Tennessee Life & Health Insurance License, Practice Exams

An accident-only policy provides benefits for:

1. Losses resulting from accidents, but not from sickness ✓
2. Both accidental injuries and any illness the insured develops
3. Routine preventive care and annual wellness checkups only
4. Long-term custodial nursing-home care after an accident

Why: Accident-only coverage is limited to losses caused by accidental injury; sickness is excluded, making it a limited (supplemental) policy.

A state Long-Term Care Partnership program allows a policyholder to:

1. Protect an amount of assets equal to the benefits the policy paid, if they later need Medicaid ✓
2. Buy long-term care coverage with no medical underwriting whatsoever, at any age the applicant chooses
3. Receive double benefits from both the insurer and the state at once
4. Avoid ever having to pay any long-term care premiums

Why: Partnership policies let insureds shelter assets equal to the LTC benefits paid when qualifying for Medicaid, encouraging private LTC coverage.

Under T.C.A. § 56-6-125, a producer who charges a permitted service fee under a written agreement must retain a copy of that agreement for at least:

1. one (1) year
2. two (2) years
3. three (3) years ✓
4. five (5) years

Why: T.C.A. § 56-6-125(a)(3) requires the producer to retain a copy of the agreement for not less than three years after completion of services — therefore three (3) years.

Nonoccupational disability coverage pays benefits for disabilities that occur:

1. Off the job (work-related injuries are covered by workers' compensation) ✓
2. Only while the insured is actively performing job duties at work
3. At any time, on or off the job, with no other coverage needed
4. Solely from illnesses, never from any type of accidental injury

Why: Nonoccupational coverage excludes on-the-job injuries (covered by workers' compensation); occupational/24-hour coverage applies both on and off the job.

Under T.C.A. § 56-8-104, knowingly making a false entry of a material fact in an insurer's books or reports is prohibited as:

1. Misrepresentation in applications
2. Unfair discrimination in records
3. Failure to maintain records
4. False statements and entries ✓

Why: T.C.A. § 56-8-104(5) prohibits knowingly making a false entry of a material fact, or omitting a true entry, in an insurer's book, report, or statement — therefore false statements and entries.

A long-term care policy has been in force for three years when the insurer discovers a misstatement. Under T.C.A. § 56-42-107, the insurer may contest the policy only upon a showing that the insured:

1. knowingly and intentionally misrepresented health facts ✓
2. made any material misrepresentation on the application
3. failed a routine post-issue medical examination
4. omitted a condition later requiring treatment

Why: T.C.A. § 56-42-107(c) provides that after two years the policy is contestable only upon a showing that the insured knowingly and intentionally misrepresented relevant health facts — therefore knowingly and intentionally misrepresented health facts.

A Tennessee resident turns 65 next month and will enroll in Medicare Part B at that time. Under TN Rule 0780-1-58, her six-month Medicare supplement open enrollment period begins:

1. only after she has held Part B for one full year
2. when she first enrolls in Medicare Part A alone
3. the first month she is both 65 and enrolled in Part B ✓
4. when she is first offered a Medicare Advantage plan

Why: TN Rule 0780-1-58 starts the open enrollment period the first month the individual is both 65 or older and enrolled in Part B — therefore the first month she is both 65 and enrolled in Part B.

A client deposits a single $100,000 premium and wants income to start in 15 years. The product is a:

1. Single-premium deferred annuity ✓
2. Single-premium immediate annuity
3. Flexible-premium deferred annuity
4. Variable life insurance policy

Why: One lump sum with income deferred to a future date is a single-premium deferred annuity (SPDA).

Three children are named beneficiaries 'per stirpes.' One child predeceases the insured, leaving two children of their own. At the insured's death, the deceased child's share passes to:

1. That deceased child's own two children ✓
2. The two surviving named children equally
3. The policyowner's estate for probate
4. The insurer as an unclaimed amount

Why: Per stirpes directs a deceased beneficiary's share down to that person's descendants — here, the deceased child's two children.

Standardized Medicare Supplement (Medigap) plans are labeled:

1. With letters such as A through N ✓
2. With numbers 1 through 10
3. By the insurer's own brand names
4. By the beneficiary's state of residence

Why: Medigap plans are standardized by letter (A–N in most states); the same letter offers the same core benefits across insurers.

An insured under a Tennessee A&H policy changes to a more hazardous occupation, then is injured. Under T.C.A. § 56-26-109, the insurer will pay...?

1. the full indemnity amount stated in the policy schedule
2. nothing at all, because the risk changed
3. double indemnity for the greater hazard
4. what the premium would buy at the more hazardous rates ✓

Why: T.C.A. § 56-26-109(1) reduces payment to the portion the premium paid would have purchased at the rates for the more hazardous occupation — therefore what the premium would buy at the more hazardous rates.

Under T.C.A. § 56-7-1002, a health insurance entity must reimburse for telehealth services without regard to:

1. the medical necessity of the service
2. the geographic location of the patient ✓
3. the licensure of the treating provider
4. the terms of the health insurance contract

Why: T.C.A. § 56-7-1002 requires reimbursement without distinction as to the geographic location of the patient or any geographic designation — therefore the geographic location of the patient.

Under T.C.A. § 56-1-102, the term "foreign," when used without limitation, includes all companies formed by the authority of:

1. Tennessee under a special charter
2. Any other state or government ✓
3. A federal agency only
4. A recognized foreign nation only

Why: T.C.A. § 56-1-102(5) defines "foreign," used without limitation, as all companies formed by the authority of any other state or government — therefore that answer is correct.

In a health maintenance organization (HMO), the primary care physician acts as a 'gatekeeper,' meaning the member usually must:

1. Get a referral before seeing a specialist ✓
2. Pay the full cost of every visit out of pocket first
3. Choose a new physician each calendar year automatically
4. Submit all claims directly to the state insurance department

Why: In a gatekeeper HMO, the PCP coordinates care and must refer the member before specialist services are covered.

A 'change of plan' provision in a life policy lets the owner:

1. Exchange the policy for a different plan of insurance ✓
2. Change the insured named in the contract
3. Receive the death benefit while still living
4. Skip premiums during financial hardship

Why: A change-of-plan provision permits converting to another policy plan (e.g., term to whole life), with premium and possibly evidence adjustments.

Under T.C.A. § 56-1-109, when a license suspended for a student loan default is reinstated, the licensing authority may not impose a reinstatement fee exceeding what amount?

1. Twenty-five dollars ($25.00)
2. Fifty dollars ($50.00) ✓
3. One hundred dollars ($100.00)
4. Two hundred dollars ($200.00)

Why: T.C.A. § 56-1-109(c) provides that upon reinstatement the licensing authority shall not impose a reinstatement fee that exceeds fifty dollars ($50.00) — therefore that answer is correct.

Under T.C.A. § 56-6-111, a temporary producer license may be issued to the designee of a licensed producer in which situation?

1. The producer enters active service in the U.S. armed forces ✓
2. The producer takes an extended overseas vacation
3. The producer transfers to a different agency
4. The producer temporarily reduces working hours

Why: T.C.A. § 56-6-111(a)(3) authorizes a temporary license to the designee of a licensed producer entering active service in the armed forces of the United States — therefore that answer is correct.

Under the uniform 'proof of loss' provision, written proof must generally be furnished within:

1. 90 days after the loss (or as soon as reasonably possible) ✓
2. 24 hours of the insured first noticing any symptom
3. 3 years from the date the policy was originally issued
4. 30 days before the loss is expected to occur

Why: Proof of loss is due within 90 days of the loss, or as soon as reasonably possible, but not later than one year except in cases of legal incapacity.

Under T.C.A. § 56-12-201, the statutory short title of the part is the Tennessee Life and Health Insurance:

1. Solvency Guaranty Fund Act
2. Guaranty Association Act ✓
3. Policyholder Protection Act
4. Insurer Rehabilitation Act

Why: T.C.A. § 56-12-201 states the part may be cited as the Tennessee Life and Health Insurance Guaranty Association Act — therefore Guaranty Association Act.

A new employee becomes eligible and applies for coverage under an existing Tennessee group accident and sickness policy. Under T.C.A. § 56-26-202, the policy must contain a provision that such newly eligible persons are:

1. added to the insured group from time to time ✓
2. covered only at the next annual renewal date
3. subject to a mandatory twelve-month waiting period
4. insured only if the total group size increases

Why: T.C.A. § 56-26-202 requires a provision that persons newly eligible for and applying for coverage be added to the group from time to time — therefore added to the insured group from time to time.

A Medicare beneficiary wants a lower Medigap premium and is willing to use a provider network. The product is:

1. Medicare SELECT ✓
2. A Medicare Advantage HMO
3. Medicaid
4. A high-deductible health plan

Why: Medicare SELECT is a Medigap policy that uses a network of providers in exchange for a lower premium.

A '20-pay whole life' policy:

1. Provides level coverage for exactly twenty years, then terminates
2. Is paid up after twenty years of premiums but covers the insured for life ✓
3. Requires premium payments every year for the insured's entire lifetime
4. Builds no cash value at all because the premium period ends early

Why: Limited-pay whole life concentrates premiums into a set period (here 20 years) while coverage lasts for life.

Survivorship (second-to-die) life insurance is most commonly used to:

1. Provide estate liquidity after the second insured dies ✓
2. Replace the income of a sole wage earner who has several young children at home
3. Cover a short-term business loan that must be fully repaid within five years
4. Fund a child's future college costs through the policy's accumulated cash value

Why: It pays at the second death and is widely used to fund estate taxes and costs.

Under T.C.A. § 56-61-116, an aggrieved person must file a request for external review within what period after receiving the notice of adverse or final adverse determination?

1. thirty (30) days
2. sixty (60) days
3. one (1) year
4. six (6) months ✓

Why: T.C.A. § 56-61-116(a) allows the person to file within six months after receipt of the notice of adverse or final adverse determination — therefore six (6) months.

Under the Medicare supplement standards adopted in TN Rule 0780-1-58, the benefit plans that insurers may offer are:

1. individually designed by each insurer
2. negotiated separately with each applicant
3. standardized into uniform benefit plans ✓
4. limited to a single mandatory plan

Why: TN Rule 0780-1-58 adopts standardized Medicare supplement benefit plans so consumers can compare identical plan designs across insurers — therefore standardized into uniform benefit plans.

Under T.C.A. § 56-7-2307, an individual life insurance policy must provide a grace for the payment of every premium after the first year of...?

1. one (1) month ✓
2. forty-five (45) days
3. two (2) months
4. fifteen (15) days

Why: T.C.A. § 56-7-2307(2) requires a grace of one month for every premium after the first year, during which the insurance continues in force — therefore one (1) month.

Under TN Rule 0780-1-40, a life insurance purchaser must be provided which two disclosure documents?

1. an annuity disclosure and a suitability form
2. a replacement notice and a claim form
3. a HIPAA notice and an outline of coverage
4. a Buyer's Guide and a Policy Summary ✓

Why: TN Rule 0780-1-40 (Life Insurance Solicitation) requires that purchasers receive a Buyer's Guide and a Policy Summary — therefore a Buyer's Guide and a Policy Summary.