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Title: Valid Insurance Licensing PA-Life-Accident-and-Health Mock Exam | PA-Life-Accide [Print This Page]
Author: benshaw268    Time: 15 hour before
Title: Valid Insurance Licensing PA-Life-Accident-and-Health Mock Exam | PA-Life-Accide
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Insurance Licensing Pennsylvania Life, Accident and Health Exam Sample Questions (Q43-Q48):NEW QUESTION # 43
Which one of the following types of benefits is often excluded from coverage under an HMO plan?
Answer: B
Explanation:
Under Pennsylvania Accident and Health Insurance principles,Health Maintenance Organization (HMO)plans are designed to provide comprehensive medical care while controlling costs through managed care networks.
HMOs typically emphasize preventive services, coordinated care, and cost efficiency. As a result, many essential medical services such as physical examinations, emergency services, and inpatient surgeries are generally included as covered benefits, subject to plan rules and network requirements.
However,adult routine eye examinationsare often excluded from standard HMO coverage. Pennsylvania- approved insurance study guides clearly distinguish betweenmedical necessityandroutine or elective care.
While eye exams related to medical conditions such as glaucoma, eye infections, or injuries may be covered, routine vision care for adults-including standard eye exams for glasses or contact lenses-is usually excluded unless a separate vision rider or supplemental plan is purchased.
The exclusion reflects the classification of routine vision care as non-essential or elective, rather than medically necessary. HMOs focus on medical treatment rather than vision correction services. This exclusion does not typically apply to children, as pediatric vision benefits are often mandated under preventive care standards. Therefore, according to Pennsylvania Life, Accident, and Health Insurance documentation,adult routine eye examinationsare the most commonly excluded benefit under HMO plans.

NEW QUESTION # 44
Which type of policy contains both a minimum and target premium?
Answer: B
Explanation:
Under Pennsylvania Life Insurance principles,universal life insurancepolicies are characterized by flexible premiums and adjustable death benefits. These policies contain both aminimum premiumand atarget premium. The minimum premium is the least amount required to keep the policy in force based on current assumptions, while the target premium is the recommended amount that will adequately fund the policy and maintain coverage as intended.
Universal life allows policyowners to vary premium payments within contract limits. Paying only the minimum premium may cause cash values to erode, while paying the target premium helps build sufficient cash value to support long-term coverage. This dual-premium structure is unique to universal life and is emphasized in Pennsylvania insurance licensing materials.
Whole life, graded premium life, and adjustable life policies do not operate with a minimum and target premium structure. Therefore, the correct and verified answer isC. universal life.

NEW QUESTION # 45
Long-term care policies may NOT exclude
Answer: B
Explanation:
Pennsylvania Long-Term Care insurance regulations require that policiesmay not exclude coverage for organic cognitive disorders, such as Alzheimer's disease or other forms of dementia. These conditions are a primary reason individuals require long-term care services, and excluding them would undermine the fundamental purpose of long-term care insurance.
State regulations ensure that insureds receive coverage for cognitive impairments that result from organic brain disease. While long-term care policies may impose certain limitations, they cannot categorically exclude benefits for these disorders.
The other options may be excluded. Treatment payable under workers' compensation is commonly excluded to prevent duplicate benefits. Alcoholism and drug addiction may be excluded or limited under policy provisions. Injuries or treatment resulting from participation in criminal activities may also be excluded.
Therefore, the correct and verified answer under Pennsylvania Life, Accident, and Health Insurance regulations isB. organic cognitive disorders.

NEW QUESTION # 46
I Which of the following documents describes the coverage, conditions, and limitations found in the master policy of a group contract?
Answer: B
Explanation:
In Pennsylvania group insurance contracts, thecertificate of coverage and benefitsis the document provided to insured group members that summarizes the coverage, conditions, exclusions, and limitations found in the master policy. While the master policy is issued to the group policyholder, such as an employer, individual insureds receive certificates explaining their rights and benefits.
Pennsylvania insurance regulations require insurers to provide certificates to ensure insured individuals understand the scope of coverage, benefit amounts, eligibility requirements, and any applicable limitations or exclusions. The certificate does not replace the master policy but serves as evidence of insurance coverage for each participant.
The other options are incorrect: a consumer brochure is a marketing document, an administrative services agreement governs administrative duties, and a certificate of authority grants an insurer permission to conduct business in the state. Therefore, option C is the correct and verified answer according to Pennsylvania insurance education standards.

NEW QUESTION # 47
The types of life insurance generally used to cover key employee indemnification are
Answer: C
Explanation:
Key employee indemnification insurance protects a business against financial loss resulting from the death of a key employee. Pennsylvania Life Insurance study materials identifyterm life, whole life, and universal life insuranceas the most commonly used policy types for this purpose.
Term life is often selected due to its lower initial cost and ability to match coverage duration with the employee's expected service period. Whole life and universal life provide permanent protection and may accumulate cash value, which can be useful for long-term business planning. The employer is typically the policyowner, premium payer, and beneficiary.
The other answer choices include policy types not typically used or incorrectly grouped for key person insurance. Therefore, the correct and verified answer isB.

NEW QUESTION # 48
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