California PSI Site – Life, Accident and Health Agent (Life Agent) Practice Exam

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• Explain the concept of "insurable interest."
• What characterizes a Contributory Plan in group insurance?
• What role does a Primary Care Physician (PCP) serve within an HMO?
• What distinguishes an admitted insurance company from a non-admitted insurance company in California?
• What is the purpose of the "incontestability clause"?
• What is a Noncontributory Plan?
• What does "co-payment" (copay) refer to in health insurance?
• What is required for an individual to have fully insured status under Social Security?
• What type of claims might an insurance adjuster handle?
• What is a beneficiary in a life insurance policy?
• What do mandatory coverage regulations in California health insurance require?
• What is the primary intention behind copayments in health care plans like HMOs?
• What happens to premium payments during the waiver of premium period?
• What kind of care does Long-Term Care (LTC) insurance provide?
• What is a common waiting period for benefits to begin under a Disability Income Rider?
• What must an insured do during the waiting period to qualify for the Waiver of Premium?
• What does "cash value" mean in whole life insurance policies?
• An agent selling long-term care insurance must complete how many hours of continuing education?
• What does custodial care include?
• In a separate account, what aspect fluctuates based on market performance?
• What is a key characteristic of disability income insurance?
• What does a hospital confinement indemnity insurance policy provide?
• What does the term "mortality rate" refer to?
• What are "accelerated death benefits"?
• What does a waiting period in health insurance refer to?
• What are "survivorship policies"?
• How long can the elimination period typically last?
• What is true about a unilateral contract in insurance?
• In life insurance, what is the term used for the period during which coverage is provided without a premium payment being made?
• What feature typically characterizes a comprehensive major medical plan?
• What will the insurer do if an insured commits suicide six months after the policy is issued according to the suicide clause?
• Why is it important that insurance adjusters remain impartial?
• What is required if an employee joins a group plan after an Enrollment Period?
• Traditional comprehensive major medical plans include all of the following, except:
• Which settlement option allows only the death benefit earnings to be paid to the beneficiary?
• What type of annuity allows the owner to purchase accumulation units and maintains a separate account?
• What is the primary function of a Disability Income Rider in life insurance?
• In what type of insurance policy is the death benefit typically not affected by the market value or cash value of the policy?
• What does "conversion privilege" in term insurance allow?
• What is the benefit of having riders on an insurance policy?
• What is true about a cost of living rider?
• All of the following statements about the gatekeeper system are true, except:
• What role does underwriting play in life insurance?
• What must a life agent do in order to be able to sell 24-hour care coverage?
• What does the elimination period signify in insurance policies?
• What is the purpose of "coinsurance" in health insurance?
• When will the cash value of a $250,000 non-par whole life policy reach $250,000 if the last premium is paid today and the owner is 70 years old?
• Which of the following is a benefit of having fully insured status?
• Who are considered "shareholders" in an insurance company?
• Tom buys his wife Mary a $50,000 diamond ring. When she is not wearing the ring, she keeps it in a safe deposit box at a local bank. This is an example of risk?
• If Ben does not have an appointment to sell Rock Solid Insurance Company policies, can he submit an application for a prospect?
• What is "term life insurance"?
• If the insured does not pay the premium for a disability policy and submits a claim after the due date, how will the insurance company respond?
• What happens to the face amount when a policy owner selects the extended term option after ceasing premium payments on a 10-pay life policy?
• When making a loan on a life insurance policy's cash value, what can the insurer not deduct from the loan value?
• What does the "entire contract" clause in a life insurance policy signify?
• What is a characteristic feature of a term life insurance policy?
• Which of the following is NOT one of the four elements of a valid contract?
• What does the Social Security Blackout Period refer to?
• Which account type in life insurance does not guarantee minimum returns and fluctuates based on market conditions?
• What is the process for renewing a life agent's license in California?
• How does a PPO typically handle billing for services?
• Which statement about a warranty is incorrect?
• What does the accidental death benefit entail?
• The price of insurance for each exposure unit is called the:
• What does the "waiver of premium" benefit allow policyholders to do?
• Life insurance settlement options include all of the following, except:
• What typically happens after the probationary period in insurance?
• What is one responsibility of an insurance adjuster regarding communication with claimants?
• In an insurance context, what does "exclusion" mean?
• What does the cash value in permanent life insurance represent?
• What is the main function of respite care?
• What is the primary characteristic of a Joint Life Annuity?
• What is a "network" in terms of health insurance?
• What is the definition of a person who advises insured individuals for a fee?
• What is the minimum grace period required for an individual health insurance policy paid annually, semi-annually, or quarterly?
• What is meant by "pre-existing condition" in health insurance?
• What defines a probationary period in insurance?
• What does the term deductible refer to in health insurance?
• What is the 'Limit of Liability' in a life insurance policy?
• What is the outcome when an insurance adjuster finds that a claim is valid?
• What is required when an applicant reveals conditions that require more information?
• What is the primary function of a Health Maintenance Organization (HMO)?
• What is the purpose of Adult Day Health Care?
• What is the "Affordable Care Act" (ACA)?
• What is the difference between revocable and irrevocable beneficiaries?
• Define "moral hazard" in the context of insurance.
• What factors determine Medi-Cal eligibility for individuals aged 19 through 64?
• What might an insurance adjuster review when investigating a claim?
• If an insurer pays an insured $25,000 in lost wages, $45,000 for physicians visits and hospital costs, and $15,000 for physical therapy treatments, and later discovers that the claim was fraudulent, the insured may be fined as much as:
• Which policy type does not require appointments for agents to submit applications?
• What is a Viatical Settlement?
• How does an HMO discourage unnecessary use of medical resources?
• What distinguishes a Joint Life policy from a Joint Survivorship policy?
• What type of benefits does an Accidental Death Benefit Rider provide?
• How often must the Commissioner examine the affairs of each domestic insurer?
• Jean's healthcare provider is a "service provider". This means:
• What protects life and health owners in the event of an insurer's impairment or insolvency?
• Which organization supports the Medical Information Bureau?
• What does "substitution of insurability" allow insurers to do?
• In the context of insurance, what does the term 'Indemnity' imply?
• According to the coordination of benefits provision, what is true regarding benefits for Arnold and Bertha's group health insurance plans?
• What is the minimum number of participating members required for a non-contributory group health plan?
• What is the difference between a conditional premium receipt and a binding premium receipt?
• How long must an individual be employed to earn fully insured status?
• Which of the following is considered an unacceptable risk to an insurance company's underwriting department?
• What type of care is NOT typically covered under Medi-Cal?
• Licensees must notify the Commissioner of a change in residence address:
• Which of the following is NOT used in determining life insurance rates?
• Under disability income insurance, bodily injury must meet the following criteria to be classified as accidental:
• Define "premium" in the context of insurance.
• Which skill is most essential for an insurance adjuster?
• What fundamental function does "coinsurance" serve in health insurance?
• Which type of insurance plan requires referrals to specialists via a primary care physician?
• What does a "network" typically entail in healthcare?
• What is the primary role of an insurance adjuster?
• What is the function of the Social Security rider in disability income insurance?
• How must an agent handle the sale of insurance to avoid "twisting"?
• According to Employee Retirement Income Security Act of 1974 (ERISA) fiduciary standards, benefit plans are operated for:
• Which of the following riders provides coverage that increases with the cost of living?
• What does "underwriting" refer to in the insurance industry?
• What does the principle of indemnity primarily aim to accomplish?
• What does the California Life and Health Insurance Guarantee Association do?
• What is the primary purpose of a rider in an insurance policy?
• What does "renewability" in term life insurance refer to?
• What does having an Irrevocable Beneficiary ensure?
• Why might "pre-existing conditions" pose a challenge in obtaining health insurance?
• What characteristic defines an aleatory contract?
• Mr. Jones answered questions on his application. What are they called?
• How does an insurance adjuster typically conclude their investigation?
• Health maintenance organizations (HMOs) are required to provide for all of the following services, except:
• What is universal life insurance?
• What does morbidity refer to in the context of insurance?
• When is an agent's license considered inactive?
• What kind of documentation is usually important in the claims process?
• Which factor does not affect the premiums charged for group disability income insurance?
• What is the difference between "assumed risk" and "transferred risk"?
• What additional feature does a Family Policy include alongside the base life insurance policy?
• What does "risk classification" involve?
• What type of service does hospice care provide?
• When might an insurance adjuster be called into action?
• What is a defining feature of a contract of adhesion?
• What is "adjustable life insurance"?
• What element is crucial in determining an insurer's liability on a claim?
• Which type of risk is characterized as insurable?
• Which of the following is NOT an example of a dividend option available on a whole life insurance policy?
• To avoid the problem of over-insurance, insurers include which provisions in their policies?
• What is a "rider" in an insurance policy?
• A supplemental insurance policy that pays a set amount for each day that an individual is hospitalized is known as?
• Employees covered by group life or health policies must be issued a/an:
• What defines a Family Policy in life insurance?
• What is a "surrender charge" in a life insurance policy?
• Which funding mechanism is emphasized in HMOs for preventive care?
• In the Needs Analysis Approach, what is one of the key factors to be calculated?
• What is Medi-Cal?
• Which of the following best describes an insurance claim?
• Who qualifies for lower premiums in the insurance context?
• Which activity is NOT legal in California?
• What action would reinstate Carl's lapsed policy?
• What constitutes "insurance fraud"?
• What happens to the cash value in a whole life policy if the policyholder cancels it?
• What consequence follows if a warranty in an insurance contract is violated?
• Jim pays his premium monthly. What is his Grace Period?
• Why is "policy renewal" important in health insurance?
• The insurer can change the premium for all insureds in a class, but cannot refuse to renew the policy or cancel it. What type of policy does this describe?
• What defines "group life insurance"?
• What are "insurance reserves"?
• Under a disability income insurance policy with an "own occupation" clause, an employee who can no longer perform the tasks of the job held at the time of injury is considered:
• What type of insurance typically has lower premiums, term or whole life?
• Which of the following actions is NOT typically performed by an insurance adjuster?
• What characterizes an EPO compared to other health plans?
• A policy owner has the right to change all of the following, except:
• Who is responsible for determining the validity of an insurance claim?
• How are HMO Primary Care Physicians compensated?
• What is true regarding the tax treatment of death benefits in life insurance?
• What key aspect does the "Affordable Care Act" focus on with regard to health insurance?
• Which statement is false regarding the comparison between a whole life policy and a 10-year renewable term plan for two individuals with the same premiums?
• In the insurance industry, what is meant by "liability"?
• According to state law, what size print must be used for the licensee's license number on all price quotes, business cards, and printed material?
• What is the purpose of long-term care insurance?
• Which term describes a policy that pays benefits only if death occurs due to an accident?
• What does the term 'underwriting' refer to in insurance?
• How does the concept of "whole life" differ from "term" insurance?
• What must an insurer provide before cancelling a policy?
• Which statement about dividends from life insurance policies is FALSE?
• Which of the following statements defines partial disability?
• What is the primary purpose of life insurance?
• How do Preferred Provider Organizations (PPO) differ from HMOs?
• What is the purpose of an insurance application?
• What are the two main types of life insurance?
• What is the primary purpose of life insurance?
• What does "disability insurance" provide?
• What best describes a contingent beneficiary in a life insurance policy?
• What does indemnity in an insurance contract refer to?
• Which policy feature provides coverage for a specific period of time at a set premium?
• The request for an attending physician's report must be accompanied by a copy of the:
• What type of insurance plan pays disability income benefits for injuries sustained at work or at home?
• What is the purpose of coordination of benefits in insurance policies?
• What type of risks do preferred risks generally represent?
• What is the function of a term rider in a life insurance policy?
• What does the term 'Maturity date' refer to in insurance policies?
• Which statement is true regarding participating in a group health insurance plan?
• Why won't Teresa's non-occupational policy cover her hospital expenses after an on-the-job injury?
• Which of the following best defines "variable life insurance"?
• What type of policy reserves helps to ensure that life insurance claims will be paid?
• In replacement, an existing insurer must provide policyowners with a policy summary for existing Life Insurance within how many days of receiving the written communication and replacement?
• What role does the insurance "agent" fulfill?
• In the insurance business, risk can best be defined as?
• What is a defining feature of an Exclusive Provider Organization (EPO)?
• A group health plan covers only non-occupational injuries. If an employee is injured at work, how is that injury classified?
• Which of the following is an advantage of whole life insurance?
• What reason might an underwriting department have to reject a disability income insurance application?
• What does the Waiver of Premium rider provide for the insured?
• Which of the following is NOT a type of risk management strategy?
• What is the primary role of a Joint Life insurance policy?
• What is the term for the initial 30 days after a policy's effective date during which there are no benefits paid for an illness?
• What occurs to a life insurance policy's cash value if the policy owner selects an extended term insurance option?
• What does the Human Life Value approach aim to determine?
• Which of the following is NOT considered ordinary insurance?
• What type of insurer is referred to as “participating” if the policy pays a dividend?
• Which non-forfeiture option uses cash surrender values to purchase paid-up term insurance for the full face amount of the policy?
• Which of the following is a type of deductible that applies to all family members and overrides individual deductibles once satisfied?
• Whose benefits are affected by the blackout period?
• What type of policy guarantees renewal as long as premiums are paid?
• What characterizes permanent life insurance?
• What is the significance of a "contestability period"?
• Which of the following is considered a non-forfeiture option in life insurance?
• Which of the following best describes a "fixed amount" in health insurance terms?