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Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Sample Questions (Q114-Q119):

NEW QUESTION # 114
An insurer operating in the U.S. but headquartered outside the U.S. is:

A. A foreign insurer
B. A reciprocal insurance exchange
C. An alien insurer
D. A captive insurer

Answer: C

Explanation:
Detailed Answer in Step-by-Step Solution:
* An alien insurer (B) is headquartered outside the U.S. but licensed to operate within it, distinguishing it from a foreign insurer (A), which is domiciled in another U.S. state.
* A captive insurer (C) insures its parent company, and a reciprocal exchange (D) is a mutual insurance structure, neither based on location.
The Virginia study guide defines an alien insurer as one incorporated outside the U.S., operating under state licensing, per standard insurance terminology. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Insurance Company Types."

NEW QUESTION # 115
If an employee in poor health is part of a large group that is acceptable for group life insurance, that employee is:

A. Ineligible for coverage under the plan
B. Eligible for the same type of coverage as other employees
C. Eligible for coverage more limited than that of other employees
D. Eligible for coverage, but on a rated basis

Answer: B

Explanation:
Group life insurance in Virginia, governed by Virginia Code § 38.2-3318 et seq., operates on a "group underwriting" basis, meaning coverage is issued to the group as a whole without individual health assessments. For large groups (typically over 10 employees, though Virginia defines "large" contextually), insurers accept the entire eligible group without requiring evidence of insurability, provided the group meets participation and eligibility standards (e.g., active employees). Option C reflects this: an employee in poor health, as part of an acceptable group, receives the same coverage as others, as health status doesn't affect eligibility or terms. Option A (ineligible) is false; group plans don't exclude based on individual health.
Option B (rated basis) applies to individual policies where substandard risks increase premiums, not group plans where risk is pooled. Option D (limited coverage) contradicts the uniformity of group coverage terms.
The study guide likely highlights this non-discriminatory feature of group life, ensuring equal benefits for all eligible members, making C the correct answer per Virginia's legal and practical framework.

NEW QUESTION # 116
Nearly all citizens of the U.S.A., regardless of age, are eligible for Medicare Part B if they are:

A. Retired permanently
B. Uninsurable through commercial insurers
C. Eligible for Medicare Part A
D. "Fully insured" under Social Security

Answer: C

Explanation:
Detailed Answer in Step-by-Step Solution:
* Medicare Part B eligibility generally requires enrollment in or eligibility for Part A (B), which covers hospital insurance and is tied to age (65+) or disability status, not just retirement (A) or insurability (C).
* "Fully insured" under Social Security (D) relates to benefits but isn't a direct Part B requirement.
The Virginia study guide states that Medicare Part B is available to those eligible for Part A, typically U.S.
citizens or residents aged 65 or disabled, regardless of other factors. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Medicare Eligibility."

NEW QUESTION # 117
A typical disability income insurance policy EXCLUDES benefits for which one of the following causes of loss?

A. Permanent injuries
B. Sporting accidents
C. Intentional self-inflicted injuries
D. Falls

Answer: C

Explanation:
Detailed Answer in Step-by-Step Solution:
* Disability income policies exclude benefits for intentional self-inflicted injuries (B) to prevent abuse or fraud.
* Permanent injuries (A), sporting accidents (C), and falls (D) are typically covered unless specifically excluded by the policy.
The Virginia study guide states that disability income insurance excludes self-inflicted injuries as a standard provision to ensure coverage applies to unforeseen events. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Disability Income Insurance."

NEW QUESTION # 118
The insurance with other insurers provision in an individual health insurance policy allows an insurer to pay benefits to the insureds on a pro-rata basis when the:

A. Insurer was not notified prior to the claim that the insured has other health coverage
B. Insured has submitted claims in excess of $2,000 during the policy year
C. Policy is within 31 days of the renewal date
D. Policy has entered into the grace period for premium payment

Answer: A

Explanation:
The "insurance with other insurers" provision, addressed in Virginia Code § 38.2-3514, is a coordination of benefits (COB) mechanism in individual health insurance policies designed to prevent over-insurance and duplicate payments when an insured has multiple policies covering the same loss. This provision allows the insurer to prorate benefits-paying a share based on the total coverage-when certain conditions are met.
Option C states that the insurer wasn't notified prior to the claim of other coverage, which triggers proration.
This aligns with standard COB rules: if the insurer isn't informed of other policies, it may assume primary liability initially but adjust to a pro-rata share upon discovery, ensuring equitable payment across insurers.
Option A (within 31 days of renewal) is irrelevant; renewal proximity doesn't affect benefit coordination.
Option B (grace period) relates to premium payment timing, not other insurance, and doesn't trigger proration.
Option D ($2,000 claim threshold) is arbitrary and not a standard condition in Virginia law or study materials for this provision. The study guide likely emphasizes notification as key to COB, as Virginia follows NAIC model regulations requiring disclosure of other coverage (e.g., via application or claim forms). Without prior notice, the insurer applies proration retroactively, making C the correct choice.

NEW QUESTION # 119
......

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