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Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Sample Questions (Q35-Q40):

NEW QUESTION # 35
Renewal of small employer health insurance plans may be denied for all of the following reasons EXCEPT:

A. Overuse of physician and hospital services
B. Having less than the required number of participants
C. Nonpayment of premiums
D. Fraud by the employer

Answer: A

Explanation:
Virginia Code § 38.2-3432.1, aligned with the Affordable Care Act (ACA), mandates guaranteed renewability for small employer health plans (1-50 employees in Virginia). Insurers can deny renewal for nonpayment of premiums (option A), insufficient participants (option B, e.g., falling below one eligible employee), or fraud (option D), per Virginia Code § 38.2-3407. However, option C-overuse of services (high claims)-a-is not a permissible reason for denial, as renewability cannot be based on claims experience or health status. The study guide emphasizes this protection under Virginia's small group market rules, making C the exception.

NEW QUESTION # 36
What kind of rider may be added to an individual disability income insurance policy to increase benefits during periods of price inflation?

A. Cost of living
B. Inflation guard
C. Wage protection
D. Price escalation

Answer: A

Explanation:
Detailed Answer in Step-by-Step Solution:
* A cost of living (COLA) rider (B) adjusts disability income benefits to account for inflation, maintaining purchasing power.
* Inflation guard (A) is more common in property insurance. Price escalation (C) and wage protection (D) are not standard disability riders.
The Virginia study guide describes the COLA rider as an optional feature in disability income policies, increasing benefits based on inflation indices like the CPI. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Disability Insurance Riders."

NEW QUESTION # 37
All of the following are underwriting criteria for individual life insurance EXCEPT:

A. Ability to pay premiums
B. Gender
C. Occupation
D. Religion

Answer: D

Explanation:
Virginia Code § 38.2-3107 governs life insurance underwriting, where insurers assess risk using factors like gender (option A, affecting mortality rates), occupation (option C, e.g., hazardous jobs increase risk), and ability to pay premiums (option D, ensuring policy sustainability). Option B (religion) is not a permissible criterion; Virginia Code § 38.2-211 prohibits unfair discrimination in insurance based on religion, race, or other protected traits, reflecting federal and state anti-discrimination laws. The study guide likely explains underwriting with examples-e.g., higher premiums for a male firefighter-but flags religion as an illegal factor, with case studies of compliance, making B the exception.

NEW QUESTION # 38
To be complete, an application for health insurance must contain all of the following EXCEPT:

A. Applicant's signature
B. Applicant's name and address
C. Initial premium
D. Date of application

Answer: C

Explanation:
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.

NEW QUESTION # 39
Under the notice of claim provision, notice given to a health insurance company's agent is:

A. An incomplete preliminary notice of claim
B. Notice to the company
C. Not valid notice to the company
D. Contrary to the uniform mandatory provisions

Answer: B

Explanation:
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, andHealth Insurance study guide, section on "Health Insurance Claims Provisions."

NEW QUESTION # 40
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