KS Life & Health common mistakes
KS Life & Health · Understand the traps and how to avoid them.
On a life policy with a misstated age, the candidate selects the incontestability provision as the reason the insurer can adjust the death benefit, or says the insurer must pay the full face amount because the contestable period has expired.
Both provisions are described as 'protections after two years,' so they get filed in memory as one rule; the candidate remembers that incontestability is a two-year clock and applies it to every post-issue dispute.
What to do instead
Build a two-column table: Incontestability = insurer cannot void the contract for material misrepresentation after the contestable period; Misstatement of Age/Sex = never expires, benefit is adjusted to what the premium would have purchased at the correct age. Then drill 10 stems where the only fact that changes is whether the misstatement goes to age or to health history.
When a question describes a replacement, the candidate assigns the 'Notice Regarding Replacement' to the wrong party (e.g., says the existing insurer must hand the notice to the applicant, or says the replacing insurer must obtain the applicant's signature on it).
Three different parties each have a duty in a replacement, and the candidate learns them as one undifferentiated blob instead of three separate obligations.
What to do instead
Memorize the three-way split by actor: the producer presents the notice and obtains the applicant's signature, leaving a copy with the applicant; the replacing insurer notifies the existing insurer; the existing insurer must furnish policy information on request. Rewrite any missed question as 'Actor - Action - Recipient' until the mapping is automatic.
The candidate says coverage is in force when the policy is physically delivered, ignoring whether a conditional receipt was issued and whether the premium was paid, or treats a conditional receipt as guaranteeing coverage regardless of the applicant's insurability.
Delivery is visually the most obvious event in a policy-issue scenario, so it absorbs the candidate's attention; the receipt type looks like boilerplate rather than the fact that decides the answer.
What to do instead
Learn the receipt types as a decision tree: conditional receipt = coverage effective the date of application or medical exam only if the applicant proves insurable under the insurer's rules; binding receipt = coverage for a stated temporary period regardless of insurability. Then practice identifying the single word ('conditional' vs 'binding') before reading the answer choices.
In reinstatement questions the candidate picks 'the policy is fully restored with no new conditions' or applies the wrong clock, and separately misses that a reinstated policy restarts the contestable period (and typically the suicide exclusion) on the reinstated amount.
Reinstatement is taught alongside grace period and lapse, so all three blur into 'the policy comes back'; the candidate focuses on the payment of back premiums and never reaches the consequence.
What to do instead
Study reinstatement as: time limit (commonly 3 years for life), evidence of insurability, payment of overdue premiums with interest (or loan repayment), and the consequence - a fresh contestable period. Make a flashcard for each element and one specifically for 'what restarts.'
The candidate confuses dividend options with nonforfeiture options - for example, saying cash surrender value is the automatic (default) nonforfeiture option, or describing paid-up additions as what happens when a policy lapses.
Both are lists of 'choices the owner has,' both contain the words cash value, and both appear in the same chapter of most study outlines, so the lists cross-contaminate.
What to do instead
Anchor each list to its trigger event. Dividends exist because the policy is participating and in force (cash, reduce premium, accumulate at interest, paid-up additions, one-year term). Nonforfeiture options exist because the policy is being surrendered or lapsing (cash surrender, reduced paid-up, extended term - with extended term as the usual automatic option). Rehearse by asking 'is the policy alive or dying?' before choosing a list.
On a coinsurance item, the candidate calculates the insurer's share against the full billed charge instead of against the charge remaining after the deductible, and then stops without testing the result against the out-of-pocket maximum.
The word '80%' triggers an immediate multiplication on the biggest number on the page; the deductible is a separate sentence earlier in the stem and gets dropped from working memory.
What to do instead
Use one written formula every time: allowed charge minus deductible = base; base times (1 minus coinsurance rate) = member share; member share plus deductible plus copays, capped at the OOP maximum. Do the arithmetic on paper in the fixed order, and always finish by checking the cap.
The candidate applies group-style pre-existing condition rules (a maximum look-back and a credit for prior creditable coverage) to an individual policy, or assumes individual policies can never exclude a pre-existing condition.
Pre-existing condition is one phrase with two regulatory regimes, and the group/HIPAA rules are the ones taught in the most detail, so they crowd out the individual-market rules.
What to do instead
Split the concept by market: group coverage is federally constrained (look-back period, maximum exclusion period, credit for creditable coverage, certificates of creditable coverage); individual coverage is state-regulated and medically underwritten, so exclusion riders and waiting periods are permitted as the state allows. Tag every pre-existing condition question 'group or individual?' before reading the options.
Given a person covered under two health plans, the candidate cannot determine which plan pays first and defaults to 'the plan the person has had longer' or 'whichever plan the patient submits to first.'
Coordination of benefits is memorized as a name, not as an ordered set of rules, so the candidate has no sequence to apply under exam pressure.
What to do instead
Memorize the order as a ladder: (1) the plan covering the person as an employee pays before the plan covering them as a dependent; (2) if both are dependent plans covering a child, the 'birthday rule' applies (parent whose birthday falls earlier in the year is primary), with the custodial-parent rule for separated parents; (3) if neither applies, the plan in force longer. Walk the ladder one rung at a time on paper.
The candidate mixes up elimination period and benefit period in a disability income question, or misstates the taxation of benefits by forgetting that employer-paid premium makes benefits taxable while individually paid premium makes them tax-free.
Both periods are expressed in days or weeks and both describe 'how long,' and the tax rule is a single sentence that is easy to read past in a long stem.
What to do instead
Define each with a distinct question: elimination period answers 'how long before benefits start' (a waiting period, and a cost lever for the buyer); benefit period answers 'how long benefits last.' For tax, trace the premium: whoever paid the premium with pre-tax dollars is taxed on the benefit. Repeat the phrase 'premiums paid by employer = benefits taxable.'
The candidate expects Medicare to pay for long-term custodial care, or answers Medigap questions by selecting benefits that belong to Medicaid or to a Medicare Advantage plan.
The three programs are all 'government health coverage for older or low-income people,' and the candidate memorizes each program's features in isolation without a contrast set.
What to do instead
Build a one-page contrast table with rows for who is eligible, what it pays for, and what it excludes. Key anchors: Medicare is federal, age/disability based, and does not pay for custodial long-term care; Medigap is private, works alongside Original Medicare, and does not cover what Medicare does not cover; Medicaid is state/federal, income based, and is the payer for custodial long-term care. Read each stem asking 'which of the three is being described?'