LLQP Accident & Sickness · Component 1.2 · 35% of the exam
A member is off sick on the day a new group disability plan takes effect. The 'actively at work' rule means that:
- AShe is enrolled at a reduced amount that rises to the full formula on her return to work
- BThe whole plan cannot take effect until every eligible member is back at work
- Her coverage is deferred until she returns to work, so she is uninsured for that absence
- DShe is enrolled immediately and may claim for the absence that began before the effective date
Correct answer: C) Her coverage is deferred until she returns to work, so she is uninsured for that absence
Actively-at-work requirements stop a group plan from inheriting claims that were already running, which leaves a member who is absent on the effective date without coverage for that episode.
Why the other options are wrong
- ACoverage is deferred entirely rather than reduced.
- BOne absent member does not delay the plan for everyone else.
- DThe rule exists precisely to exclude an absence that began before the plan started.
Exam tip
Actively at work is a condition of enrolment, not of the claim.
Common mistake
Promising a member coverage for an absence that started before the plan did.
What this tests
CISRO competency component 1.2 — Assess the client's needs and situation — which is weighted at 35% of the Accident & Sickness module. Written against the published curriculum.
More from component 1
- The single most important fact for sizing a client's disability income need is:
- A client's beneficiaries for assets are listed in the fact-finding. Why does this matter for A&S planning?
- A client asks why the agent wants to know how assets are owned (jointly or individually). In the A&S context the answer is:
- A client mentions a back injury five years ago that fully resolved. The agent should:
- Which element of a client's situation most affects the definition of disability that should be recommended?
- Which of the following health facts is most relevant to a client's disability insurance situation?
Practice the whole Accident & Sickness module
Timed sets weighted like the exam, and review of every question you miss. Free to start.