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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Accident and Health Insurance | 35% | - Policy Provisions and Claims
|
| Topic 2: Underwriting, Marketing and Sales Practices | 15% | - Application and Underwriting Procedures
|
| Topic 3: Insurance Regulation and General Principles | 20% | - New York Insurance Code and Laws
|
| Topic 4: Life Insurance Products and Provisions | 30% | - Types of Life Insurance Policies
|
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NEW QUESTION # 23
Mortality is based on a large risk pool of
Answer: B
Explanation:
The correct answer is people and time . In insurance, mortality refers to the statistical measurement of death within a defined population. Insurers rely on mortality tables , which are developed using large pools of data that track the probability of death among groups of people over specific periods of time. These tables allow insurance companies to estimate the likelihood that individuals within certain age groups will die within a given year. The concept is based on the law of large numbers , meaning that when a very large group of people is observed over time, patterns of mortality become predictable and can be used to calculate insurance premiums.
Life insurance companies analyze mortality data across large populations and extended time periods to determine appropriate premium rates and to ensure that they maintain sufficient reserves to pay future claims.
By spreading risk across many policyholders, insurers can accurately project expected losses and maintain financial stability.
The other options are incorrect because mortality statistics are not primarily based on income, geographic area alone, or personal characteristics such as hobbies or family history. The essential foundation of mortality calculations is large groups of people observed over time .
NEW QUESTION # 24
Which of the following groups is NOT eligible for the Healthy New York Program?
Answer: D
Explanation:
The correct answer is A. Large employers. The Healthy New York Program was designed by New York State to make health insurance more affordable for individuals and small businesses that typically have difficulty obtaining reasonably priced coverage. The program targets small employers , generally those with a limited number of employees, as well as sole proprietors and certain working individuals who are uninsured . By providing subsidized coverage options, the program helps these groups access basic health insurance protection.
Under the program guidelines used in New York Life, Accident and Health licensing materials, eligibility includes small businesses , self-employed individuals , and working uninsured individuals who meet specific income and employment criteria. These groups are considered eligible because they often lack access to affordable group coverage through large employer-sponsored plans.
Large employers , however, are not eligible for the Healthy New York Program. Large companies typically have access to standard group health insurance markets and therefore are not the intended beneficiaries of this subsidized program. Because the program specifically focuses on small businesses and uninsured workers, large employers are excluded from eligibility , making option A the correct answer.
NEW QUESTION # 25
A company may insure an employee with specialized skills under a key employee disability insurance policy.
Which of the following statements is TRUE?
Answer: C
Explanation:
The correct answer is A. The business is the applicant. In key employee disability insurance (also called key person disability income), the purpose of coverage is to protect the business against financial loss if an employee with unique skills, knowledge, or production value becomes disabled. New York's Life, Accident and Health Agent/Broker examination content outline specifically includes "Business disability insurance" and "Key person disability income" as tested topics, confirming that this is a recognized business-use disability coverage concept in the New York licensing curriculum.
Under this arrangement, the business applies for and owns the policy , pays the premiums, and is generally the beneficiary of any benefits payable because the loss being insured is the company's loss, not the employee's family loss. Industry explanations of key person disability insurance are consistent on this point: the key employee is the insured , while the company buys the coverage and makes the premium payments .
That makes the other options incorrect. The employee's spouse is not the beneficiary, the employee usually does not pay the premium, and the employee is not the applicant.
NEW QUESTION # 26
An insured individual purchases a disability policy with a waiver of premium rider on January 1. The individual is disabled on June 1. On July 1, he receives proof of permanent and total disability, and submits a claim. He begins receiving benefits on July 15. When are his premiums waived?
Answer: A
Explanation:
A waiver of premium rider on a disability policy is designed to keep coverage in force by waiving required premium payments once the insured becomes totally disabled , subject to the policy's conditions (such as required proof and any waiting/elimination period stated in the rider). The key concept tested is that waiver is tied to the date the disability begins , not the date proof is submitted or the date benefit checks start. Proof of disability (submitted July 1) is the administrative step that allows the insurer to approve the waiver, but the waiver itself applies because the insured has been disabled since June 1 . In standard disability provisions, if premiums are paid while the claim is being evaluated (or during any waiting period), those premiums are typically refunded once the waiver is approved, because the rider treats premiums as waived back to the disability start date (or back to the end of any stated waiting period, depending on the contract). Since June 1 is the onset of total disability, that is when the premium waiver is considered effective for purposes of this question.
NEW QUESTION # 27
An annuitant dies during the accumulation period. What happens to the cash value in the annuity?
Answer: A
Explanation:
During the accumulation period of an annuity, the contract owner is building value through premium payments and interest/earnings. If the annuitant dies before annuitization begins , the annuity does not simply disappear and the insurer does not "keep" the funds. Instead, the contract's value is paid out as a death benefit
, which is generally based on the annuity's cash value (account value) , subject to the contract's terms (for example, adjustments for surrender charges may or may not apply depending on the product). The payment is made to the named beneficiary on the contract, which is why beneficiary designation is important for annuities just as it is for life insurance.
Option B would apply only if there is no living beneficiary (or no valid beneficiary designation), in which case proceeds may be paid to the owner's estate. Option C is incorrect because the IRS is not the recipient of the cash value; taxes may be due on taxable gains, but proceeds are payable to beneficiaries/estate. Therefore, the correct answer is that the cash value is paid to the beneficiary.
NEW QUESTION # 28
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