Mock paper #5

General Lines - Life, Accident and Health Agent (Texas)

A full paper drawn to the blueprint. Answers and worked explanations are at the back of this file.

Questions: 130
Time: 150minutes
Mark: - our target
Paper: #5of 5

Single-user licence. You may print this file and write on it. You may not redistribute, resell or post it. © Sitonce 2026.

Before you start

Sit this the way you will sit the real one. A mock done in pieces over three evenings measures your notes, not your recall.

Questions

130

Minutes

150

Per question

69s

Started at

Set a timer for 150 minutes and do not stop it. Running over is the commonest way a prepared candidate fails, and the only place you can find that out safely is here.
Mark one answer for each question on the answer sheet.
Answer every question. There is no penalty for a wrong answer. A blank is a guaranteed zero and a guess is not.
Flag anything you are unsure of as you go. When you mark the paper, a question you flagged and got right is worth as much of your attention as one you got wrong - you do not yet know it, you guessed it.
When the timer runs out, turn to the Answers section at the back of this file. Mark the paper against the quick-reference key first, fill in the score table, and only then read the worked explanations.

What this paper covers

Area	Questions	Share
V. Types of policies (accident and health)	16	12%
I. Types of policies (life)	15	12%
II. Policy riders, provisions, options and exclusions (life)	15	12%
VI. Policy provisions, clauses and riders (accident and health)	15	12%
TX-I. Texas statutes and rules common to life and health insurance	14	11%
III. Completing the application, underwriting and delivering the policy	12	9%
IV. Retirement and other insurance concepts	8	6%
IX. Field underwriting procedures	8	6%
TX-III. Texas statutes and rules pertinent to accident and health insurance only	7	5%
TX-II. Texas statutes and rules pertinent to life insurance only	6	5%
VII. Social insurance	6	5%
VIII. Other insurance concepts	5	4%
TX-IV. Texas statutes and rules pertinent to health maintenance organisations	3	2%
Total	130	100%

Answer sheet - paper #5

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Paper #5

130 questions. 150 minutes.

1

An applicant is a licensed private pilot and wants full coverage with no aviation exclusion. What is the insurer most likely to offer?

AThe policy at an increased premium reflecting the additional risk
BThe policy at standard rates, because aviation is no longer a rated risk
CA policy with the death benefit halved while the insured continues to fly
DA policy with the aviation risk covered only after a two-year waiting period

2

What is a deductible in a medical expense policy?

AThe amount of covered expense the insured absorbs before the insurer becomes liable to pay anything at all under the terms of the policy
BThe percentage of each covered expense that remains with the insured after the insurer has paid its own share of that same expense
CThe amount the insurer deducts from a claim payment to recover premium that fell due during the grace period and was never actually paid
DThe maximum the insurer will pay for any single episode of care, with anything beyond that figure remaining the responsibility of the insured

3

What is a dual eligible individual?

ASomeone entitled to both the hospital and the medical parts of the federal health program
BSomeone covered by an employer group health plan as well as the federal health program
CSomeone eligible for the means tested program in two states at the same time
DSomeone entitled to Medicare and also qualifying for Medicaid on financial grounds

Worked explanations

The paper carries one for every question, at the back. These are the three above.

Q1 A Ch. 2: II. Policy riders, provisions, options and exclusions (life)

Answer: A - The policy at an increased premium reflecting the additional risk

Because An insurer facing a known extra risk has three moves: decline, exclude the risk by rider, or accept it and charge for it. A flat extra premium is common for aviation and it is often removed later if the insured stops flying.

Where the other options lead

B.Assuming an activity is either excluded or ignored. Where an insurer will cover the risk it charges for it. A flat extra premium is the usual mechanism.
C.Inventing a benefit reduction as an underwriting response. Insurers respond with an exclusion rider or a rating, not by scaling the benefit up and down with the insured's activities.
D.Confusing an underwriting response with the suicide or contestable periods. Waiting periods of that kind belong to the suicide clause, not to hazardous activity underwriting.

Q2 A Ch. 6: VI. Policy provisions, clauses and riders (accident and health)

Answer: A - The amount of covered expense the insured absorbs before the insurer becomes liable to pay anything at all under the terms of the policy

Because The deductible is the first slice and the insured owns it. Everything else in the cost sharing structure - coinsurance, out-of-pocket maximums, benefit maximums - is applied to what is left after that slice has been taken.

Where the other options lead

B.Describing coinsurance. A percentage share is coinsurance. A deductible is a fixed amount that comes off the front of the claim.
C.Confusing the word with a premium set-off. Deducting unpaid premium from a claim is a feature of the grace period. A deductible is a cost sharing amount.
D.Confusing a deductible with a benefit maximum. A cap on what the insurer pays is a benefit maximum. A deductible sits at the other end of the claim.

Q3 D Ch. 7: VII. Social insurance

Answer: D - Someone entitled to Medicare and also qualifying for Medicaid on financial grounds

Because A dual eligible has both. In practice the means tested program picks up premiums and cost sharing the contributory one leaves, and covers services such as long term care that the contributory program does not reach. It is worth recognizing because it changes what a client needs to buy privately, which is often nothing.

Where the other options lead

A.Reading dual as the two parts of one program. Holding both parts of that program is ordinary. Dual eligibility means qualifying under two separate programs.
B.Reading dual as any two sources of coverage. Two sources of coverage raise a question of which pays first. Dual eligibility is a defined status across the two public programs.
C.Reading dual as two states rather than two programs. A person is enrolled in one state program. The term describes eligibility under two different programs.

Worked explanations

The paper carries one for every question, at the back. These are the three above.

Q1 A Ch. 2: II. Policy riders, provisions, options and exclusions (life)

Answer: A - The policy at an increased premium reflecting the additional risk

Because An insurer facing a known extra risk has three moves: decline, exclude the risk by rider, or accept it and charge for it. A flat extra premium is common for aviation and it is often removed later if the insured stops flying.

Where the other options lead

B.Assuming an activity is either excluded or ignored. Where an insurer will cover the risk it charges for it. A flat extra premium is the usual mechanism.
C.Inventing a benefit reduction as an underwriting response. Insurers respond with an exclusion rider or a rating, not by scaling the benefit up and down with the insured's activities.
D.Confusing an underwriting response with the suicide or contestable periods. Waiting periods of that kind belong to the suicide clause, not to hazardous activity underwriting.

Q2 A Ch. 6: VI. Policy provisions, clauses and riders (accident and health)

Answer: A - The amount of covered expense the insured absorbs before the insurer becomes liable to pay anything at all under the terms of the policy

Because The deductible is the first slice and the insured owns it. Everything else in the cost sharing structure - coinsurance, out-of-pocket maximums, benefit maximums - is applied to what is left after that slice has been taken.

Where the other options lead

B.Describing coinsurance. A percentage share is coinsurance. A deductible is a fixed amount that comes off the front of the claim.
C.Confusing the word with a premium set-off. Deducting unpaid premium from a claim is a feature of the grace period. A deductible is a cost sharing amount.
D.Confusing a deductible with a benefit maximum. A cap on what the insurer pays is a benefit maximum. A deductible sits at the other end of the claim.

Q3 D Ch. 7: VII. Social insurance

Answer: D - Someone entitled to Medicare and also qualifying for Medicaid on financial grounds

Because A dual eligible has both. In practice the means tested program picks up premiums and cost sharing the contributory one leaves, and covers services such as long term care that the contributory program does not reach. It is worth recognizing because it changes what a client needs to buy privately, which is often nothing.

Where the other options lead

A.Reading dual as the two parts of one program. Holding both parts of that program is ordinary. Dual eligibility means qualifying under two separate programs.
B.Reading dual as any two sources of coverage. Two sources of coverage raise a question of which pays first. Dual eligibility is a defined status across the two public programs.
C.Reading dual as two states rather than two programs. A person is enrolled in one state program. The term describes eligibility under two different programs.

The rest of this mock paper comes with the course

Texas Life and Health: the whole syllabus taught, the questions that test it, 5 timed mocks, and all 6 PDFs to print.