[2026] Valid Virginia-Life-Annuities-and-Health-Insurance test answers & Virginia Insurance Virginia-Life-Annuities-and-Health-Insurance exam pdf
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NEW QUESTION # 42
All of the following factors influence the underwriting of group health insurance for an association EXCEPT:
- A. Prior claims experience of the association
- B. The average age of the membership
- C. Type of trade or occupation of the association's members
- D. Marital status of the members
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* Group health underwriting considers average age (A), claims history (B), and occupation type (D) to assess risk, but marital status (C) is typically irrelevant for group policies, unlike individual underwriting.
The Virginia study guide notes that group underwriting focuses on collective risk factors like age, claims experience, and occupation, not personal details like marital status. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Group Insurance Underwriting."
NEW QUESTION # 43
An insurance company writing business in a state other than the one in which it is domiciled is called:
- A. An alien insurer
- B. A captive insurer
- C. A domestic insurer
- D. A foreign insurer
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* A foreign insurer (A) is an insurance company operating in a state other than its state of domicile (where it is incorporated).
* A domestic insurer (B) operates in its home state. An alien insurer (C) is domiciled outside the U.S. A captive insurer (D) insures its parent company, not based on location.
The Virginia study guide defines a foreign insurer as one licensed to do business in Virginia but incorporated in another state, per insurance regulatory terminology. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Insurance Company Types."
NEW QUESTION # 44
Which benefit is usually excluded from major medical plan coverage?
- A. Hospital expense
- B. Custodial care
- C. Physicians' visits
- D. Surgical expense
Answer: B
Explanation:
Virginia Code § 38.2-3500 et seq. governs major medical plans, which cover catastrophic costs like hospital expenses (option A), physicians' visits (option C), and surgical expenses (option D). Option B (custodial care)
-non-medical assistance with daily living (e.g., bathing)-is typically excluded, as it's not "medically necessary" under standard definitions (Virginia Code § 38.2-3407.10). The study guide likely lists inclusions (A, C, D) with examples-e.g., $5,000 for surgery-versus exclusions like custodial care, covered by LTC policies instead, making B the usual exception.
NEW QUESTION # 45
Which is true about an adjustable life insurance policy?
- A. It is a form of retirement income annuity
- B. No settlement options are available
- C. The only nonforfeiture option available is cash
- D. The policy while in force can alternate between forms of term life insurance and whole life insurance
Answer: D
Explanation:
Adjustable life insurance (Virginia Code § 38.2-3113.1) allows flexibility in face amount and premiums, effectively shifting between term (lower cost, no cash value) and whole life (higher cost, cash value) features while in force (option A). Option B is false; nonforfeiture options include cash, reduced paid-up, or extended term. Option C is false; settlement options (e.g., lump sum) apply as with other policies. Option D is wrong; it' s life insurance, not an annuity. The study guide likely explains this adaptability-e.g., increasing premiums to build cash value (whole life)-making A the true statement.
NEW QUESTION # 46
The injury or damage sustained by the insured is called:
- A. A claim
- B. A loss
- C. A peril
- D. An accident
Answer: B
Explanation:
Virginia Code § 38.2-100 et seq. defines insurance terms. A loss (option C) is the actual injury or damage sustained (e.g., a broken leg or burned house), the event insurance covers. Option A (claim) is the request for payment post-loss, not the loss itself. Option B (peril) is the cause (e.g., fire, collision), not the result. Option D (accident) is a type of peril or event, not the damage. The study guide likely clarifies this chain-e.g., a car crash (peril/accident) causes $5,000 damage (loss), prompting a claim-using examples to distinguish loss as the outcome, making C the precise term.
NEW QUESTION # 47
What kind of rider may be added to an individual disability income insurance policy to increase benefits during periods of price inflation?
- A. Wage protection
- B. Price escalation
- C. Inflation guard
- D. Cost of living
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* A cost of living (COLA) rider (B) adjusts disability income benefits to account for inflation, maintaining purchasing power.
* Inflation guard (A) is more common in property insurance. Price escalation (C) and wage protection (D) are not standard disability riders.
The Virginia study guide describes the COLA rider as an optional feature in disability income policies, increasing benefits based on inflation indices like the CPI. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Disability Insurance Riders."
NEW QUESTION # 48
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?
- A. The insurer is prohibited from contesting the coverage
- B. Any time up to two years
- C. Any time up to six months
- D. Any time during the duration of the policy
Answer: B
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 # 49
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. Premiums are guaranteed as long as renewal conditions are met
- C. A covered individual's health status may be a condition for renewal
- D. The insurer may refuse renewal if they move outside of the stated geographical location
Answer: C
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 # 50
On an application for individual health insurance, all of the following are typically included on the agent's report EXCEPT:
- A. Applicant's financial status
- B. Applicant's signature
- C. Applicant's general character
- D. Agent's relationship to the applicant
Answer: B
Explanation:
Detailed Answer in Step-by-Step Solution:
* The agent's report includes the agent's observations, such as relationship to the applicant (A), financial status (B), and general character (C), to aid underwriting.
* The applicant's signature (D) is on the application itself, not the agent's separate report.
The Virginia study guide specifies that the agent's report supplements the application with the agent's insights, while the applicant signs the main application, not the report. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Application Process."
NEW QUESTION # 51
Who normally bears the cost of excess charges in a Medicare claim?
- A. The Social Security Administration
- B. The Centers for Medicare & Medicaid Services
- C. The insured
- D. The service provider
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 # 52
Nearly all citizens of the U.S.A., regardless of age, are eligible for Medicare Part B if they are:
- A. "Fully insured" under Social Security
- B. Retired permanently
- C. Uninsurable through commercial insurers
- D. Eligible for Medicare Part A
Answer: D
Explanation:
Detailed Answer in Step-by-Step Solution:
* Medicare Part B eligibility generally requires enrollment in or eligibility for Part A (B), which covers hospital insurance and is tied to age (65+) or disability status, not just retirement (A) or insurability (C).
* "Fully insured" under Social Security (D) relates to benefits but isn't a direct Part B requirement.
The Virginia study guide states that Medicare Part B is available to those eligible for Part A, typically U.S.
citizens or residents aged 65 or disabled, regardless of other factors. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Medicare Eligibility."
NEW QUESTION # 53
If an employee in poor health is part of a large group that is acceptable for group life insurance, that employee is:
- A. Eligible for coverage more limited than that of other employees
- B. Ineligible for coverage under the plan
- C. Eligible for coverage, but on a rated basis
- D. Eligible for the same type of coverage as other employees
Answer: D
Explanation:
Group life insurance in Virginia, governed by Virginia Code § 38.2-3318 et seq., operates on a "group underwriting" basis, meaning coverage is issued to the group as a whole without individual health assessments. For large groups (typically over 10 employees, though Virginia defines "large" contextually), insurers accept the entire eligible group without requiring evidence of insurability, provided the group meets participation and eligibility standards (e.g., active employees). Option C reflects this: an employee in poor health, as part of an acceptable group, receives the same coverage as others, as health status doesn't affect eligibility or terms. Option A (ineligible) is false; group plans don't exclude based on individual health.
Option B (rated basis) applies to individual policies where substandard risks increase premiums, not group plans where risk is pooled. Option D (limited coverage) contradicts the uniformity of group coverage terms.
The study guide likely highlights this non-discriminatory feature of group life, ensuring equal benefits for all eligible members, making C the correct answer per Virginia's legal and practical framework.
NEW QUESTION # 54
Which of the following is required to hold an appointment with the insurance company it represents?
- A. An insured
- B. A consultant
- C. An agent
- D. An employee of the insurer
Answer: C
Explanation:
Virginia Code § 38.2-1833 defines an "appointment" as a formal authorization by an insurer for a licensed agent to act on its behalf in transacting insurance. An insured (option A) is the policyholder or beneficiary and has no role in representing the insurer. An employee of the insurer (option B) may work internally but isn't automatically appointed to sell insurance unless they hold an agent's license and an appointment, which isn't implied here. A consultant (option C), under Virginia Code § 38.2-1837, advises on insurance but doesn't transact it unless also licensed and appointed as an agent, making this a less direct fit. Only an agent (option D), licensed under Virginia Code § 38.2-1819 and appointed per § 38.2-1833, is required to hold an appointment to represent an insurer. The study guide emphasizes that appointments link licensed agents to specific insurers, solidifying D as the correct choice.
NEW QUESTION # 55
Under Virginia standards for marketing long-term care coverage, all of these are prohibited sales practices EXCEPT:
- A. Twisting
- B. Replacing existing coverage
- C. High pressure tactics
- D. Cold lead advertising
Answer: D
Explanation:
Virginia Code § 38.2-5207 and 14VAC5-200-185 outline marketing standards for long-term care (LTC) insurance to protect consumers. Option A (twisting)-misrepresenting a policy to induce replacement-is prohibited as an unfair practice (Virginia Code § 38.2-502). Option C (high pressure tactics)-aggressive sales forcing quick decisions-violates ethical standards and is banned (14VAC5-200-40). Option B (replacing existing coverage) is incorrect as stated; replacement itself isn't prohibited but requires disclosure via a replacement notice (14VAC5-200-75), making it regulated, not banned outright-however, the question implies unauthorized or deceptive replacement, which is prohibited. Option D (cold lead advertising)- soliciting via broad, unsolicited leads (e.g., mailers)-is permitted if it complies with disclosure rules and isn' t deceptive (14VAC5-200-50). The study guide likely lists twisting and high pressure as unethical, with examples like misstating benefits, while allowing cold lead ads with proper labeling (e.g., "advertisement"), making D the exception.
NEW QUESTION # 56
A function performed by both the life insurance agent and the home office underwriter is:
- A. Evaluating risks
- B. Collecting premiums
- C. Finding new clients
- D. Reviewing a client's coverage periodically
Answer: A
Explanation:
Virginia Code § 38.2-1800 et seq. outlines roles in life insurance. Agents and underwriters bothevaluate risks (option B): agents assess initial client risk (e.g., health questions) for application accuracy, while underwriters analyze it for approval (e.g., medical records). Option A (finding clients) is agent-only; underwriters don't prospect. Option C (collecting premiums) is primarily the agent's task, not underwriting's. Option D (reviewing coverage) is a post-sale service, not a core underwriting function. The study guide likely contrasts roles but notes this shared risk focus-e.g., an agent flags smoking, underwriter rates it-making B the common duty.
NEW QUESTION # 57
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?
- A. The face amount of the policy less the premium due
- B. The face amount of the policy
- C. The cash value of the policy
- D. The reduced amount of paid-up insurance provided under the nonforfeiture provisions
Answer: B
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 # 58
The voluntary act of terminating an insurance contract is called:
- A. Finalization
- B. Rejection
- C. Cancellation
- D. Elimination
Answer: C
Explanation:
Cancellation, per Virginia Code § 38.2-3106 (life) and § 38.2-3508 (health), is the voluntary termination of a policy by the insured or insurer. Options A, B, and C aren't standard terms for this action in Virginia insurance law. The study guide defines cancellation as a deliberate act, distinct from lapse (nonpayment) or nonrenewal, making D the correct term.
NEW QUESTION # 59
When a health insurer requires a covered individual to undergo a physical examination, who pays the cost of the examination?
- A. The principal insured individual
- B. The patient or parent of the patient
- C. The insurer
- D. The premium payor
Answer: C
Explanation:
Detailed Answer in Step-by-Step Solution:
* If a health insurer requires a physical exam (e.g., for underwriting or claims), the insurer pays the cost (D), as it's their condition for coverage or payment.
* The premium payor (A), insured (B), or patient (C) aren't responsible for insurer-mandated exams.
The Virginia study guide specifies that insurer-required exams, such as for contesting claims, are at the insurer's expense, per the physical examination provision. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Policy Provisions."
NEW QUESTION # 60
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