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Insurance Licensing Oklahoma Life, Accident, and Health or Sickness Producer Exam Sample Questions (Q26-Q31):

NEW QUESTION # 26
Both husband and wife have group health insurance through their employers. Each spouse is covered under both policies. Under the coordination of benefits provision, how will the benefits be paid if the wife incurs a
$400 covered loss?

A. Only the primary insurer will pay expenses toward the loss under the limits of the plan.
B. The husband's insurer will pay as much of the claim as the policy permits, then the wife's insurer will pay the remainder.
C. Only the wife's insurer will pay expenses toward the loss.
D. The primary insurer will pay as much of the claim as the policy permits, then the secondary insurer will pay the remainder of the claim as its policy permits.

Answer: D

Explanation:
Thecoordination of benefits (COB)provision, as regulated in Oklahoma (O.A.C. 365:10-5-4), prevents overinsurance when an individual is covered by multiple health plans. For spouses, theprimary insureris typically the wife's employer plan for her claims, as it covers her as an employee. Thesecondary insurer(the husband's plan) pays any remaining covered expenses up to its policy limits, ensuring the total payment does not exceed the loss.
* Option A: Incorrect. Both insurers may pay under COB, not just the wife's insurer.
* Option B: Incorrect. The secondary insurer may also pay if the primary does not cover the full loss.
* Option C: Correct. The primary insurer (wife's plan) pays first, and the secondary insurer (husband's plan) pays the remainder, per COB rules.
* Option D: Incorrect. The husband's insurer is secondary, not primary, for the wife's claim.
This question aligns with the Prometric content outline under "Provisions, Options, Exclusions, Riders, Clauses, and Rights," which covers coordination of benefits.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Accident and Health Insurance).
Oklahoma Insurance Department, O.A.C. 365:10-5-4 (coordination of benefits).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

NEW QUESTION # 27
Insurers do business in Oklahoma only after a thorough financial review. Insurance policies written in Oklahoma, that are protected by the Guaranty Association, protect policyowners in the event an admitted company

A. merges with a foreign insurer.
B. depletes its loss reserves.
C. becomes financially insolvent.
D. cannot meet its capital surplus requirements.

Answer: C

Explanation:
TheOklahoma Life and Health Insurance Guaranty Association, established under Title 36 O.S. § 2025 et seq., protects policyowners of admitted insurers in Oklahoma if the insurer becomesfinancially insolvent.
The association provides coverage up to statutory limits (e.g., $300,000 for life insurance death benefits,
$100,000 for cash value) to ensure policyholders receive benefits despite the insurer's insolvency.
* Option A: Incorrect. A merger with a foreign insurer does not trigger Guaranty Association protection unless it leads to insolvency.
* Option B: Correct. The Guaranty Association protects policyowners when an admitted insurer becomes financially insolvent.
* Option C: Incorrect. Failure to meet capital surplus requirements may lead to regulatory action but does not directly trigger Guaranty Association coverage.
* Option D: Incorrect. Depleting loss reserves is a financial issue but not the specific condition for Guaranty Association intervention, which requires insolvency.
This question falls under the Prometric content outline section on "State Insurance Statutes, Rules, and Regulations," which includes knowledge of the Guaranty Association.
:
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. § 2025 et seq. (Life and Health Insurance Guaranty Association Act).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

NEW QUESTION # 28
In a term life insurance policy, premiums may be increased at the renewal of the policy. Prior to renewal, the premiums would be considered

A. convertible.
B. adjustable.
C. variable.
D. level.

Answer: D

Explanation:
In aterm life insurance policy, premiums are typicallylevelduring the policy term (e.g., 10, 20 years), meaning they remain constant. At renewal, premiums may increase based on the insured's attained age, but during the initial term, they are fixed, as outlined in Oklahoma's life insurance regulations (Title 36 O.S. §
4002).
* Option A: Incorrect. Convertible refers to a policy's ability to convert to permanent insurance, not premium structure.
* Option B: Correct. Premiums are level during the term prior to renewal.
* Option C: Incorrect. Variable premiums apply to certain flexible policies like universal life, not term.
* Option D: Incorrect. Adjustable premiums are not a standard term for level term policies.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Life Insurance).
Oklahoma Insurance Department, Title 36 O.S. § 4002 (life insurance products).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

NEW QUESTION # 29
Which of the following BEST describes a waiver of premium clause in a typical disability policy?

A. The monthly benefit under the policy is reduced to offset the premium that is no longer being paid.
B. The waiver of premium benefit pays the policy premium during a disability claim.
C. This clause generally begins immediately with the doctor stating that the insured person is completely disabled.
D. This clause eliminates any premium being paid for the lifetime of the insured individual.

Answer: B

Explanation:
Thewaiver of premium clausein a disability income policy waives the policy's premiums during a disability claim, ensuring the policy remains in force without the insured having to pay premiums while disabled. This typically begins after the elimination period, as outlined in Oklahoma's health insurance provisions (Title 36
O.S. § 4405).
* Option A: Correct. The waiver of premium pays the policy premium during a disability claim.
* Option B: Incorrect. Premiums are waived only during disability, not for the insured's lifetime.
* Option C: Incorrect. Monthly benefits are not reduced to offset waived premiums.
* Option D: Incorrect. The waiver begins after the elimination period, not immediately upon a doctor's statement.
:
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. § 4405 (health insurance provisions).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

NEW QUESTION # 30
Term life insurance differs from permanent life insurance in that MOST often, term life insurance

A. remains in force for a specific period of time.
B. accumulates a much smaller cash value.
C. has a longer premium payment period.
D. is automatically renewable at the end of the term period.

Answer: A

Explanation:
Term life insuranceprovides coverage for a specific period (e.g., 10, 20 years) and does not accumulate cash value, unlikepermanent life insurance(e.g., whole life), which provides lifelong coverage with cash value.
Term policies may be renewable, but this is not automatic unless specified, and premium payment periods are shorter than permanent policies (Title 36 O.S. § 4002).
* Option A: Incorrect. Term life accumulates no cash value, not a smaller amount.
* Option B: Incorrect. Term life has a shorter premium payment period than permanent life.
* Option C: Correct. Term life remains in force for a specific period, unlike lifelong permanent coverage.
* Option D: Incorrect. Renewal is not automatic; it depends on the policy's terms.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Life Insurance).
Oklahoma Insurance Department, Title 36 O.S. § 4002 (life insurance products).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.

NEW QUESTION # 31
......

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