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Free ID Accident & Health or Sickness Producer Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the ID Accident & Health or Sickness Producer practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1A self-employed consultant wants a policy that will replace part of her personal earnings if illness prevents her from working. Which coverage fits that need?

    1. A. Individual disability income policy
    2. B. Business overhead expense policy
    3. C. Key employee disability policy
    4. D. Hospital confinement indemnity policy

    Answer: A

    Explanation: Idaho's insurance department says, "Disability Insurance provides income to the policyholder when the policyholder is prevented from working and earning an income due to sickness or injury." The consultant needs her own lost income replaced. Overhead covers operating costs, key employee coverage pays a business, and hospital indemnity pays for confinement rather than lost earnings.

    Reference: Idaho Department of Insurance — Disability Insurance — Disability Insurance, opening paragraph

  2. 2An Idaho disability policy has been reinstated after lapse. Under the standard reinstatement provision, what minimum delay applies before a newly beginning sickness can produce a covered loss?

    1. A. No delay; sickness may begin on the reinstatement date.
    2. B. Seven days; sickness may begin after that interval.
    3. C. Ten days; sickness must begin more than ten days afterward.
    4. D. Thirty days; sickness must begin after that interval.

    Answer: C

    Explanation: Idaho Code § 41-2108 states that a reinstated policy covers sickness loss only if the sickness "may begin more than ten (10) days after such date." The applicable boundary is more than ten days after reinstatement. The longer interval is more restrictive than the statutory minimum; zero or seven is too short.

    Reference: Idaho Code § 41-2108 — Idaho Code § 41-2108(1), Reinstatement

  3. 3A Medicare enrollee asks for an approved private plan that bundles Part A and Part B benefits and usually drug coverage. Which option matches that description?

    1. A. Original Medicare with a separate Medigap policy.
    2. B. Medicare Advantage, also known as Part C.
    3. C. A standalone Medicare Part D drug plan.
    4. D. A Medicaid plan combined with Medicare savings.

    Answer: B

    Explanation: Medicare.gov explains that Medicare Advantage is an approved private health plan and that "These “bundled” plans include Part A, Part B, and usually Part D." Part C is the bundled pathway. Original Medicare with Medigap, standalone Part D, and Medicaid do not themselves provide that Part C bundle.

    Reference: Medicare.gov — Parts of Medicare — Parts of Medicare, Medicare Advantage (Part C)

  4. 4A Medicare beneficiary has another health plan, and coordination rules identify that plan as primary for a covered claim. What does primary status determine?

    1. A. It pays the claim first, before a secondary payer considers any remaining liability.
    2. B. It pays after Medicare has made its primary payment on the claim.
    3. C. It pays only covered cost sharing left after Medicare adjudicates the claim.
    4. D. It pays only after another insurer has exhausted its policy benefits.

    Answer: A

    Explanation: CMS says coordination of benefits ensures "the primary payer, whether Medicare or other insurance, pays first." Primary status establishes the first payment responsibility. The other statements describe secondary, supplemental, or excess payment, which occurs after a different payer has acted.

    Reference: CMS — Coordination of Benefits — Coordination of Benefits, The COB Process

  5. 5A producer entered an adult client's answers on Idaho's individual health application. Under the form's affirmation, who must review all answers and verify that they are true and complete?

    1. A. The adult applicant who will sign the individual application.
    2. B. The independent producer who entered the applicant's answers.
    3. C. The carrier underwriter who will evaluate the individual application.
    4. D. The employer benefits officer who handles group enrollment.

    Answer: A

    Explanation: Idaho's application says, "I affirm that I have reviewed all answers given on this application" and adds that this remains true regardless of whether an independent producer or other person filled them out. The signing adult applicant makes this verification; the producer's transcription, carrier underwriting, or group administrator's role does not replace it.

    Reference: Idaho Department of Insurance — Idaho Universal Individual Application — Idaho Universal Individual Application, affirmation, page 3

  6. 6Who appoints the Director of the Idaho Department of Insurance?

    1. A. The Governor
    2. B. The Secretary of State
    3. C. The state Senate
    4. D. The Attorney General

    Answer: A

    Explanation: Idaho Code § 41-202 states, "The director shall be appointed by the governor." The Senate is not named as the appointing authority.

    Reference: Accident and Health or Sickness (Disability/Health Producer) Exam Content Outline — Idaho Code § 41-202(2)

  7. 7When an Idaho creditor requires credit disability insurance as security, what option must the debtor receive?

    1. A. Use existing coverage or obtain coverage from any authorized insurer
    2. B. Buy coverage only from the creditor's affiliated insurer
    3. C. Replace every existing disability policy
    4. D. Waive all rights to a premium refund

    Answer: A

    Explanation: IDAPA 18.03.05.011 requires the debtor be allowed to furnish insurance through existing policies or "through any insurer authorized to transact insurance business in this state."

    Reference: 180305 — IDAPA 18.03.05.011.02

  8. 8What is a stated purpose of Idaho's individual disability policy minimum-standards law?

    1. A. Facilitate public understanding and comparison of coverage
    2. B. Set producer appointment fees
    3. C. Establish insurer capital stock
    4. D. Create criminal sentencing guidelines

    Answer: A

    Explanation: Idaho Code § 41-4201 says the act provides standardization and simplification "to facilitate public understanding and comparison" and full disclosure.

    Reference: Section 41-4201 – Idaho State Legislature — Idaho Code § 41-4201

  9. 9An owner expects to be unable to work for months and wants insurance to keep the firm's rent, utilities, and payroll paid during that disability. Which coverage addresses those expenses?

    1. A. Individual disability income coverage
    2. B. Business overhead expense coverage
    3. C. Key employee disability coverage
    4. D. Hospital confinement indemnity coverage

    Answer: B

    Explanation: NAIC explains that a business overhead provision "covers standard business expenses such as payroll, utilities, rent, etc., while the business owner recovers from a disability." The goal is payment of firm expenses, not replacement of the owner's personal earnings or an employee's value to the firm.

    Reference: NAIC — Small Business Insurance — Disability Insurance, business overhead paragraph

  10. 10A covered loss occurs under an Idaho individual disability policy, and prompt notice is reasonably possible. What is the latest ordinary deadline to give written notice of claim to the insurer?

    1. A. Within 10 days after the covered loss begins.
    2. B. Within 15 days after the covered loss begins.
    3. C. Within 20 days after the covered loss begins.
    4. D. Within 90 days after the covered loss begins.

    Answer: C

    Explanation: Idaho Code § 41-2109 requires "Written notice of claim ... within twenty days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible." Because prompt notice is possible here, twenty days is the latest ordinary deadline; earlier notices also comply but do not state that boundary.

    Reference: Idaho Code § 41-2109 — Idaho Code § 41-2109(1), Notice of Claim

Topics in this practice bank

These topics describe the available practice for ID Accident & Health or Sickness Producer. Review the examination outline and its sources for scope and allocation details.

  • General Knowledge — I. Types of Policies
    • A. Disability income
    • A. Disability income / 1. Individual disability income policy
    • A. Disability income / 2. Business overhead expense policy
    • A. Disability income / 3. Business disability buyout policy
    • A. Disability income / 4. Group disability income policy
    • A. Disability income / 5. Key employee policy
    • B. Accidental death and dismemberment
    • C. Medical expense insurance
    • C. Medical expense insurance / 1. Basic hospital, medical, and surgical policies
    • C. Medical expense insurance / 2. Major medical policies
    • C. Medical expense insurance / 3. Health Maintenance Organizations (HMOs)
    • C. Medical expense insurance / 4. Preferred Provider Organizations (PPOs)
    • C. Medical expense insurance / 5. Point of Service (POS) plans
    • C. Medical expense insurance / 6. Flexible Spending Accounts (FSAs)
    • C. Medical expense insurance / 7. High Deductible Health Plans (HDHPs) and related Health Savings Accounts (HSAs)
    • C. Medical expense insurance / 8. Health Reimbursement Accounts (HRAs)
    • D. Medicare supplement policies
    • E. Group insurance
    • E. Group insurance / 1. Differences between individual and group contracts
    • E. Group insurance / 2. General characteristics
    • E. Group insurance / 3. COBRA
    • F. Individual/Group Long Term Care (LTC)
    • F. Individual/Group Long Term Care (LTC) / 1. Eligibility
    • F. Individual/Group Long Term Care (LTC) / 2. Levels of care
    • G. Other policies
    • G. Other policies / 1. Dental
    • G. Other policies / 2. Vision
    • G. Other policies / 3. Cancer
    • G. Other policies / 4. Critical illness or specified disease
    • G. Other policies / 5. Worksite (employer-sponsored)
    • G. Other policies / 6. Hospital indemnity
    • G. Other policies / 7. Short-term medical
    • G. Other policies / 8. Accident
  • General Knowledge — II. Policy Provisions, Clauses, and Riders
    • A. Mandatory and optional provisions
    • A. Mandatory and optional provisions / 1. Entire contract
    • A. Mandatory and optional provisions / 2. Time limit on certain defenses (incontestable)
    • A. Mandatory and optional provisions / 3. Grace period
    • A. Mandatory and optional provisions / 4. Reinstatement
    • A. Mandatory and optional provisions / 5. Notice of claim
    • A. Mandatory and optional provisions / 6. Claim forms
    • A. Mandatory and optional provisions / 7. Proof of loss
    • A. Mandatory and optional provisions / 8. Time of payment of claims
    • A. Mandatory and optional provisions / 9. Payment of claims
    • A. Mandatory and optional provisions / 10. Physical examination and autopsy
    • A. Mandatory and optional provisions / 11. Legal actions
    • A. Mandatory and optional provisions / 12. Change of beneficiary
    • A. Mandatory and optional provisions / 13. Misstatement of age or gender
    • A. Mandatory and optional provisions / 14. Change of occupation
    • A. Mandatory and optional provisions / 15. Illegal occupation
    • A. Mandatory and optional provisions / 16. Relation of earnings to insurance
    • B. Other provisions and clauses
    • B. Other provisions and clauses / 1. Insuring clause
    • B. Other provisions and clauses / 2. Free look
    • B. Other provisions and clauses / 3. Consideration clause
    • B. Other provisions and clauses / 4. Probationary period
    • B. Other provisions and clauses / 5. Elimination period
    • B. Other provisions and clauses / 6. Waiver of premium
    • B. Other provisions and clauses / 7. Exclusions and limitations
    • B. Other provisions and clauses / 8. Preexisting conditions
    • B. Other provisions and clauses / 9. Coinsurance
    • B. Other provisions and clauses / 10. Deductibles
    • B. Other provisions and clauses / 11. Eligible expenses
    • B. Other provisions and clauses / 12. Copayments
    • B. Other provisions and clauses / 13. Pre-authorizations and prior approval requirements
    • B. Other provisions and clauses / 14. Usual, reasonable, and customary (URC) charges
    • B. Other provisions and clauses / 15. Lifetime, annual, or per cause maximum benefit limits
    • C. Riders
    • C. Riders / 1. Impairment/exclusions
    • C. Riders / 2. Guaranteed insurability
    • C. Riders / 3. Future increase option
    • D. Rights of renewability
    • D. Rights of renewability / 1. Noncancelable
    • D. Rights of renewability / 2. Cancelable
    • D. Rights of renewability / 3. Guaranteed renewable
  • General Knowledge — III. Social Insurance
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • General Knowledge — IV. Other Insurance Concepts
    • A. Total, partial, recurrent and residual disability
    • B. Owner’s rights
    • C. Dependent children benefits
    • D. Primary and contingent beneficiaries
    • E. Modes of premium payments
    • F. Nonduplication and coordination of benefits (e.g., primary vs. excess)
    • G. Occupational vs. non-occupational
    • H. Tax treatment of premiums and proceeds of insurance contracts (e.g., disability income and medical expenses, etc.)
    • I. Managed care
    • J. Workers Compensation
    • J. Workers Compensation / 1. Impact on health insurance benefits
    • K. Subrogation
    • L. Cost containment
  • General Knowledge — V. Field Underwriting Procedures
    • A. Completing the application
    • B. Explaining sources of insurability and HIPAA privacy information (e.g., MIB Report, Fair Credit Reporting Act, etc.)
    • C. Initial premium payment and receipt and consequences of the receipt (e.g., medical examination, etc.)
    • D. Submitting application (and initial premium if collected) to company for underwriting
    • E. Policy delivery
    • F. Explaining policy and its provisions, riders, exclusions, and ratings to clients
    • G. Replacement
    • H. Contract law
    • H. Contract law / 1. Elements of a contract
    • H. Contract law / 2. Insurable interest
    • H. Contract law / 3. Warranties and representations
    • H. Contract law / 4. Unique aspects of the insurance contract
    • H. Contract law / 4. Unique aspects of the insurance contract / a. Conditional
    • H. Contract law / 4. Unique aspects of the insurance contract / b. Unilateral
    • H. Contract law / 4. Unique aspects of the insurance contract / c. Adhesion
    • H. Contract law / 4. Unique aspects of the insurance contract / d. Aleatory
  • Idaho Specific Health — I. Idaho Statutes, Rules, and Regulations Common to Life, Health/Disability, Property, Casualty, and Personal Lines Insurance
    • A. Responsibilities of the Director of the Department of Insurance
    • A. Responsibilities of the Director of the Department of Insurance / 1. Appointment
    • A. Responsibilities of the Director of the Department of Insurance / 2. General duties and powers
    • A. Responsibilities of the Director of the Department of Insurance / 3. Examinations
    • A. Responsibilities of the Director of the Department of Insurance / 4. Hearings/notice of hearings/orders
    • A. Responsibilities of the Director of the Department of Insurance / 5. Penalties
    • B. Definitions
    • B. Definitions / 1. Domestic company
    • B. Definitions / 2. Foreign company
    • B. Definitions / 3. Alien company
    • B. Definitions / 4. Authorized and unauthorized companies/admitted and nonadmitted companies
    • B. Definitions / 5. Stock and mutual companies and reciprocals
    • B. Definitions / 6. Certificate of authority
    • B. Definitions / 7. Transacting insurance
    • B. Definitions / 8. Negotiate
    • C. Licensing
    • C. Licensing / 1. Persons required to be licensed
    • C. Licensing / 1. Persons required to be licensed / a. Producer
    • C. Licensing / 1. Persons required to be licensed / b. Resident/nonresident
    • C. Licensing / 2. Producer appointment/termination of appointment
    • C. Licensing / 3. Obtaining a license
    • C. Licensing / 3. Obtaining a license / a. Qualifications
    • C. Licensing / 3. Obtaining a license / b. License application
    • C. Licensing / 3. Obtaining a license / c. Written examinations
    • C. Licensing / 3. Obtaining a license / d. Exemptions/exceptions
    • C. Licensing / 3. Obtaining a license / e. License denial/refusal
    • C. Licensing / 4. Maintaining a license
    • C. Licensing / 4. Maintaining a license / a. Continuing education
    • C. Licensing / 4. Maintaining a license / b. Change of address/place of business
    • C. Licensing / 4. Maintaining a license / c. Fees/renewal
    • C. Licensing / 4. Maintaining a license / d. Record keeping
    • C. Licensing / 4. Maintaining a license / e. License expiration
    • C. Licensing / 4. Maintaining a license / f. Suspension or revocation of licenses/felony convictions
    • D. Producer responsibilities
    • D. Producer responsibilities / 1. Fiduciary capacity
    • D. Producer responsibilities / 2. Commissions and compensation
    • D. Producer responsibilities / 3. Charging of fees and disclosure requirements
    • D. Producer responsibilities / 4. Reporting of actions
    • E. Insurance contracts
    • E. Insurance contracts / 1. Filing and approval of policy forms
    • E. Insurance contracts / 2. Payment of claims
    • E. Insurance contracts / 3. Power to contract
    • F. Marketing practices
    • F. Marketing practices / 1. Unfair claims practices
    • F. Marketing practices / 2. Unfair methods of competition
    • F. Marketing practices / 2. Unfair methods of competition / a. Rebating
    • F. Marketing practices / 2. Unfair methods of competition / b. Misrepresentation
    • F. Marketing practices / 2. Unfair methods of competition / c. False advertising
    • F. Marketing practices / 2. Unfair methods of competition / d. Defamation
    • F. Marketing practices / 2. Unfair methods of competition / e. False financial statements
    • F. Marketing practices / 2. Unfair methods of competition / f. Boycott, coercion, intimidation
    • F. Marketing practices / 2. Unfair methods of competition / g. Unfair discrimination
    • F. Marketing practices / 2. Unfair methods of competition / h. Coercion of borrower
    • F. Marketing practices / 2. Unfair methods of competition / i. Fraud
    • F. Marketing practices / 3. Penalties
  • Idaho Specific Health — II. Idaho Statutes, Rules, and Regulations Common to Life and Health/Disability Insurance Only
    • A. Credit life and disability insurance
    • B. Life and Health Insurance Guaranty Association Act
    • C. Assignment
  • Idaho Specific Health — III. Idaho Statutes, Rules, and Regulations Pertinent to Health/Disability Insurance Only
    • A. Policy clauses and provisions
    • A. Policy clauses and provisions / 1. Minimum standards
    • A. Policy clauses and provisions / 1. Minimum standards / a. Purpose
    • A. Policy clauses and provisions / 1. Minimum standards / b. Definition
    • A. Policy clauses and provisions / 2. Required and optional coverages
    • A. Policy clauses and provisions / 2. Required and optional coverages / a. Newborns and adopted children
    • A. Policy clauses and provisions / 2. Required and optional coverages / b. Maternity benefits
    • A. Policy clauses and provisions / 2. Required and optional coverages / c. Handicapped dependents
    • A. Policy clauses and provisions / 2. Required and optional coverages / d. Reconstructive surgery/prosthetic devices
    • A. Policy clauses and provisions / 2. Required and optional coverages / e. Free look
    • A. Policy clauses and provisions / 2. Required and optional coverages / f. Right of insurer to contest (time limit on certain defenses)
    • A. Policy clauses and provisions / 2. Required and optional coverages / g. Grace period
    • A. Policy clauses and provisions / 2. Required and optional coverages / h. Pre-existing conditions
    • A. Policy clauses and provisions / 2. Required and optional coverages / i. Skilled nursing facility
    • A. Policy clauses and provisions / 2. Required and optional coverages / j. Mammograms
    • A. Policy clauses and provisions / 3. Benefit standards
    • B. Accidental death and dismemberment
    • C. Disclosure
    • C. Disclosure / 1. Outline of coverage
    • C. Disclosure / 2. Renewal agreements/nonrenewal and cancellation
    • D. Medicare supplement insurance
    • E. Long term care
    • E. Long term care / 1. Definitions
    • E. Long term care / 2. Disclosure Statements
    • E. Long term care / 3. Activities of Daily Living
    • E. Long term care / 4. Producer Training Requirement
    • E. Long term care / 5. Suitability
    • F. Small employer health insurance availability act
    • F. Small employer health insurance availability act / 1. Special provisions
    • F. Small employer health insurance availability act / 2. Disclosure requirements
    • F. Small employer health insurance availability act / 3. Termination/nonrenewal
    • F. Small employer health insurance availability act / 4. Fair marketing standards
    • F. Small employer health insurance availability act / 5. Definitions
    • F. Small employer health insurance availability act / 5. Definitions / a. Small employer
    • F. Small employer health insurance availability act / 5. Definitions / b. Eligible employee
    • G. Individual health insurance availability act
    • H. Disability income protection
    • I. Idaho Health Carrier External Review Act

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