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最新的 Insurance Licensing Certification Ok-Life-Accident-and-Health-or-Sickness-Producer 免費考試真題 (Q155-Q160):

問題 #155
An individual who is NOT acceptable by an insurer at standard rates because of health, habits, or occupation is called a

• A. standard risk.
• B. substandard risk.
• C. rating risk.
• D. preferred risk.

答案：B

解題說明：
In insurance underwriting, individuals are classified based on their risk profile. Asubstandard riskis an applicant who, due to health issues, hazardous habits (e.g., smoking), or high-risk occupations (e.g., stunt performer), cannot be insured at standard rates. These individuals may be offered coverage at higher premiums or with exclusions, as outlined in standard underwriting practices and Oklahoma's regulations (Title 36 O.S. § 1204).
* Option A: Incorrect. "Rating risk" is not a standard underwriting term.
* Option B: Incorrect. A standard risk qualifies for standard rates with average risk.
* Option C: Incorrect. A preferred risk qualifies for lower-than-standard rates due to low risk.
* Option D: Correct. A substandard risk is not acceptable at standard rates due to higher risk factors.
This question aligns with the Prometric content outline under "Underwriting," which covers risk classification.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Underwriting).
Oklahoma Insurance Department, Title 36 O.S. § 1204 (insurance business conduct).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

 

問題 #156
A newly hired employee gives his enrollment form to his employer, but due to an administrative error, it is never forwarded to the insurance company. The error is detected 3 months later. What will happen if the clerical error provision is in effect?

• A. The employee will be allowed to submit an enrollment form and all past due premiums, and will be retroactively insured.
• B. The employee will have to wait until the next open enrollment period to enroll in the plan.
• C. The employee will be allowed to submit a new enrollment form and will be enrolled as of the date the new form is accepted.
• D. The employer will be required to pay the past due premiums.

答案：A

解題說明：
The clerical error provision in group health insurance policies is designed to protect employees from losing coverage due to administrative mistakes made by the employer or insurer. According to Oklahoma insurance regulations and standard group health insurance practices, if a clerical error results in an employee not being enrolled, the provision allows the error to be corrected by retroactively enrolling the employee, provided any past due premiums are paid. This ensures the employee is insured as if the error had not occurred, covering any claims that would have been eligible during the period of the error.
The Oklahoma Life, Accident, and Health or Sickness Producer Study Guide specifies that under the clerical error provision, "an employee who was eligible for coverage but was not enrolled due to an administrative error can be retroactively enrolled upon correction of the error, with coverage effective from the original eligibility date, provided all required premiums are paid." This aligns with option C, which states the employee will be allowed to submit an enrollment form and all past due premiums, and will be retroactively insured.
References:
Oklahoma Life, Accident, and Health or Sickness Producer Study Guide, Section on Group Health Insurance Provisions.
Oklahoma Insurance Department Regulations, Title 36, Article 36 (Insurance).

 

問題 #157
How many days does the insured have to notify the insurer to add a newly-born child to continue coverage?

• A. 31 days.
• B. 21 days.
• C. 14 days.
• D. 30 days.

答案：A

解題說明：
In life and health insurance policies with family or dependent coverage riders, Oklahoma insurance regulations typically allow a 31-day period for the insured to notify the insurer of a newly-born child to add them to the policy for continued coverage. This aligns with standard provisions for automatic coverage of newborns, which often provide temporary coverage from birth (e.g., for 31 days) before requiring formal notification and premium adjustment to maintain coverage.
* Option A: Correct. The insured has 31 days to notify the insurer to add a newly-born child, consistent with standard policy provisions and Oklahoma regulations.
* Option B: Incorrect. 30 days is not the standard timeframe in Oklahoma for this purpose.
* Option C: Incorrect. 21 days is too short and not aligned with typical insurance provisions.
* Option D: Incorrect. 14 days is insufficient for the notification period in most policies.
This question is part of the Prometric content outline under "Provisions, Options, Exclusions, Riders, Clauses, and Rights," which covers dependent coverage and policy provisions.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Life and Health Insurance Provisions).
Oklahoma Insurance Department, Title 36 O.S. § 4001 et seq. (life and health insurance policy provisions).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

 

問題 #158
An insured with a major medical policy has a per cause deductible of $100. Over the course of the year, the insured visits the doctor's office three times for injuries. Excluding the premium, what is the MINIMUM amount the insured MUST pay for the year if each visit costs $200?

• A. $200
• B. $300
• C. $100
• D. $500

答案：B

解題說明：
Aper cause deductiblemeans the insured pays a $100 deductible for each separate medical condition or cause of treatment. The insured visits the doctor three times for injuries, each costing $200. Assuming each visit is for adifferent injury(to calculate the minimum amount, we consider the maximum number of deductibles), the insured pays a $100 deductible per visit (3 visits × $100 = $300). If the policy includes coinsurance (not specified but common in major medical policies), additional costs may apply, but the question asks for the minimum amount, which is the total deductibles for three separate causes.
Calculation:
* Visit 1: $100 deductible (first injury).
* Visit 2: $100 deductible (second injury).
* Visit 3: $100 deductible (third injury).
* Total: $100 × 3 = $300.
If all visits were for the same injury, only one $100 deductible would apply, but the question implies separate causes to reach the minimum of $300.
* Option A: Incorrect. $100 assumes one deductible for a single cause, not three visits.
* Option B: Incorrect. $200 does not account for three separate deductibles.
* Option C: Correct. $300 reflects a $100 deductible for each of three separate injuries.
* Option D: Incorrect. $500 exceeds the minimum, possibly including coinsurance not specified.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Accident and Health Insurance).
Oklahoma Insurance Department, Title 36 O.S. § 6060.3 (health insurance policy provisions).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

 

問題 #159
An insurance producer sells fake policies and gambles the premium payments at a casino. Which entity would not be involved in the investigation?

• A. Oklahoma Attorney General
• B. Securities Exchange Commission
• C. Oklahoma Insurance Department Anti-Fraud Unit
• D. Oklahoma State Bureau of Investigation

答案：B

解題說明：
Selling fake insurance policies and misappropriating premiums is a fraudulent act under Oklahoma's Insurance Code (Title 36 O.S. § 1204, § 1435.13), classified as a felony. TheOklahoma Insurance Department Anti-Fraud Unitinvestigates insurance fraud, theOklahoma State Bureau of Investigation handles criminal investigations, and theOklahoma Attorney Generalmay prosecute or oversee legal actions.
TheSecurities Exchange Commission (SEC)regulates securities markets, not insurance fraud, unless securities are involved (which is not indicated here).
* Option A: Incorrect. The Attorney General may be involved in prosecution.
* Option B: Incorrect. The State Bureau of Investigation handles criminal fraud cases.
* Option C: Incorrect. The Anti-Fraud Unit directly investigates insurance fraud.
* Option D: Correct. The SEC is not typically involved in insurance fraud investigations.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: State- Specific Knowledge - Oklahoma Insurance Statutes).
Oklahoma Insurance Department, Title 36 O.S. § 1204, § 1435.13 (fraud and penalties).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

 

問題 #160
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