. If the amount received at surrender is greater than that basis, the excess is treated as taxable ordinary income . For that reason, A is correct.
                          Choice B is incorrect because if the cash value is less than the premiums paid, there is generally no taxable gain. Choice C is incorrect because an exchange of one life insurance policy for another policy of equal value may qualify as a 1035 exchange , which allows the transaction to occur without immediate taxation, provided it meets the tax code requirements. Choice D is not the best answer to this question because the issue asked is specifically about surrender for cash value, and the taxable event in that context depends on whether the policyowner receives more than the policy's basis. On licensing exams, "cash value exceeds premiums paid" is the key rule.


                          59. Frage
                          In broad terms, the types of support and services generally associated with Long-Term Care policies are provided at which three levels of care?

                          Antwort: D

                          Begründung:
                          The correct answer is D. Skilled nursing, Intermediate, and custodial care. Long-Term Care insurance is designed to help cover ongoing care for individuals who cannot fully care for themselves because of chronic illness, disability, cognitive impairment, or the inability to perform activities of daily living. In traditional insurance licensing materials, long-term care services are commonly described as being delivered at three broad levels: skilled nursing care , intermediate care , and custodial care .
                          Skilled nursing care is the highest level and involves medically necessary services performed by licensed medical personnel under a doctor's supervision. Intermediate care is less intensive than skilled nursing care but still involves professional oversight and some medical or rehabilitative support. Custodial care provides assistance with personal needs such as bathing, dressing, eating, and moving about, and it is the type of care most commonly associated with long-term care claims.
                          The other answer choices do not reflect the standard three recognized levels used in long-term care insurance terminology. Therefore, the broad categories of care generally associated with Long-Term Care policies are skilled nursing, intermediate, and custodial care .


                          60. Frage
                          At the time of an insured ' s death, a per capita distribution of policy proceeds are paid to

                          Antwort: B

                          Begründung:
                          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.


                          61. Frage
                          Which of the following is described when a selected group of practitioners, in a certain area, agrees to provide services at a pre-arranged cost on a fee-for-service basis?

                          Antwort: B

                          Begründung:
                          The correct answer is A. preferred provider organization. A Preferred Provider Organization (PPO) is a health care arrangement in which an insurer or plan contracts with a selected network of doctors, hospitals, and other providers in a geographic area to deliver medical services at negotiated or reduced charges . Federal and New York sources describe PPOs as networks of participating providers that agree to furnish care at discounted rates, while patients generally retain the flexibility to use non-network providers at a higher cost. That matches the question's description of a selected group of practitioners agreeing to provide services at a pre- arranged cost on a fee-for-service basis . ( HealthCare.gov ) The other options do not fit this definition. An indemnity organization traditionally reimburses covered losses and does not depend on a contracted provider network with prearranged fees. A risk purchasing group is associated with liability insurance purchasing arrangements, not standard health provider networks. Coalition group is not the recognized term for this managed care structure. Therefore, the correct description is a preferred provider organization . ( Department of Financial Services )


                          62. Frage
                          Which of the following services must be provided by a health benefit plan issued on or after January 1, 2014?

                          Antwort: A

                          Begründung:
                          The correct answer is D. Preventive health services. Health benefit plans issued on or after January 1, 2014 became subject to the Affordable Care Act's essential health benefit and preventive-service requirements for non-grandfathered coverage in the individual and small-group markets. Those rules require coverage for specified preventive services without cost-sharing when provided in accordance with federal guidelines. New York's post-2014 marketplace coverage materials likewise explain that plans must include the ACA's required essential health benefits, which include preventive and wellness services.
                          The other options are not the mandatory general requirement described in this question. Adult eye care and adult dental care are not universally required as core benefits in the same way preventive services are; the ACA's pediatric services category specifically includes pediatric vision and dental, not broad adult routine vision or dental as mandatory across all such plans. Long-term care services are also not one of the essential health benefits that every post-2014 health benefit plan must provide. Therefore, among the choices given, the service that must be provided is preventive health services


                          63. Frage
                          ......

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