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19 53.


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28 146.415  159.817  174.535  190.699  208.452  227.950  249.366  272.889  298.726  327.104  
29 162.789  178.397  195.607  214.583  235.508  258.583  284.031  312.094  343.041  377.170  
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35 304.159  341.590  383.879  431.663  485.660  546.681  615.640  693.573  781.644  881.170  
40 507.252  581.826  667.850  767.091  881.592  1013.70  1166.14  1342.03  1544.96  1779.09  
45 841.836  986.639  1157.23  1358.23  1595.07  1874.16  2203.04  2590.56  3047.17  3585.13  
50 1393.05  1668.77  2000.61  2400.02  2880.79  3459.51  4156.10  4994.52  6003.54  7217.72  

Tables  
360 Copyright reserved by the Singapore College of Insurance Limited  [V1.


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79  3459.51  4156.10  4994.52  6003.54  7217.72  

Tables  
360 Copyright reserved by the Singapore College of Insurance Limited  [V1.4] Time Value Of Money Tables  
 
TABLE A 1 (CONTINUED)  
FUTURE VALUE OF ANNUITY FACTORS  
FVA Factor = [(1+i)n−1] / i where i = rate and n = periods  
i = 16% 17% 18% 19% 20% 22% 24% 26% 28% 30% 
n=1 1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  
2 2.1600  2.1700  2.1800  2.1900  2.2000  2.2200  2.2400  2.2600  2.2800  2.3000  
3 3.5056  3.5389  3.5724  3.6061  3.6400  3.7084  3.7776  3.8476  3.9184  3.9900  
4 5.0665  5.1405  5.2154  5.2913  5.3680  5.5242  5.6842  5.8480  6.0156  6.1870  
5 6.8771  7.0144  7.1542  7.2966  7.4416  7.7396  8.0484  8.3684  8.6999  9.0431  
            
6 8.9775  9.2068  9.4420  9.6830  9.9299  10.4423  10.9801  11.5442  12.1359  12.7560  
7 11.4139  11.7720  12.1415  12.5227  12.9159  13.7396  14.6153  15.5458  16.5339  17.5828  
8 14.2401  14.7733  15.3270  15.9020  16.4991  17.7623  19.1229  20.5876  22.1634  23.8577  
9 17.5185  18.2847  19.0859  19.9234  20.7989  22.6700  24.7125  26.9404  29.3692  32.0150  
10 21.3215  22.3931  23.5213  24.7089  25.9587  28.6574  31.6434  34.9449  38.5926  42.6195  
            
11 25.7329  27.1999  28.7551  30.4035  32.1504  35.9620  40.2379  45.0306  50.3985  56.4053  
12 30.8502  32.8239  34.9311  37.1802  39.5805  44.8737  50.8950  57.7386  65.5100  74.3270  
13 36.7862  39.4040  42.2187  45.2445  48.4966  55.7459  64.1097  73.7506  84.8529  97.6250  
14 43.6720  47.1027  50.8180  54.8409  59.1959  69.0100  80.4961  93.9258  109.612  127.913  
15 51.6595  56.1101  60.9653  66.2607  72.0351  85.


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16 60.9250  66.6488  72.9390  79.8502  87.4421  104.935  126.011  151.377  181.868  218.472  
17 71.6730  78.9792  87.0680  96.0218  105.931  129.020  157.253  191.735  233.791  285.014  
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23 183.601  211.801  244.487  282.362  326.237  435.861  582.630  778.771  1040.36  1388.46  
24 213.978  248.808  289.494  337.010  392.484  532.750  723.461  982.251  1332.66  1806.00  
25 249.214  292.105  342.603  402.042  471.981  650.955  898.092  1238.64  1706.80  2348.80  
            
26 290.088  342.763  405.272  479.431  567.377  795.165  1114.63  1561.68  2185.71  3054.44  
27 337.502  402.032  479.221  571.522  681.853  971.102  1383.15  1968.72  2798.71  3971.78  
28 392.503  471.378  566.481  681.112  819.223  1185.74  1716.10  2481.59  3583.34  5164.31  
29 456.303  552.512  669.447  811.523  984.068  1447.61  2128.96  3127.80  4587.68  6714.60  
30 530.312  647.439  790.948  966.712  1181.88  1767.08  2640.92  3942.03  5873.23  8729.99  
            
35 1120.71  1426.49  1816.65  2314.21  2948.34  4783.64  7750.23  12527.4  20189.0  32422.9  
40 2360.76  3134.52  4163.21  5529.83  7343.86  12936.5  22728.8  39793.0  69377.5  120393  
45 4965.27  6879.29  9531.


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50 10435.6  15089.5  21813.1  31515.3  45497.2  94525.3  195373  401374  819103  1659761  

                Tables   
Copyright reserved by the Singapore College of Insurance Limited  [Version 1.4] 361 Time Value of Money Tables  
 
TABLE A 2  
PRESENT VALUE OF AN ANNUITY  DUE OF ONE DOLLAR  
PVAD = ({1−[1/(1+i)n]} / i )×(1+i) where i = rate and n = periods  
i = 0.5%  1% 1.5%  2% 2.5%  3% 3.5%  4% 4.5%  5% 
n=1 1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  
2 1.9950  1.9901  1.9852  1.9804  1.9756  1.9709  1.9662  1.9615  1.9569  1.9524  
3 2.9851  2.9704  2.9559  2.9416  2.9274  2.9135  2.8997  2.8861  2.8727  2.8594  
4 3.9702  3.9410  3.9122  3.8839  3.8560  3.8286  3.8016  3.7751  3.7490  3.7232  
5 4.9505  4.9020  4.8544  4.8077  4.7620  4.7171  4.6731  4.6299  4.5875  4.5460  
            
6 5.9259  5.8534  5.7826  5.7135  5.6458  5.5797  5.5151  5.4518  5.3900  5.3295  
7 6.8964  6.7955  6.6972  6.6014  6.5081  6.4172  6.3286  6.2421  6.1579  6.0757  
8 7.8621  7.7282  7.5982  7.4720  7.3494  7.2303  7.1145  7.0021  6.8927  6.7864  
9 8.8230  8.6517  8.4859  8.3255  8.1701  8.0197  7.8740  7.7327  7.5959  7.4632  
10 9.7791  9.5660  9.3605  9.1622  8.9709  8.7861  8.6077  8.4353  8.2688  8.1078  
            
11 10.7304  10.4713  10.2222  9.9826  9.7521  9.5302  9.3166  9.1109  8.9127  8.7217  
12 11.6770  11.3676  11.0711  10.7868  10.5142  10.2526  10.0016  9.7605  9.5289  9.3064  
13 12.6189  12.2551  11.


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13 12.6189  12.2551  11.9075  11.5753  11.2578  10.9540  10.6633  10.3851  10.1186  9.8633  
14 13.5562  13.1337  12.7315  12.3484  11.9832  11.6350  11.3027  10.9856  10.6829  10.3936  
15 14.4887  14.0037  13.5434  13.1062  12.6909  12.2961  11.9205  11.5631  11.2228  10.8986  
            
16 15.4166  14.8651  14.3432  13.8493  13.3814  12.9379  12.5174  12.1184  11.7395  11.3797  
17 16.3399  15.7179  15.1313  14.5777  14.0550  13.5611  13.0941  12.6523  12.2340  11.8378  
18 17.2586  16.5623  15.9076  15.2919  14.7122  14.1661  13.6513  13.1657  12.7072  12.2741  
19 18.1728  17.3983  16.6726  15.9920  15.3534  14.7535  14.1897  13.6593  13.1600  12.6896  
20 19.0824  18.2260  17.4262  16.6785  15.9789  15.3238  14.7098  14.1339  13.5933  13.0853  
            
21 19.9874  19.0456  18.1686  17.3514  16.5892  15.8775  15.2124  14.5903  14.0079  13.4622  
22 20.8880  19.8570  18.9001  18.0112  17.1845  16.4150  15.6980  15.0292  14.4047  13.8212  
23 21.7841  20.6604  19.6208  18.6580  17.7654  16.9369  16.1671  15.4511  14.7844  14.1630  
24 22.6757  21.4558  20.3309  19.2922  18.3321  17.4436  16.6204  15.8568  15.1478  14.4886  
25 23.5629  22.2434  21.0304  19.9139  18.8850  17.9355  17.0584  16.2470  15.4955  14.7986  
            
26 24.4456  23.0232  21.7196  20.5235  19.4244  18.4131  17.4815  16.6221  15.8282  15.0939  
27 25.3240  23.7952  22.3986  21.1210  19.9506  18.8768  17.8904  16.9828  16.1466  15.3752  
28 26.1980  24.5596  23.0676  21.7069  20.4640  19.3270  18.2854  17.3296  16.4513  15.6430  
29 27.0677  25.


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50 44.3635  39.5881  35.5247  32.0521  29.0714  26.5017  24.2766  22.3415  20.6513  19.1687  

Tables  
362 Copyright reserved by the Singapore College of Insurance Limited  [V1.4] Time Value of Money Tables  
 
TABLE A 2 (CONTINUED)  
PRESENT VALUE OF AN ANNUITY  DUE OF ONE DOLLAR  
PVAD = ({ 1−[1/ (1+i)n]} / i )×(1+i) where i = rate and n = periods  
i = 5.5%  6% 6.5%  7% 7.5%  8% 8.5%  9% 9.5%  10% 
n=1 1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  
2 1.9479  1.9434  1.9390  1.9346  1.9302  1.9259  1.9217  1.9174  1.9132  1.9091  
3 2.8463  2.8334  2.8206  2.8080  2.7956  2.7833  2.7711  2.7591  2.7473  2.7355  
4 3.6979  3.6730  3.6485  3.6243  3.6005  3.5771  3.5540  3.5313  3.5089  3.4869  
5 4.5052  4.4651  4.4258  4.3872  4.3493  4.3121  4.2756  4.2397  4.2045  4.1699  
            
6 5.2703  5.2124  5.1557  5.1002  5.0459  4.9927  4.9406  4.8897  4.8397  4.7908  
7 5.9955  5.9173  5.8410  5.7665  5.6938  5.6229  5.5536  5.4859  5.4198  5.3553  
8 6.6830  6.5824  6.4845  6.3893  6.2966  6.2064  6.1185  6.0330  5.


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16 11.0376  10.7122  10.4027  10.1079  9.8271  9.5595  9.3042  9.0607  8.8282  8.6061  
17 11.4622 11.1059 10.7678 10.4466 10.1415 9.8514 9.5753 9.3126 9.0623 8.8237 
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22 13.2752  12.7641  12.2850  11.8355  11.4135  11.0168  10.6436  10.2922  9.9611  9.6487  
23 13.5832  13.0416  12.5352  12.0612  11.6172  11.2007  10.8098  10.4424  10.0969  9.7715  
24 13.8750  13.3034  12.7701  12.2722  11.8067  11.3711  10.9629  10.5802  10.2209  9.


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45 17.4579  16.3832  15.4214  14.5579  13.7800  13.0771  12.4399  11.8605  11.3322  10.8491  
50 17.8628  16.7076  15.6816  14.7668  13.9479  13.2122  12.5487  11.9482  11.4030  10.9063  

                Tables   
Copyright reserved by the Singapore College of Insurance Limited  [Version 1.4] 363 Time Value of Money Tables  
 
TABLE A 2 (CONTINUED)  
PRESENT VALUE OF AN ANNUITY  DUE OF ONE DOLLAR  
PVAD = ({ 1−[1/ (1+i)n]} / i )×(1+i) where i = rate and n = periods  
i = 10.5%  11% 11.5%  12% 12.5%  13% 13.5%  14% 14.5%  15% 
n=1 1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  
2 1.9050  1.9009  1.8969  1.8929  1.8889  1.8850  1.8811  1.8772  1.8734  1.8696  
3 2.7240  2.7125  2.7012  2.6901  2.6790  2.6681  2.6573  2.6467  2.6361  2.6257  
4 3.4651  3.4437  3.4226  3.4018  3.3813  3.3612  3.


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13 7.6500  7.4924  7.3406  7.1944  7.0535  6.9176  6.7867  6.6603  6.5383  6.4206  
14 7.9230  7.7499  7.5835  7.4235  7.2698  7.1218  6.9794  6.8424  6.7103  6.5831  
15 8.1702  7.9819  7.8013  7.6282  7.4620  7.3025  7.1493  7.0021  6.8606  6.7245  
            
16 8.3938  8.1909  7.9967  7.8109  7.6329  7.4624  7.2989  7.1422  6.9918  6.8474  
17 8.5962 8.3792 8.1719 7.9740 7.7848 7.6039 7.4308 7.2651 7.1063 6.9542 
18 8.7794  8.5488  8.3291  8.1196  7.9198  7.7291  7.5469  7.3729  7.2064  7.0472  
19 8.9451  8.7016  8.4700  8.2497  8.0398  7.8399  7.6493  7.4674  7.2938  7.1280  
20 9.0952  8.8393  8.5964  8.3658  8.1465  7.9380  7.


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40 10.3299  9.9357  9.5710  9.2330  8.9191  8.6268  8.3543  8.0997  7.8615  7.6380  
45 10.4061  9.9988  9.6233  9.2764  8.9551  8.6568  8.3792  8.1205  7.8787  7.6524  
50 10.4524  10.0362  9.6537  9.3010  8.9751  8.6730  8.3924  8.1312  7.8875  7.6596  

Tables  
364 Copyright reserved by the Singapore College of Insurance Limited  [V1.


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9751  8.6730  8.3924  8.1312  7.8875  7.6596  

Tables  
364 Copyright reserved by the Singapore College of Insurance Limited  [V1.4] Time Value of Money Tables  
 
TABLE A 2 (CONTINUED)  
PRESENT VALUE OF AN ANNUITY  DUE OF ONE DOLLAR  
PVAD = ({ 1−[1/ (1+i)n]} / i )×(1+i) where i = rate and n = periods  
i = 16% 17% 18% 19% 20% 22% 24% 26% 28% 30% 
n=1 1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  1.0000  
2 1.8621  1.8547  1.8475  1.8403  1.8333  1.8197  1.8065  1.7937  1.7813  1.7692  
3 2.6052  2.5852  2.5656  2.5465  2.5278  2.4915  2.4568  2.4235  2.3916  2.3609  
4 3.2459  3.2096  3.1743  3.1399  3.1065  3.0422  2.9813  2.9234  2.8684  2.8161  
5 3.7982  3.7432  3.6901  3.6386  3.5887  3.4936  3.4043  3.3202  3.2410  3.1662  
            
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8 5.0386  4.9224  4.8115  4.7057  4.6046  4.4155  4.2423  4.0833  3.9370  3.8021  
9 5.3436  5.2072  5.0776  4.9544  4.8372  4.6193  4.4212  4.2407  4.0758  3.9247  
10 5.6065  5.4506  5.3030  5.1633  5.0310  4.7863  4.5655  4.3657  4.1842  4.0190  
            
11 5.8332  5.6586  5.4941  5.3389  5.1925  4.9232  4.6819  4.4648  4.2689  4.0915  
12 6.0286 5.8364 5.6560 5.4865 5.3271 5.0354 4.7757 4.5435 4.3351 4.1473 
13 6.1971  5.9884  5.7932  5.6105  5.4392  5.1274  4.8514  4.6059  4.3868  4.1903  
14 6.3423  6.1183  5.9095  5.7147  5.5327  5.2028  4.9124  4.6555  4.4272  4.2233  
15 6.4675  6.2293  6.0081  5.


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                Tables   
Copyright reserved by the Singapore College of Insurance Limited  [Version 1.4] 365  
ACCESS TO ONLINE LEARNING RESOURCES  
 
(1) Login using your SCI profile credentials using this link:  
https://www.scicollege.org.sg/Account/Login.  
 
(2) Click the “eBook/eMock Examination/Supplementary Notes” icon from 
the Student dashboard.  
 
(3) The examination module which you had registered for would be 
displayed on your screen.  
 
(4) Learning Resources include: eBOOK, eMOCK and video tutorials.   

Health Insurance  (7th Edition  Version 1. 4) – List of Changes  
Copyright reserved by the Singapore College of Insurance Limited [ Version 1. 4]                                    Page 1 of 2 
 HI V1. 4 – List of Changes  
There will not be any changes to the testable contents for Version 1. 4.  
Chapter 1 – Overview of Healthcare Environment in Singapore  
Section/Paragraph  Paragraph  Page  Amendments  
3C 3.13 6 Included footnote.  
4B 4.9 8 Amended.  
4B 4.12 8 The phrase “from middle of 2022” has 
been amended to “from 1 November 
2022”.  
Chapter 2 – Medical Expense Insurance  
Section/Paragraph  Paragraph  Page  Amendments  
Appendix 2C  - 40 Amended.  
Chapter 3 – Group Medical Expense Insurance  
Section/Paragraph  Paragraph  Page  Amendments  
4B4 4.22 60 Amended.  
Chapter  5 – Long -Term Care Insurance  
Section/  
Paragraph  Paragraph  Page  Amendments  
7A4 7.5 96 Amended.  
7B2 7.10 96 Amended.  
Chapter 9 Part I – Healthcare Financing  
Section/Paragraph  Paragraph  Page  Amendments  
2A1 2.4 170 The phrase “from the middle of 2022” has been amended to “from 1 November 
2022”.  
2A2 2.7 170 The phrase “in the middle of 2022” has 
been amended to “from 1 January 2023”.  
 The sentence “Permanent Residents will 
continue to receive 25% subsidy.” has 
been added.  
2A3 2.10 171 Amended.  
3B1 3.12 (a)  174 Amended.  
5 5.2 185 “NTUC Income IncomeShield” has been 
amended to “Income Insurance Limited’s 
IncomeShield”.  
Chapter 9 Part II – Healthcare Financing  
Section/Paragraph  Paragraph  Page  Amendments  
6 6.4 205 “NTUC Income Insurance Co -operative 
Limited” has been amended to “Income 
Insurance Limited” . 
6H 6.23 209 “NTUC Income Insurance Co- operative 
Limited” has been amended to “Income 
Insurance Limited” . 
7 7.8 211 “NTUC Income” has been amended to 
“Income Insu rance Limited”.  

Health Insurance  (7th Edition  Version 1. 4) – List of Changes  
Copyright reserved by the Singapore College of Insurance Limited [ Version 1. 4]                                    Page 2 of 2 
 8F 8.29 to 8.37  219 to 
220 Amended.


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4]                                    Page 2 of 2 
 8F 8.29 to 8.37  219 to 
220 Amended.  
Chapter 13 – Notice No: MAS 120 – Disclosure and Advisory Process Requirements for 
Accident and Health Insurance Products  
Section/Paragraph  Paragraph  Page  Amendments  
1 1.1 282 Amended.  
Appendix 13A  -  285 to 
312 Amended.  
Chapter 15 – Case Studies  
Section/Paragraph  Paragraph  Page  Amendments  
2B Table 15.1  344 Amended the Enhance IncomeShield 
Advantage Plan premium amount.  
Appendix 15B  - 351 to 
355 Amended.  
 
 

Singapore College of Insurance 
9 Temasek Boulevard #14-01/02/03, 
Suntec Tower Two, Singapore  038989
General Enquiry: (65) 6221 2336
Fax: (+65) 6220 6684
Email: talk2us@scidomain.org.sg
Website: www.scicollege.org.sg
CPE Registration No.:199408491M
Period Of CPE Registration:
From 26 September 2019 to 25 September 2023
HI.7.2020.4

Assistant: 
Hello, my name is Winnie. I am your Study Bear 🐻.
Let's study together and pass the exam without worries.
As the saying goes:

Any day spent with you is my favorite day. So, today is my new favorite day.

Let me know what should we study today 😉.

The content of the textbook Health Insurance 7th Edition are as follows,

Chapter 1: Overview Of Healthcare Environment In Singapore
Chapter 2: Medical Expense Insurance
Chapter 3: Group Medical Expense Insurance
Chapter 4: Disability Income Insurance
Etc ...
For examples, you could ask me

How many modules I have to take to become an insurance agent in Singapore?
How many chapters are there in textbook 'Health Insurance 7th Edition'?
Can you list all the chapters by name and its chapter number for me?
Based on the textbook, please extract the important key concepts from chapter 1 - overview of healthcare environment in singapore, into 10 bullet points
Please ask me a question so that I can tell if I have enough understanding about Chapter 2


User: 
I want to learn about insurance


Assistant: 
Sure, I can provide you with information on various types of insurance. 
Is there a specific type of insurance you are interested in learning about, such as health insurance, life insurance, car insurance, or any other type? 
Let me know so I can provide you with relevant details.


User: 
I want to learn about health insurance, specifically from the textbook 'Health Insurance'


Assistant: 
The textbook "Health Insurance 7th Edition" has undergone several versions, with the latest being Version 1.4 released on 1 October 2022. 
The content of Version 1.4 includes updates and amendments to different sections and chapters related to health insurance products, disclosure requirements, case studies, and healthcare financing schemes. 
The updates aim to provide accurate and current information to ensure the study text remains relevant and up-to-date with industry practices and regulations. 
If you would like to learn more about a specific chapter or topic within the textbook, please let me know!


User: 
Yup, i want to understand more about the content from the textbook, how many chapters are there


Assistant: 
The textbook "Health Insurance 7th Edition" consists of 15 chapters. 
Each chapter covers different aspects of health insurance, including medical expense insurance, group medical expense insurance, disability income insurance, long-term care insurance, critical illness insurance, managed healthcare, healthcare financing, policy provisions, pricing, underwriting, disclosure requirements, financial needs analysis, and case studies. 
If you would like to explore a specific chapter or have any questions related to the content, feel free to let me know!


User: 
Can you list all the chapters by name and its chapter number for me?


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string_value:
User: 
Can you list all the chapters by name and its chapter number for me?


Assistant:
The content of the textbook "Health Insurance 7th Edition" consists of the following chapters:
Chapter 1: Overview Of Healthcare Environment In Singapore
Chapter 2: Medical Expense Insurance
Chapter 3: Group Medical Expense Insurance
Chapter 4: Disability Income Insurance
Chapter 5: Long-Term Care Insurance
Chapter 6: Critical Illness Insurance
Chapter 7: Other Types Of Health Insurance
Chapter 8: Managed Healthcare
Chapter 9: Part I Healthcare Financing
Chapter 9: Part II Healthcare Financing
Chapter 10: Common Policy Provisions
Chapter 11: Health Insurance Pricing
Chapter 12: Health Insurance Underwriting
Chapter 13: Notice No: MAS 120 Disclosure And Advisory Process - Requirements For Accident And Health Insurance Products
Chapter 14: Financial Needs Analysis
Chapter 15: Case Studies
These are the 15 chapters included in the "Health Insurance 7th Edition" textbook.


User:
Bravo, based on the textbook, let's start with chapter 1, overview of the healthcare environment, what are the important key points about this chapter that I should know? can you list them in 10 bullet points?


Assistant:
The question extracted is not related to the key points of Chapter 1. Let me try to extract the key points for you.


User:
Yup yup, please extract the key points for me


Assistant:
The key points from Chapter 1: Overview Of Healthcare Environment In Singapore are:
- Singapore's healthcare environment is guided by a philosophy of individual responsibility and accessible healthcare for all.
- The philosophy emphasizes promoting a healthy population through preventive care.
- Personal responsibility for healthy living is encouraged through the "3M" system.
- Healthcare costs are controlled through subsidies and managing the supply of services.
- The Healthcare 2020 Masterplan aims to enhance accessibility, quality of care, and affordability of healthcare services.
- Primary healthcare services in Singapore are provided by general practitioners.
- Hospital services are offered by various public hospitals in Singapore.
- Intermediate and Long-Term Care services are available for patients requiring ongoing care outside of hospitals.
- The healthcare system in Singapore focuses on preventive care, accessibility, and quality of services.
- The government plays a significant role in ensuring healthcare affordability and accessibility for all Singaporeans.


User:
Woah, what is the overview of the healthcare 2020 masterplan


Assistant:
The Healthcare 2020 Masterplan in Singapore aims to enhance the accessibility, affordability, and quality of healthcare services for Singaporeans. It focuses on several key areas to achieve its objectives:
- Enhancing Access: The masterplan aims to improve access to healthcare services for all Singaporeans, ensuring that they can receive timely and appropriate care when needed.
- Improving Affordability: One of the key goals is to make healthcare services more affordable for Singaporeans, reducing the financial burden on individuals and families seeking medical treatment.
- Enhancing Quality: The masterplan focuses on raising the quality of healthcare services provided in Singapore, ensuring that patients receive safe, effective, and patient-centered care.
- Promoting Innovation: Embracing innovation in healthcare is a crucial aspect of the masterplan, encouraging the adoption of new technologies and practices to improve healthcare outcomes.
- Empowering Patients: The masterplan emphasizes empowering patients to take an active role in managing their health, promoting health literacy and patient engagement.
- Building a Sustainable Healthcare System: Sustainability is a key consideration, ensuring that the healthcare system can meet the evolving needs of the population while maintaining financial viability.
- Collaboration and Integration: The masterplan promotes collaboration among healthcare providers and stakeholders, as well as integration across different levels of care to ensure seamless and coordinated services.
- Focus on Prevention and Wellness: Preventive healthcare and wellness initiatives are prioritized to promote healthy living and reduce the incidence of chronic diseases.
- Enhancing Healthcare Infrastructure: Investments in healthcare infrastructure and facilities are essential to support the delivery of quality healthcare services across Singapore.
- Patient-Centered Care: The masterplan emphasizes the importance of patient-centered care, focusing on meeting the individual needs and preferences of patients to enhance their overall healthcare experience.


User:
Please summarise and give me more detailed information about Chapter 2 - Medical Expense Insurance, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 2 - Medical Expense Insurance, into 10 bullet points


Assistant:
Chapter 2 - Medical Expense Insurance covers various aspects related to medical expenses and insurance coverage. Here are 10 key points from this chapter:
- Medical Expense Insurance provides coverage for a wide range of medical expenses incurred by individuals.
- Inpatient expenses covered under this insurance may include daily room and board charges, surgeon's fees, and other related hospital costs.
- Outpatient expenses, such as catastrophic outpatient charges, may also be included in the coverage.
- Medical Expense Insurance policies may offer benefits like coverage for specific medical procedures or treatments.
- Some policies may provide reimbursement for expenses related to miscarriage or other medical situations.
- The coverage and benefits of Medical Expense Insurance can vary based on the policy terms and conditions.
- Policyholders need to understand the scope of coverage, exclusions, and limitations of their Medical Expense Insurance policy.
- Insurers may have specific requirements for claim submissions and documentation to process medical expense reimbursements.
- Individuals should review and compare different Medical Expense Insurance policies to choose the one that best suits their healthcare needs.
- It is essential for policyholders to stay informed about any updates or changes in their Medical Expense Insurance coverage to ensure adequate protection for medical expenses.


User:
Please summarise and give me more detailed information about Chapter 3 - Group Medical Expense Insurance, into 10 bullet points


Assistant:
Chapter 3: Group Medical Expense Insurance provides an in-depth look into the specifics of insurance policies designed for groups, primarily focusing on those provided by employers to their employees and their families. Here are 10 key points from the chapter:
- Distinction Between Individual and Group Insurance: The chapter outlines the differences between individual and group medical expense insurance, emphasizing the context in which each is used.
- Employer-Purchased Policies: It highlights that group medical expense insurance policies are often purchased by employers to offer benefits to their employees and, in some cases, the employees' immediate family members.
- Structure of Group Insurance: The text discusses the structure of group insurance, including compulsory (non-contributory) and voluntary (contributory) plans, and the advantages of each.
- Eligibility and Contract Specifics: There's a comparison between individual and group insurance in terms of eligibility for coverage, specifics of the contract, and choice of plan.
- Portable Medical Benefits Scheme (PMBS): The chapter introduces PMBS, explaining how it works, its benefits, and the eligibility criteria for employees.
- Transferable Medical Insurance Scheme (TMIS): Similarly, TMIS is discussed, providing insights into its operation, benefits, and who qualifies for it.
- Template for Transferable Medical Insurance Certification: An appendix offers a template for a Transferable Medical Insurance Certification, useful for practical application.
- Comprehensive Understanding of Group Insurance: The learning outcomes aim to equip readers with a thorough understanding of group insurance cover criteria and the characteristics of group insurance policies.
- Requirements for Foreign Workers' Medical Insurance: The chapter also touches on the specific requirements for medical insurance for foreign workers, an important aspect for employers in Singapore.
- Differences Between Compulsory and Voluntary Plans: Lastly, it delves into the differences between compulsory and voluntary plans, providing clarity on these two types of group medical expense insurance.


User:
Please summarise and give me more detailed information about Chapter 2 - Medical Expense Insurance, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 2 - Medical Expense Insurance, into 10 bullet points


Assistant:
Chapter 2 of the textbook, focusing on Medical Expense Insurance, provides a detailed overview of its importance, coverage, and key features. Here are 10 bullet points summarizing the chapter:
- Introduction to Rising Medical Costs: Highlights the concern of escalating medical expenses in Singapore, especially with an aging population, and the limitations of Medisave and MediShield Life in covering prolonged or major treatments.
- Need for Additional Financial Resources: Emphasizes the necessity for extra financial means to cover serious illnesses requiring expensive treatments beyond what national health schemes cover.
- Definition and Coverage: Describes Medical Expense Insurance as providing benefits for inpatient and some outpatient expenses, covering common medical expenses, complex surgeries, and costly treatments like dialysis and chemotherapy.
- Categories of Health Insurance: Outlines three broad categories, including reimbursement for medical treatment costs, periodic income upon disability or hospitalization, and a fixed cash amount for major illnesses.
- Key Features of Policies: Discusses options for stand-alone policies or riders, choice of plans, family coverage, and the reimbursement basis of these policies.
- Expense Participation Mechanisms: Explains deductibles, co-insurance, and pro-ration factors as methods to manage insurance costs and promote responsible medical service usage.
- Benefits Offered: Lists various benefits under Medical Expense Insurance policies, such as specific disease insurance, miscarriage benefit, and emergency medical evacuation benefit.
- Limits on Covered Expenses: Emphasizes the importance of understanding policy limits, including "as charged" benefits versus sub-limits, and the implications for reimbursement.
- Communication of Coverage Terms: Highlights the necessity for clear communication about what is covered under the policy and the potential for not receiving full reimbursement for incurred medical expenses.
- Comprehensive Overview: Provides a thorough understanding of Medical Expense Insurance, its purpose, the types of expenses covered, and the significance of knowing the terms and limits of coverage.
This chapter serves as a crucial guide for understanding Medical Expense Insurance in the context of Singapore's healthcare environment and the need for additional coverage beyond national health schemes.


User:
Please summarise and give me more detailed information about Chapter 4: Disability Income Insurance, into 10 bullet points


Assistant:
Here are 10 detailed bullet points about Chapter 4: Disability Income Insurance from the textbook:
- Introduction to Disability Income Insurance: This insurance is designed as an income-protection product that replaces a portion of the insured's income lost due to incapacity from an accident or illness, under certain conditions.
- Differentiation from Total and Permanent Disability Benefit: The chapter clarifies that Disability Income Insurance focuses on income replacement for those unable to work due to temporary or long-term disabilities, unlike Total and Permanent Disability Benefit, which accelerates the death benefit under a Life Insurance policy for those with total and permanent disabilities.
- Computation of Benefits: Benefits are typically capped at 75% of the insured's average income over the past 12 months, subject to certain ceilings, to prevent over-insurance and motivate return to work.
- Types of Benefits: It includes total disability benefit and partial disability benefit, catering to different levels of incapacity.
- Policy Features: The chapter discusses several policy features such as rehabilitation expense benefit, escalation benefit, waiver of premium benefit, and death benefit.
- Underwriting Considerations: Factors like occupation, benefit amount, benefit period, and deferred/elimination period are crucial in underwriting Disability Income Insurance.
- Termination of Benefits: The chapter outlines the conditions under which benefits cease to be payable, including recovery from disability or reaching the end of the benefit period.
- Common Exclusions: It lists common exclusions in Disability Income Insurance policies, such as self-inflicted injuries and pre-existing conditions.
- Group Disability Income Insurance: This section covers the coverage and features of Group Disability Income Insurance, highlighting its role in providing income protection to employees.
- Underwriting Principles and Claims Procedures: The chapter concludes with a discussion on general underwriting principles and claims procedures for both individual and group Disability Income Insurance policies, emphasizing the importance of accurate information and timely claims processing.
This chapter provides a comprehensive overview of Disability Income Insurance, detailing its purpose, benefits, policy features, underwriting considerations, and claims procedures.


User:
Please summarise and give me more detailed information about Chapter 5: Long-Term Care Insurance, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 5: Long-Term Care Insurance, into 10 bullet points


Assistant:
Here are 10 bullet points summarizing Chapter 5: Long-Term Care Insurance:
- Introduction to Long-Term Care Insurance: The chapter begins by explaining what Long-Term Care (LTC) Insurance is and why it is crucial for covering long-term care needs that arise from chronic illnesses, disabilities, or aging.
- Benefits of LTC Insurance: It details the benefits provided under LTC Insurance, including coverage for services like home care, community services, and facility care when a person cannot perform Activities of Daily Living (ADLs).
- Types of LTC Policies: The chapter discusses the various types of LTC policies available, including traditional LTC policies, hybrid policies, and government-sponsored programs.
- Eligibility Criteria for LTC Benefits: It explains how eligibility for LTC benefits is typically determined based on the inability to perform a certain number of ADLs, such as bathing, dressing, eating, transferring, toileting, and continence.
- Activities of Daily Living (ADLs): The significance of ADLs in determining benefit eligibility under LTC Insurance is highlighted, with a detailed explanation of each ADL.
- Other Benefits and Features: The chapter covers additional benefits and features of LTC Insurance, such as inflation protection, non-forfeiture benefits, and return of premium options.
- ElderShield Program: It introduces ElderShield, a basic LTC Insurance program focusing on severe disability, primarily aimed at Singapore's elderly population.
- CareShield Life: The chapter provides an overview of CareShield Life, a newer and more comprehensive LTC Insurance scheme that replaces ElderShield, offering higher and lifetime payouts.
- Comparison between CareShield Life and ElderShield: A comparative analysis of these two government-sponsored LTC Insurance programs is provided, highlighting the differences in coverage, benefits, and eligibility.
- MediSave Care: Briefly mentions MediSave Care, a program that allows Singaporeans to use their MediSave savings for long-term care expenses under certain conditions.
This chapter emphasizes the importance of LTC Insurance in providing financial support for individuals who require long-term care due to various conditions, highlighting government-sponsored programs like ElderShield and CareShield Life in Singapore.


User:
Please summarise and give me more detailed information about Chapter 6: Critical Illness Insurance, into 10 bullet points


Assistant:
Chapter 6: Critical Illness Insurance provides an in-depth look into the specifics of Critical Illness (CI) Insurance policies. Here are 10 key points from the chapter:
- Introduction to CI Insurance: The chapter begins with the history of CI Insurance, tracing its origins to 1983 in South Africa, initially known as dread disease insurance. It highlights the evolution and global acceptance of CI Insurance.
- Critical Illness Framework of 2019: It discusses the framework established in consultation with the Monetary Authority of Singapore, aimed at offering clear and consistent coverage to balance the interests of consumers and insurance companies.
- Benefits of CI Insurance: The chapter details the financial support provided to policyholders diagnosed with a specified critical illness or who have undergone a covered surgical procedure, which can be used for care, treatment, recuperation, or income loss compensation.
- Variations in CI Insurance: It emphasizes understanding the specific conditions and stages of illnesses covered by a policy, introducing Severity-Based Critical Illness plans that offer payouts at earlier stages.
- Severity-Based Critical Illness Plans: These plans are highlighted for their advantage of providing early financial support for better treatment outcomes.
- Underwriting Processes: The chapter discusses the underwriting processes involved in CI Insurance, including factors considered in determining the adequacy of CI coverage.
- Common Exclusions: It addresses common exclusions in CI Insurance policies, providing insights into what is not covered.
- Termination of Cover: The chapter explains the conditions under which CI Insurance coverage may be terminated.
- Claims Procedures: Detailed information on the procedures to follow when making a claim under CI Insurance is provided.
- Group Critical Illness Insurance: The chapter concludes with an overview of Group Critical Illness Insurance policies, explaining how they operate and differ from individual CI Insurance policies.
Additionally, appendices and annexes offer resources like standard definitions for severe stages of 37 critical illnesses and a list of changes to the standard list of critical illnesses under the 2019 framework, enhancing understanding of CI Insurance.


User:
Please summarise and give me more detailed information about Chapter 7: Other Types Of Health Insurance, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 7: Other Types Of Health Insurance, into 10 bullet points


Assistant:
Chapter 7: "Other Types Of Health Insurance" provides an in-depth look into various health insurance options beyond the standard models. Here are 10 key points from the chapter:
- Introduction to Diverse Health Insurance Types: The chapter begins by emphasizing the importance of understanding the wide range of health insurance options available, catering to different health-related needs and circumstances.
- Hospital Cash (Income) Insurance: This section details insurance policies that provide a daily cash benefit to policyholders hospitalized due to illness or injury, helping to cover incidental expenses.
- Medical Expense Benefits under Travel Insurance: Explores how travel insurance policies often include coverage for medical expenses incurred while traveling abroad, highlighting the conditions and limitations of such benefits.
- Group Dental Care Insurance: Discusses insurance policies designed to cover dental care expenses, typically offered as part of group insurance plans to employees or members of organizations.
- Conditions for Claims: Each section meticulously outlines the specific conditions under which claims can be made for the respective types of insurance, ensuring clarity for policyholders.
- Features and Types: The chapter provides detailed descriptions of the features and variations of each insurance type, helping readers understand the options available to them.
- Underwriting Processes: Insight into the underwriting processes for these insurance types is provided, explaining how insurers assess risk and determine policy terms.
- Exclusions: Highlights common exclusions across different health insurance types, informing readers about what is not covered under their policies.
- Termination of Coverage: Discusses the circumstances under which coverage can be terminated, offering guidance on how to maintain continuous protection.
- Claims Procedures: The chapter concludes with an overview of the claims procedures for each insurance type, ensuring readers are well-informed on how to proceed in the event of a claim.
Additionally, appendices likely offer further insights or case studies, enriching the reader's understanding of the diverse health insurance landscape.


User:
Please summarise and give me more detailed information about Chapter 8: Managed Healthcare, into 10 bullet points


Assistant:
Here are 10 detailed bullet points about Chapter 8: Managed Healthcare from the textbook:
- Introduction to Managed Healthcare (MHC): The chapter begins by explaining the evolution of MHC as a strategy developed in response to escalating healthcare costs, focusing on its role in insurance-backed plans, particularly within Employee Benefit packages.
- Definition and Purpose: MHC is defined as a system designed to manage the cost, accessibility, and quality of healthcare services. It aims to contain healthcare expenses while ensuring that patients receive appropriate care.
- Operation of MHC: The chapter outlines how MHC operates through a network of healthcare providers. It involves managing care accessibility, negotiating contracts with healthcare services, and controlling expenditures to manage costs effectively.
- Types of MHC Plans: The text delves into common MHC plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point-of-Service (POS) plans, explaining their structures and differences in provider choice and cost control.
- Role of Primary Care Physicians (PCPs): It highlights the critical role of PCPs in MHC plans, emphasizing their importance in providing primary and preventive care, and acting as gatekeepers for specialist services.
- MHC Insurance Specifics: The chapter covers the specifics of MHC insurance, including the benefits offered, elements of co-insurance and deductibles, common exclusions, underwriting requirements, and claims procedures.
- Overview of MHC in Singapore: It concludes with insights into the implementation of MHC schemes in Singapore, providing a local perspective on how MHC models operate within the country.
- Learning Outcomes: Readers are expected to understand what MHC is, describe how it works, list common payment methods and types of MHC plans, and differentiate between types of HMOs.
- Balance Between Provider Choice and Cost Control: The chapter discusses the balance MHC plans strike between offering patients a choice of providers and controlling healthcare costs, a key aspect of MHC strategies.
- Benefits of MHC Insurance: It identifies the benefits of MHC insurance, including how it can lead to more efficient healthcare delivery and cost savings for both providers and patients, through the structured management of care.
This chapter provides a thorough overview of Managed Healthcare, its mechanisms, types of plans, and its implementation, particularly focusing on the Singapore context.


User:
Please summarise and give me more detailed information about Chapter 9: Part I Healthcare Financing, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 9: Part I Healthcare Financing, into 10 bullet points


Assistant:
Here's a summary of Chapter 9: Part I Healthcare Financing, detailed into 10 bullet points:
- Introduction to Singapore's Healthcare Financing: The chapter begins by explaining Singapore's healthcare financing philosophy, which combines government subsidies, compulsory savings, insurance, and out-of-pocket payments to achieve high healthcare outcomes at a relatively low cost.
- Government Subsidies and Direct Funding: It highlights the role of direct government funding and subsidies in making healthcare affordable, especially for lower-income groups, through public healthcare institutions and selected private clinics.
- Means-Testing for Subsidies: The chapter discusses the use of means-testing to determine the level of subsidies a patient is eligible for, ensuring that financial assistance is targeted towards those in need.
- MediSave Scheme: A compulsory savings plan that allows Singaporeans to set aside part of their income for future medical expenses, including hospitalization, certain outpatient treatments, and health insurance premiums.
- MediShield Life: This is a basic health insurance scheme designed to help citizens and permanent residents pay for large hospital bills and selected costly outpatient treatments, with coverage for life.
- Integrated Shield Plans (IPs): Private health insurance plans that offer additional coverage on top of MediShield Life, allowing for a higher ward class in hospitals and coverage for additional medical services.
- Community Health Assist Scheme (CHAS): The chapter also covers CHAS, which provides subsidies for medical and dental care at participating clinics for lower- and middle-income Singaporeans.
- ElderShield and CareShield Life: These are long-term care insurance schemes designed to provide financial support to those with severe disabilities. CareShield Life, which will eventually replace ElderShield, offers higher payouts and lifetime coverage.
- Utilization of MediSave: The chapter explains how MediSave funds can be used for various healthcare needs, including hospitalization, approved outpatient treatments, and health insurance premiums for MediShield Life and Integrated Shield Plans.
- Affordability and Coverage: Lastly, it discusses the efforts to keep MediShield Life premiums affordable through government subsidies and the enhanced benefits provided under MediShield Life, ensuring comprehensive coverage for all Singaporeans.
This chapter provides a detailed understanding of the multifaceted healthcare financing system in Singapore, emphasizing the government's approach to ensuring affordability and accessibility of healthcare services for all citizens.


User:
Please summarise and give me more detailed information about Chapter 9: Part II Healthcare Financing, into 10 bullet points


Assistant:
Chapter 9: Part II Healthcare Financing provides an in-depth look into the continuation of healthcare financing schemes in Singapore, focusing on the support for elderly citizens and other specific groups. Here are the key points:
- ElderShield and ElderShield Supplements: Introduced as a basic long-term care insurance scheme aimed at providing financial support to those who need long-term care due to severe disabilities. ElderShield Supplements are optional add-ons for higher coverage.
- Transition to CareShield Life: Starting from 2020, Singapore transitioned from ElderShield to CareShield Life, a more comprehensive long-term care insurance scheme that provides better financial support and is mandatory for all Singaporeans born in 1980 or later.
- Enhanced Benefits under CareShield Life: CareShield Life offers higher payouts that increase over time, with lifetime coverage for severe disability, ensuring better financial protection.
- Pioneer Generation Package: A scheme designed to honor and provide additional healthcare support to Singaporeans who were aged 65 and above in 2014 and obtained citizenship before 1987.
- Merdeka Generation Package: Targets Singaporeans who were aged 60 to 69 in 2019, providing them with additional subsidies for outpatient care, MediShield Life premium subsidies, and other benefits.
- Interim Disability Assistance Programme for the Elderly (IDAPE): Offers financial assistance to elderly Singaporeans who were not eligible for ElderShield due to age or pre-existing conditions.
- ElderFund: A scheme that provides additional financial support for lower-income Singaporeans aged 30 and above who need long-term care but are not eligible for other insurance schemes due to severe disabilities.
- MediFund: An endowment fund set up by the government to help Singaporeans who are unable to afford their medical bills despite government subsidies and other health financing schemes.
- Coverage of COVID-19 Medical Bills: The Singapore Government covers the COVID-19 medical bills for Singaporeans, Permanent Residents, and Long-Term Pass Holders, excluding those who test positive after returning from overseas travel under non-permitted travel arrangements.
- Comprehensive Approach to Healthcare Financing: Part II emphasizes Singapore's comprehensive and inclusive approach to healthcare financing, ensuring that various schemes and packages are in place to support citizens at different stages of life, particularly focusing on the elderly and those with long-term care needs.


User:
Please summarise and give me more detailed information about Chapter 10: Common Policy Provisions, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 10: Common Policy Provisions, into 10 bullet points


Assistant:
Chapter 10, titled "Common Policy Provisions," provides a detailed exploration of the standard elements and clauses found in health insurance policy contracts. Here's a summary in 10 bullet points:
- Introduction to Policy Provisions: The chapter begins by highlighting the importance of understanding policy provisions to avoid disputes between the insurer and the insured.
- Structure of a Health Insurance Policy: It outlines the typical sections of a health insurance policy, including the Policy Schedule, Insuring Clause & Definitions, General Conditions, Benefit Provisions, Exclusions, Claim Conditions, and Endorsements.
- Policy Schedule: This section contains specific details about the policy owner, insured persons, coverage limits, and other pertinent information.
- Insuring Clause & Definitions: Defines the scope of coverage and key terms used throughout the policy, ensuring clarity and understanding.
- General Conditions: Covers aspects related to policy management, such as premium payments, renewal terms, and the effective date of the policy.
- Benefit Provisions: Details the benefits that the policyholder is entitled to under the policy.
- Exclusions: Lists what is not covered by the policy, helping policyholders understand the limitations of their coverage.
- Claim Conditions: Outlines the procedures and requirements for filing claims, including the necessity for original documentation and the insurer's right to request medical examinations.
- Endorsements: Addresses any amendments or additional clauses attached to the policy, which may modify its terms or coverage.
- Dispute Resolution: Details the steps for resolving disputes, including mediation/arbitration and legal action provisions, emphasizing the role of the Financial Industry Disputes Resolution Centre Ltd (FIDReC) and the legal framework within the Republic of Singapore.
This chapter aims to provide readers with a comprehensive understanding of the common provisions found in health insurance policies, enabling them to navigate their insurance contracts effectively.


User:
Please summarise and give me more detailed information about Chapter 11: Health Insurance Pricing, into 10 bullet points


Assistant:
Chapter 11 of "Health Insurance 7th Edition" on Health Insurance Pricing provides a detailed exploration of how health insurance premiums are determined, focusing on various influencing factors and parameters. Here's a summary in 10 bullet points:
- Introduction to Premium Computation: The chapter begins by setting the stage for understanding the complex process of determining health insurance premiums, emphasizing the importance of various factors and parameters.
- Key Factors in Premium Calculation: It outlines the major factors influencing premium costs, including morbidity experience, investment income, operating expenses, medical inflation, the scope of benefits, insurer’s profit, premium payment modes, and underwriting depth.
- Morbidity Experience: This factor refers to the historical data on the frequency and severity of claims, which significantly influences premium rates.
- Investment Income: Insurers consider potential income from investing premiums when determining the cost, as this can offset some of the expenses related to claims.
- Operating Expenses: The costs associated with administering health insurance plans, including marketing, claims processing, and other administrative tasks, are factored into premiums.
- Medical Inflation: Rising costs of healthcare services and technologies contribute to increasing premium rates over time.
- Scope of Benefits Covered: The extent and variety of benefits offered by a policy directly impact the premium, with more comprehensive coverage requiring higher premiums.
- Insurer’s Profit and Risk Margin: Premiums include a margin to ensure the insurer remains profitable and can cover unexpected losses.
- Parameters for Premium Rating: Individual or group characteristics such as age, gender, health status, lifestyle, and occupation influence premium rates due to their impact on the risk of claims.
- Complexity of Pricing: The chapter emphasizes the multifaceted nature of health insurance pricing, highlighting the need for insurers to balance covering costs and obligations while ensuring affordability for policyholders.
Through this chapter, readers gain a foundational understanding of the principles and practices behind health insurance pricing, including the myriad factors and parameters that insurers consider when setting premiums.


User:
Please summarise and give me more detailed information about Chapter 12: Health Insurance Underwriting, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 12: Health Insurance Underwriting, into 10 bullet points


Assistant:
Chapter 12, titled "Health Insurance Underwriting," provides a comprehensive look into the underwriting process for health insurance. Here are the key points summarized:
- Introduction to Underwriting: Defines underwriting as the process of assessing risks to decide on accepting an insurance application and determining the terms. It's crucial for setting premiums that reflect the risks each applicant poses.
- Focus on Morbidity Risks: Unlike life insurance, which focuses on mortality risks, health insurance underwriting is concerned with morbidity risks, evaluating the likelihood of illness or injury leading to claims.
- Medical and Non-Medical Factors: Underwriting considers both medical factors, like an applicant's health history and current conditions, and non-medical factors, including financial status, occupation, age, and residency.
- Types of Health Insurance: The chapter discusses underwriting considerations unique to various health insurance types, such as medical expense insurance, disability income insurance, long-term care insurance, critical illness insurance, and managed healthcare.
- Underwriting Methods: Describes different methods, including full medical underwriting, moratorium underwriting, simplified issuance offer (SIO), and guaranteed issuance offer (GIO).
- Group Insurance Underwriting: Highlights factors like group stability, size, business nature, employee classes, participation level, age and gender demographics, expected persistency, past claims experience, and medical inflation.
- Sources of Underwriting Information: Identifies sources such as the proposal form, agent's statement, medical examinations/tests, attending physician's statement (APS), and supplementary questionnaires.
- Final Underwriting Decision: Discusses the potential outcomes, including acceptance, modification of terms, or decline due to serious medical or other reasons.
- Commencement of Risk: Risk begins once the proposer agrees to the terms of acceptance and pays the premium, marking the start of the insurance coverage.
- Importance of Underwriting: Underwriting is portrayed as a vital process that protects insurers against anti-selection risk and ensures premiums are proportionate to the risks involved.
This chapter underscores the complexity and critical nature of health insurance underwriting in maintaining the balance between risk management and premium affordability.


User:
Please summarise and give me more detailed information about Chapter 13: Notice No: MAS 120 Disclosure And Advisory Process - Requirements For Accident And Health Insurance Products, into 10 bullet points


Assistant:
Chapter 13 of the textbook, titled "Notice No: MAS 120 – Disclosure and Advisory Process Requirements for Accident and Health Insurance Products," provides a detailed overview of the regulatory guidelines issued by the Monetary Authority of Singapore (MAS) for the sale of accident and health insurance products. Here are the key points summarized:
- Objective of MAS Notice 120: The chapter begins by explaining the purpose of MAS Notice 120, which is to ensure that consumers are well-informed and receive appropriate advice when purchasing accident and health insurance products.
- Scope of Products: It specifies the types of insurance products covered under this notice, including accident and health insurance policies as well as life insurance policies that offer accident and health benefits.
- Definitions: The chapter provides definitions for key terms and concepts relevant to the notice, ensuring clarity in understanding the regulatory requirements.
- Disclosure Requirements: A significant portion of the chapter is dedicated to detailing the mandatory disclosure requirements that insurers and their representatives must adhere to during the sales process. This includes providing comprehensive information about the product features, benefits, exclusions, and risks.
- Advisory Process: The chapter outlines the advisory process requirements, emphasizing the importance of conducting a thorough needs analysis to ensure that the advice given is suitable for the client's financial situation and insurance needs.
- Know-Your-Client Procedures: It discusses the know-your-client (KYC) procedures that must be followed, including collecting and assessing information about the client's financial situation, objectives, and risk tolerance.
- Documentation and Record-Keeping: The chapter highlights the importance of proper documentation and record-keeping of the advice provided and the information disclosed during the sales process.
- Policy Switches: It addresses the handling of policy switches, including the need for clear documentation and justification when recommending a switch from one policy to another.
- Non-Mandatory Best Practices: The chapter also touches on non-mandatory best practice standards that insurers are encouraged to follow, including enhanced information disclosure and monitoring of policy switches.
- Regulatory Compliance: Finally, the chapter underscores the importance of compliance with MAS Notice 120 as part of the broader regulatory framework governing the sale of accident and health insurance products in Singapore, aiming to protect consumers and maintain the integrity of the insurance market.
This chapter provides a comprehensive guide to the regulatory requirements and best practices for the disclosure and advisory process in the sale of accident and health insurance products, as mandated by MAS Notice 120.


User:
Please summarise and give me more detailed information about Chapter 14: Financial Needs Analysis, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 14: Financial Needs Analysis, into 10 bullet points


Assistant:
Chapter 14, focusing on "Financial Needs Analysis" provides a comprehensive guide to understanding and implementing a client-centric approach in the financial advisory process. Here are the key highlights summarized into 10 bullet points:
- Needs Selling Versus Product Selling: The chapter begins by contrasting two sales approaches, emphasizing that needs selling prioritizes the client's financial needs and goals over pushing specific products, leading to more client satisfaction and long-term relationships.
- What Is Fact-Finding?: Fact-finding is introduced as a critical step in the financial needs analysis process, involving gathering comprehensive information about the client's financial situation, goals, and risk tolerance to make informed recommendations.
- Identifying & Quantifying Needs: This section details how to identify and quantify the client's financial needs, including immediate, short-term, and long-term goals, which is essential for creating a tailored financial plan.
- Product Recommendations: After analyzing the client's needs, the chapter discusses how to match these needs with appropriate financial products, ensuring that recommendations are suitable and aligned with the client's objectives.
- Presenting Your Recommendations: Techniques for effectively presenting recommendations to clients are covered, highlighting the importance of clear communication and how to address any concerns or objections they may have.
- Periodic Client Review: The chapter underscores the necessity of conducting periodic reviews with clients to assess their changing financial needs and circumstances, ensuring that their financial plan remains relevant and effective.
- Building Trust and Rapport: It emphasizes the importance of building trust and rapport with clients through transparency, active listening, and demonstrating a genuine interest in their well-being.
- Ethical Considerations: Ethical considerations in the financial needs analysis process are discussed, including the importance of honesty, integrity, and putting the client's interests first.
- Documentation and Compliance: The chapter highlights the need for thorough documentation of the fact-finding process, recommendations made, and any actions taken, ensuring compliance with regulatory requirements and standards.
- Continuous Learning and Improvement: Finally, it advocates for continuous learning and improvement in financial advisory skills, staying updated with industry trends, and adapting to new tools and methodologies to better serve clients.
This chapter provides a roadmap for financial advisors to conduct a thorough financial needs analysis, ensuring that clients receive personalized, goal-oriented advice and solutions.


User:
Please summarise and give me more detailed information about Chapter 15: Case Studies, into 10 bullet points


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User:
Please summarise and give me more detailed information about Chapter 15: Case Studies, into 10 bullet points


Assistant:
Chapter 15 of "Health Insurance 7th Edition" focuses on case studies related to individual and group health insurance scenarios. Here's a summary in 10 bullet points:
- Individual Case Study: Utilizes a Fact Find Form to gather information, identifying Disability Income Insurance and Total Permanent Disability (TPD)/Personal Accident Policy as suitable products based on employment status. It also highlights various products to cover medical costs, including Medical Expense Insurance and Critical Illness Insurance.
- Group Case Study: Uses a Group Fact Find Form for data collection, determining Sum Assured for Group Term Life Insurance either by rank or a multiple of the employee's basic salary. It emphasizes the importance of obtaining the company's past claim history for premium determination and the procedural steps from quotation to policy issuance.
- Managed Healthcare: Describes Managed Healthcare as a strategy for providing appropriate medical care while containing costs, focusing on accessibility, quality of care, and cost containment methods like capitation and discounted fees.
- Medical Expense Insurance: Covers specific medical expenses resulting from accidents and sickness, including inpatient and outpatient expenses, with various reimbursement benefits.
- Disability Income Insurance: Offers income replacement to safeguard one's earning capacity in case of total disability, with benefits including death, partial, and total disability during the benefit period.
- Long-Term Care Insurance: Pays benefits for the cost of care for those who are physically impaired and cannot function independently, covering conditions like Alzheimer's disease.
- Critical Illness Insurance: Provides a lump sum upon diagnosis of a specified dread disease, with new plans offering severity-based payouts and the possibility of multiple claims for different stages of a critical illness.
- Hospital Cash Insurance: Offers a daily cash benefit if hospitalized due to accident or illness, with a fixed cash amount not related to actual costs incurred.
- Exclusions and Underwriting: Lists common exclusions across different types of health insurance, such as pre-existing conditions and self-inflicted injuries. It also outlines important factors in underwriting, including medical history and current physical condition.
- Termination of Cover and Claims: Details scenarios leading to the termination of coverage, such as death of the insured or reaching the lifetime limit. It also explains the claims process, including the requirement for original medical bills and physician statements for out-of-network care.
This chapter provides a comprehensive overview of various health insurance products, their features, exclusions, underwriting considerations, and the claims process through practical case studies.

Chapter 1 - 2
Question: Which is not a government healthcare philosophy? 
A. To nurture a healthy nation by promoting good health.
B. To rely on competition to improve service and raise efficiency
C. To intervene directly whenever necessary
D. To provide for the care of employees
Answer: D. The correct answer is "To provide for the care of employees".


Chapter 1 - 5.2
Question: Which of the following is TRUE on the similarity of Means Testing and Casemix?
A. Both are financing mechanism.
B. Both are cost allocation mechanism.
C. Both are subsidies given by the government.
D. Both uses gross income of the patient to determine subsidy
Answer: C. The correct answer is "Both are subsidies given by the government".


C2/2.1.1(i)
Question: Under Medical Expense Insurance, what is not included in Inpatient Expenses?
A. Daily Room and Board Charges
B. Emergency Accidental Treatment Charges
C. Surgeon’s Fees
D. Congenital Anomalies
Answer: B. The correct answer is "Emergency Accidental Treatment Charges is not included in Inpatient Expenses".


C2/2.1.1(iii)
Question: Which of the following is covered under catastrophic outpatient expenses in Medical Expense
Insurance Policy?
A. Outpatient liver treatment charges
B. Outpatient kidney treatment charges
C. Outpatient Hepatitis B Vaccination
D. Outpatient assisted conception procedures
Answer: B. The correct answer is "Outpatient kidney treatment charges".


C2/2.2.3
Question: Miscarriage Benefit in a Medical Expense Policy provides for:
A. The reimbursement of expenses in a willful termination to a pregnancy.
B. The reimbursement of Assisted Conception Procedure treatments.
C. The reimbursement of charges incurred for the consultation of a specialist within a number of days before termination.
D. The reimbursement of medical expenses in an ectopic pregnancy
Answer: D. The correct answer is "The reimbursement of medical expenses in an ectopic pregnancy".


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C2/3.3
Question: Mr. Lim is buying a policy for himself and his wife and 2 children of the same premium each. 
What is the premium payable given the following?
Mr. Ang’s premium $182.31
Mrs. Ang’s premium $227.89
1 child’s premium $102.50
A. $512.70
B. $584.44
C. $615.20
D. $487
Answer: B. The correct answer is "The premium payable is $584.44". Rationale is that ($182.31 + $227.89 + $102.5 + $102.5 )X 95% (enjoy family discount of 5%) = $584.44


C2/3.5.1
Question: Which of the following is NOT a characteristic of medical expense insurance?
A. Pro ration factor and co-insurance.
B. Deductibles apply for all treatments.
C. Impose Sub- Limits.
D. Can be issued as a rider or stand-alone.
Answer: B. The correct answer is "Deductibles apply for all treatments".


C2/3.5.1
Question: Which of the following statement is TRUE?
A. Per disability/per year deductible is more restrictive as compared to per disability/per claim deductible.
B. The same sickness or injury within the same policy year applies to “per disability/per claim deductible”.
C. Per annum deductible includes a variety of covered sickness or injuries within a policy year.
D. Under per disability/per year deductible, the insured will have to bear the deductible each time he makes a claim regardless of the number claims made within the same year.
Answer: C. The correct answer is "Per annum deductible includes a variety of covered sickness or injuries within a policy year".


C2/3.5.3
Question: When the insured person is admitted to a ward higher than what he is entitled to under his existing plan, ___________is applied on the actual charges incurred and covered under the policy. It will cause actual benefits payable to be reduced. 
A. Deductible
B. Co–insurance
C. Means Testing
D. Pro-ration factor
Answer: D. The correct answer is "Pro-ration factor".


C3/2
Question: Which of the following characteristics of group insurance is important to the underwriter in determining the “feel” of future claim experience? 
A. Minimal underwriting requirement, as employee only need to complete a health declaration form.
B. Experience-rating, as it is usually underwritten based on past claims experience.
C. Cost effective, as it provides low cost protection.
D. Plan is renewable by the employer on a yearly basis.
Answer: B. The answer is "Experience-rating, as it is usually underwritten based on past claims experience".


C3/2
Question: Group Polices often have an “actively at work” clause. In order to be eligible for the cover, this clause requires:
A. The employee to be under a compulsory scheme.
B. The employee to be full time employed on the day the insurance coverage takes effect.
C. The employee to be at work on the day the insurance coverage takes effect.
D. The employee to obtain official Medical Certificate if he is unwell on the day the insurance coverage takes effect.
Answer: C. The answer is "The employee to be at work on the day the insurance coverage takes effect".


C3/4.1
Question: Which of the key factor in Portable Medical Benefit Scheme is most correct?
A. Employees will be medically insured in between jobs.
B. Employers are automatically granted tax deduction.
C. Employees contribute and pay through his own Medisave.
D. Employees have no control over the policy.
Answer: A. The answer is "Employees will be medically insured in between jobs".


C3/4.2
Question: When an employee leaves his current company, medical benefits provided by his employer will automatically be terminated. Which of the following plans purchased by the employer will solve this problem?
A. Group Medical Expense Insurance
B. Portable Medical Benefit Scheme
C. Transferable Medical Insurance Scheme
D. Integrated Shield Plans
Answer: C. The answer is "Transferable Medical Insurance Scheme".


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C4/Eg 4.3
Question: Compute Disability Income Benefit. Given the following details:
Escalation Benefit : 3%
Monthly Income : $5000
Monthly Expense : $3000
No of years : 30 years
A. $1,141,809
B. $1,712,714
C. $2,140,893
D. $2,854,524
Answer: C. The answer is "$2,140,893". 
Rationale is that:
$5000 x 75% = $3750
$3750 X 12 x *47.5754 = $2,140,893
* 47.5754 (factor from Table A1 – 3%; 30 years)


C4/5.1.2
Question: “The insured’s inability to perform any gainful occupation or a similar occupation for which he is reasonably suited by reason of education, training or experience” refers to: 
A. Any Occupation
B. Own Occupation
C. Specific Occupation
D. Modified Own Occupation
Answer: D. The answer is "Modified Own Occupation".


C4/6.2b
Question: Mr Tan, who is an accountant, used to earn $4,000 per month before he was disabled. After partial recovery from his disability, he found a suitable job as a clerk, which pays him $1,500 per month. What would Mr Tan’s disability income benefit be?
A. $3,000 per month
B. $2,500 per month
C. $1,875 per month
D. $4,000 per month
Answer: C. The answer is "$1,875 per month". Rationale is that $4000 - $1500 / $4000 x $3000 = $1875.


C4/11
Question: Disability Income will not terminate when the insured________.
A. changes his occupation.
B. resides outside Singapore for a specified period of time.
C. is unemployed for a period of time.
D. has not paid up his premiums due after the grace period.
Answer: A. The answer is "changes his occupation".


C5/2
Question: Which of the following regarding Long Term Care Insurance (LTCI) is true?
A. LTCI is meant to meet costs of care to a special group of elderly who is physically impaired and unable to function independently.
B. The young and healthy need not buy LTCI.
C. It is not governed by the Over Insurance Provision Clause.
D. Premiums are based on age band basis.
Answer: C. The answer is "It is not governed by the Over Insurance Provision Clause".


C5/3.1a 
Question: Which of the following payment method is associated with LTCI benefits issued under “Service Based” Policy ?
A. Indemnity Method.
B. Pays if meet benefit trigger.
C. Pays 100% if unable to perform 4 out of 6 ADLs.
D. Level Premium basis. 
Answer: A. The answer is "Indemnity Method".


C5/3.2.1
Question: Which of the following is NOT an Activity of Daily Living?
A. Continence
B. Morbidity
C. Dressing
D. Transferring
Answer: B. The answer is "Morbidity".


C5/8, 8/3.2.6
Question: In which area is Eldershield and Long Term Care Insurance different?
A. Free look Period.
B. The definition of Activity of Daily Livings (ADLs).
C. Purpose of the plans.
D. On how the plan is issued, eg guaranteed renewable basis.
Answer: A. The answer is "Free look Period".


C6/2.1g
Question: The insured must survive the survival period before the dread disease benefit becomes payable. The survival period is a period of time:
A. from the date of policy issue
B. from the date of any reinstatement of the policy
C. from the date of inception
D. from the occurrence of a dread disease
Answer: D. The answer is "from the occurrence of a dread disease".


C6/2.2& 2.7
Question: Critical Illness cover will not terminate when :-
A. Policy is converted into an Extended Term Policy.
B. A critical illness claim has been made.
C. Policy owner exercises Paid Up Option under the non forfeiture options.
D. Policy lapses due to non-payment of premium.
Answer: C. The answer is "Policy owner exercises Paid Up Option under the non forfeiture options".


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C6/2.3.1
Question: Mr. X bought a $150,000 whole life type of Critical Illness Policy with 50% acceleration benefit. How much is payable to him upon diagnosis of cancer? 
A. $150,000
B. $75,000
C. $50,000
D. $225,000
Answer: B. The answer is "$75,000".


C6/3
Question: Calculate the total maximum amount this Hospital Cash Income Insurance Policy will pay based on these policy details:
Daily Benefit: $100
Max of 180 days per hospitalization
Lifetime Limit: 1000 days
He was hospitalized for 185 days per hospitalization
A. $100,000
B. $18,500
C. $18,000
D. $180,000 
Answer: A. The answer is "$100,000". Rationale is that Lifetime limit of 1000 days X $100 per day = $100,000.


C7/3
Question: Managed Healthcare Organisations work through which components to manage healthcare expenditure?
A. Quality of Care.
B. Premiums.
C. Enrolment fee for non usage.
D. Number of members eligible for enrolment.
Answer: A. The answer is "Quality of Care."


C7/3.2
Question: To control increasing medical costs, which of the following is not used by Managed Healthcare? 
A. Capitation
B. Salary
C. Profit Sharing
D. Fee Schedule 
Answer: C. The answer is "Profit Sharing".


C7/5
Question: Which of the following MHC plans has the lowest degree of Cost Control?
A. Staff Model HMO
B. Group Model HMO
C. Network Model HMO
D. Traditional Medical Expense Insurance 
Answer: D. The answer is "Traditional Medical Expense Insurance".


C7/6.1
Question: Which of the following is not a benefit of Managed HealthCare Plans?
A. Preventive Care
B. Specialist Care
C. Intensive Care
D. Emergency Care
Answer: C. The asnwer is "Intensive Care".


C8/2.1
Question: Which of the following medical expenses could not be used to pay from one’s Medisave?
A. Spouse
B. Children
C. Parents
D. Grandparents (regardless of nationality)
Answer: D. The answer is "Grandparents (regardless of nationality)".


C8/2.1, 2.2
Question: Which of the following regarding Medisave and MediShield is true?
A. Medisave is a saving scheme and MediShield cover is granted automatically to Singaporeans when they became CPF members.
B. Both schemes are opt out scheme.
C. Both are low cost catastrophic medical insurance schemes.
D. Both have high deductibles.
Answer: A. The answer is "Medisave is a saving scheme and MediShield cover is granted automatically to Singaporeans when they became CPF members".


C8/2.1.1(f)
Question: Which of the following is not covered under Chronic Disease Management Programme?
A. Diabetes Mellitus
B. Osteoporosis (brittle bones)
C. Lipid Disorders
D. Hypertension
Answer: B. The answer is "Osteoporosis (brittle bones)".


C8/2.2.3
Question: Miss Ang was hosptialised for 8 days. Her total hospital bill was $22,400. She was able to receive $11,000 from her company group Medical Expense Policy. She is now awaiting for the reimbursement from her own private medical insurance (PMI). Details of her hospital bill & PMI (no deductibles and co insurance) as follows: 
| Description | Hospital Bills | Amount covered under PMI |
|---|---|---|
| Room and board | S$300 x 8 = $2,400 | S$250 x 8 = $2,000 |
| Surgery | S$20,000 | S$10,000 |
| Total | $22,400 | S$12,000 |
How much is she able to claim from her PMI?
A. S$11,400
B. S$12,000
C. S$22,400
D. S$10,400
Answer: A. The answer is "S$11,400". Rationale is that $22400 - $11000 = $11,400.


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C8/2.2.3
Question: Jenny went to Johor Bahru and while on her way back to Singapore, she met with an accident on March 2008. She incurred a bill of $6,300. Policy came with a deductible of $1500 and a co-insurance as follows:
$1000 - $3000 : 15%
$3001 - $6000 : 20%
How much would the insurer have paid her?
A. $3,840
B. $3,940
C. $3,990
D. $4,080
Answer: B. The answer is "$3,940".
Rationale is that,
Total expenses = $6300
Less deductible = ($1500)
Less co-insurance = *($860)
Claimable = $3940
* Computation of Co insurance
$1000 - $3000: $300 (15% x $2000)
$3001- $6000 : $560 (20% x $2800)
Total : $860


C9/3
Question: Which of the following section in a Health Insurance Contract must the adviser goes through with the client to ensure no typographical error?
A. Policy Schedule
B. Insuring Clause
C. Entire Contract Clause
D. Benefit Provision
Answer: A. The answer is "Policy Schedule".


C9/4.1
Question: Which of the following sections in a Health Insurance Policy contract represents the “foundation” of a Health Insurance Policy? 
A. Policy Schedule
B. General Conditions
C. Insuring Clause & Definitions
D. Benefits Provisions
Answer: C. The answer is "Insuring Clause & Definitions".


C9/5.3
Question: Which clause states that the policy shall not be in-force, unless premium is paid to the company on or before the inception date of the policy?
A. Insuring Clause
B. Renewal Provision
C. Incontestability Clause
D. Premium Warranty Clause. 
Answer: D. The answer is "Premium Warranty Clause".


C10/2.1
Question: What is the key factor for Health Insurance Pricing?
A. Mobility
B. Morbidity
C. Mortality
D. Longevity 
Answer: B. The answer is "Morbidity".


C11/2
Question: The role of underwriting is important because it enables the underwriter to:
A. Help to protect the insurer against anti-selection and in the preservation of the insurer’s reserves.
B. Ensure that the premium charged corresponds with the risk involved.
C. Ensure the re-insurance limits will not be exceeded.
D. Ensure that the premium charge is fair to the policyowner. 
Answer: B. The answer is "Ensure that the premium charged corresponds with the risk involved".


C11/3.1.1
Question: Which of the following is false with regard to insurers reviewing history of previous condition?
A. Effect of a medical history on the proposer’s general health.
B. Complications that may develop later on.
C. Possibility of a non recurrence.
D. Normal progression of any impairment.
Answer: C. The answer is "Possibility of a non recurrence".


C11/4.4
Question: To get a better insight to insured’s medical history, not available from medical examinations, underwriter request for:
A. Agent’s Statement
B. Supplementary Questionnaires
C. Medical Examination/Test
D. Attending Physician Statement
Answer: D. The answer is "Attending Physician Statement".


C12/5
Question: “Personal Accident Policy” means accident and health policy where accident and health benefits are paid out only:-
A. In the event of an injury to, or disability of, the insured as a result of accident.
B. On the death by accident of the insured.
C. All of the above
D. None of the above 
Answer: C. The answer is "All of the above".


C12/30
Question: An A&H Insurance Intermediary shall have a reasonable basis for providing advice to the insured. This shall not apply to:
A. Eldershield Policy
B. Long Term Care Insurance
C. Hospital Cash (Income) Insurance
D. Disability Insurance
Answer: A. The answer is "Eldershield Policy".


C13/App 13A(pg 241)
Question: During the Pre- Sale Stage for Individual Business, it is compulsory to provide which document(s) to the client?
A. “Know Your Client” form.
B. “Our Advice & Reasons Why” form.
C. Product Summary
D. Your Guide to Health Insurance and Product Summary. 
Answer: D. The answer is "Your Guide to Health Insurance and Product Summary."


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C13/App 13 (pg 243)
Question: Application of the Guidelines to direct marketing and telemarketing channels apply to:
A. When there is a face to face contact between the client and intermediary.
B. Marketing through the use of a call centre.
C. Road show conduct by intermediary
D. Visit to client from referrals.
Answer: B. The answer is "Marketing through the use of a call centre".


C13/App 13A (pg 263)
Question: Under LIA Guidelines, which penalty constitutes the 3rd offence for non compliance by the Representatives for not having submitted the completed and signed Fact Find Form and “Our Advice and Reason Why Form”?
A. Letter of warning
B. Counseling
C. Three months suspension
D. Retraining on Health Insurance
Answer: A. The answer is "Letter of warning".


C14/3.1(f)
Question: What serves as a starting or reference point for the advisers to recommend further A & H insurance recommendations to their clients? 
A. Client’s existing Health Insurance Policies
B. Client’s pay increase
C. Client’s promotion
D. Client’s affordability
Answer: A. The answer is "Client’s existing Health Insurance Policies".


C14/eg 14.3
Question: Compute maintenance cost using TPD Method. Given: Monthly Income : $4000; Monthly Expenses :$2000; No of years income needed : 21; Expected rate of return : 5%; Inflation Rate : 2% ; Existing fund : $0
A. $381,060
B. $739,920
C. $762,118
D. $1,417,766
Answer: A. The answer is "$381,060". 
Rationale is that,
$2000 x 12 = $24,000 x 15.8775 (table A2; 3%; 21 years)
 = $381,060


C14/4.2.4
Question: Calculation of how much Critical Illness Insurance the client needs is more of an art than a science as there are many uncertainties. Which of these factors would be most important?
A. Whether the client has the means to pay the premium.
B. Need to know the client’s family medical history to determine which disease the client is most susceptible.
C. Obtain the latest attending physician statement as an indication of his current physical condition.
D. Occupational risk classification of the client
Answer: B. The answer is "Need to know the client’s family medical history to determine which disease the client is most susceptible".


C15/2.1
Question: Which of the following product is often associated with providing maintenance costs for a client?
A. Disability Income Insurance
B. Dread Disease
C. Hospital Cash Insurance
D. Managed Healthcare Insurance
Answer: A. The answer is "Disability Income Insurance".


C1/5
Question: The fundamental principle of Singapore healthcare financing is ____________.
A. The 3’s M. That is Medisave, Medishield, Medifund.
B. Means Testing and Casemix.
C. Individual Savings.
D. Tax based subsidies and government subvention.
Answer: C. The answer is "Individual Savings".


C1/5.2
Question: Which of the following is not a feature of Casemix?
A. Patients in the same class have similar clinical conditions.
B. Patients in the same class generally cost the same amount to treat.
C. There must be optimal number in each classes.
D. Subsidies will be allocated to those patients accordingly.
Answer: D. The answer is "Subsidies will be allocated to those patients accordingly".


C2/2.1.1(iii)
Question: Which is included in Catastrophic Outpatient Treatment for Medical Expense Insurance? 
A. Outpatient Liver Charges
B. Outpatient Heart Charges
C. Outpatient Cancer charges
D. Outpatient Tuberculosis Charges 
Answer: C. The answer is "Outpatient Cancer charges".


C2/1.1(a)
Question: Which of the following is NOT covered under Daily Room and Board Charges in a Medical Expense Insurance?
A. Accommodation
B. Meals
C. General Nursing Services
D. Medicines and drugs 
Answer: D. The answer is "Medicines and drugs".


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C2/3.3
Question: If Mr Tan is enquiring about buying a policy for himself, his wife and 2 sons. Premium is as follows:
Himself = $500
His wife = $700
1 son = $300
After considering he would like to cover only himself and his wife. How much family discount did he enjoy? 
A. $0
B. $60
C. $75
D. $90
Answer: B. The answer is "$60". Rationale is that ($500 + $700) X 5% = $60.


C2/3.5
Question: Which of the following is Not part of expense participation?
A. Deductibles.
B. Co-insurance
C. Pro- ration factor
D. Co-ordination of benefits
Answer: D. The answer is "Co-ordination of benefits".


C2/3.5.1
Question: Mr. Tan and his family were injured while on holiday. They were covered under MEI, with a deductible of $3000 and a co-insurance of 10%. Determine the total amount payable to Mr.Tan, given hospital bills as follows:
Mr. Tan - $15,000
Mrs. Tan - $20,000
Son - $2,500
Daughter – $3,200
A. $26,280
B. $31,680
C. $33,630
D. $36,630 
Answer: A. The answer is "$26,280".
Rationale is that,
Mr. Tan : $15,000 - $3000 = $12,000 - $1,200 (coinsurance 10%) = $10,800
Mrs. Tan : $20,000 - $3000 = $17,000 - $1,700 (coinsurance 10%) = $15,300
Son : cannot claim as expense is below deductible
Daughter : $3,200 - $3000 = $200 - $20 (coinsurance 10%) = $180
Hence total payable = $10,800 + $15,300 + $180 = $26,280


C2/6
Question: Coverage on a life insured who is covered under Medical Expense Insurance will terminate when:
A. The total amount of claims has reached the annual limit.
B. When the insured attains the age of 80.
C. When the insured enters full time military service.
D. When the insured enters National Service Reservist Training.
Answer: C. The answer is "When the insured enters full time military service".


C3/2
Question: Which of the following is NOT a feature of Group Medical Insurance Policy?
A. Policy continues after one employee makes a claim.
B. All employees must undergo medical examination.
C. There are many life insureds in one master contract.
D. The policy covers all employees below the statutory retirement age. 
Answer: B. The answer is "All employees must undergo medical examination".


C3/3
Question: Mr. Tan would like his wife to be included under his company’s Group Medical Insurance Policy. What would the commencement date of cover for Mrs. Tan be?
A. Anytime within 30 days after marriage.
B. Anytime within 15 days after marriage.
C. Anytime within the half year after marriage.
D. Anytime as and when Mr. Tan apply for her to be included and cover approved by underwriting.
Answer: A. The answer is "Anytime within 30 days after marriage".


C3/4.3
Question: Coverage for which plan will expires at statutory retirement age? 
A. Medical Expense Insurance
B. Private Shield Plans
C. Portable Medical Benefit Scheme
D. Transferable Medical Insurance Scheme
Answer: D. The answer is "Transferable Medical Insurance Scheme".


C3/4.4
Question: Employers providing their employees with a Shield Plan can claim how many percent of tax deduction on their employees’ total remunerations? 
A. 1%
B. 2%
C. 3%
D. 4%
Answer: B. The answer is "2%".


C4/Table 4.1 
Question: Which of the following is a characteristic of Disability Income Insurance? 
A. Maximum sum assured is based on the salary.
B. Choice of deferred period.
C. Partial disability is not covered.
D. Incorporated into life policies. 
Answer: B. The answer is "Choice of deferred period".


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C4/Eg 4.3 
Question: David has a monthly income of $6,000 and has bought a Disability Income policy at 75% of his monthly income with a 3% escalation benefit. He is disabled and made a claim successfully on 1-1-2000. What is the amount that he will receive on the 1-3-2001?
A. $4,500
B. $6,000
C. $4,635
D. $4,770
Answer: C. The answer is "$4,635".
Rationale is that,
$6000 X 75% = $4500
$4500 + (3% X $4500 ) = $4635


C4/6.2.1
Question: Which type of payment will not affect Disability Benefit Payout?
A. Rental Income
B. Salary from ex-employer
C. Workman Compensation
D. TPD benefits under Life Insurance Policies
Answer: D. The answer is "TPD benefits under Life Insurance Policies".


C4/7
Question: Which of the following is NOT a feature of a Disability Income Insurance policy?
A. Premium based on age band.
B. No surrender value.
C. No assignment is allowed.
D. Can be issued as a stand-alone.
Answer: A. The answer is "Premium based on age band".


C5/3.1
Question: Which of the following least describes Long Term Care Insurance payment?
A. Monthly Basis
B. Daily Basis
C. Disability Based Basis
D. Yearly Basis
Answer: D. The answer is "Yearly Basis".


C5/3.2.1
Question: Which factor is the most important factor affecting premium for LTCI Plans? 
A. Renewability
B. Number of exclusions
C. Number of Activities of Daily Living
D. Insured’s choice of distribution channels
Answer: C. The answer is "Number of Activities of Daily Living".


C5/3.2.1b
Question: Which of the following condition is covered by Long Term Care Insurance?
A. Parkinson’s disease
B. Neurosis
C. Psychiatric illness
D. Dementia from Alzheimer’s Disease
Answer: D. The answer is "Dementia from Alzheimer’s Disease".


C5/9
Question: The following are exclusions under LTCI policies EXCEPT:
A. All pre-existing conditions, which were not fully declared and described by the insured at the time of application.
B. Alcoholism and drug abuse.
C. Any form of Acquired Immune Deficiency Syndrome (AIDS) or infection by any Human Immunodeficiency Virus (HIV).
D. Self inflicted injury.
Answer: C. The answer is "Any form of Acquired Immune Deficiency Syndrome (AIDS) or infection by any Human Immunodeficiency Virus (HIV)".


C6/2.2
Question: Which of the following is FALSE regarding Critical Illness riders?
A. Critical Illness riders do not acquire cash value.
B. It can also be issued as a Stand Alone Policy.
C. Packaged Critical Illness Policies may accumulate cash value, hence have non-forfeiture options.
D. There is no minimum and maximum sum assured restriction.
Answer: D. The answer is "There is no minimum and maximum sum assured restriction".


C6/2.2&2.7
Question: Critical Illness cover will be terminated:
A. When the policyowner exercise paid up option under Non forfeiture option.
B. When the policy is converted into an extended term insurance policy.
C. When the insured is diagnosed with a critical illness.
D. When an invalid critical illness claim has been made.
Answer: B. The answer is "When the policy is converted into an extended term insurance policy".


C6/2.3.1
Question: You are proposing a 50% Acceleration Dread Disease Policy to your client for his wife who is a homemaker. In this case, you should also propose to attach a
A. Waiver of Premium Rider to the policy.
B. Disability Income Insurance Rider to the policy.
C. Dread Disease Waiver of Premium Rider to the policy.
D. Total and Permanent Disability Benefit Rider to the policy.
Answer: C. The answer is "Dread Disease Waiver of Premium Rider to the policy".


C6/2.3.1
Question: Which of the following type of CI Cover you may not need to attached a Critical Illness Waiver of Premium Rider?
A. Acceleration Type
B. Additional Type
C. Both types
D. None of the types 
Answer: A. The answer is "Acceleration Type".


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C6/3.3.1
Question: Which of the following regarding Standalone Hospital Cash Insurance is false?
A. Free death benefit
B. Triple payment if hospitalized overseas due to accident
C. Double payment if in Intensive Care Unit
D. Get well benefit
Answer: A. The answer is "Free death benefit".


C7/3
Question: Which component of managed healthcare is not used to contain and control healthcare expenditure?
A. Accessibility
B. Cost
C. Quality of Care
D. Wide healthcare coverage
Answer: D. The answer is "Accessibility".


C7/3.1
Question: Primary care physician in Managed Healthcare Plan is NOT known as the following names:-
A. Backbone of Managed Healthcare plans
B. Gatekeepers
C. Personal Physician
D. Specialist 
Answer: D. The answer is "Specialist".


C7/4.1.5
Question: Which of the following offers the broadest consumer choice of physicians and clinical settings?
A. Staff Model
B. Group Model
C. Network Model
D. Mixed Model HMO
Answer: D. The answer is "Mixed Model HMO".


C7/4.2
Question: What are Preferred Provider Organisations(PPOs)? 
A. PPOs are gatekeepers.
B. PPOs allow clients to see specialist with referrals.
C. PPOs require greater “out of pocket” payments from members.
D. PPOs allow clients to choose to stay in the network or outside the network at point of service.
Answer: C. The answer is "PPOs require greater “out of pocket” payments from members".


C8/2.1.1b
Question: Which of the following regarding maternity charges is true of the Medisave Maternity Package?
A. It allow members to use Medisave to pay for pre-delivery expenses and delivery expenses up to the 4th living child.
B. It can be used to pay for pre-delivery expenses and delivery expenses up to the 5th and subsequent children.
C. Only female CPF members can use their Medisave to pay.
D. It allows for Assisted Conception Procedures to pay in full.
Answer: A. The answer is "It allow members to use Medisave to pay for pre-delivery expenses and delivery expenses up to the 4th living child".


C8/2.1.4
Question: Which of the following restrictions on use of Medisave is false?
A. Current Medisave ceiling may not be sufficient to cover catastrophic illness.
B. Covers limited outpatient treatments.
C. Must be hospitalized for more than 6 hours.
D. Covers only a maximum of 3 surgical operations
Answer: C. The answer is "Must be hospitalized for more than 6 hours".


C8/2.2.1
Question: MediShield has been enhanced in March 2013. Which of the enhancement(s) is/are True?
A. Maximum coverage has been increased to 92 years.
B. Policy year limit and lifetime limit has been increased to $70,000 to $300,000 respectively.
C. Maximum age of 75 has been removed.
D. All of the above. 
Answer: D. The answer is "All of the above".


C8/2.2.3
Question: John drove to Malaysia in March. On his way back, the lights were too dim, he got into an accident. He was hospitalised for 8 days, and the hospitalisation fees is $12,000. 3 months later, John had food poisoning and was admitted for 2 days. His hospitalisation fee is $2,500. Calculate how much John receives from his policy.
Given:
Policy renewable every September
Per disability /per year
Deductible : $1500
Co-insurance : $0-$3000 : 20%
$3001- $5000 : 15%
Above $5001 : 10% 
A. $11,700
B. $11,750
C. $11,500
D. $11,300
Answer: D. The answer is "$11,300".
Rationale is that,
Total expenses = $12,000 + $2,500 = $14,500
Less deductible = ($1500)
Less co-insurance = *($1700)
Claimable = $11,300
* Computation of Co insurance
$0 - $3000 : $600 (20% x $3000)
$3001- $5000 : $300 (15% x $2000)
Above $5001 : $800 (10% x 8000)
Total : $1700


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C8/3.3
Question: Interim Disability Assistance Program for the elderly came about:
A. To help the poor pay for medical bills.
B. To provide subsidies for the entire range of elderly and continuing care.
C. Eldershield is too costly.
D. To help those who cannot qualify for Eldershield Scheme due to their age or health reasons.
Answer: D. The answer is "To help those who cannot qualify for Eldershield Scheme due to their age or health reasons".


C9/3
Question: Which of the following are found in the Policy Schedule? 
A. Name, NRIC of Insured
B. Name, NRIC of Beneficiary
C. Claim procedures
D. Insurer’s contractual rights
Answer: A. The answer is "Name, NRIC of Insured".


C9/5.8
Question: The Renewal Provision in a Health Insurance Contract describes:
A. Insurer’s right to increase premium on policy.
B. Insured’s right to renew his policy under certain conditions.
C. Circumstances which the insurer has the right to offer a change in plan.
D. Insured’s right to renew at certain dates.
Answer: A. The answer is "Insurer’s right to increase premium on policy".


C9/9
Question: What are endorsements found in a Health Insurance Policy Contract?
A. Promise to pay by insurer
B. Restrict the scope of coverage
C. Actively At Work
D. Legal actions which insured can take against insurer
Answer: B. The answer is "Restrict the scope of coverage".


C10/2.2
Question: An increase in which of the following factor will NOT increase premium computation?
A. Investment income
B. Scope of benefits
C. Insurer’s expenses
D. Medical inflation
Answer: A. The answer is "Investment income".


C11/3.1.2
Question: Medical Aspects of Underwriting requires the consideration of___________.
A. Financial Factors
B. Current Physical Condition
C. Occupational Factors
D. Age Factors
Answer: B. The answer is "Current Physical Condition".


C11/3.4.2 
Question: What is NOT an advantage of Moratorium Underwriting? 
A. Insured will have the certainty as to what is covered at the point of joining, rather than at claim.
B. Insured need only provide basic information about himself.
C. Need not disclose the details of medical history.
D. Pre-existing conditions is covered after a few years, should it recur later, subject to conditions. 
Answer: A. The answer is "Insured will have the certainty as to what is covered at the point of joining, rather than at claim".


C11/4.4
Question: An underwriter needs to know more about a client’s medical history which the medical examination was not able to reveal. What form does he need?
A. Agent’s Statement
B. Attending Physician’s Statement
C. Supplementary Questionnaires
D. Fact Find Form 
Answer: B. The answer is "Attending Physician’s Statement".


C12/15
Question: An A&H Insurance Intermediary are required to disclose in writing to their clients before fact find stage: 
A. Potential conflict of interest
B. His qualifications
C. No. of times insurer receives claims
D. Detrimental switch 
Answer: A. The answer is "Potential conflict of interest".


C12/52(h)
Question: Which of these offences under MAS Notice 120 is not considered a criminal offence and does not attract any penalties?
A. Failure to disclose the conditions under which payment of policy moneys will not be made to insured.
B. Failure by the A&H representative to use only marketing materials that has been approved by the insurance intermediary.
C. Documents given to the insured are kept up to date.
D. Opinions expressed and facts are not differentiated.
Answer: C. The answer is "Documents given to the insured are kept up to date".


C13/App 13A (pg 244)
Question: For policies sold through direct marketing and telemarketing, insurer must ensure: 
A. A follow up letter to advise clients to read the Guide to Health Insurance and product summary which is enclosed.
B. A follow up letter to advise clients to return the policy to them if they find it unsuitable.
C. A follow up letter to advise clients to collect the Guide to Health Insurance and product summary from insurer.
D. A follow up letter to advise clients that an adviser will call on them to deliver and explain the Guide to Health Insurance and product summary.
Answer: A. The answer is "A follow up letter to advise clients to read the Guide to Health Insurance and product summary which is enclosed".


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C13/App 13A (pg 246)
Question: Under LIA Guidelines which documents, should insurer under Corporate Business make available to insured members’ of a voluntary plans?
A. “Know Your Client’ form
B. “Our Advice & Reason Why” form
C. Your Guide to Health Insurance
D. Benefit Illustration
Answer: C. The answer is "Your Guide to Health Insurance".


C13/App 13B(pg 276)
Question: When recommending a Group A&H Policy, what must be given to the client before the client applies for the product?
A. Group Insurance Fact Find Form.
B. Your Guide to Health Insurance.
C. Our Reasons and Why form.
D. Product Summary.
Answer: A. The answer is "Group Insurance Fact Find Form".


C14/3.3
Question: Most group insurance is issued without medical examination as the risk for the insurer diminishes as the size of the group increases. This is known as _________________.
A. The law of large numbers.
B. Principle of Utmost Good Faith.
C. Principle of Ordinary Good Faith.
D. Principle of insurable interest.
Answer: A. The answer is "The law of large numbers".


C14/Eg 14.3
Question: Mr Tan has a monthly income and expenditure of $7,000 and $5,000 respectively. His son is currently 2 years old and he would like to provide for his son till age 25. Assuming that the interest rate is 5% and inflation is 2%, please calculate his maintenance cost.
A. $ 406,486
B. $1,016,214
C. $1,076,130
D. $1,422,700
Answer: B. The answer is "$1,016,214".
Rationale is that,
$5000 x 12 = $60,000 x 16.9369 (table A2 – 3%’ 23 yrs) = $1,016,214


C14/4.1.1
Question: Mr. Lim the prospective client does not have an emergency fund, you should:
A. still recommend suitable products.
B. ensure he ticks Type 1 of the application type.
C. not recommend any policies as it may affect his ability to service the policies.
D. recommend disability income insurance. 
Answer: C. The answer is "not recommend any policies as it may affect his ability to service the policies".


C15/2.1
Question: Which of the following policy is MOST suitable for meeting the maintenance costs of a client?
A. Personal Accident Policy (with medical expense benefit)
B. Critical Illness Insurance
C. Long Term Care Insurance
D. Disability Income Insurance
Answer: D. The answer is "Disability Income Insurance".


C1/3.1
Question: Primary Care Partnership Scheme does not cover treatment for:
A. Cancer Treatment
B. Diabetes Mellitus
C. Hypertension
D. Lipid Disorders
Answer: A. The answer is "Cancer Treatment".


C1/5.2
Question: Which of the following is a Costing Mechanism to determine amount of subsidies to be given?
A. Means Testing
B. Casemix
C. Universal Coverage
D. Voluntary Welfare Organization
Answer: B. The answer is "Casemix".


C2/2.2.3
Question: Which of the following regarding Medical Expense Insurance is true?
A. Only per policy year limits are stated.
B. Miscarriage due to ectopic pregnancy is covered.
C. Payment is on a per charged benefits basis.
D. Policy will not cease if it reaches the lifetime limit.
Answer: B. The answer is "Miscarriage due to ectopic pregnancy is covered."


C2/2.2.8
Question: Final Expenses Benefit in a Medical Expense Insurance covers:
A. Death that occurs within a specified no. of days after leaving the hospital and is a result of the cause of the hospitalization.
B. Death that occurs during hospitalization or within a specified no. of days after discharge from the hospital.
C. The cost of medical evacuation of patients and repatriation of mortal remains.
D. Death that occurs after a waiting period of 30 days, from the issue date or reinstatement date of the policy before any claim is payable
Answer: A. The answer is "Death that occurs within a specified no. of days after leaving the hospital and is a result of the cause of the hospitalization".


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C2/3.5.1
Question: When one is required to pay a deductible regardless of the no. of claims made in a year, this type of deductible is known as:
A. Per Annum Deductible
B. Per Disability/Per Year Deductible
C. Per Disability/ Per Claim Deductible
D. Per Disability/Per Annum Deductible
Answer: C. The answer is "Per Disability/ Per Claim Deductible".


C2/3.5.1
Question: Mrs Lim has bought a Medical Expense Insurance with a deductible for $10,000 for 1st June 2012 to 31st May 2013. On 1st Sept 2012, she encountered an accident and the total claimable medical expenses were $3,000. In March 2013, she went for surgery to remove her womb and the medical costs were $8,000. How much can Mrs Lim claim, given that a per-disability/per claim deductible applies?
A. $11,000
B. $8,000
C. $1,000
D. $0
Answer: D. The answer is "$0".


C2/3.5.1
Question: Which is the most suitable plan type to recommend to a client who has financial constraint?
A. with deductible
B. with co-insurance
C. both deductible and co-insurance
D. no deductible and co-insurance
Answer: C. The answer is "both deductible and co-insurance".


C2/3.12
Question: All integrated Shield Policies are guaranteed renewable. Which of the following is Not True?
A. Insurer cannot terminate the policy owing to poor claims experience.
B. Insurer cannot terminate the policy owing to insured’s poor health condition.
C. Insurer cannot terminate the policy if policyowner continues to pay his premium till death occurs.
D. Insurer cannot terminate the policy owing to insured’s change in occupation.
Answer: C. The answer is "Insurer cannot terminate the policy if policyowner continues to pay his premium till death occurs".


C3/2
Question: Which of the following characteristics of group insurance describes multiple lives under one contract?
A. Master contract
B. Plan continuation
C. Experience rating
D. Minimal underwriting
Answer: A. The answer is "Master contract".


C3/3.1
Question: Which of the following must be disclosed to the participants for Group Voluntary A&H Policies? 
A. Premium is fully paid by the employer.
B. They have a say in the type of coverage that they want.
C. Contractual rights of the insurer.
D. Duration of coverage is until age 62.
Answer: B. The answer is "They have a say in the type of coverage that they want".


C3/3.2
Question: Which of the following is the most important factor for the underwriter when underwriting Group Insurance?
A. Gender & age.
B. Health & financial status.
C. Smoking habit and family history.
D. Occupational risks.
Answer: A. The answer "Gender & age".


C3/4.2.1 
Question: Which of the following is NOT TRUE of the employer to qualify for Transferable Medical Insurance Scheme (TMIS)? 
A. Must have a group size of 11 or more employees.
B. To take up a Group Medical Expense Insurance Plan.
C. Insure at least 50% of its local employees.
D. Pay 50% of the premium for the Group Medical Expense Insurance coverage.
Answer: D. The answer is "Pay 50% of the premium for the Group Medical Expense Insurance coverage".


C4/5.1.3
Question: Which of the following is most stringent in the definition of Total Disability under Disability Income Insurance? 
A. Own Occupation
B. Any Occupation
C. Modified Occupation
D. Similar Occupation 
Answer: B. The answer is "Any Occupation".


C4/5.3
Question: If an insured who has been receiving disability benefits under a Disability Income policy returns to work, but suffers a relapse within a specified period of time for the same cause, most insurers will: 
A. Waive the deferment period and benefit payments will recommence immediately.
B. Waive the deferred period and benefit payments will be at least 25% lower as it is considered a partial disability.
C. Treat it as a new claim, for the purpose of determining the duration of the benefit payment period.
D. Treat it a new claim and subject insured to the waiting period again.
Answer: A. The answer is "Waive the deferment period and benefit payments will recommence immediately".


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C4/6.2d
Question: Mary, a lecturer bought a DI Policy, became disabled on 30/6/08. 
Her details as follows:
Salary : $8000 per month ;
Her expenses: $3000 per month;
Annual Escalation Benefit : 3% ;
6 Month Deferred Period chosen.
When will she received the first payment from the insurer and for how much? 
A. 1/1/2009 for $8000
B. 1/1/2009 for $6000
C. 31/12/2008 for $6180
D. 31/12/2008 for $2250
Answer: B. The answer is "1/1/2009 for $6000".
Rationale is that,
Deferred period 6 months from 30/6/08, hence payable on 1/1/09. Payments = $8000 x 75% = $6000


C4/6.2d
Question: Mary, a lecturer bought a DI Policy, became disabled on 30/6/08. 
Her details as follows:
Salary : $8000 per month ;
Her expenses: $3000 per month;
Annual Escalation Benefit : 3% ;
6 Month Deferred Period chosen.
When will the escalation benefit kicked in and how much will she get?
A. 30/6/2009 for $8240
B. 31/12/2008 for $5150
C. 1/2/2009 for $6080
D. 1/1/2010 for $6180 
Answer: D. The answer is "1/1/2010 for $6180".
Rationale is that,
Escalation will be effective on the 2nd year ie 1.1.2010 at $6180 ($6000 + $6000 x3%)


C4/6.2d
Question: Mary, a lecturer bought a DI Policy, became disabled on 30/6/08. 
Her details as follows:
Salary : $8000 per month ;
Her expenses: $3000 per month;
Annual Escalation Benefit : 3% ;
6 Month Deferred Period chosen.
Mary subsequently on 1/2/2010 found a job as a tutor which pays her $2000 a month. Calculate partial disability benefit payable on 1/2/2010
A. $3,090
B. $4,500
C. $4,635
D. $4,180
Answer: C. The answer is "$4,635".
Rationale is that, ($8000 - $2000)/$8000 x $6180 = $4635


C5/3.2
Question: Which of the following criteria for payment of Long Term Care Insurance Benefit is False?
A. Need to be hospitalised.
B. Need not be hospitalised.
C. Use the benefits to pay for the cost of engaging a maid.
D. Use the benefits to pay for costs of staying in a nursing home.
Answer: A. The answer is "Need to be hospitalised".


C5/3.2.2
Question: In Long Term Care insurance, the deferred period is defined as a period of time:
A. after the insured is certified by a medical practitioner that he is unable to perform specified numbers of ADLs.
B. from the inception of the policy or any reinstatement of the policy
C. from the commencement date of the policy.
D. from the time the insured is hospitalized.
Answer: A. The answer is "after the insured is certified by a medical practitioner that he is unable to perform specified numbers of ADLs".


C5/4
Question: When a person requires an assistive rehabilitation device, which of the following benefits available under a Long Term Care plan could provide it?
A. Rehabilitation Benefit
B. Extended Care Benefit
C. Surgical and Prosthesis Device
D. Financial Assistance with Adaptation
Answer: D. The answer is "Financial Assistance with Adaptation".


C5/9
Question: Which of these exclusions apply to Long term Care Insurance?
A. All forms of AIDS.
B. Participation in a felony, riot or insurrection.
C. Flying other than a fare paying passenger.
D. Convalescent & special nursing care, general medical checkup
Answer: B. The answer is "Participation in a felony, riot or insurrection".


C6/2.3.1
Question: 100% Acceleration Dread Disease Policy is MOST suitable for clients who:
A. has dependents.
B. has sufficient life insurance.
C. disability income insurance.
D. wish to stay in A class or B1 class wards when hospitalized.
Answer: B. The answer is "has sufficient life insurance".


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C6/2.3.1
Question: Mr Tan has a Critical Illness Policy with a 50% acceleration benefit. The policy also has a Critical illness waiver of premium rider attached to it. After a dread disease claim by Mr Tan, which of the following statement(s) regarding the premium is most true?
A. remain unchanged
B. premium is waived for the full sum assured
C. premium reduced in proportion to how the basic sum assured is reduced.
D. premium will be reduced by 50%.
Answer: C. The answer is "premium reduced in proportion to how the basic sum assured is reduced".


C6/5.5
Question: Group Dental Care will terminate under which event?
A. Insured enters full time military service.
B. Insured exercises one of the non forfeiture options.
C. Insured could claim from other sources like Workmen Compensation.
D. Insured reaches age 60.
Answer: A. The answer is "Insured enters full time military service".


C6/5.6
Question: Which of the following is TRUE regarding claims on Group Dental Care?
A. Insured can only use insurer panel of dentists.
B. Insured have to make payment first and file a claim with insurer for reimbursement if he uses his own dentists.
C. Insured has to make payment first whether or not he uses his own or insurer’s panel of dentists.
D. The dental clinic will bill the insurer directly for bills incurred.
Answer: B. The answer is "Insured have to make payment first and file a claim with insurer for reimbursement if he uses his own dentists".


C7/3
Question: How does Managed Healthcare Organizations control expenditure on healthcare?
A. Controlling the premium charged to members.
B. Enrolment fees for members.
C. Implementing enrolment fees for non utilisation of services by members.
D. Accessibility.
Answer: D. The answer is "Accessibility".


C7/3.2
Question: Which of the following is not a feature of the cost management of Managed Healthcare Organisations?
A. Large member enrolment
B. Consumer choices for healthcare services
C. Negotiated Provider Fees
D. Government subsidies on hospitals 
Answer: D. The answer is "Government subsidies on hospitals".


C7/4.14
Question: Which one of the following models do the physicians actively continue to develop their own private practices?
A. Staff Model HMO
B. Group Model HMO
C. Independent Practitioners Association (IPA) HMO
D. Network Model HMO
Answer: C. The answer is "Independent Practitioners Association (IPA) HMO".


C7/6.5
Question: When making a claim under Managed Healthcare Insurance, the documents to be provided are :-
A. original medical bill
B. claimant's NRIC
C. letter from employer
D. letter from Attending Physician confirming the necessity of the treatment.
Answer: A. The answer is "original medical bill".


C8/2.1.1(h)
Question: To buy any of the approved products, such as Private Integrated Shield Plans using Medisave savings, which of the following is true? 
A. Premium is limited to $800 (per person per year) if the insured is below 65 years old.
B. Premium is limited to $1,000 (per person per year) if the insured is below 65 years old.
C. Premium is limited to $1,200 (per person per year) if the insured is above 65 years old.
D. No withdrawal limit. 
Answer: A. The answer is "Premium is limited to $800 (per person per year) if the insured is below 65 years old".


C8/2.1.4
Question: Which of the following is NOT true of restrictions imposed on Medisave? 
A. It covers unlimited outpatient treatments.
B. Pays if hospitalised more than 8 hours.
C. Covers maximum 3 surgical operations.
D. Withdrawal limits imposed are usually not sufficient to cover the full hospital bills.
Answer: A. The answer is "It covers unlimited outpatient treatments".


C8/3
Question: The main difference between CPF MediShield Scheme and a Private Integrated Plan is:
A. Both are administered by CPF Board.
B. No expiry age for both.
C. Annual limits and Lifetime limits are applicable for both
D. Annual limits are applicable for both. 
Answer: D. The answer is "Annual limits are applicable for both".


C8/3.2
Question: Which of the following is not for the poor and needy Singaporeans?
A. Eldershield
B. Elderfund
C. Medifund
D. Mediguard
Answer: A. The answer is "Eldershield".


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C8/3.2.6
Question: Which of the following key features of Eldershield Schemes is/are FALSE?
A. No surrender value
B. 75 days grace period
C. Has minimum and maximum entry age
D. None of the above 
Answer: D. The answer is "None of the above".


C9/3
Question: In a Health Insurance Policy Contract, what is included in Policy Schedule?
A. Premiums and effective date of cover.
B. Name and NRIC of Beneficiaries.
C. Nature and objective of plan.
D. Risks of the product.
Answer: A. The answer is "Premiums and effective date of cover".


C9/5.8
Question: The Renewal Provision describes:
A. Insurer’s right to renew the coverage.
B. Insured’s right to have his coverage renewed
C. Insurer’s right to decrease sum assured
D. Insurer’s right to cancel the coverage. 
Answer: D. The answer is "Insurer’s right to cancel the coverage".


C9/8.3
Question: Physical examination provision is included in Disability Income Polices to enable insurer to;
A. have the insured examined by the insurer’s doctor at the insured’s expense.
B. have the insured examined by the insured’s doctor at the insurer’s expense.
C. have the insured examined by the insurer’s doctor at the insurer’s expense.
D. have the insured examined by the insured’s choice of doctors on a contributory basis
Answer: C. The answer is "have the insured examined by the insurer’s doctor at the insurer’s expense".


C10/2
Question: Which of the following key factors is NOT used in computing premium for Health Insurance Products?
A. Investment Income
B. Mode of Premium
C. Operating expenses
D. Occupation
Answer: D. The answer is "Occupation".


C11/3.3.2
Question: Underwriters look particularly for applicant’s earning and overall financial situation in underwriting:
A. Long Term Care Insurance
B. Disability Income Insurance
C. Critical Illness
D. Managed Health Care
Answer: B. The answer is "Disability Income Insurance".


C11/3.3.3
Question: Cognitive assessment is normally required during the underwriting stage for which plan?
A. Long Term Care Insurance.
B. Basic Medical Expense Insurance.
C. Eldershield.
D. Disability Income Insurance. 
Answer: A. The answer is "Long Term Care Insurance".


C11/3.3.4
Question: Which of the following factor is most important for underwriting Critical Illness Insurance?
A. Family history.
B. Overall financial condition.
C. Cognitive impairment.
D. Age and gender.
Answer: A. The answer is "Family history".


C11/4.2
Question: Agent’s statement is needed to:
A. Let underwriter knows why that product is recommended.
B. Indicate applicant’s approximate net worth.
C. Clarify situations that is unquestionable.
D. Indicate information that is important to the applicant.
Answer: B. The answer is "Indicate applicant’s approximate net worth".


C12/18
Question: Which of the following is considered an offence and liable to a fine not exceeding $25,000 or imprisonment for a term not exceeding 12 months or both?
A. Failure to comply with the “Know Your Client” requirements.
B. Failure to have a reasonable basis for providing advice.
C. Failure to use marketing materials approved by the intermediary.
D. Failure to provide and explain the benefit illustration or product summary to the insured.
Answer: D. The answer is "Failure to provide and explain the benefit illustration or product summary to the insured".


C13/App 13A(pg 242)
Question: What is not included under the Product Information Section in the LIA & GIA Guidelines on Disclosure Requirements?
A. Benefits Schedule Table
B. Premium rates
C. Definition of activities of daily living
D. Waiting period 
Answer: D. The answer is "Waiting period".


C13/13B(pg 259)
Question: The requirement of using fact find form, LIA Guidelines on Needs- Based Sales Process for individual health insurance products does not apply to: 
A. Direct marketing
B. Personal Accident Policy
C. Eldershield
D. All of the above 
Answer: D. The answer is "All of the above".


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C13/App 13B(pg 260)
Question: “Application Type 1” in the Fact Find Form means: 
A. Full completion of the Fact Find Form and the client wishes to receive the representative’s recommendation of product suitability.
B. Partial completion of the Fact Find Form and the client wishes to receive the representative’s recommendation of product suitability.
C. It is the client responsibility to ensure product suitability.
D. Client did not undergo any needs analysis.
Answer: A. The answer is "Full completion of the Fact Find Form and the client wishes to receive the representative’s recommendation of product suitability".


C14/3.1(f)
Question: What is true of the minimum requirements when the client chooses Type 1, 2, or 3 of the Application Types in the Fact Find Form? 
A. Personal Information
B. Recommendation
C. Existing health polices
D. Health conditions 
Answer: A. The answer is "Personal Information".


C14/Eg 14.3
Question: Calculate Maintenance Cost given these assumptions:
Monthly income needed = $1,500
No. of years income needed = 21
Rate of return = 5%
Inflation rate = 2%
Existing Life Insurance = $150,000
A. $350,139
B. $285,795
C. $135,794
D. $87,705
Answer: C. The answer is "$135,794".
Rationale is that, 
$1500 X 12 = $18,000
$18,000 X 15.8775 (table A2– 21 yrs; 3%) = $$285,794
$285,794 – $150,000 (life insurance )= $135,794


C14/4.2.4
Question: During need analysis, when recommending a Critical Illness Insurance, what must an advisor advise a client? 
A. Claims procedures.
B. Underwriting considerations.
C. Mode of Payment.
D. Coverage
Answer: D. The answer is "Coverage".


C15/2.2
Question: Quantify the level of Medical Expense needed, given the following:
Basic average medical expenses = $24,000
Benefits paying under Group policy = $18,240
Amount payable under Incomeshield Plan = $7,335
A. $5,760
B. $16,665
C. $1,575
D. No Shortage of medical expense protection
Answer: D. The answer is "No Shortage of medical expense protection".
Rationale is that, $24,000 – ($18,240 +$7335) = ($1,575); no shortage


C 1/4
Question: Voluntary Welfare Organisations does not refer to an organization that________________.
A. provides healthcare services for the elderly.
B. is driven by a strong spirit of volunteerism.
C. is profit making.
D. caters to those in need and helps disabled to be independent.
Answer: C. The answer is "is profit making".


C1/5.1.1
Question: Means Testing in public hospitals was introduced:
A. To provide B2 and C class subsidies in a fair manner with the lower income group.
B. To provide all Singaporeans who stays in hospital regardless of the ward class.
C. To provide subsidies for specialist outpatient and polyclinic visits.
D. As a cost allocation mechanism.
Answer: A. The answer is "To provide B2 and C class subsidies in a fair manner with the lower income group".


C2/2.2
Question: The other benefits provided by the insurers under Medical Expense Insurance include:
A. Miscarriage Benefit
B. Gamma Knife Charges
C. Emergency Accidental Treatment
D. Anesthetist’s Fees
Answer: A. The answer is "Miscarriage Benefit".


C2/2.2.1
Question: Under Medical Expense Insurance, when the Insured Person is a recipient, Major Organ Transplant Benefit covers: 
A. Donor Costs
B. Cost of Surgeries
C. Acquisition of Organ
D. Recipient Costs
Answer: B. The answer is "Cost of Surgeries".


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C2/3.5.1
Question: Nelson Tan has a medical expense insurance policy which has a deductible of $2000 per policy year from 1st Jan to 31st Dec 2013. He was warded for high fever in 1st Apr and incurred a bill of $1200 for a two day stay in the hospital. Four months later, he was treated in hospital due to a fracture of the leg and incurred a hospital bill of $2100. How much can Nelson claim from the insurer under per annum deductible?
A. $100
B. $1300
C. $2000
D. $3300
Answer: B. The answer is "$1300". Rationale is that, $1200 + $2100 - $2000 = $1,300.


C2/3.9
Question: Waiting Period is Not applicable for:
A. Accidental Injury
B. Sickness
C. First year of coverage
D. Disease 
Answer: A. The answer is "Accidental Injury". 


C2/3.10
Question: A waiting period protects _____________, by ensuring that individuals are not able to make claims shortly after joining and cancelling membership.
A. members within the portfolio
B. insured party
C. insurer
D. Insured and Insurer
Answer: A. The answer is "members within the portfolio".


C2/3.13
Question: Which of the following exclusions and limitations under Medical Expense Insurance is FALSE?
A. To avoid the policyowner selecting against the insured.
B. To make premium more affordable.
C. To avoid policyowner receiving reimbursement twice and making a profit.
D. To define more clearly the necessary medical care and treatment. 
Answer: A. The answer is "To avoid the policyowner selecting against the insured".


C3/3.1
Question: Which type of Group Medical Expense Insurance Plans gives the employees some control over the plan?
A. Voluntary Plan
B. Compulsory Plan
C. Compulsory Plan and Voluntary Plan
D. None
Answer: A. The answer is "Voluntary Plan".


C3/3.2
Question: Which of the following factors are considered the most important to the underwriters in Individual Insurance underwriting?
A. Eligibility
B. Choice of plan
C. Gender and age
D. Health and financial status 
Answer: D. The answer is "Health and financial status".


C4/2 &8
Question: Peter is covered with a Disability Income and has been receiving benefits. However, he recovered from his disability, 
A. the insurance cover will continue covering if Peter starts paying premium.
B. policy will terminate as maximum limit of benefit reached.
C. policy continues paying benefits to Peter.
D. policy provides for a reduced benefit to be paid to Peter. 
Answer: A. The answer is "the insurance cover will continue covering if Peter starts paying premium".


C4/5.4 
Question: Mr. Sim has requested for a Disability Income Policy with a short benefit period. Hence insurer will: 
A. Charge a lower premium.
B. Charge a higher premium.
C. Reduce the payouts.
D. Increase the payouts. 
Answer: A. The answer is "Charge a lower premium".


C4/6.2.1
Question: The disability benefit payable under a Disability Income policy will be reduced by the following sources of income:
A. payments from other insurance against illness/ sickness.
B. any gains from other insurance investment policies.
C. any continuing salary derived by the insured from the occupation engaged immediately prior to disability.
D. if the insured fails to pay any premiums due for the Disability Income policy.
Answer: C. The answer is "any continuing salary derived by the insured from the occupation engaged immediately prior to disability".


C4/7,5/8
Question: Disability Income is similar to Long Term Care in that:
A. If insured recovers from the disability, payment will stop but policy will not be terminated if premiums are paid by the insured.
B. Benefits are level throughout the policy period.
C. They cover hospitalization charges.
D. Available only to working adults with earned salary.
Answer: A. The answer is "If insured recovers from the disability, payment will stop but policy will not be terminated if premiums are paid by the insured".


C4/9
Question: Benefits under a Disability Income Insurance policy will cease upon occurrence of any of the following events: 
A. when the insured changes his occupation.
B. when the benefit period expired.
C. when the insured fails to pay his premiums due.
D. when the insured changes from full-time employment to part-time employment.
Answer: B. The answer is "when the benefit period expired".


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C3/3.2 Table
Question: Which of the following is not true of Group Insurance? 
A. The group must have been formed for some purpose other than to obtain insurance.
B. Underwriting of the group on the whole is based on gender and age.
C. Premium is age related.
D. The individual life insured’s coverage stop when he leaves the group.
Answer: C. The answer is "Premium is age related".


C3/4.2.2
Question: How does the “continuation benefits” under the TMIS benefits the employee?
A. To continue enjoying hospitalization coverage from the termination for 12 months.
B. To enjoy automatic coverage under the New Employer Group Medical Expense Plan.
C. Waiver of exclusion on pre existing medical conditions when joining his new employer.
D. Enjoy a lower entitlement of either the new employer TMIS plan or prior employer TMIS plan. 
Answer: A. The answer is "To continue enjoying hospitalization coverage from the termination for 12 months.".


C5/4
Question: What is Extended Care Benefit under Long Term Care Insurance? 
A. 2 times of the monthly benefit payable to assist the insured to perform an ADL.
B. An extra monthly benefit given to the insured.
C. To extend the payout period of Eldershield.
D. To increase the monthly payment under Eldershield.
Answer: B. The answer is "An extra monthly benefit given to the insured".


C5/4
Question: In Long Term Care Insurance, Financial Assistance with Adaptation Benefit is:
A. An extra specified amount paid daily.
B. An extra monthly benefit.
C. A specified amount, 2 times the monthly benefit.
D. A specified sum more than the sum assured payable in special interval time.
Answer: C. The answer is "A specified amount, 2 times the monthly benefit".


C5/7
Question: The following features of LTCI are FALSE EXCEPT:
A. Plans cover advanced dementia due to Acquired Immune Deficiency Syndrome.
B. It can either be non-participating or participating, depending on the basic plan.
C. Premiums are escalating based on age bands.
D. Should the insured recover from his disability, payments will stop.
Answer: D. The answer is "Should the insured recover from his disability, payments will stop".


C6/3.1.1
Question: Which of the following is NOT a feature of Hospital Cash Insurance?
A. Waiting period applies for illness and injury.
B. Waiting period does not apply for injury.
C. Benefit payments not affected by payments from other medical insurance policies.
D. Mostly guaranteed renewable on a yearly basis. 
Answer: A. The answer is "Waiting period applies for illness and injury".


C6/3.1.1
Question: Which of the following situation will be covered during the waiting period for a Hospital Cash Insurance Policy? 
A. Kidney failure
B. Miscarriage
C. Food poisoning
D. None of the above
Answer: C. The answer is "Food poisoning".


C6/5.3
Question: Group Dental Insurance usually does NOT cover
A. Scaling and polishing of teeth.
B. Wisdom tooth extraction.
C. Pre-existing dental conditions.
D. Replacement of stolen dentures.
Answer: D. The answer is "Replacement of stolen dentures".


C6/5.3
Question: Which of the following does Group Dental Care insurance NOT cover?
A. Pre-existing dental conditions.
B. Medicine given.
C. Wisdom tooth extraction.
D. Scaling, polishing and root canal treatment.
Answer: B. The answer is "Medicine given".


C6/4.3
Question: Which of the following is provided under Emergency Medical Evacuation in the Medical Expense Benefits under Travel Insurance?
A. Travel and accommodation expenses.
B. Transportation of deceased insured’s mortal remains to his country of origin.
C. Hospital deposit guarantees.
D. Covers the cost of moving insured to another place to seek treatment because of inadequate local medical services. 
Answer: D. The answer is "Covers the cost of moving insured to another place to seek treatment because of inadequate local medical services".


C7/4.1
Question: Which of the following type is the most restrictive under Managed Healthcare Plans? 
A. Point of Service Plans
B. Preferred Provider Organisations
C. Health Maintenance Organisations
D. Traditional Medical Expense Insurance
Answer: C. The answer is "Health Maintenance Organisations".


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C7
Question: Which of the following is NOT true of Managed Healthcare Insurance?
A. It excludes pre-existing conditions.
B. Payments are reduced by reimbursements from Work Injury Compensation and other forms of insurance.
C. Deductibles and Co-insurance do not apply in Managed Healthcare Insurance.
D. Members have a choice of in-network or out-network providers.
Answer: C. The answer is "Deductibles and Co-insurance do not apply in Managed Healthcare Insurance".


C7/6.2 
Question: Deductibles and Co- Insurance are found in which kind of policy?
A. Disability Income Insurance Policy
B. Hospital Cash Income Policy
C. Managed Healthcare Insurance
D. Transferable Medical Insurance Scheme
Answer: C. The answer is "Managed Healthcare Insurance".


C7/6.5
Question: Which is true regarding claims procedure for Managed Healthcare?
A. Members who use in network care are not required to file any claims with insurer.
B. Members who use out of network providers are not required to file claims with insurer.
C. Documents to be submitted to insurer is original bill and disability report.
D. No need to inform insurer for both in network or out of network care. 
Answer: A. The answer is "Members who use in network care are not required to file any claims with insurer".


C8/2.2
Question: Which of the following is not a feature of MediShield?
A. Scheme will terminate if the per lifetime limit is reached.
B. Meant to help pay for hospitalization at class B1 – C Class Wards.
C. Subject to deductibles and co-insurance.
D. Auto granted to Singaporeans and Permanent Residents.
Answer: B. The answer is "Meant to help pay for hospitalization at class B1 – C Class Wards".


C8/2.2.2
Question: How is MediShield Cover effected for Singaporeans and Permanent Residents?
A. If their births are registered in Singapore on or after 1 Dec 2007.
B. If they are under 21 years old as of 30 June 2010.
C. If they get married or registered their marriage in Singapore.
D. All of the above.
Answer: D. The answer is "All of the above".


C8/3.1
Question: Claiming under MediShield & Integrated Shield Plan is similar in that:
A. Insured does not need to submit their claim to the insurer.
B. Insured is required to sign forms in the hospital on admission.
C. Hospital will claim from CPF Board on his behalf.
D. Any outstanding amount not covered by MediShield can be settled by the insurers from the Integrated Shield Plan.
Answer: A. The answer is "Insured does not need to submit their claim to the insurer".


C8/3.2
Question: The purpose of Eldershield is to :
A. provide long-term care protection to elderly Singaporeans in the event of severe disabilities.
B. provide nursing care to elderly Singaporeans in their old age.
C. provide for hospital expenses in the event of dread diseases.
D. provide subsidies to families of elderly Singaporeans who require institutional care.
Answer: A. The answer is "provide long-term care protection to elderly Singaporeans in the event of severe disabilities".


C8/3.2
Question: Government has launched a new severe disability scheme where premiums can be paid from CPF member’s Medisave. The Scheme is _________________. 
A. Medifund
B. MediShield
C. Eldershield
D. Eldercare Fund 
Answer: C. The answer is "Eldershield".


C9/8.3
Question: Physical examination provision is included in Disability Income Polices to enable insurer to;
A. have the insured examined by the insurer’s doctor at the insured’s expense.
B. have the insured examined by the insured’s doctor at the insurer’s expense.
C. have the insured examined by the insurer’s doctor at the insurer’s expense.
D. have the insured examined by the insured’s choice of doctors on a contributory basis.
Answer: C. The answer is "have the insured examined by the insurer’s doctor at the insurer’s expense."


C9/4.2k
Question: Which of the following least describes pre-existing condition?
A. Of which the insured is not aware.
B. In respect of which the insured showed symptoms.
C. For which the insured received treatment or medical advice.
D. Of which the insured should reasonably have been aware.
Answer: A. The answer is "Of which the insured is not aware."


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C9/5.1 
What is included in the “Entire Contract Clause” in a Health Insurance Contract? 
A. Policy Document and Proposal Form.
B. Policy Document and Fact Find Form.
C. Policy Document and Insuring clause.
D. Policy Document and Schedule of Benefits.
Answer: A. The answer is "Policy Document and Proposal Form".


C10/3.5
The following statement about parameters in pricing of Health insurance is true?
A. Increase in proportion of females in a group will reduce the premiums.
B. Increase in morbidity experience will reduce premiums.
C. Increase in persistency will decrease premiums.
D. Increase in participation rate will increase premiums.
Answer: C. The answer is "Increase in persistency will decrease premiums".


C11/6.2.1
Modified Underwriting does not include:
A. Charge extra premiums.
B. Increase deductible on the policy.
C. Reduce premium-paying.
D. A longer deferred period. 
Answer: C. The answer is "Reduce premium-paying".


C11/3.3.3
The detection of any early cognitive impairment is essential when underwriting:
A. Dread Disease Insurance.
B. Disability Income Insurance.
C. Long Term Care Insurance.
D. Managed Healthcare Insurance.
Answer: C. The answer is "Long Term Care Insurance".


C11/3.5.5
In group underwriting, over representation by a highly paid class could result in:
A. Higher than average medical claim.
B. Higher than desired rate of turnover.
C. Higher budget for a better plan.
D. Higher than average bonus payment.
Answer: A. The answer is "Higher than average medical claim".


C11/6.2.1
For which of the following is ‘extra premiums’ NOT commonly used for sub-standard risks?
A. Disability Income.
B. Medical Expense Insurance.
C. Long Term Care Insurance.
D. Dread Disease Insurance.
Answer: B. The answer is "Medical Expense Insurance".


C12/52(g)
Which of the following constitutes the Best Practice Standards on Information Disclosure and Provision Of Advice? 
A. Jargon should be avoided in order not to mislead clients.
B. Information provided should be presented in plain language, easy for the insured and insurer to understand.
C. Information provided must be sufficient to help the insured makes a right decision.
D. Opinions must be unambiguously stated that it is a statement of opinion.
Answer: D. The answer is "Opinions must be unambiguously stated that it is a statement of opinion".


C13/App 13A(pg 244)
Post- sales disclosure, in the form of a “follow-up” letter” must be made by the insurer through telemarketing channels. This letter does not attempt to do: 
A. Advises the proposer to read the 2 compulsory documents.
B. Highlights the “14 day Free Look” period.
C. Highlights the 30 days grace period.
D. Request proposer to return the enclosed pre-paid reply card to the insurer. 
Answer: C. The answer is "Highlights the 30 days grace period".


C13/App13A(pg 245)
Regarding post-sale disclosure on modifications to the product information or key product provision, insurer must observe which of the following that is true?
A. Give advance notice at least 14 days before modifications take effect.
B. Only modified terms need to be shown.
C. Obtain written acceptances of the modified terms.
D. Print size of modified term should be smaller than the rest of the text on the notification letter.
Answer: C. The answer is "Obtain written acceptances of the modified terms".


C13/App 13B(pg 262)
Under LIA Guidelines, insurer is required to intervene to rectify erroneous recommendations by its representatives during which period? 
A. Deferred Period
B. Waiting Period
C. Survival Period
D. Free Look Period 
Answer: D. The answer is "Free Look Period".


C14/3.1(i)
Client wants to replace existing Health Policy. The insurer should advise on which of the following? 
A. Client will get a discount on the new policy.
B. Insurer should mention that the new policy will be considered a sub standard risk.
C. Insurer should advise on the disadvantages of replacing health insurance policy.
D. Client will enjoy the same conditions as the original policy. 
Answer: C. The answer is "Insurer should advise on the disadvantages of replacing health insurance policy".


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C14/Eg 14.3
Mr. Lim has recently bought Dread Disease Insurance. He is concerned about Mrs. Lim, who is a housewife, his son who is a newborn and their future daily expenses should anything happen to him. Given that his family’s monthly expenses amount to $3,000, with existing inflation rate of 2% and investment return of 7%, how much would Mrs. Lim require in the event that Mr. Lim is not around, assuming number of years income needed is 21. 
A. $630,775
B. $47,632
C. $484,639
D. $554,940
Answer: C. The answer is "$484,639".


C14/7
Generally you should do a review with your existing clients under which of the following circumstances? 
A. At the birth of a child.
B. Changes to CPF rulings.
C. Launching of new products.
D. All of above 
Answer: D. The answer is "All of above".


C15/3
Which of the following method is fairer in determining the sum assured for group health insurance?
A. Employee’s Salary X Performance Factor
B. Employee’s Salary X Standard Factor
C. According to Rank
D. Lower position; higher sum assured.
Answer: B. The answer is "Employee’s Salary X Standard Factor".

Question: Which is not a government healthcare philosophy? 
Answer: The correct answer is "To provide for the care of employees".

Question: Which of the following is TRUE on the similarity of Means Testing and Casemix?
Answer: The correct answer is "Both are subsidies given by the government".

Question: Under Medical Expense Insurance, what is not included in Inpatient Expenses?
Answer: The correct answer is "Emergency Accidental Treatment Charges is not included in Inpatient Expenses".

Question: Which of the following is covered under catastrophic outpatient expenses in Medical Expense
Insurance Policy?
Answer: The correct answer is "Outpatient kidney treatment charges".

Question: Miscarriage Benefit in a Medical Expense Policy provides for:
Answer: The correct answer is "The reimbursement of medical expenses in an ectopic pregnancy".

Question: Mr. Lim is buying a policy for himself and his wife and 2 children of the same premium each. 
What is the premium payable given the following?
Mr. Ang’s premium $182.31
Mrs. Ang’s premium $227.89
1 child’s premium $102.50
Answer: The correct answer is "The premium payable is $584.44". Rationale is that ($182.31 + $227.89 + $102.5 + $102.5 )X 95% (enjoy family discount of 5%) = $584.44

Question: Which of the following is NOT a characteristic of medical expense insurance?
Answer: The correct answer is "Deductibles apply for all treatments".

Question: Which of the following statement is TRUE?
Answer: The correct answer is "Per annum deductible includes a variety of covered sickness or injuries within a policy year".

Question: When the insured person is admitted to a ward higher than what he is entitled to under his existing plan, ___________is applied on the actual charges incurred and covered under the policy. It will cause actual benefits payable to be reduced. 
Answer: The correct answer is "Pro-ration factor".

Question: Which of the following characteristics of group insurance is important to the underwriter in determining the “feel” of future claim experience? 
Answer: The answer is "Experience-rating, as it is usually underwritten based on past claims experience".

Question: Group Polices often have an “actively at work” clause. In order to be eligible for the cover, this clause requires:
Answer: The answer is "The employee to be at work on the day the insurance coverage takes effect".

Question: Which of the key factor in Portable Medical Benefit Scheme is most correct?
Answer: The answer is "Employees will be medically insured in between jobs".

Question: When an employee leaves his current company, medical benefits provided by his employer will automatically be terminated. Which of the following plans purchased by the employer will solve this problem?
Answer: The answer is "Transferable Medical Insurance Scheme".

Question: Compute Disability Income Benefit. Given the following details:
Escalation Benefit : 3%
Monthly Income : $5000
Monthly Expense : $3000
No of years : 30 years
Answer: The answer is "$2,140,893".


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Given the following details:
Escalation Benefit : 3%
Monthly Income : $5000
Monthly Expense : $3000
No of years : 30 years
Answer: The answer is "$2,140,893". 
Rationale is that:
$5000 x 75% = $3750
$3750 X 12 x *47.5754 = $2,140,893
* 47.5754 (factor from Table A1 – 3%; 30 years)

Question: “The insured’s inability to perform any gainful occupation or a similar occupation for which he is reasonably suited by reason of education, training or experience” refers to: 
Answer: The answer is "Modified Own Occupation".

Question: Mr Tan, who is an accountant, used to earn $4,000 per month before he was disabled. After partial recovery from his disability, he found a suitable job as a clerk, which pays him $1,500 per month. What would Mr Tan’s disability income benefit be?
Answer: The answer is "$1,875 per month". Rationale is that $4000 - $1500 / $4000 x $3000 = $1875.

Question: Disability Income will not terminate when the insured________.
Answer: The answer is "changes his occupation".

Question: Which of the following regarding Long Term Care Insurance (LTCI) is true?
Answer: The answer is "It is not governed by the Over Insurance Provision Clause".

Question: Which of the following payment method is associated with LTCI benefits issued under “Service Based” Policy ?
Answer: The answer is "Indemnity Method".

Question: Which of the following is NOT an Activity of Daily Living?
Answer: The answer is "Morbidity".

Question: In which area is Eldershield and Long Term Care Insurance different?
Answer: The answer is "Free look Period".

Question: The insured must survive the survival period before the dread disease benefit becomes payable. The survival period is a period of time:
Answer: The answer is "from the occurrence of a dread disease".

Question: Critical Illness cover will not terminate when :-
Answer: The answer is "Policy owner exercises Paid Up Option under the non forfeiture options".

Question: Mr. X bought a $150,000 whole life type of Critical Illness Policy with 50% acceleration benefit. How much is payable to him upon diagnosis of cancer? 
Answer: The answer is "$75,000".

Question: Calculate the total maximum amount this Hospital Cash Income Insurance Policy will pay based on these policy details:
Daily Benefit: $100
Max of 180 days per hospitalization
Lifetime Limit: 1000 days
He was hospitalized for 185 days per hospitalization
Answer: The answer is "$100,000". Rationale is that Lifetime limit of 1000 days X $100 per day = $100,000.

Question: Managed Healthcare Organisations work through which components to manage healthcare expenditure?
Answer: The answer is "Quality of Care."

Question: To control increasing medical costs, which of the following is not used by Managed Healthcare? 
Answer: The answer is "Profit Sharing".

Question: Which of the following MHC plans has the lowest degree of Cost Control?
Answer: The answer is "Traditional Medical Expense Insurance".

Question: Which of the following is not a benefit of Managed HealthCare Plans?
Answer: The asnwer is "Intensive Care".

Question: Which of the following medical expenses could not be used to pay from one’s Medisave?
Answer: The answer is "Grandparents (regardless of nationality)".

Question: Which of the following regarding Medisave and MediShield is true?
Answer: The answer is "Medisave is a saving scheme and MediShield cover is granted automatically to Singaporeans when they became CPF members".

Question: Which of the following is not covered under Chronic Disease Management Programme?
Answer: The answer is "Osteoporosis (brittle bones)".

Question: Miss Ang was hosptialised for 8 days. Her total hospital bill was $22,400. She was able to receive $11,000 from her company group Medical Expense Policy. She is now awaiting for the reimbursement from her own private medical insurance (PMI). Details of her hospital bill & PMI (no deductibles and co insurance) as follows: 
| Description | Hospital Bills | Amount covered under PMI |
|---|---|---|
| Room and board | S$300 x 8 = $2,400 | S$250 x 8 = $2,000 |
| Surgery | S$20,000 | S$10,000 |
| Total | $22,400 | S$12,000 |
How much is she able to claim from her PMI?
Answer: The answer is "S$11,400". Rationale is that $22400 - $11000 = $11,400.


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Answer: The answer is "S$11,400". Rationale is that $22400 - $11000 = $11,400.

Question: Jenny went to Johor Bahru and while on her way back to Singapore, she met with an accident on March 2008. She incurred a bill of $6,300. Policy came with a deductible of $1500 and a co-insurance as follows:
$1000 - $3000 : 15%
$3001 - $6000 : 20%
How much would the insurer have paid her?
Answer: The answer is "$3,940".
Rationale is that,
Total expenses = $6300
Less deductible = ($1500)
Less co-insurance = *($860)
Claimable = $3940
* Computation of Co insurance
$1000 - $3000: $300 (15% x $2000)
$3001- $6000 : $560 (20% x $2800)
Total : $860

Question: Which of the following section in a Health Insurance Contract must the adviser goes through with the client to ensure no typographical error?
Answer: The answer is "Policy Schedule".

Question: Which of the following sections in a Health Insurance Policy contract represents the “foundation” of a Health Insurance Policy? 
Answer: The answer is "Insuring Clause & Definitions".

Question: Which clause states that the policy shall not be in-force, unless premium is paid to the company on or before the inception date of the policy?
Answer: The answer is "Premium Warranty Clause".

Question: What is the key factor for Health Insurance Pricing?
Answer: The answer is "Morbidity".

Question: The role of underwriting is important because it enables the underwriter to:
Answer: The answer is "Ensure that the premium charged corresponds with the risk involved".

Question: Which of the following is false with regard to insurers reviewing history of previous condition?
Answer: The answer is "Possibility of a non recurrence".

Question: To get a better insight to insured’s medical history, not available from medical examinations, underwriter request for:
Answer: The answer is "Attending Physician Statement".

Question: “Personal Accident Policy” means accident and health policy where accident and health benefits are paid out only:-
Answer: When in the event of an injury to, or disability of, the insured as a result of accident. In addition, to be paid out on the death by accident of the insured.

Question: An A&H Insurance Intermediary shall have a reasonable basis for providing advice to the insured. This shall not apply to:
Answer: The answer is "Eldershield Policy".

Question: During the Pre- Sale Stage for Individual Business, it is compulsory to provide which document(s) to the client?
Answer: The answer is "Your Guide to Health Insurance and Product Summary."

Question: Application of the Guidelines to direct marketing and telemarketing channels apply to:
Answer: The answer is "Marketing through the use of a call centre".

Question: Under LIA Guidelines, which penalty constitutes the 3rd offence for non compliance by the Representatives for not having submitted the completed and signed Fact Find Form and “Our Advice and Reason Why Form”?
Answer: The answer is "Letter of warning".

Question: What serves as a starting or reference point for the advisers to recommend further A & H insurance recommendations to their clients? 
Answer: The answer is "Client’s existing Health Insurance Policies".

Question: Compute maintenance cost using TPD Method. Given: Monthly Income : $4000; Monthly Expenses :$2000; No of years income needed : 21; Expected rate of return : 5%; Inflation Rate : 2% ; Existing fund : $0
Answer: The answer is "$381,060". 
Rationale is that,
$2000 x 12 = $24,000 x 15.8775 (table A2; 3%; 21 years)
 = $381,060

Question: Calculation of how much Critical Illness Insurance the client needs is more of an art than a science as there are many uncertainties. Which of these factors would be most important?
Answer: The answer is "Need to know the client’s family medical history to determine which disease the client is most susceptible".

Question: Which of the following product is often associated with providing maintenance costs for a client?
Answer: The answer is "Disability Income Insurance".

Question: The fundamental principle of Singapore healthcare financing is ____________.
Answer: The answer is "Individual Savings".

Question: Which of the following is not a feature of Casemix?
Answer: The answer is "Subsidies will be allocated to those patients accordingly".

Question: Which is included in Catastrophic Outpatient Treatment for Medical Expense Insurance? 
Answer: The answer is "Outpatient Cancer charges".

Question: Which of the following is NOT covered under Daily Room and Board Charges in a Medical Expense Insurance?


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Question: Which is included in Catastrophic Outpatient Treatment for Medical Expense Insurance? 
Answer: The answer is "Outpatient Cancer charges".

Question: Which of the following is NOT covered under Daily Room and Board Charges in a Medical Expense Insurance?
Answer: The answer is "Medicines and drugs".

Question: If Mr Tan is enquiring about buying a policy for himself, his wife and 2 sons. Premium is as follows:
Himself = $500
His wife = $700
1 son = $300
After considering he would like to cover only himself and his wife. How much family discount did he enjoy? 
Answer: The answer is "$60". Rationale is that ($500 + $700) X 5% = $60.

Question: Which of the following is Not part of expense participation?
Answer: The answer is "Co-ordination of benefits".

Question: Mr. Tan and his family were injured while on holiday. They were covered under MEI, with a deductible of $3000 and a co-insurance of 10%. Determine the total amount payable to Mr.Tan, given hospital bills as follows:
Mr. Tan - $15,000
Mrs. Tan - $20,000
Son - $2,500
Daughter – $3,200
Answer: The answer is "$26,280".
Rationale is that,
Mr. Tan : $15,000 - $3000 = $12,000 - $1,200 (coinsurance 10%) = $10,800
Mrs. Tan : $20,000 - $3000 = $17,000 - $1,700 (coinsurance 10%) = $15,300
Son : cannot claim as expense is below deductible
Daughter : $3,200 - $3000 = $200 - $20 (coinsurance 10%) = $180
Hence total payable = $10,800 + $15,300 + $180 = $26,280

Question: Coverage on a life insured who is covered under Medical Expense Insurance will terminate when:
Answer: The answer is "When the insured enters full time military service".

Question: Which of the following is NOT a feature of Group Medical Insurance Policy?
Answer: The answer is "All employees must undergo medical examination".

Question: Mr. Tan would like his wife to be included under his company’s Group Medical Insurance Policy. What would the commencement date of cover for Mrs. Tan be?
Answer: The answer is "Anytime within 30 days after marriage".

Question: Coverage for which plan will expires at statutory retirement age? 
Answer: The answer is "Transferable Medical Insurance Scheme".

Question: Employers providing their employees with a Shield Plan can claim how many percent of tax deduction on their employees’ total remunerations? 
Answer: The answer is "2%".

Question: Which of the following is a characteristic of Disability Income Insurance? 
Answer: The answer is "Choice of deferred period".

Question: David has a monthly income of $6,000 and has bought a Disability Income policy at 75% of his monthly income with a 3% escalation benefit. He is disabled and made a claim successfully on 1-1-2000. What is the amount that he will receive on the 1-3-2001?
Answer: The answer is "$4,635".
Rationale is that,
$6000 X 75% = $4500
$4500 + (3% X $4500 ) = $4635

Question: Which type of payment will not affect Disability Benefit Payout?
Answer: The answer is "TPD benefits under Life Insurance Policies".

Question: Which of the following is NOT a feature of a Disability Income Insurance policy?
Answer: The answer is "Premium based on age band".

Question: Which of the following least describes Long Term Care Insurance payment?
Answer: The answer is "Yearly Basis".

Question: Which factor is the most important factor affecting premium for LTCI Plans? 
Answer: The answer is "Number of Activities of Daily Living".

Question: Which of the following condition is covered by Long Term Care Insurance?
Answer: The answer is "Dementia from Alzheimer’s Disease".

Question: The following are exclusions under LTCI policies EXCEPT:
Answer: The answer is "Any form of Acquired Immune Deficiency Syndrome (AIDS) or infection by any Human Immunodeficiency Virus (HIV)".

Question: Which of the following is FALSE regarding Critical Illness riders?
Answer: The answer is "There is no minimum and maximum sum assured restriction".

Question: Critical Illness cover will be terminated:
Answer: The answer is "When the policy is converted into an extended term insurance policy".

Question: You are proposing a 50% Acceleration Dread Disease Policy to your client for his wife who is a homemaker.


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Question: You are proposing a 50% Acceleration Dread Disease Policy to your client for his wife who is a homemaker. In this case, you should also propose to attach a
Answer: The answer is "Dread Disease Waiver of Premium Rider to the policy".

Question: Which of the following type of CI Cover you may not need to attached a Critical Illness Waiver of Premium Rider?
Answer: The answer is "Acceleration Type".

Question: Which of the following regarding Standalone Hospital Cash Insurance is false?
Answer: The answer is "Free death benefit".

Question: Which component of managed healthcare is not used to contain and control healthcare expenditure?
Answer: The answer is "Accessibility".

Question: Primary care physician in Managed Healthcare Plan is NOT known as the following names:-
Answer: The answer is "Specialist".

Question: Which of the following offers the broadest consumer choice of physicians and clinical settings?
Answer: The answer is "Mixed Model HMO".

Question: What are Preferred Provider Organisations(PPOs)? 
Answer: The answer is "PPOs require greater “out of pocket” payments from members".

Question: Which of the following regarding maternity charges is true of the Medisave Maternity Package?
Answer: The answer is "It allow members to use Medisave to pay for pre-delivery expenses and delivery expenses up to the 4th living child".

Question: Which of the following restrictions on use of Medisave is false?
Answer: The answer is "Must be hospitalized for more than 6 hours".

Question: MediShield has been enhanced in March 2013. Which of the enhancement(s) is/are True?
Answer: The enhancements are "Maximum coverage has been increased to 92 years", "Policy year limit and lifetime limit has been increased to $70,000 to $300,000 respectively" and "Maximum age of 75 has been removed".

Question: John drove to Malaysia in March. On his way back, the lights were too dim, he got into an accident. He was hospitalised for 8 days, and the hospitalisation fees is $12,000. 3 months later, John had food poisoning and was admitted for 2 days. His hospitalisation fee is $2,500. Calculate how much John receives from his policy.
Given:
Policy renewable every September
Per disability /per year
Deductible : $1500
Co-insurance : $0-$3000 : 20%
$3001- $5000 : 15%
Above $5001 : 10% 
Answer: The answer is "$11,300".
Rationale is that,
Total expenses = $12,000 + $2,500 = $14,500
Less deductible = ($1500)
Less co-insurance = *($1700)
Claimable = $11,300
* Computation of Co insurance
$0 - $3000 : $600 (20% x $3000)
$3001- $5000 : $300 (15% x $2000)
Above $5001 : $800 (10% x 8000)
Total : $1700

Question: Interim Disability Assistance Program for the elderly came about:
Answer: The answer is "To help those who cannot qualify for Eldershield Scheme due to their age or health reasons".

Question: Which of the following are found in the Policy Schedule? 
Answer: The answer is "Name, NRIC of Insured".

Question: The Renewal Provision in a Health Insurance Contract describes:
Answer: The answer is "Insurer’s right to increase premium on policy".

Question: What are endorsements found in a Health Insurance Policy Contract?
Answer: The answer is "Restrict the scope of coverage".

Question: An increase in which of the following factor will NOT increase premium computation?
Answer: The answer is "Investment income".

Question: Medical Aspects of Underwriting requires the consideration of___________.
Answer: The answer is "Current Physical Condition".

Question: What is NOT an advantage of Moratorium Underwriting? 
Answer: The answer is "Insured will have the certainty as to what is covered at the point of joining, rather than at claim".

Question: An underwriter needs to know more about a client’s medical history which the medical examination was not able to reveal. What form does he need?
Answer: The answer is "Attending Physician’s Statement".

Question: An A&H Insurance Intermediary are required to disclose in writing to their clients before fact find stage: 
Answer: The answer is "Potential conflict of interest".

Question: Which of these offences under MAS Notice 120 is not considered a criminal offence and does not attract any penalties?
Answer: The answer is "Documents given to the insured are kept up to date".


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Question: Which of these offences under MAS Notice 120 is not considered a criminal offence and does not attract any penalties?
Answer: The answer is "Documents given to the insured are kept up to date".

Question: For policies sold through direct marketing and telemarketing, insurer must ensure: 
Answer: The answer is "A follow up letter to advise clients to read the Guide to Health Insurance and product summary which is enclosed".

Question: Under LIA Guidelines which documents, should insurer under Corporate Business make available to insured members’ of a voluntary plans?
Answer: The answer is "Your Guide to Health Insurance".

Question: When recommending a Group A&H Policy, what must be given to the client before the client applies for the product?
Answer: The answer is "Group Insurance Fact Find Form".

Question: Most group insurance is issued without medical examination as the risk for the insurer diminishes as the size of the group increases. This is known as _________________.
Answer: The answer is "The law of large numbers".

Question: Mr Tan has a monthly income and expenditure of $7,000 and $5,000 respectively. His son is currently 2 years old and he would like to provide for his son till age 25. Assuming that the interest rate is 5% and inflation is 2%, please calculate his maintenance cost.
Answer: The answer is "$1,016,214".
Rationale is that,
$5000 x 12 = $60,000 x 16.9369 (table A2 – 3%’ 23 yrs) = $1,016,214

Question: Mr. Lim the prospective client does not have an emergency fund, you should:
Answer: The answer is "not recommend any policies as it may affect his ability to service the policies".

Question: Which of the following policy is MOST suitable for meeting the maintenance costs of a client?
Answer: The answer is "Disability Income Insurance".

Question: Primary Care Partnership Scheme does not cover treatment for:
Answer: The answer is "Cancer Treatment".

Question: Which of the following is a Costing Mechanism to determine amount of subsidies to be given?
Answer: The answer is "Casemix".

Question: Which of the following regarding Medical Expense Insurance is true?
Answer: The answer is "Miscarriage due to ectopic pregnancy is covered."

Question: Final Expenses Benefit in a Medical Expense Insurance covers:
Answer: The answer is "Death that occurs within a specified no. of days after leaving the hospital and is a result of the cause of the hospitalization".

Question: When one is required to pay a deductible regardless of the no. of claims made in a year, this type of deductible is known as:
Answer: The answer is "Per Disability/ Per Claim Deductible".

Question: Mrs Lim has bought a Medical Expense Insurance with a deductible for $10,000 for 1st June 2012 to 31st May 2013. On 1st Sept 2012, she encountered an accident and the total claimable medical expenses were $3,000. In March 2013, she went for surgery to remove her womb and the medical costs were $8,000. How much can Mrs Lim claim, given that a per-disability/per claim deductible applies?
Answer: The answer is "$0".

Question: Which is the most suitable plan type to recommend to a client who has financial constraint?
Answer: The answer is "both deductible and co-insurance".

Question: All integrated Shield Policies are guaranteed renewable. Which of the following is Not True?
Answer: The answer is "Insurer cannot terminate the policy if policyowner continues to pay his premium till death occurs".

Question: Which of the following characteristics of group insurance describes multiple lives under one contract?
Answer: The answer is "Master contract".

Question: Which of the following must be disclosed to the participants for Group Voluntary A&H Policies? 
Answer: The answer is "They have a say in the type of coverage that they want".

Question: Which of the following is the most important factor for the underwriter when underwriting Group Insurance?
Answer: The answer "Gender & age".
 
Question: Which of the following is NOT TRUE of the employer to qualify for Transferable Medical Insurance Scheme (TMIS)? 
Answer: The answer is "Pay 50% of the premium for the Group Medical Expense Insurance coverage".

Question: Which of the following is most stringent in the definition of Total Disability under Disability Income Insurance? 
Answer: The answer is "Any Occupation".

Question: If an insured who has been receiving disability benefits under a Disability Income policy returns to work, but suffers a relapse within a specified period of time for the same cause, most insurers will: 
Answer: The answer is "Waive the deferment period and benefit payments will recommence immediately".

Question: Mary, a lecturer bought a DI Policy, became disabled on 30/6/08.


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Question: Mary, a lecturer bought a DI Policy, became disabled on 30/6/08. 
Her details as follows:
Salary : $8000 per month ;
Her expenses: $3000 per month;
Annual Escalation Benefit : 3% ;
6 Month Deferred Period chosen.
When will she received the first payment from the insurer and for how much? 
Answer: The answer is "1/1/2009 for $6000".
Rationale is that,
Deferred period 6 months from 30/6/08, hence payable on 1/1/09. Payments = $8000 x 75% = $6000

Question: Mary, a lecturer bought a DI Policy, became disabled on 30/6/08. 
Her details as follows:
Salary : $8000 per month ;
Her expenses: $3000 per month;
Annual Escalation Benefit : 3% ;
6 Month Deferred Period chosen.
When will the escalation benefit kicked in and how much will she get?
Answer: D. The answer is "1/1/2010 for $6180".
Rationale is that,
Escalation will be effective on the 2nd year ie 1.1.2010 at $6180 ($6000 + $6000 x3%)

Question: Mary, a lecturer bought a DI Policy, became disabled on 30/6/08. 
Her details as follows:
Salary : $8000 per month ;
Her expenses: $3000 per month;
Annual Escalation Benefit : 3% ;
6 Month Deferred Period chosen.
Mary subsequently on 1/2/2010 found a job as a tutor which pays her $2000 a month. Calculate partial disability benefit payable on 1/2/2010
Answer: The answer is "$4,635".
Rationale is that, ($8000 - $2000)/$8000 x $6180 = $4635

Question: Which of the following criteria for payment of Long Term Care Insurance Benefit is False?
Answer: The answer is "Need to be hospitalised".

Question: In Long Term Care insurance, the deferred period is defined as a period of time:
Answer: The answer is "after the insured is certified by a medical practitioner that he is unable to perform specified numbers of ADLs".

Question: When a person requires an assistive rehabilitation device, which of the following benefits available under a Long Term Care plan could provide it?
Answer: The answer is "Financial Assistance with Adaptation".

Question: Which of these exclusions apply to Long term Care Insurance?
Answer: The answer is "Participation in a felony, riot or insurrection".

Question: 100% Acceleration Dread Disease Policy is MOST suitable for clients who:
Answer: The answer is "has sufficient life insurance".

Question: Mr Tan has a Critical Illness Policy with a 50% acceleration benefit. The policy also has a Critical illness waiver of premium rider attached to it. After a dread disease claim by Mr Tan, which of the following statement(s) regarding the premium is most true?
Answer: The answer is "premium reduced in proportion to how the basic sum assured is reduced".

Question: Group Dental Care will terminate under which event?
Answer: The answer is "Insured enters full time military service".

Question: Which of the following is TRUE regarding claims on Group Dental Care?
Answer: The answer is "Insured have to make payment first and file a claim with insurer for reimbursement if he uses his own dentists".

Question: How does Managed Healthcare Organizations control expenditure on healthcare?
Answer: The answer is "Accessibility".

Question: Which of the following is not a feature of the cost management of Managed Healthcare Organisations?
Answer: The answer is "Government subsidies on hospitals".

Question: Which one of the following models do the physicians actively continue to develop their own private practices?
Answer: The answer is "Independent Practitioners Association (IPA) HMO".

Question: When making a claim under Managed Healthcare Insurance, the documents to be provided are :-
Answer: The answer is "original medical bill".

Question: To buy any of the approved products, such as Private Integrated Shield Plans using Medisave savings, which of the following is true? 
Answer: The answer is "Premium is limited to $800 (per person per year) if the insured is below 65 years old".

Question: Which of the following is NOT true of restrictions imposed on Medisave? 
Answer: The answer is "It covers unlimited outpatient treatments".

Question: The main difference between CPF MediShield Scheme and a Private Integrated Plan is:
Answer: The answer is "Annual limits are applicable for both".

Question: Which of the following is not for the poor and needy Singaporeans?
Answer: The answer is "Eldershield".

Question: Which of the following key features of Eldershield Schemes is/are FALSE?
Answer: The answer is "None of the above".


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Answer: The answer is "Eldershield".

Question: Which of the following key features of Eldershield Schemes is/are FALSE?
Answer: The answer is "None of the above".

Question: In a Health Insurance Policy Contract, what is included in Policy Schedule?
Answer: The answer is "Premiums and effective date of cover".

Question: The Renewal Provision describes:
Answer: The answer is "Insurer’s right to cancel the coverage".

Question: Physical examination provision is included in Disability Income Polices to enable insurer to;
Answer: The answer is "have the insured examined by the insurer’s doctor at the insurer’s expense".

Question: Which of the following key factors is NOT used in computing premium for Health Insurance Products?
Answer: The answer is "Occupation".

Question: Underwriters look particularly for applicant’s earning and overall financial situation in underwriting:
Answer: The answer is "Disability Income Insurance".

Question: Cognitive assessment is normally required during the underwriting stage for which plan?
Answer: The answer is "Long Term Care Insurance".

Question: Which of the following factor is most important for underwriting Critical Illness Insurance?
Answer: The answer is "Family history".

Question: Agent’s statement is needed to:
Answer: The answer is "Indicate applicant’s approximate net worth".

Question: Which of the following is considered an offence and liable to a fine not exceeding $25,000 or imprisonment for a term not exceeding 12 months or both?
Answer: The answer is "Failure to provide and explain the benefit illustration or product summary to the insured".

Question: What is not included under the Product Information Section in the LIA & GIA Guidelines on Disclosure Requirements?
Answer: The answer is "Waiting period".

Question: The requirement of using fact find form, LIA Guidelines on Needs- Based Sales Process for individual health insurance products does not apply to: 
Answer: The scenarios "Direct marketing", "Personal Accident Policy" and "Eldershield".

Question: “Application Type 1” in the Fact Find Form means: 
Answer: The answer is "Full completion of the Fact Find Form and the client wishes to receive the representative’s recommendation of product suitability".

Question: What is true of the minimum requirements when the client chooses Type 1, 2, or 3 of the Application Types in the Fact Find Form? 
Answer: The answer is "Personal Information".

Question: Calculate Maintenance Cost given these assumptions:
Monthly income needed = $1,500
No. of years income needed = 21
Rate of return = 5%
Inflation rate = 2%
Existing Life Insurance = $150,000
Answer: The answer is "$135,794".
Rationale is that, 
$1500 X 12 = $18,000
$18,000 X 15.8775 (table A2– 21 yrs; 3%) = $$285,794
$285,794 – $150,000 (life insurance )= $135,794

Question: During need analysis, when recommending a Critical Illness Insurance, what must an advisor advise a client? 
Answer: The answer is "Coverage".

Question: Quantify the level of Medical Expense needed, given the following:
Basic average medical expenses = $24,000
Benefits paying under Group policy = $18,240
Amount payable under Incomeshield Plan = $7,335
Answer: The answer is "No Shortage of medical expense protection".
Rationale is that, $24,000 – ($18,240 +$7335) = ($1,575); no shortage

Question: Voluntary Welfare Organisations does not refer to an organization that________________.
Answer: The answer is "is profit making".

Question: Means Testing in public hospitals was introduced,
Answer: The answer is "to provide B2 and C class subsidies in a fair manner with the lower income group".

Question: The other benefits provided by the insurers under Medical Expense Insurance include,
Answer: The answer is "Miscarriage Benefit".

Question: Under Medical Expense Insurance, when the Insured Person is a recipient, Major Organ Transplant Benefit covers,
Answer: The answer is "Cost of Surgeries".

Question: Nelson Tan has a medical expense insurance policy which has a deductible of $2000 per policy year from 1st Jan to 31st Dec 2013. He was warded for high fever in 1st Apr and incurred a bill of $1200 for a two day stay in the hospital. Four months later, he was treated in hospital due to a fracture of the leg and incurred a hospital bill of $2100. How much can Nelson claim from the insurer under per annum deductible?
Answer: The answer is "$1300". Rationale is that, $1200 + $2100 - $2000 = $1,300.

Question: Waiting Period is Not applicable for,
Answer: The answer is "Accidental Injury".


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Rationale is that, $1200 + $2100 - $2000 = $1,300.

Question: Waiting Period is Not applicable for,
Answer: The answer is "Accidental Injury".

Question: A waiting period protects _____________, by ensuring that individuals are not able to make claims shortly after joining and cancelling membership.
Answer: The answer is "members within the portfolio".

Question: Which of the following exclusions and limitations under Medical Expense Insurance is FALSE?
Answer: The answer is "To avoid the policyowner selecting against the insured".

Question: Which type of Group Medical Expense Insurance Plans gives the employees some control over the plan?
Answer: The answer is "Voluntary Plan".

Question: Which of the following factors are considered the most important to the underwriters in Individual Insurance underwriting?
Answer: The answer is "Health and financial status".

Question: Peter is covered with a Disability Income and has been receiving benefits. However, he recovered from his disability, 
Answer: The answer is "the insurance cover will continue covering if Peter starts paying premium".

Question: Mr. Sim has requested for a Disability Income Policy with a short benefit period. Hence insurer will
Answer: The answer is "Charge a lower premium".

Question: The disability benefit payable under a Disability Income policy will be reduced by the following sources of income
Answer: The answer is "any continuing salary derived by the insured from the occupation engaged immediately prior to disability".

Question: Disability Income is similar to Long Term Care in that,
Answer: The answer is "If insured recovers from the disability, payment will stop but policy will not be terminated if premiums are paid by the insured".

Question: Benefits under a Disability Income Insurance policy will cease upon occurrence of any of the following events,
Answer: The answer is "when the benefit period expired".

Question: Which of the following is not true of Group Insurance? 
Answer: The answer is "Premium is age related".

Question: How does the “continuation benefits” under the TMIS benefits the employee?
Answer: The answer is "To continue enjoying hospitalization coverage from the termination for 12 months".

Question: What is Extended Care Benefit under Long Term Care Insurance? 
Answer: The answer is "An extra monthly benefit given to the insured".

Question: In Long Term Care Insurance, Financial Assistance with Adaptation Benefit is,
Answer: The answer is "A specified amount, 2 times the monthly benefit".

Question: The following features of LTCI are FALSE EXCEPT,
Answer: The answer is "Should the insured recover from his disability, payments will stop".

Question: Which of the following is NOT a feature of Hospital Cash Insurance?
Answer: The answer is "Waiting period applies for illness and injury".

Question: Which of the following situation will be covered during the waiting period for a Hospital Cash Insurance Policy? 
Answer: The answer is "Food poisoning".

Question: Group Dental Insurance usually does NOT cover
Answer: The answer is "Replacement of stolen dentures".

Question: Which of the following does Group Dental Care insurance NOT cover?
Answer: The answer is "Medicine given".

Question: Which of the following is provided under Emergency Medical Evacuation in the Medical Expense Benefits under Travel Insurance?
Answer: The answer is "Covers the cost of moving insured to another place to seek treatment because of inadequate local medical services".

Question: Which of the following type is the most restrictive under Managed Healthcare Plans? 
Answer: The answer is "Health Maintenance Organisations".

Question: Which of the following is NOT true of Managed Healthcare Insurance?
Answer: The answer is "Deductibles and Co-insurance do not apply in Managed Healthcare Insurance".

Question: Deductibles and Co- Insurance are found in which kind of policy?
Answer: The answer is "Managed Healthcare Insurance".

Question: Which is true regarding claims procedure for Managed Healthcare?
Answer: The answer is "Members who use in network care are not required to file any claims with insurer".

Question: Which of the following is not a feature of MediShield?
Answer: The answer is "Meant to help pay for hospitalization at class B1 – C Class Wards".

Question: How is MediShield Cover effected for Singaporeans and Permanent Residents?
Answer: The answers are 
- If their births are registered in Singapore on or after 1 Dec 2007
- If they are under 21 years old as of 30 June 2010
- If they get married or registered their marriage in Singapore
All of these scenarios are how MediShield Cover effected for Singaporeans and Permanent Residents.

Question: Claiming under MediShield & Integrated Shield Plan is similar in that,
Answer: The answer is "Insured does not need to submit their claim to the insurer".

Question: The purpose of Eldershield is to,
Answer: The answer is "provide long-term care protection to elderly Singaporeans in the event of severe disabilities".

Question: Government has launched a new severe disability scheme where premiums can be paid from CPF member’s Medisave.


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Question: Government has launched a new severe disability scheme where premiums can be paid from CPF member’s Medisave. The Scheme is _________________. 
Answer: The answer is "Eldershield".

Question: Physical examination provision is included in Disability Income Polices to enable insurer to,
Answer: The answer is "have the insured examined by the insurer’s doctor at the insurer’s expense."

Question: Which of the following least describes pre-existing condition?
Answer: The answer is "Of which the insured is not aware."

Question: What is included in the “Entire Contract Clause” in a Health Insurance Contract? 
Answer: The answer is "Policy Document and Proposal Form".

Question: The following statement about parameters in pricing of Health insurance is true?
Answer: The answer is "Increase in persistency will decrease premiums".

Question: Modified Underwriting does not include,
Answer: The answer is "Reduce premium-paying".

Question: The detection of any early cognitive impairment is essential when underwriting,
Answer: The answer is "Long Term Care Insurance".

Question: In group underwriting, over representation by a highly paid class could result in,
Answer: The answer is "Higher than average medical claim".

Question: For which of the following is ‘extra premiums’ NOT commonly used for sub-standard risks?
Answer: The answer is "Medical Expense Insurance".

Question: Which of the following constitutes the Best Practice Standards on Information Disclosure and Provision Of Advice? 
Answer: The answer is "Opinions must be unambiguously stated that it is a statement of opinion".

Question: Post- sales disclosure, in the form of a “follow-up” letter” must be made by the insurer through telemarketing channels. This letter does not attempt to do,
Answer: The answer is "Highlights the 30 days grace period".

Question: Regarding post-sale disclosure on modifications to the product information or key product provision, insurer must observe which of the following that is true?
Answer: The answer is "Obtain written acceptances of the modified terms".

Question: Under LIA Guidelines, insurer is required to intervene to rectify erroneous recommendations by its representatives during which period? 
Answer: The answer is "Free Look Period".

Question: Client wants to replace existing Health Policy. The insurer should advise on which of the following? 
Answer: The answer is "Insurer should advise on the disadvantages of replacing health insurance policy".

Question: Mr. Lim has recently bought Dread Disease Insurance. He is concerned about Mrs. Lim, who is a housewife, his son who is a newborn and their future daily expenses should anything happen to him. Given that his family’s monthly expenses amount to $3,000, with existing inflation rate of 2% and investment return of 7%, how much would Mrs. Lim require in the event that Mr. Lim is not around, assuming number of years income needed is 21. 
Answer: The answer is "$484,639".

Question: Generally you should do a review with your existing clients under which of the following circumstances? 
Answer: Under the following circumstances, a review with existing clients is required,
- At the birth of a child.
- Changes to CPF rulings.
- Launching of new products.
These 3 scenarios are the triggers for a review.

Question: Which of the following method is fairer in determining the sum assured for group health insurance?
Answer: The answer is "Employee’s Salary X Standard Factor".


