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NEW QUESTION # 30
In HMO coverage, preventive services include:
Answer: A
Explanation:
Health Maintenance Organizations (HMOs) in Virginia, per Virginia Code § 38.2-4306, emphasize preventive care to reduce long-term costs. Preventive services, as defined in the study guide and aligned with ACA standards, include childhood immunizations (option C), such as vaccines for measles or polio, offered at no cost to members. Option A (rehabilitation therapy) is restorative, not preventive, addressing existing conditions. Option B (treatment for alcoholism) is a treatment service, not prevention, though HMOs cover it separately. Option D (home health services) supports recovery or chronic care, not primary prevention. The study guide likely lists immunizations as a core preventive benefit, contrasting them with treatment-oriented services, confirming C as the correct answer.
NEW QUESTION # 31
An individual currently owns a long-term care policy. At the time of application for similar coverage, which item must be signed by the applicant and retained by the insurer?
Answer: D
Explanation:
Virginia Code § 38.2-5207.1 and 14VAC5-200-75 regulate replacement of long-term care (LTC) insurance, requiring a replacement notice when an applicant with existing coverage applies for a new policy that may replace it. This signed notice, provided to the applicant and retained by the insurer, ensures transparency about potential duplication or lapse of the original policy, protecting consumers from unintended coverage gaps or costs. Option C (replacement notice) fits this requirement. Option A (cancellation notice) relates to terminating a policy, not applying for a new one. Option B (substitution notice) isn't a standard term;
"replacement" is the legal phrase. Option D (duplication notice) might imply overlap but lacks regulatory specificity. The study guide likely includes a sample replacement form, stressing its role in LTC sales compliance, confirming C as the correct choice.
NEW QUESTION # 32
An insured with a long-term care (LTC) policy knowingly and intentionally misrepresented relevant facts relating to the insured's health. How long does an insurer have to contest the coverage?
Answer: A
Explanation:
Detailed Answer in Step-by-Step Solution:
* The incontestability provision in LTC policies typically limits the insurer's ability to contest coverage based on misrepresentations to two years (B) from issuance, unless fraud is proven (which may extend this in some states).
* Option A (six months) is too short. Option C (entire duration) applies only to fraud in some cases, not standard misrepresentations. Option D (prohibited) is incorrect due to the contestable period.
The Virginia study guide, aligned with NAIC standards, notes a two-year contestable period for health-related policies like LTC, after which misrepresentations cannot be challenged absent fraud. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Incontestability."
NEW QUESTION # 33
Assuming no indebtedness or dividend accumulations, how much will the insurer pay under a life insurance policy if the insured dies during the grace period without having paid the premium?
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* The grace period in a life insurance policy (typically 30 or 31 days) allows the policy to remain in force even if the premium is unpaid, provided the insured dies during this period.
* If death occurs during the grace period, the insurer must pay the full death benefit (face amount), minus any unpaid premium, but only if explicitly stated. In this question, no indebtedness or dividends complicate the scenario, and standard practice assumes full payment unless otherwise specified.
* Option B (cash value) applies to surrender, not death claims.
* Option C (face amount less premium due) is a possibility in some policies, but absent specific policy language here, the default is full payment.
* Option D (nonforfeiture provisions) applies if the policy lapses, not during the grace period.
* Thus, the insurer pays the face amount (A).
The Virginia study guide states that the grace period provision protects the policyholder by keeping coverage active for a short period after a missed premium, and upon death during this time, the full face amount is payable unless loans or specific deductions apply. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Standard Policy Provisions - Grace Period."
NEW QUESTION # 34
The designation of a beneficiary by class in a life insurance policy means that:
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* Designating a beneficiary "by class" means identifying a group (e.g., "my children") rather than naming specific individuals (C).
* Option A (business life insurance) is unrelated to class designation.
* Option B (no primary beneficiary) is incorrect; a class can still be primary.
* Option D (unrelated beneficiaries) is not a requirement of class designation.
The Virginia study guide notes that a class designation identifies beneficiaries by a category (e.g., "spouse" or
"heirs") rather than specific names, offering flexibility. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Beneficiary Designations."
NEW QUESTION # 35
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