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Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Sample Questions (Q74-Q79):
NEW QUESTION # 74
Renewal of small employer health insurance plans may be denied for all of the following reasons EXCEPT:
- A. Having less than the required number of participants
- B. Overuse of physician and hospital services
- C. Nonpayment of premiums
- D. Fraud by the employer
Answer: B
Explanation:
Virginia Code § 38.2-3432.1, aligned with the Affordable Care Act (ACA), mandates guaranteed renewability for small employer health plans (1-50 employees in Virginia). Insurers can deny renewal for nonpayment of premiums (option A), insufficient participants (option B, e.g., falling below one eligible employee), or fraud (option D), per Virginia Code § 38.2-3407. However, option C-overuse of services (high claims)-a-is not a permissible reason for denial, as renewability cannot be based on claims experience or health status. The study guide emphasizes this protection under Virginia's small group market rules, making C the exception.
NEW QUESTION # 75
Under which type of policy are benefit payments treated as taxable income?
- A. Key person disability income
- B. Individual disability income
- C. Disability buy-sell
- D. Business overhead expense
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* Individual disability income (C) benefits are taxable if the insured paid premiums with pre-tax dollars (e.g., employer-paid), but tax-free if paid with after-tax dollars. The question implies taxable benefits, typical when premiums are deductible.
* Business overhead expense (A), disability buy-sell (B), and key person disability (D)benefits are generally tax-free to the business or recipient, as premiums are not deductible.
The Virginia study guide, per IRS rules, states that individual disability income benefits are taxable if premiums were paid pre-tax (e.g., by an employer), unlike business-related disability policies where benefits serve specific tax-exempt purposes. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Taxation of Insurance Benefits."
NEW QUESTION # 76
When the employer pays the premium, covered individuals normally receive tax-free benefits under all of the following group health plans EXCEPT:
- A. Health maintenance organization
- B. Disability income
- C. Major medical
- D. Dental
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* Employer-paid premiums for group health plans like major medical (B), dental (C), and HMOs (D) result in tax-free benefits under IRC Section 106.
* Disability income (A) benefits are taxable if the employer pays the premium, per IRS rules, unlike medical benefits.
The Virginia study guide, aligned with IRS regulations, notes that employer-funded disability income benefits are taxable to the recipient, while medical, dental, and HMO benefits remain tax-free. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Taxation of Insurance Benefits."
NEW QUESTION # 77
In the solicitation and sale of Medicare Supplement insurance policies, when must an agent deliver the buyer' s guide?
- A. Only when the solicitation involves replacement
- B. Only when the purchaser is a first-time buyer
- C. At the time of application
- D. Prior to accepting any payment of premium
Answer: C
Explanation:
Detailed Answer in Step-by-Step Solution:
* The buyer's guide for Medicare Supplement insurance must be provided to the consumer at the time of application (B) to ensure they understand the policy's benefits and limitations before committing.
* Option A (replacement only) is incorrect; the guide is required for all sales, though additional notices apply for replacements.
* Option C (prior to payment) is too vague and not a specific requirement.
* Option D (first-time buyer) is not a condition under Virginia or federal rules.
Per the Virginia study guide, agents must deliver the buyer's guide at the time of application for Medicare Supplement policies, as mandated by federal and state regulations to promote informed decisions. Reference:
Virginia Life, Annuities, and Health Insurance study guide, section on "Medicare Supplement Insurance Regulations."
NEW QUESTION # 78
All changes and corrections made to an application for health insurance by an agent must be initialed by the:
- A. Applicant's physician
- B. Applicant
- C. Agent
- D. Insurance company underwriter
Answer: B
Explanation:
Virginia Code § 38.2-3501 governs health insurance applications, requiring accuracy and applicant consent.
Changes or corrections by an agent (e.g., fixing a misspelled name) must be initialed by the applicant (option B) to verify agreement, as the application becomes part of the contract (Virginia Code § 38.2-3503). Option A (agent) initialing alone risks unauthorized alterations. Option C (physician) is irrelevant; medical input isn't standard for application edits. Option D (underwriter) assesses, not corrects, applications post-submission.
The study guide likely stresses this consumer protection rule, with examples-e.g., an agent correcting a birthdate, initialed by the applicant-ensuring transparency, making B the correct party.
NEW QUESTION # 79
......
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