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California Department of Insurance CA Life, Accident and Health or Sickness Examination Sample Questions (Q111-Q116):

NEW QUESTION # 111
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), which of the following is a qualifying event?

A. Marriage
B. Promotion
C. Divorce
D. Relocation

Answer: C

Explanation:
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a qualifying event is an occurrence that results in the loss of health coverage for an employee or their dependents. Divorce is one such qualifying event, as it can result in the loss of health insurance coverage for the spouse who is no longer covered under the employee's health plan. Other qualifying events include termination of employment (other than for gross misconduct), reduction in the number of hours of employment, death of the covered employee, and certain other events. This provision ensures that individuals who lose coverage due to these events can continue their health insurance for a limited period under COBRA.

NEW QUESTION # 112
What policy is a savings instrument designed to first accumulate funds and then systematically to liquidate the funds?

A. Mortgage insurance.
B. Disability income insurance.
C. Term life.
D. Deferred annuity.

Answer: D

Explanation:
* Definition: A deferred annuity is a type of insurance contract designed as a long-term savings instrument that allows the policyholder to accumulate funds on a tax-deferred basis.
* Accumulation Phase: During the accumulation phase, the policyholder makes contributions to the annuity, which can grow based on the investment options selected (fixed or variable).
* Liquidation Phase: Once the accumulation period ends, the annuity enters the distribution or liquidation phase, where the accumulated funds are systematically paid out to the annuitant, typically as a series of regular payments (e.g., monthly, quarterly).
* Purpose: The primary goal of a deferred annuity is to provide a steady income stream during retirement, ensuring financial stability for the annuitant.
* Regulations: Deferred annuities are regulated under the California Insurance Code and must comply with state-specific rules regarding disclosures, guarantees, and consumer protections.
References:
* California Department of Insurance guidelines on annuities.
* Annuity policy provisions and state regulations.

NEW QUESTION # 113
All of the following are characteristics of adverse selection EXCEPT

A. it normally occurs if the premium is low relative to the loss exposure.
B. people with the greatest probability of loss are the ones most likely to buy insurance.
C. poor underwriting results may occur if too many of the applicants accepted for insurance are those most likely to incur serious losses.
D. insurance companies cannot discriminate against applicants who have a higher probability of loss.

Answer: D

Explanation:
Adverse selection refers to a situation where those most likely to file claims are the ones most eager to purchase insurance, which can lead to higher-than-expected loss ratios for insurers. Characteristics of adverse selection include:
* Occurring when premiums are low relative to the risk (A).
* Attracting individuals with the greatest probability of loss (B).
* Leading to poor underwriting results if many high-risk applicants are accepted (D).However, insurance companies can and do use underwriting criteria to assess and mitigate risks, meaning they can discriminate based on the probability of loss, which makes option C incorrect.

NEW QUESTION # 114
A Hospital Confinement Indemnity insurance policy pays

A. an indemnity to the insured for all expenses incurred when the insured is confined in a hospital.
B. the daily benefit dollar amount stated in the policy for each day the insured is confined ina hospital.
C. the amount of the actual hospital expenses.
D. 100% of the covered medical expenses less the deductible and coinsurance percentage.

Answer: B

Explanation:
A Hospital Confinement Indemnity insurance policy provides a specific daily benefit amount for each day the insured is confined in a hospital, as stated in the policy. This benefit is predetermined and paid directly to the insured, regardless of the actual hospital expenses incurred. It helps cover out-of-pocket costs and other expenses that may arise during a hospital stay, giving the insured more flexibility in managing their finances during a period of confinement.

NEW QUESTION # 115
It is considered an unfair method of competition for an agent to advertise that the insurer the agent is appointed with is

A. fully authorized by certification to sell insurance.
B. highly rated by A.M. Best Company.
C. a member of the Insurance Guarantee Association.
D. an admitted insurer in the state of California.

Answer: C

Explanation:
Definition of Unfair Methods of Competition: According to the California Department of Insurance, unfair methods of competition and deceptive practices are prohibited under the California Insurance Code (CIC) Section 790.03.
Insurance Guarantee Association: The California Life and Health Insurance Guarantee Association (CLHIGA) is a state-established entity that provides protection to policyholders if an insurer becomes insolvent. However, agents are prohibited from using the existence of CLHIGA as a sales inducement or to give an impression that an insurer is more secure because it is a member.
Prohibited Advertising Practices: Advertising that an insurer is a member of the Insurance Guarantee Association can mislead consumers about the security or reliability of the insurer, which is why it is prohibited.
Regulatory References: The specific prohibition can be found under the California Insurance Code Section
1067.18, which details unfair and deceptive acts and practices related to the Guarantee Association.

NEW QUESTION # 116
......

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