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Valid CA-Life-Accident-and-Health Real Test - Valid CA-Life-Accident-and-Health Guide Files

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California Department of Insurance CA Life, Accident and Health or Sickness Examination Sample Questions (Q58-Q63):

NEW QUESTION # 58
A contract in which one party promises to indemnify another against loss that arises from an unknown event is

A. a retrocession agreement.
B. a hold-harmless agreement.
C. an insurance policy.
D. a restoration policy.

Answer: C

Explanation:
Definition:An insurance policy is a contract in which one party (the insurer) promises to indemnify another party (the insured) against loss that arises from an unknown event, providing financial protection against specified risks.
Other Terms:Restoration policy (B), retrocession agreement (C), and hold-harmless agreement (D) refer to different types of agreements not specifically defined as insurance policies.
Reference:The definition aligns with standard insurance terminology and is supported by the California Department of Insurance documentation.

NEW QUESTION # 59
A health insurance issuer offering coverage in the individual market must provide premium rebates if its medical loss ratio (MLR) is less than what percentage?

A. 85%
B. 70%
C. 80%
D. 75%

Answer: C

Explanation:
Medical Loss Ratio (MLR): The MLR is a measure of the percentage of premium revenues that an insurance company spends on clinical services and quality improvement.
Requirement for Individual Market: Health insurance issuers in the individual market must have an MLR of at least 80%. This means at least 80% of premiums must be spent on healthcare claims and quality improvement.
Premium Rebates: If an insurer fails to meet the 80% MLR, they must provide rebates to policyholders.
References: California Insurance Code Section 10112.25 and the Affordable Care Act regulations require insurers to meet specific MLR standards and issue rebates if these standardsare not met.

NEW QUESTION # 60
A contract in which only one party to the contract is legally bound to do anything is

A. aleatory.
B. personal.
C. conditional.
D. unilateral.

Answer: D

Explanation:
* Definition: A unilateral contract is one where only one party makes a legally enforceable promise.
* Mechanism: In a unilateral contract, the other party is not obligated to act, but if they do, the promisor is bound to fulfill their promise.
* Example: Insurance policies are classic examples of unilateral contracts. The insurer promises to pay benefits in the event of a covered loss, but the policyholder is not obligated to file a claim.
* Characteristics: These contracts differ from bilateral contracts, where both parties exchange mutual promises.
* Regulations: California insurance law recognizes unilateral contracts as valid and enforceable, provided they meet all other legal contract requirements.
References:
* California Department of Insurance contract law guidelines.
* Legal definitions and examples of unilateral contracts.

NEW QUESTION # 61
People commonly purchase an annuity to protect against the risk of

A. dying before their home mortgage is paid off.
B. becoming uninsurable.
C. dying too soon.
D. outliving their financial resources.

Answer: D

Explanation:
Purpose of Annuities: Annuities are financial products that provide a stream of payments to the purchaser, typically after retirement.
Risk Protection: The primary risk addressed by annuities is longevity risk, or the risk of outliving one's financial resources.
Financial Security: By providing guaranteed income for life or a specified period, annuities help ensure that individuals do not run out of money in retirement.References: California Insurance Code Section 10170.3 defines annuities and the risks they are designed to mitigate.

NEW QUESTION # 62
All of the following are optional group medical coverages EXCEPT

A. vision.
B. prescription drug.
C. maternity.
D. dental.

Answer: C

Explanation:
In group medical coverages, optional coverages are those that can be added to the basic health plan at the employer's or employee's discretion. Dental, prescription drug, and vision coverages are typically considered optional benefits that can be selected in addition to the basic health plan. Maternity coverage, however, is often included as a mandatory benefit in group health insurance policies due to regulations and requirements for comprehensive coverage, particularly under the Affordable Care Act (ACA).References: California Department of Insurance guidelines on group health insurance benefits and ACA requirements.

NEW QUESTION # 63
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