Virginia-Life-Annuities-and-Health-Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Questions and Answers

Keogh plans, established under the Internal Revenue Code, are retirement plans for self-employed individuals and small businesses, also known as HR 10 plans (option B) after the 1962 legislation (H.R. 10) creating them. They allow tax-deferred contributions, similar to qualified plans. Option A (Section 457 plans) applies to government and nonprofit employees, not self-employed individuals. Option C (403(b) plans) is for nonprofit employees (e.g., teachers), distinct from Keogh’s self-employed focus. Option D (Section 2503(c) trusts) relates to gifting for minors, not retirement. The study guide likely contrasts Keogh (HR 10) with other plans in a retirement section, noting its tax benefits and eligibility, confirming B as the correct synonym.

The Bureau of Insurance has the authority to examine a licensee's books and records to determine if unfair trade practices have been violated. This regulatory body ensures compliance with state insurance laws and regulations, and it has the power to investigate potential violations within the industry. The National Association of Insurance Commissioners (NAIC) provides model laws but does not have regulatory power over individual insurers.

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."

Once an agent is appointed by an insurer in Virginia, the appointment remains in effect until either the insurer or the Bureau of Insurance terminates it. No quarterly renewal or NAIC approval is required.

Exact Extract (Virginia Producer Licensing Rules): “Appointments remain in effect until terminated by the insurer or the Bureau of Insurance.”

References (Virginia Documents / Study Guide):

— Code of Virginia §38.2-1833 (Appointments of agents)

Penalty-free withdrawals from a traditional IRA before age 59½ are permitted for disability, qualified first-time home purchase (up to $10,000), or certain unreimbursed medical expenses. Bankruptcy is not a qualifying exception.

Exact Extract (Virginia Retirement Study Guide): “Exceptions to early withdrawal penalty include disability, first-time home purchase, qualified education, or medical expenses. Bankruptcy is not included.”

References (Virginia Documents / Study Guide):

— Virginia Life & Annuities Examination Outline, Retirement Plans – Taxation Rules

Mutual insurers are organized for the benefit of their policyholders, who are the owners of the company. Profits are returned to policyholders in the form of dividends or reduced premiums, unlike stock insurers which are owned by shareholders.

Exact Extract (Virginia Insurance Study Guide): “Mutual insurance company—owned by policyholders; profits distributed as dividends or premium reductions.”

References (Virginia Documents / Study Guide):

— Virginia General Insurance Concepts Outline, Section 1.1 Types of insurers

A major medical policy is designed as a comprehensive health policy, covering a wide range of expenses, including hospital, surgical, physician, and prescription costs. It provides broader coverage than limited benefit plans such as dental or vision policies. Workers’ compensation is not considered a general health policy because it specifically covers occupational injuries.

Exact Extract (Virginia Health Insurance Study Guide): “Major medical insurance—provides comprehensive coverage for hospital, physician, surgical, and other medical expenses, subject to deductibles and coinsurance. Distinguished from limited health expense policies (dental, vision).”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Section 2.2 Comprehensive vs. Limited Policies

The incontestability clause in health insurance policies generally provides that after two years from the date of issue, the insurer cannot deny a claim or void coverage due to material misrepresentation in the application, except in cases of fraud. This ensures that policyholders have long-term protection from policy rescission due to innocent mistakes.

Virginia Code § 38.2-5208 allows LTC policy cancellation by the insurer for nonpayment of premium (option A) after a 31-day grace period and notice, a standard contract right. Option B (Medicaid eligibility) isn’t a cancellation cause; it may coordinate benefits, not terminate coverage. Option C (insurer insolvency) affects payment ability, not lawful cancellation grounds. Option D (nuisance claims) isn’t a legal basis; claims frequency doesn’t void coverage unless fraudulent (Virginia Code § 38.2-309). The study guide likely lists nonpayment as the primary insurer-initiated cancellation reason, with examples like missed payments triggering notice, making A the lawful cause.

The return of premium benefit refunds a percentage of premiums paid if the policy is canceled or if the insured dies before benefits are used. Exact extract: “A return of premium rider provides a refund of premiums paid, less claims paid, upon cancellation or death of the insured.” This option is often added to long-term care policies to protect policyholder investment.

The elimination of a hazard is an example of risk avoidance. This involves removing or eliminating the risk entirely by preventing hazardous activities or conditions. This is different from other risk management strategies such as transfer (shifting risk to another party), pooling (combining risks to spread the impact), or retention (accepting the risk).

Detailed Answer in Step-by-Step Solution:

An irrevocable beneficiary has a vested interest, and the policyowner cannot change the designation without their consent unless the beneficiary dies (C), at which point the owner regains control.

Option A (renewal) and B (assignment) don’t override irrevocability. Option D (consent) is true for living beneficiaries, but “ONLY” restricts it to death in this context.

The Virginia study guide notes that an irrevocable beneficiary’s rights persist until death, after which the policyowner can freely change the designation. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Beneficiary Designations."

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.

A Virginia agent license remains valid until revoked, suspended, or terminated. Appointments with insurers are separate, but the agent holds only one license. Exact extract: “Licenses are perpetual, subject to biennial renewal requirements and compliance; termination occurs only through suspension, revocation, or voluntary surrender.”

Virginia requires life insurance policies to include an incontestability provision stating that, after the policy has been in force during the insured’s lifetime for two years from the date of issue, the insurer cannot contest the policy’s validity (with the key exception of nonpayment of premiums). This is exactly what the question describes: a clause that limits the insurer’s ability to challenge the policy after a defined time period, providing stability and protection to policyowners and beneficiaries.

The other clauses serve different purposes. The entire contract clause identifies what documents make up the contract (typically the policy and attached application), but it does not bar contestability after a time period. Guaranteed renewable and noncancelable are health insurance concepts that address renewal rights and premium stability, not the life policy’s contestability window. The incontestability clause is also closely tied to representations/misrepresentations and underwriting: the insurer has a limited time to investigate and rescind for material misstatements, after which the policy becomes “incontestable” under Virginia statute (again, except for premium nonpayment and certain limited exceptions allowed by law).

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."

A market value adjusted (MVA) annuity applies an adjustment to the annuity’s value if funds are withdrawn before the end of the guarantee period. Virginia regulations require sales materials to clearly and fairly explain how MVAs work, including the fact that the adjustment may be either positive or negative, depending on interest rate movements.

Misleading illustrations suggesting guaranteed gains or consistently negative adjustments are prohibited. Insurers must ensure consumers understand that interest rate changes affect annuity values and that withdrawals during certain periods may result in either an increase or decrease in value.

Options A and B improperly imply projections or guarantees, which are not allowed. Option C is incorrect because MVAs are not always negative. Therefore, option D is correct.

An automatic premium loan provision is typically found in whole life insurance policies. This provision allows the insurer to automatically pay the premium from the cash value of the policy if the policyholder fails to pay the premium on time. This is a feature unique to permanent life insurance, like whole life, where the policy builds cash value over time. Credit insurance, decreasing term, and level term policies generally do not include such provisions because they are term-based policies and do not accumulate cash value.

Detailed Answer in Step-by-Step Solution:

Virginia law requires due process, meaning an agent’s license cannot be revoked until they’ve had a hearing (A) to contest the charges.

Options B (three violations), C (jury), and D (cease and desist) are not prerequisites for revocation proceedings.

The Virginia study guide mandates that the Bureau of Insurance provide a hearing before revoking a license, ensuring fairness under state administrative law. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "License Regulation."

A mortality table displays the statistical probability of death at each age for a defined population. Insurers use mortality tables as a foundational tool in underwriting, premium calculation, and reserve determination for life insurance and annuity products.

Morbidity tables measure the likelihood of illness or disability, not death. Premium rate tables show pricing information derived from actuarial data, while dividend tables reflect non-guaranteed policy dividends.

Virginia licensing materials emphasize mortality tables as essential actuarial tools that help insurers predict life expectancy and properly price life insurance policies. Therefore, option A is correct.

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."

Universal life insurance is a flexible type of permanent life insurance. The policyowner may be able to increase the death benefit, but this is typically subject to proof of insurability (such as a medical exam). Universal life allows adjustments to premiums and death benefits within policy limits. The interest credited is guaranteed at a minimum rate set by the insurer, not tied to the CPI. Coverage does not automatically terminate at retirement.

Under the Affordable Care Act (ACA), Essential Health Benefits (EHB) include a variety of categories such as hospitalization, laboratory services, and preventive care services. However, adult dental services are not included as one of the ACA's required essential benefits, though they may be offered as part of a separate plan or rider. This distinction is important as it affects coverage requirements and benefits for different age groups.

Detailed Answer in Step-by-Step Solution:

The "time limit on certain defenses" provision (B), often tied to incontestability, limits the insurer’s ability to deny claims based on application errors after a period (e.g., 2 years), unless fraud is proven.

Legal actions (A) governs lawsuits, grace period (C) covers premium delays, and time payment of claims (D) sets claim payment deadlines—none relate to application defenses.

The Virginia study guide explains that the time limit on certain defenses provision protects insureds by restricting post-issuance claim denials after a contestable period, absent fraud. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Policy Provisions."

Under federal law, an insurance agent may face imprisonment for embezzling money from an insurance company. This is a serious offense that involves misappropriating or stealing funds entrusted to the agent. Other options, such as selling insurance with a nonresident license or inducing a client to sign an application, may result in administrative penalties or fines, but embezzlement can lead to criminal prosecution and prison time.

Detailed Answer in Step-by-Step Solution:

Agents assist underwriting by collecting application data (A), obtaining additional info (C), and reporting material facts (D), but determining the final rate classification (B) is the insurer’s underwriter’s role, not the agent’s.

Rate classification involves risk assessment, which is beyond an agent’s authority.

The Virginia study guide specifies that agents facilitate underwriting by providing accurate information, while the insurer’s underwriters set rates based on that data. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Underwriting Process."

Universal life insurance is a type of permanent life insurance that provides flexible premiums, adjustable death benefits, and a cash value component. One distinguishing feature of universal life is that it allows policyowners to access cash value through both policy loans and partial withdrawals. Withdrawals permanently reduce the cash value and may also reduce the death benefit, while policy loans accrue interest and must be repaid to avoid reducing benefits. Whole life insurance generally allows policy loans but not partial withdrawals of cash value. Term life insurance does not accumulate cash value and therefore does not allow loans or withdrawals. While “permanent life” is a broad category, universal life is the specific policy type that permits both loans and withdrawals, making it the correct answer.

Under Virginia licensing standards and federal tax principles taught for the life insurance exam, life insurance death proceeds are generally exempt from federal income tax when paid to a beneficiary due to the insured’s death. This long-standing rule is a fundamental advantage of life insurance and is frequently tested.

The transfer-for-value rule applies only in limited situations when a life insurance policy is sold or transferred for consideration, which is not the general rule for death benefits. The cost recovery rule and interest-first rule apply to annuities, not life insurance death proceeds. Therefore, options B, C, and D are incorrect.

This tax-free treatment allows beneficiaries to receive the full face amount without reduction for income taxes, making life insurance an effective financial protection and estate planning tool. While estate taxes may apply in certain high-value estates, income tax treatment remains favorable in most cases.

Qualified retirement plans are subject to federal participation standards to ensure broad employee access. Generally, employees age 21 or older must be allowed to participate after completing one year of service. One year of service typically means working at least 1,000 hours during a 12-month period. While some plans may impose longer vesting schedules for employer contributions, participation requirements are designed to prevent unreasonable exclusion of employees. The other options exceed the standard participation limit and are not consistent with general qualified plan rules. Therefore, one year of service is the correct minimum requirement.

Virginia’s insurance data security requirements mandate that licensees maintain and update an information security program based on risk assessment. Adjustments are required when there are changes in technology, evolving internal or external threats, or changes in the sensitivity of nonpublic personal information.

The appointment of a new Insurance Commissioner has no direct impact on a licensee’s cybersecurity risk profile and does not require modification of the information security program. Therefore, option D is the correct answer.

Virginia exam materials emphasize that cybersecurity obligations are risk-based and operational, not political or administrative in nature.

Disability buy-sell insurance funds a business partner’s buyout if one becomes disabled, per Virginia Code § 38.2-3100 et seq. Option C is true; proceeds are typically tax-free under IRC § 104(a)(3) as insurance benefits, not income, if premiums aren’t deducted. Option A is false; the policyowner (e.g., a partner or business) is often the beneficiary to fund the buyout. Option B is false; benefits go to the business or partner, not the disabled individual, who may receive separate disability income coverage. Option D is false; premiums aren’t tax-deductible (IRC § 265), preserving tax-free proceeds. The study guide likely explains this with scenarios—e.g., $500,000 paid tax-free to buy out a disabled partner—highlighting tax treatment, making C the true statement.

Group credit life insurance is typically structured as decreasing term insurance. This means the death benefit decreases over time, generally in line with the outstanding balance of a loan or debt that the insurance is intended to cover. It is commonly used for loans, such as mortgages, where the liability decreases as the debt is paid down.

Virginia Code § 38.2-3117.1 permits life insurance policies to include an accelerated death benefit (ADB) provision, allowing the policyowner to receive a portion of the death benefit early if the insured is diagnosed with a terminal illness (typically less than 12-24 months life expectancy, per policy terms). Option B correctly identifies this benefit, often used for medical expenses or quality-of-life needs. Option A (death benefit) is paid only upon death, not during life, so it’s incorrect here. Option C (reduced paid-up insurance) is a nonforfeiture option converting cash value to a smaller, paid-up policy, unrelated to terminal illness. Option D (extended term insurance) uses cash value to extend term coverage, also not tied to life expectancy triggers. The study guide likely details ADB as a modern feature addressing critical health scenarios, distinguishing it from standard death benefits or nonforfeiture options, confirming B as the accurate choice.

Detailed Answer in Step-by-Step Solution:

Insurable risks require accidental loss (B), a large number of similar exposure units (C), and measurable loss (D) to allow statistical predictability and premium calculation.

Speculative risk (A), like gambling or business ventures, involves potential gain or loss and is not insurable, as insurance covers only pure risk (loss only).

The Virginia study guide distinguishes pure risk (insurable) from speculative risk (uninsurable), listing accidental, measurable, and widespread exposure as key criteria. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Risk and Insurance."

Virginia exam materials describe standard STD plan design as wage-replacement for a short duration with a weekly cap; integration with Social Security and multi-year benefit periods are characteristics of long-term disability (LTD), not STD. Exact extract (Study Guide): “Short-Term Disability (STD) pays weekly benefits, typically 50%–60% of earnings, subject to a weekly maximum, for a short duration (commonly up to 13–26 weeks).” “Coordination with Social Security benefits is generally a feature of LTD, not STD.”

Detailed Answer in Step-by-Step Solution:

Accidental death and dismemberment (AD&D) insurance (B) provides a lump sum benefit for specific losses, such as loss of sight in both eyes, due to an accident.

Hospital expense (A) covers hospital stays, not lump sums for dismemberment.

Major medical (C) and medical expense (D) cover healthcare costs, not specific injury benefits.

The Virginia study guide describes AD&D as providing lump sum payments for accidental death or specific injuries like loss of sight, distinct from medical expense coverage. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Types."

Virginia Code § 38.2-3505 requires disability income policies to include a misstatement of age provision. If an applicant misstates their age, the insurer adjusts benefits to what the paid premium would have purchased at the correct age, rather than voiding or canceling the policy. Option A reflects this adjustment process. Option B is false; the insurer remains liable, adjusting claims rather than denying them outright. Option C is incorrect; immediate cancellation isn’t standard unless fraud is proven (Virginia Code § 38.2-309), and age misstatements are typically clerical errors, not fraud. Option D is wrong; voiding from inception requires material misrepresentation with intent to deceive, not a simple age error. The study guide likely explains this clause as a fairness mechanism, protecting both parties, making A the correct answer.

The application is the primary underwriting source for personal data and risk assessment. It provides the insured’s age, health, occupation, and lifestyle factors. Exact extract: “The application is a written request to the company for a contract and is the source of the insurer’s underwriting information.”

Detailed Answer in Step-by-Step Solution:

Life insurance policies must include a misstatement of age clause (B), grace period clause (C), and incontestability clause (D) as standard provisions under state law.

The waiver of premium clause (A) is optional, typically a rider, not a required provision.

The Virginia study guide lists mandatory life insurance provisions (e.g., grace period, incontestability, misstatement of age) but notes that waiver of premium is an optional benefit, not required. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Life Insurance Policy Provisions."

Federal Age Discrimination in Employment Act (ADEA) requires equal benefits for older workers. Employers cannot deny the same group health coverage offered to younger employees. Exact extract: “Employees age 65 and older must be offered the same health benefits as those under 65.”

A term life insurance policy provides temporary protection for a specified period, such as 10, 20, or 30 years, and does not accumulate cash value like whole life policies. Term life insurance is often renewable, but premiums typically increase with each renewal. It is designed to provide coverage for a set period, offering financial protection if the insured passes away within that term.

The main advantage of tax-qualified retirement plans is that earnings accumulate tax-deferred until distributed to participants. This allows employees’ investments to grow more quickly compared to taxable accounts. Exact extract: “Employees benefit from tax-deferred accumulation of pension and profit-sharing contributions until retirement distribution.” Employers may deduct contributions, but the true long-term tax benefit accrues to employees.

Needs analysis is a method used in life insurance planning to identify the specific needs of the individual and their dependents in case of death or disability. It includes assessing income, debt, future expenses (such as education), and existing coverage. The analysis helps determine the appropriate amount of life insurance coverage. While it involves estimating future expenses, including Social Security benefits, it does not ignore them but rather incorporates them in calculating overall needs.

In Virginia, the responsibilities of a licensed life insurance agent (also called a producer) are clearly distinguished from those of the insurance company.

Delivery of policies: The agent must deliver newly issued policies to the applicant. Virginia regulations require that, upon policy delivery, the agent must also provide required disclosures and obtain any necessary signed statements (such as delivery receipts).

Replacement notification: If an agent is aware that a new policy will replace an existing one, the agent must notify the insurance company and comply with Virginia’s replacement regulations, which include providing written notices and ensuring that applicants are fully informed.

Collection of premiums: An agent is authorized to collect the initial premium from the applicant at the time of application or upon delivery of the policy, provided the insurer allows such practice.

However, approving policies for issue is not within the authority of an agent. Only the insurer has the legal authority to underwrite and approve policies for issue. Agents are producers and representatives of the insurer, but they do not possess underwriting authority to approve or reject applications.

This distinction is reinforced by the Virginia Bureau of Insurance regulations, which specify that the insurer is responsible for policy issuance and underwriting decisions, while agents are responsible for solicitation, policy delivery, disclosure, and premium collection.

References (Virginia official documents and study materials):

Code of Virginia § 38.2-1825 (Agent’s authority and responsibilities)

Code of Virginia § 38.2-1834 (Duties in policy replacement — notice requirements)

Virginia Administrative Code 14VAC5-200-110 (Replacement regulations and disclosure duties)

Virginia Life, Annuities & Health Insurance Study Guide — Producer responsibilities section

Detailed Answer in Step-by-Step Solution:

Life insurance premiums are calculated based on three factors: mortality (death rates), interest (investment earnings), and expenses (operating costs).

When an insurer earns interest on premiums invested, it increases the funds available to pay claims, reducing the amount needed from policyholders.

This results in a decrease in the premium rate (C), as higher interest earnings offset the cost of coverage.

Option A (increase premium rate) would occur if interest earnings decreased.

Options B and D (mortality rate changes) are unrelated to interest, as mortality is a statistical factor, not a financial one.

The Virginia study guide explains that interest earned on premiums is a key component of pricing life insurance, allowing insurers to lower premium rates when investment returns are favorable. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Premium Determination."

ADLs (Activities of Daily Living) in long-term care insurance typically include dressing, eating, bathing, transferring (moving from one place to another), and toileting. These are fundamental tasks that individuals need to perform every day to live independently. If a person is unable to perform a certain number of ADLs, they may qualify for benefits under a long-term care insurance policy.

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."

Group medical benefits may be offered through trade associations where members share a common professional or occupational interest. Associations must exist for purposes other than solely obtaining insurance. Therefore, the correct feature is that members are usually in the same industry.

Exact Extract (Virginia Group Health Insurance Study Guide): “Trade association groups—members are engaged in the same type of business or industry and may be eligible for group medical coverage if the association is not formed solely for insurance purposes.”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Group Insurance Eligibility

The primary purpose of credit life insurance is to pay off the outstanding debt of a borrower in the event of their death. This ensures that the borrower’s family or estate is not burdened with the debt after their passing. It does not cover illness, act as a savings vehicle, or directly increase financing ability.

A deferred annuity would be appropriate for an individual, age 50, who wants to help pay for a grandchild's college expenses in fifteen years. With a deferred annuity, the individual can make contributions now, and the annuity will accumulate value over time. The annuity will begin making payments in the future (in this case, fifteen years) to help fund the grandchild’s college expenses. A survivorship annuity, immediate annuity, or pure life annuity would not be suitable for this purpose, as they either begin payments immediately or are focused on providing income for the lifetime of the annuitant.

Medicare supplement policies in Virginia are guaranteed renewable. This means the insurer cannot cancel coverage as long as premiums are paid on time, regardless of the insured’s health status or claim history. Exact extract: “Every Medicare supplement policy shall be guaranteed renewable and may not be terminated except for nonpayment of premium or material misrepresentation.” This provides strong consumer protection for seniors relying on supplemental coverage.

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."

PPO plans allow members to seek care from non-network providers but at reduced benefit levels. This typically results in higher deductibles, coinsurance, and overall out-of-pocket expenses. Members retain freedom of choice, but the plan incentivizes using preferred providers.

Exact Extract (Virginia Health Insurance Study Guide): “Preferred Provider Organizations allow coverage for non-network services, but at a lower reimbursement level, leading to greater out-of-pocket expenses.”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, PPO Plan Features

When a health insurer requires a physical examination, the insurer typically has the right to choose the examining physician. This is because the insurer is the one paying for the examination as part of the claims or underwriting process, ensuring that the exam is conducted by a professional selected by the insurance company. While the insured may be asked for preferences in some cases, the final decision is generally up to the insurer.

Detailed Answer in Step-by-Step Solution:

Disability income insurance covers loss of income from accidental injuries (D), provided they aren’t excluded.

Self-inflicted injuries (A), military service injuries (B), and war-related disabilities (C) are standard exclusions in most policies.

The Virginia study guide specifies that disability income insurance pays for accidental or illness-related income loss, excluding self-inflicted, military, or war-related causes. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Disability Income Insurance."

Detailed Answer in Step-by-Step Solution:

When age is misstated, the insurer adjusts the death benefit based on the premium paid versus what should have been paid.

Premium paid: $15 per $1,000 (understated age). Correct premium: $18 per $1,000 (actual age).

Ratio: $15/$18 = 5/6 of the intended coverage. Thus, the benefit is 15/18 of the face amount (A).

Option B (95%) is arbitrary. Option C (full amount) ignores the misstatement. Option D (nothing) applies only in fraud cases beyond the incontestability period, not specified here.

The Virginia study guide states that under the misstatement of age provision, the benefit is adjusted proportionally to the premium paid versus the correct premium, not denied entirely. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Life Insurance Policy Provisions."

Virginia Code § 38.2-3501 requires health insurance applications to include essential details for underwriting and contract formation: the applicant’s name and address (option A), signature (option B) to affirm accuracy, and date (option C) to establish timing. These are mandatory for a complete application. Option D (initial premium) is not required on the application itself; while payment may accompany it to bind coverage (e.g., via a conditional receipt), it’s a separate transaction, not an application component. The study guide likely lists these elements in a sample application, noting that premium submission is optional until acceptance, making D the exception.

Detailed Answer in Step-by-Step Solution:

A 30-year decreasing term policy (B) reduces its death benefit over time, matching the declining 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."

Eligibility for long-term care benefits is based on inability to perform Activities of Daily Living (ADLs). Functional assessment measures this ability. Exact extract: “Functional assessments measure the insured’s ability to perform ADLs such as bathing, dressing, eating, continence, and transferring.”

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."

A straight life annuity pays income until death, with no further payments to beneficiaries. Exact extract: “Straight life annuities provide income for the life of the annuitant only; payments cease upon death with no refund.” This option offers the maximum periodic income but no residual value.

The extended term nonforfeiture option uses the cash value to purchase term insurance for the full face amount ($35,000) for as long a term as the cash value allows. The face amount remains unchanged; only the term length varies.

Exact Extract (Virginia Life Insurance Study Guide): “Extended term—uses cash value to buy term insurance equal to the original face amount for a period determined by cash value.”

References (Virginia Documents / Study Guide):

— Virginia Life Insurance Examination Outline, Nonforfeiture Options

The coordination of benefits provision in group health insurance is designed to reduce duplication of coverage when an individual is covered by multiple insurance plans. It ensures that the total benefits paid by all insurers do not exceed the total amount of the claim. This provision helps coordinate the payment of benefits between primary and secondary insurers.

A decreasing term policy provides a declining death benefit over the policy term, while premiums remain level. These policies are often used for mortgage protection, as the insurance amount reduces in line with the declining loan balance.

Exact Extract (Virginia Life Insurance Study Guide): “Decreasing term insurance—provides a level premium and a decreasing face amount throughout the term of coverage, often used for debt protection.”

References (Virginia Documents / Study Guide):

— Virginia Life & Annuities Examination Outline, Term Insurance

Virginia Code § 38.2-3407 et seq. covers health services, where ambulatory care centers (e.g., outpatient clinics) specialize in same-day procedures like outpatient surgical procedures (option C—e.g., cataract surgery). Option A (physical therapy) may occur there but isn’t the primary use; therapy clinics differ. Option B (wellness centers) focuses on prevention, not procedures. Option D (overnight accommodations) contradicts “ambulatory,” meaning walk-in/walk-out care. The study guide likely defines this in a health facilities section, with examples like knee arthroscopy, making C the most frequent use.

Insurers may consider objective risk-related factors such as age, gender, health, and occupation when underwriting disability insurance. Religion, however, is not an allowable underwriting factor. Exact extract: “Underwriting criteria may not unfairly discriminate based on race, color, creed, or religion.” This prohibition ensures fair treatment of all applicants while still allowing actuarial factors like age and occupation to determine risk.

Rebating is an unfair trade practice where an agent offers a portion of their commission or any other inducement to encourage the insured to purchase a policy. This is considered illegal because it could mislead the buyer into making a purchase based on incentives rather than the suitability of the policy for their needs.

False advertising regarding insurance policies involves exaggerating or misrepresenting information that could mislead consumers. Representing past dividends, benefits under the policy, or incorrectly describing an insurance policy as a share of stock are examples of false advertising. However, comparing policy benefits with a competitor’s benefits is generally permitted, as long as the comparison is truthful and not misleading.

Medicare Part A is generally available at age 65, but younger individuals may qualify if they have received Social Security disability benefits for at least 24 months.

Exact Extract (Virginia Medicare Study Guide): “Individuals under age 65 become eligible for Medicare Part A after receiving Social Security disability benefits for 24 months.”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Medicare Eligibility

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.

If the initial premium is not paid at the time of application, the life insurance coverage typically begins when the agent delivers the policy to the insured and collects the required premium. This is known as the "delivery and premium collection" method, which ensures that the insurer receives payment before coverage becomes effective.

In individual health insurance, the insured's application becomes a part of the insurance contract when attached to the policy. The application is considered part of the contract, and the insurer may use it to evaluate the risk and determine the premium. If the policy is issued, the application is typically attached to the policy, becoming a permanent part of the contract.

Tax-sheltered annuities (TSAs), per IRC § 403(b) and Virginia Code § 38.2-3100 et seq., are retirement plans for nonprofit employees. Option A is true; they’re synonymous with 403(b) plans. Option B is true; contributions often come from voluntary salary reductions, tax-deferred until withdrawal. Option C is true; participants can have individual contracts or accounts. Option D is false; investment gains are tax-deferred, not included in gross income annually, only taxed upon distribution. The study guide highlights TSAs’ tax advantages, making D the incorrect statement.

The automatic premium loan provision is an optional feature found in many cash value life insurance policies. Its purpose is to prevent a policy from lapsing when the policyowner fails to pay a premium by the end of the grace period. If the policy has sufficient cash value, the insurer will automatically issue a policy loan in the amount needed to cover the overdue premium. This loan is secured by the policy’s cash value and accrues interest according to the policy’s loan terms. Over time, unpaid loan balances and interest may reduce the policy’s cash value and death benefit. This provision differs from a waiver of premium, which waives premiums due to disability, and from options that purchase additional insurance. The automatic premium loan simply uses the policy’s existing value to keep coverage in force.

A joint and survivor annuity is designed to provide income for two individuals, typically for retirement planning. When one annuitant dies, payments continue to the surviving annuitant, either at the same amount or at a reduced percentage, depending on the contract terms selected at issue.

Payments do not cease at the first death, and refund or period-certain options apply only if specifically elected. Virginia annuity education emphasizes joint and survivor annuities as a way to protect surviving spouses from loss of income, making option C correct.

Insurers may evaluate actuarial risk factors such as age, health, weight, and occupation. Religion is never a permissible underwriting factor. Exact extract: “Underwriting practices may not discriminate based on race, color, creed, or religion.” This ensures compliance with fairness standards and anti-discrimination laws.

A class designation of beneficiary is used when the policyowner wishes to name beneficiaries as a group rather than listing each individual by name. This method is especially useful when the number or identity of beneficiaries may change over time. Naming “the insured’s children” allows all individuals who meet that description at the time of the insured’s death to share in the proceeds, including children born after the policy is issued. This avoids the need to update beneficiary designations whenever family circumstances change. Donating proceeds to a charity requires naming a specific organization, not a class. Establishing a trust requires a trust to be named as beneficiary, which is not a class designation. Naming a specific person to act on behalf of others is also not a class designation because the beneficiary must be clearly defined. Therefore, naming children as a group without listing them individually is the proper use of a class designation.

Individual disability income insurance policies are designed to provide coverage for both accident-related disabilities and sickness-related disabilities, unless otherwise excluded.

Exact Extract (Virginia Disability Insurance Study Guide): “Disability income insurance provides benefits for loss of income due to both accident and sickness.”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Disability Income Insurance

A nonoccupational disability income policy covers accidents and sicknesses occurring off the job. Disabilities caused while performing work-related duties are excluded, since they are covered by workers’ compensation instead.

Exact Extract (Virginia Disability Insurance Study Guide): “Nonoccupational policies exclude coverage for work-related disabilities, which are handled under workers’ compensation.”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Disability Income Insurance Exclusions

An agent must provide an outline of coverage to an applicant for long-term care insurance at the time of the initial solicitation. This ensures that the applicant is fully informed about the key features and benefits of the long-term care insurance policy before they make a decision. The outline provides details about the policy's coverage, limitations, exclusions, and other essential elements.

When an HIV test is requested by a health insurer, the applicant must sign the consent form. This ensures that the insured is aware of the test and agrees to its administration. The insurance agent, physician, or medical laboratory technician are not required to sign the consent, though they may be involved in administering or facilitating the test.

Twisting involves misrepresenting or making incomplete comparisons to induce a policyholder to replace an existing policy with one from another insurer, often to the client’s detriment.

Exact Extract (Virginia Unfair Trade Practices Law): “Twisting—making incomplete or misleading comparisons of policies to induce replacement.”

References (Virginia Documents / Study Guide):

— Code of Virginia §38.2-503 (Twisting prohibited)

Detailed Answer in Step-by-Step Solution:

The accumulation period (D) is the phase in a deferred annuity where premiums are paid to build value before payouts begin.

The liquidation period (A) is not a standard term here; it might imply payout but isn’t correct.

The annuity period (B) is when payments are received, not paid.

Period certain (C) refers to a payout option, not premium payment phase.

The Virginia study guide defines the accumulation period as the time during which premium payments are made into a deferred annuity, accumulating value until the payout phase. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Annuities."

Virginia’s Unfair Claims Settlement Practices Act prohibits insurers or agents from misrepresenting facts or policy provisions relating to coverage. Doing so after a loss is classified as an unfair claims settlement practice.

Exact Extract (Virginia Unfair Claims Settlement Law): “Misrepresenting pertinent facts or policy provisions relating to coverages at issue is an unfair claim settlement practice.”

References (Virginia Documents / Study Guide):

— Code of Virginia §38.2-510 (Unfair claim settlement practices)

Virginia law requires insurers to provide each group member with a certificate that summarizes the group policy’s benefits and features, including coverage, exclusions, and how to file claims.

Exact Extract (Virginia Group Health Law): “Each individual insured under a group health policy shall be provided with a certificate summarizing the essential features of the insurance coverage.”

References (Virginia Documents / Study Guide):

— Code of Virginia §38.2-3521.2 (Certificates of coverage under group health policies)

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."

The agent’s report includes observations on the applicant’s financial status, character, and other relevant factors, but the applicant’s signature belongs on the application form, not the agent’s report.

Exact Extract (Virginia Health Insurance Study Guide): “The agent’s report is confidential and includes information on financial condition and character. It does not contain the applicant’s signature.”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Field Underwriting

During the contestable period (typically the first two years of a life insurance policy), insurers may rescind a policy for material misrepresentation, fraud, or material concealment. These actions affect underwriting decisions and risk evaluation and are grounds for rescission under Virginia law.

However, misstatement of age is treated differently. Virginia-required policy provisions mandate that if the insured’s age is misstated, the insurer does not rescind the policy. Instead, benefits are adjusted to reflect what the premium would have purchased at the correct age. This makes option A the correct exception.

This distinction protects consumers from harsh outcomes for honest mistakes while still preserving insurer rights against intentional deception. Misstatement-of-age clauses are standard in life insurance policies and are specifically excluded from contestability rescission rules.

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."

In the context of health insurance, particularly dental coverage, Virginia Code § 38.2-3407.1 et seq. governs mandated benefits, though dental specifics often appear in policy riders or standalone plans. Orthodontics (option A) is the branch of dentistry focused on preventing and correcting irregularities of the teeth and jaws using mechanical devices like braces or aligners, precisely matching the question’s description. Endodontics (option B) deals with the tooth’s interior (e.g., root canals), not mechanical correction of alignment. Periodontics (option C) addresses gum diseases and supporting structures, not tooth positioning. Prosthodontics (option D) involves replacing missing teeth with prosthetics (e.g., dentures), not correcting irregularities mechanically. The study guide likely defines these terms in a health insurance section, emphasizing orthodontics’ role in alignment correction—both preventive (e.g., avoiding bite issues) and corrective—making A the clear answer. Examples like braces for malocclusion reinforce this distinction from other specialties.

The insurance with other insurers provision prevents over-insurance and duplication of benefits by allowing insurers to coordinate coverage. If an insured has multiple policies with different insurers and fails to notify, each insurer will pay only a proportionate share of the claim.

Exact Extract (Virginia Health Policy Provisions): “If the insurer was not notified that the insured has other valid coverage, benefits will be prorated to prevent duplication.”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Required Policy Provisions

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."

Virginia Code § 38.2-3100 et seq. governs annuities. A joint life annuity (option C) pays income until the first of two annuitants dies, then ceases—ideal for temporary dual coverage. Option A (joint and survivor annuity) continues payments until the last survivor dies, not stopping at the first death. Option B (temporary annuity) pays for a fixed term (e.g., 10 years), regardless of death, and isn’t tied to two lives. Option D (single life annuity) covers one person until their death, not two. The study guide likely defines these with examples—e.g., a couple receiving $1,000 monthly until one dies (joint life) versus until both die (joint and survivor)—highlighting C’s “first death” cutoff, making it the correct answer.

Group credit life insurance does not insure the life of an individual for personal benefit. Instead, it insures a debtor’s obligation, with the creditor as beneficiary. The purpose is to pay off a loan balance if the borrower dies, not to provide income protection to survivors.

Employer group plans and association group plans insure individuals within a defined group, and equity indexed universal life insures a specific individual with cash value linked to an equity index. Therefore, those options do insure individual lives.

Virginia licensing materials clearly distinguish credit life insurance as debt protection rather than personal life insurance, making option C the correct answer.

Detailed Answer in Step-by-Step Solution:

An absolute assignment transfers all ownership rights (C) of a life insurance policy to a new owner, relinquishing the original owner’s control.

Option A (limited rights) is a partial assignment. Option B (premium payment) is not ownership. Option D (collateral) is a collateral assignment, not absolute.

The Virginia study guide defines absolute assignment as the complete transfer of all policy rights to a new owner, distinct from collateral assignments for loans. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Policy Assignments."

The concept of agency authority is foundational in Virginia insurance law, derived from general agency principles and reflected in Title 38.2, Chapter 18. Express authority is explicitly granted in the agency agreement (e.g., soliciting and binding coverage), per Virginia Code § 38.2-1800 et seq. Implied authority, however, is not written but assumed to be necessary for carrying out express duties—such as scheduling client meetings or collecting initial premiums—unless restricted by the insurer. “Mandated authority” (option B) is not a recognized term in Virginia insurance regulations or study materials. Option C (express authority) is incorrect because it’s explicitly stated, not unwritten. Option D (nonexistent) denies the presence of authority, which contradicts the question’s premise. The Virginia Life, Annuities, and Health Insurance study guide likely highlights implied authority as a key concept for agents’ day-to-day operations, making A the correct answer.

In insurance contract law, per Virginia Code § 38.2-102, a contract requires consideration—something of value exchanged to make it legally binding. Option C (consideration) fits this definition: the insured’s premium payment and the insurer’s promise of coverage form the mutual value. Option A (grant) implies a unilateral transfer, not a contract element. Option B (codicil) is a will amendment, irrelevant to insurance contracts. Option D (covenant) is a promise within a contract, not the value exchanged. The study guide likely explains consideration as a foundational principle, using examples like a $500 premium for a $100,000 policy, distinguishing it from other legal terms. Virginia follows common law requiring consideration for enforceability, making C the precise answer.

The accidental death benefit is typically provided as an optional policy rider. This rider offers additional coverage, paying an extra benefit if the insured dies due to an accident. It is not an exclusion, annuity, or nonforfeiture option. The rider adds extra protection for accidents but is not part of the base policy unless specifically added.

A beneficiary designation by class identifies beneficiaries as a group rather than by individual names. Common class designations include children, grandchildren, or surviving spouse. “All children of the insured” is a classic example because it includes all individuals who meet that description at the time of the insured’s death, even if the number of children changes over time. A specified parent, a named shareholder, or the insured’s estate are not class designations. The estate is a legal entity, not a class of individuals, and naming a specific person does not constitute a class designation.

The deductible is the initial portion of covered expenses the insured must pay before the insurer pays benefits. Coinsurance applies only after the deductible has been met. Exact extract: “The deductible is the amount of covered expenses an insured must pay out of pocket before the insurer is obligated to pay under the major medical policy.” This provision ensures cost-sharing and discourages excessive claims.

Tax-sheltered annuities (403(b) plans) are funded by employer salary reduction agreements, not personal checks written directly to the insurer. Eligible participants are employees of nonprofit or educational institutions. Exact extract: “Contributions to tax-sheltered annuities are made by salary reduction agreements; employees of public schools and nonprofit organizations are eligible.”

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."

During the annuitization or distribution phase, the annuitant receives regular income payments—monthly, quarterly, or annually—depending on contract terms. These payments may last for life or a specified period.

Exact Extract (Virginia Annuities Study Guide): “Distribution phase—annuitant receives systematic periodic payments of principal and interest.”

References (Virginia Documents / Study Guide):

— Virginia Life & Annuities Insurance Examination Outline, Annuity Phases

Under required uniform provisions, once an insurer receives notice of claim, it must provide claim forms to the insured within a specified period (usually 15 days). If forms are not provided, the claimant may submit proof of loss in any reasonable written form.

Exact Extract (Virginia Uniform Policy Provisions): “Upon receipt of notice of claim, the insurer shall furnish the claimant forms for filing proof of loss.”

References (Virginia Documents / Study Guide):

— Code of Virginia §38.2-3514 (Uniform accident and sickness provisions – Notice and claim forms)

A single premium whole life policy requires only one lump-sum payment. That single payment fully funds the policy for the insured’s lifetime. The insurer places the premium into the policy’s cash value account, where it grows to cover the cost of insurance throughout life. Exact extract: “Single premium whole life provides lifetime protection with one lump-sum premium payment at issue.” This design is often used for estate planning or wealth transfer because the insured never has to make another payment, and the cash value builds immediately.

The doctrine of reasonable expectations holds that insurance contracts will be interpreted as a reasonable person would expect, even if fine print suggests otherwise. Exact extract: “Under the principle of reasonable expectations, coverage is interpreted in line with what a prudent policyholder would believe was provided.” This prevents insurers from denying claims based on obscure or technical language.

Detailed Answer in Step-by-Step Solution:

False advertising includes exaggerating dividends (A), misrepresenting benefits (B), or claiming a policy is a stock (C), all deceptive practices.

Comparing benefits with a competitor (D) is permissible if accurate and not misleading, thus not inherently false advertising.

The Virginia study guide, per state law, prohibits deceptive advertising but allows factual comparisons with competitors, provided they are truthful. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Unfair Trade Practices."

Medical expense claim forms are designed to gather information relevant to the medical loss itself—its occurrence, character, and extent. Employee salary is not part of the standard claim form for medical expense policies.

Exact Extract (Virginia Health Insurance Study Guide): “Claim forms must provide space for details of the occurrence, character, and extent of loss but do not request information unrelated to medical expenses, such as salary.”

References (Virginia Documents / Study Guide):

— Virginia Uniform Health Policy Provisions

Virginia law uses the term viatical settlement contract for an agreement in which compensation (or anything of value) that is less than the expected death benefit is paid in exchange for the policyowner/“viator” transferring ownership or benefits of a life insurance policy. This matches the question’s description: a terminally ill person sells a life policy at a discount to obtain cash—often to cover medical or living expenses—while the purchaser assumes premium payments and receives the death benefit later. Virginia’s administrative definitions also clarify that viatical settlements are distinct from accelerated death benefit riders contained within the life insurance policy itself (those are governed under different rules).

The other answer choices do not fit. “Nonforfeiture” refers to benefits/options available when a policy with cash value lapses, such as cash surrender, reduced paid-up insurance, or extended term—these do not involve selling the policy to a third party. “Living wills” are advance medical directives, not insurance transactions. “Repurchase agreements” are unrelated financial arrangements. Because the described transaction is a sale/transfer of a life policy for less than the expected death benefit, the correct term in Virginia is viatical settlement.

Virginia Code § 38.2-3209 allows a guaranteed insurability rider, enabling the policyowner to buy additional coverage at specified intervals (e.g., every 3 years or life events like marriage) without proving insurability. Option D matches this definition. Option A is unrelated; non-medical underwriting isn’t implied. Option B contradicts the rider’s purpose, which waives insurability proof. Option C is false; premium adjustments aren’t part of this rider. The study guide describes this rider as a planning tool for future needs, confirming D.

In Virginia, an insurance agent is treated as the insurer’s agent when selling/soliciting/negotiating insurance, which is why insurers are generally accountable to insureds for authorized acts of their agents in those transactions. However, that does not mean the agent is immune from personal responsibility. When an agent goes beyond the authority granted by the insurer—especially by doing something the agency agreement expressly forbids—the agent is acting outside the scope of the contractually granted authority and may face personal consequences (including civil liability exposure depending on the harm caused and the legal theory asserted). Virginia regulatory guidance also warns that exceeding authority is a violation of Virginia law, underscoring that an agent’s actions are constrained by the authority they’ve been granted. By contrast, “oral but unwritten authority” can still be actual authority if the insurer granted it, and using insurer-provided materials (even if problematic) typically implicates the insurer’s oversight and advertising compliance duties rather than automatically shifting liability to the agent. The “never” option is incorrect because liability can arise when authority is exceeded or prohibited conduct occurs.

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."

The notice of claim provision states that notice may be given to the insurer or its authorized agent. Legally, providing notice to an authorized agent constitutes notice to the insurer itself.

Exact Extract (Virginia Uniform Policy Provisions): “Notice of claim may be given to the insurer or to any authorized agent of the insurer.”

References (Virginia Documents / Study Guide):

— Code of Virginia §38.2-3514 (Uniform accident and sickness provisions – Notice of claim)

Indemnity dental insurance plans generally cover treatments directly related to dental health, such as fillings, root canal treatments, extractions, and certain preventive treatments like fluoride treatments for children under 16. However, dietary counseling and instructions are typically not covered under indemnity dental plans as they fall outside the scope of dental treatment.

Detailed Answer in Step-by-Step Solution:

Life insurance policies typically include a two-year suicide clause; if the insured dies by suicide within this period (e.g., six months), the insurer pays only a refund of premiums, not the full death benefit (C).

Options A (accidental injury), B (lung cancer), and D (heart attack) are covered causes, barring misrepresentation or exclusions, within the first two years.

The Virginia study guide notes that the suicide provision limits payment to premiums paid if suicide occurs within two years of issuance, protecting insurers from early intentional loss. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Life Insurance Policy Provisions."

Reinsurance is a legitimate risk management tool used between insurers. Misrepresentation, fraudulent advertising, and illegal inducements are specifically prohibited as unfair trade practices in Virginia.

Exact Extract (Virginia Unfair Trade Practices Act): “Unfair practices include misrepresentation, false advertising, and offering unlawful inducements. Reinsurance is not an unfair practice.”

References (Virginia Documents / Study Guide):

— Code of Virginia §38.2-500 et seq. (Unfair Trade Practices Act)

Detailed Answer in Step-by-Step Solution:

A single premium whole life policy is a type of permanent life insurance where the entire premium for the policy’s lifetime coverage is paid in one lump sum at issuance.

Unlike policies with recurring premiums (e.g., monthly or annual), this single payment funds the policy for the insured’s full life (D).

Options A (one month) and B (one year) apply to term or recurring premium policies.

Option C (to age 65) might relate to limited-pay policies, not single premium ones.

Per the Virginia study guide, a single premium whole life policy requires one payment upfront, providing coverage for the insured’s entire life and building immediate cash value. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Types of Life Insurance Policies."

An agent's license will not be revoked unless the agent has been afforded the right to a hearing on the charges. This ensures due process and that the agent is given an opportunity to present their case before any disciplinary action is taken. Revoking a license is a serious matter, and the law requires a fair hearing process to protect the agent's rights before taking such steps.

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."

A SIMPLE IRA plan is designed for small employers and is known for ease of administration. One key characteristic is that employers generally do not have complex annual filing requirements, unlike many qualified retirement plans that require detailed reporting. Employees may choose whether or not to contribute through salary deferrals, so contributions are not mandatory. SIMPLE IRA plans have immediate vesting, meaning employees are 100% vested in both employer and employee contributions right away, not after years of service. Additionally, SIMPLE IRA plans are limited to employers with 100 or fewer employees, not 500. The simplicity and low administrative burden make these plans attractive to small businesses.

Adjustable life insurance is specifically designed to provide flexibility in both face amount and premium structure, allowing policyowners to adapt coverage as financial needs and objectives change. This flexibility may include adjustments to death benefit levels and premium payments within policy limits.

Term life and modified premium whole life lack this degree of adaptability. Current assumption whole life allows interest rate sensitivity but does not permit the same broad adjustments to coverage structure.

Virginia licensing materials identify adjustable life as a hybrid policy combining features of term and whole life insurance, making option B the correct answer.

Detailed Answer in Step-by-Step Solution:

The policyowner (A) has the right to designate the beneficiary, as they control the policy’s terms and ownership rights.

The insurer (B) issues the policy, the beneficiary (C) receives proceeds, and the agent (D) facilitates but doesn’t decide.

The Virginia study guide confirms that the policyowner selects the beneficiary, exercising a fundamental ownership right, unless assigned otherwise. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Beneficiary Designations."

The insuring clause in a health insurance policy is a key provision that outlines the general terms of the coverage provided by the insurer. It typically includes a broad description of what the policy covers and the conditions under which benefits will be paid. It does not contain a list of specific hospitals, nor does it detail how premiums are determined or act as part of the application.

Disability income insurance requires insurable interest based on potential income loss. If no substantial loss would occur, underwriting guidelines permit the insurer to decline coverage. Exact extract: “Disability income protection shall not be issued where no substantial loss of earned income would result from disability.”

Twisting is an unfair trade practice that involves persuading an insured, to the insured's detriment, to switch policies. This practice usually occurs when an agent convinces the insured to cancel or replace their existing policy with a new one, often through misleading comparisons or false representations. This is illegal because it may harm the policyholder by canceling coverage that would be beneficial to them.

The federal estate tax is the tax cost typically associated with death. It is imposed on the estate of a deceased person, and it applies to the transfer of assets above a certain threshold. Life insurance proceeds are generally not taxable to beneficiaries; however, if the policy is part of the estate, the proceeds may be subject to estate taxes. Excise taxes and state sales taxes are not typically related to death.

In a noncontributory group life insurance plan, the employer pays the entire premium. Because employees are not required to contribute, Virginia group insurance standards require 100% participation of eligible employees to prevent adverse selection.

Lower participation thresholds apply only to contributory plans, where employees share premium costs. Therefore, option D correctly reflects the participation requirement for noncontributory group life insurance.

Detailed Answer in Step-by-Step Solution:

The notice of claim provision typically deems notice to an agent as notice to the company (B), as agents act on the insurer’s behalf.

Options A (incomplete), C (not valid), and D (contrary) contradict standard practice unless the policy specifies otherwise.

The Virginia study guide, per NAIC model laws, confirms that notice to an agent satisfies the notice of claim requirement, equating it to notice to the insurer. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Claims Provisions."