[Dec 30, 2025] Verified Virginia-Life-Annuities-and-Health-Insurance dumps and 152 unique questions
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NEW QUESTION # 59
A health insurer must generally pay for all of the following types of claims EXCEPT:
- A. Those related to mental or nervous disorders
- B. Those incurred after termination of coverage
- C. Those incurred before termination of coverage
- D. Those less than $20 above the deductible amount
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* Health insurance covers claims incurred during the policy period (A), not after termination (B), unless extended benefits (e.g., COBRA) apply, which is not indicated here.
* Claims above the deductible (C), regardless of amount, are payable if covered.
* Mental or nervous disorder claims (D) are typically covered unless excluded by the policy, which is not specified.
* Thus, claims after termination (B) are the exception.
The Virginia study guide states that health insurance liability ends upon policy termination, barring specific continuation provisions, making post-termination claims generally non-payable. Reference:Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Coverage Terms."
NEW QUESTION # 60
When an HIV test is requested by a health insurer, who signs the consent form?
- A. The medical laboratory technician
- B. The insurance agent
- C. The applicant
- D. The applicant's physician
Answer: C
Explanation:
Virginia Code § 38.2-600 requires written consent for HIV testing in insurance underwriting, signed by the applicant (option A) to comply with privacy laws (e.g., Virginia Code § 32.1-36.1). This ensures the individual authorizes the test, protecting their rights. Option B (physician) may order tests but doesn't consent for insurance. Option C (agent) facilitates but can't consent. Option D (technician) performs the test, not authorizes it. The study guide likely stresses this consent process in a privacy section, with examples of applicants signing before blood draws, making A the correct party.
NEW QUESTION # 61
An agent or insurer who unknowingly violates insurance laws may be charged a maximum penalty of:
- A. $750 per occurrence, with a cap of $10,000
- B. $1,500 per occurrence, with a cap of $10,000
- C. $500 per occurrence, with a cap of $10,000
- D. $1,000 per occurrence, with a cap of $10,000
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* For unintentional violations in Virginia, the maximum penalty is $1,000 per occurrence, with an aggregate cap of $10,000 (C), per state insurance regulations.
* Options A, B, and D deviate from this standard penalty structure.
The Virginia study guide, per Virginia Code, sets unintentional violation penalties at up to $1,000 per act, with a $10,000 total cap, escalating for willful violations. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Penalties and Enforcement."
NEW QUESTION # 62
An individual health insurance policy must include:
- A. Coverage for pre-existing conditions
- B. A 10-day free look provision
- C. Only the optional uniform provisions
- D. A 60-day grace period
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* Individual health insurance policies in Virginia must include a 10-day free look provision (B), allowing the policyholder to review and return the policy for a full refund.
* Option A (pre-existing conditions) is not mandatory unless required by the ACA, and exclusions may apply.
* Option C (only optional provisions) is incorrect; mandatory provisions are required, not just optional ones.
* Option D (60-day grace period) is excessive; the standard is typically 30 or 31 days for health insurance.
The Virginia study guide mandates a 10-day free look period for individual health insurance policies, ensuring consumer protection, as per state law and NAIC standards. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Policy Provisions."
NEW QUESTION # 63
An insurance contract that identifies individuals by relationship to a particular organization is called:
- A. COBRA coverage
- B. Group insurance
- C. Health insurance
- D. Contributory insurance
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* Group insurance (B) covers individuals based on their affiliation with an organization (e.g., employees of a company), not as individuals.
* Contributory insurance (A) refers to group plans where employees pay part of the premium, but it's not the defining feature.
* Health insurance (C) is too broad, and COBRA (D) extends group coverage, not defines it.
The Virginia study guide defines group insurance as coverage tied to membership in an organization, such as an employer or association. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on
"Group Insurance."
NEW QUESTION # 64
When a Medicare Supplement policy is purchased during the open enrollment period:
- A. The exclusions may be more numerous than usual
- B. The policy must be issued regardless of health status
- C. The premium cost may be higher than usual
- D. The benefits may be lower than usual
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* The Medicare Supplement open enrollment period (6 months starting the first month a person is 65 and enrolled in Medicare Part B) guarantees issuance of a policy without regard to health status (D).
* Premiums (A), benefits (B), and exclusions (C) are standardized and not altered during this period due to health.
The Virginia study guide states that during the Medicare Supplement open enrollment, insurers must issue policies without medical underwriting, ensuring access regardless of health. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Medicare Supplement Insurance."
NEW QUESTION # 65
Who normally bears the cost of excess charges in a Medicare claim?
- A. The Centers for Medicare & Medicaid Services
- B. The service provider
- C. The insured
- D. The Social Security Administration
Answer: C
Explanation:
Detailed Answer in Step-by-Step Solution:
* Excess charges in Medicare occur when a provider charges more than the Medicare-approved amount, and the insured (D) is responsible for the difference unless covered by supplemental insurance.
* The Social Security Administration (A) and CMS (B) administer Medicare, not pay claims.
* Providers (C) may charge excess but don't absorb it unless they accept assignment.
The Virginia study guide explains that Medicare beneficiaries bear excess charges unless a provider accepts Medicare assignment or a Medigap policy covers them. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Medicare Basics."
NEW QUESTION # 66
Coverage under a cancelable health insurance policy may be terminated by:
- A. Either the insured or the insurer
- B. An arbitration committee
- C. The insurer only
- D. The insured only
Answer: A
Explanation:
Virginia Code § 38.2-3508 defines a cancelable health policy as one either party-the insured or insurer-can terminate before its term ends, with notice (e.g., 30 days). Option C reflects this mutual right. Option A (insurer only) and option B (insured only) are too restrictive; cancelable policies aren't unilateral. Option D (arbitration committee) isn't a standard mechanism; cancellation follows policy terms, not third-party rulings.
The study guide likely contrasts cancelable with non-cancelable policies, using examples like an insurer canceling for nonpayment or an insured canceling due to better rates, making C the correct scope.
NEW QUESTION # 67
A health maintenance organization (HMO) member receives all preventive and routine medical care from the:
- A. Routine care physician
- B. Provider association
- C. Medical director
- D. Primary care physician
Answer: D
Explanation:
Virginia Code § 38.2-4303 defines the HMO model, where the primary care physician (PCP, option A) acts as the gatekeeper, delivering preventive (e.g., vaccines) and routine care (e.g., checkups), and coordinating referrals. Option B (medical director) oversees HMO operations, not direct care. Option C (routine care physician) isn't a standard term; the PCP fills this role. Option D (provider association) might imply a network, but care comes from the individual PCP, not a collective. The study guide likely explains the PCP's central role with examples-e.g., a member seeing their PCP for a flu shot-highlighting HMO cost-control via this structure, making A the correct provider.
NEW QUESTION # 68
What is a situation or condition that increases the likelihood of an insured loss occurring?
- A. Exposure
- B. Peril
- C. Hazard
- D. Risk
Answer: C
Explanation:
In insurance terminology, per Virginia Code § 38.2-100 et seq., a hazard (option A) is a condition increasing the likelihood or severity of a loss from a covered peril (e.g., smoking increases fire risk). Option B (peril) is the cause of loss (e.g., fire, theft). Option C (exposure) is the extent of potential loss, not the condition itself.
Option D (risk) is the broader uncertainty of loss, encompassing hazards and perils. The study guide likely differentiates these with examples-e.g., icy roads (hazard) causing a crash (peril)-highlighting hazard's role in amplifying loss probability, making A the exact match.
NEW QUESTION # 69
Which type of health insurance helps to pay for the cost of care in cases where hospitalization is not required but the individuals are unable to care for themselves?
- A. Major medical
- B. Disability income
- C. Medicare
- D. Long-term care
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* Long-term care insurance (B) is designed to cover custodial care (e.g., help with daily activities like bathing or dressing) when individuals cannot care for themselves, often outside a hospital setting.
* Medicare (A) provides limited long-term care coverage (e.g., skilled nursing for a short period), not comprehensive custodial care.
* Major medical (C) covers hospital and medical expenses, not long-term custodial care.
* Disability income (D) replaces lost income, not care costs.
The Virginia study guide defines long-term care insurance as coverage for extended care needs, such as in nursing homes or at home, when individuals cannot perform activities of daily living, distinguishing it from Medicare or major medical plans. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Types of Health Insurance."
NEW QUESTION # 70
Which policy provision allows an employee to change from group coverage to an individual life insurance policy?
- A. Conversion
- B. Assignment
- C. Nonforfeiture
- D. Incontestability
Answer: A
Explanation:
Virginia Code § 38.2-3330 requires group life insurance policies to include a conversion provision,allowing an employee to convert group coverage to an individual policy without evidence of insurability, typically within 31 days after termination of employment or group eligibility. Option B (conversion) directly describes this right, ensuring continued protection. Option A (nonforfeiture) applies to cash value options (e.g., reduced paid-up insurance) in individual policies, not group-to-individual transitions. Option C (assignment) transfers policy ownership, unrelated to conversion. Option D (incontestability) limits the insurer's ability to deny claims after a period (e.g., 2 years), not a conversion mechanism. The study guide likely highlights conversion as a key group life feature, with scenarios like an employee leaving a job and converting to a whole life policy, making B the precise answer.
NEW QUESTION # 71
The owner of a life insurance policy who enters into a viatical settlement contract is called:
- A. A viatee
- B. A viatical settlement provider
- C. A viatical settlement broker
- D. A viator
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* A viatical settlement involves a terminally ill policyowner selling their life insurance policy for a lump sum. The policyowner in this transaction is called the viator (C).
* The viatical settlement provider (A) is the entity purchasing the policy.
* The viatical settlement broker (B) facilitates the transaction.
* "Viatee" (D) is not a recognized term in this context.
The Virginia study guide defines the viator as the insured policyowner who sells their policy in a viatical settlement, typically due to a terminal illness. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Viatical Settlements."
NEW QUESTION # 72
A coordination of benefits provision is included in group health insurance to reduce:
- A. Probationary periods
- B. Dependent coverage
- C. Waiting periods
- D. Overinsurance
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* The coordination of benefits (COB) provision prevents overinsurance (B) by ensuring that total payments from multiple group plans don't exceed 100% of covered expenses, avoiding duplication.
* It doesn't affect dependent coverage (A), probationary periods (C), or waiting periods (D), which are unrelated to claim payments.
The Virginia study guide describes COB as a mechanism to coordinate payments among multiple insurers, reducing overinsurance and ensuring fair claim distribution. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Group Health Insurance Provisions."
NEW QUESTION # 73
The reinstatement provision in individual health insurance:
- A. Reinstates the amount of insurance after payment of a loss
- B. Allows the insured to reinstate the policy after coverage lapses for nonpayment of premium
- C. Allows the insured to change statements made in the application
- D. Requires that all reinstatement applications must be approved by the Bureau of Insurance
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* The reinstatement provision in health insurance allows a policy that lapsed due to nonpayment of premiums to be restored (B), typically within a set period (e.g., 3 years), if the insured pays back premiums and meets conditions like proving insurability.
* Option A (reinstates amount after loss) relates to property insurance, not health.
* Option C (change application statements) is unrelated to reinstatement.
* Option D (Bureau approval) is false; reinstatement is handled by the insurer, not a regulatory body.
The Virginia study guide explains that the reinstatement provision protects policyholders by allowing revival of a lapsed health policy upon payment of overdue premiums and, if required, evidence of insurability.
Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Policy Provisions."
NEW QUESTION # 74
A licensee is NOT required by Virginia law to keep which of the following records?
- A. Policy renewal notices
- B. Files of insurance applications on current policies issued
- C. Accounting records of premium payments
- D. Premium quotations of unissued policies
Answer: D
Explanation:
Virginia Code § 38.2-1809 mandates that licensees maintain specific records for regulatory oversight and consumer protection. Option A (accounting records of premium payments) is required to track funds received and remitted, ensuring financial accountability (e.g., premiums collected for a $1,000 policy). Option B (files of insurance applications on current policies) must be kept as part of the contract and for audit purposes, per
38.2-1810. Option C (policy renewal notices) is required to document communication with policyholders about ongoing coverage, ensuring transparency. Option D (premium quotations of unissued policies) is not mandated; while agents may provide quotes (e.g., $500 annually for a term policy), these are preliminary offers, not binding until a policy is issued, and Virginia law doesn't require retaining them unless they result in a transaction. The study guide likely details recordkeeping in a compliance chapter, contrasting required records (A, B, C) with optional ones like quotes (D), using examples-e.g., keeping a paid policy's file but not a rejected quote-making D the item not required. This reflects Virginia's focus on executed contracts over prospective ones.
NEW QUESTION # 75
Which of these is true of a conditionally renewable individual health contract?
- A. The insurer may change the conditions of renewability at any time
- B. A covered individual's health status may be a condition for renewal
- C. Premiums are guaranteed as long as renewal conditions are met
- D. The insurer may refuse renewal if they move outside of the stated geographical location
Answer: B
Explanation:
Virginia Code § 38.2-3508 allows conditionally renewable health policies, where renewal isn't guaranteed and depends on insurer-specified conditions. Option A is true; health status (e.g., new chronic illness) can be a renewal condition, unlike guaranteed renewable policies. Option B is false; premiums can increase based on risk, not guaranteed. Option C is incorrect; geographic moves typically don't void renewability unless specified, but health status is more common. Option D is wrong; conditions are set at issuance, not altered arbitrarily. The study guide likely contrasts this with guaranteed renewable policies, using examples like non- renewal for worsening health, makingA the true statement.
NEW QUESTION # 76
Which type of life insurance policy is designed to pay the balance of a thirty-year home mortgage loan in the event of the insured's death?
- A. 30-year level term
- B. 30-payment whole life
- C. 30-year endowment
- D. 30-year decreasing term
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* A 30-year decreasing term policy (B) reduces its death benefit over time, matching thedeclining balance of a 30-year mortgage, making it ideal for this purpose.
* 30-payment whole life (A) is permanent with level benefits. 30-year level term (C) maintains a constant benefit. 30-year endowment (D) builds cash value and pays out at maturity, not tied to a mortgage.
The Virginia study guide describes decreasing term insurance as tailored for obligations like mortgages, with the benefit decreasing as the debt is paid off. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Types of Life Insurance."
NEW QUESTION # 77
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