Laws and Rules
An individual applying for a Michigan resident producer license must have completed the required pre-licensing education within ____ months of license application
12
For individual health insurance, coverage for pre-existing consider is may be excluded for up to ___ months after issuance of the policy
12 months
a producer is hired to sell insurance for an insurer. Upon submission of agency contract application, a producer must be appointed by the insurer within ____ days
15
To be classified as a small employer in Michigan, an employer must employ
2-50 employees
In Michigan, legal action can be taken for up to ____ year(s) against an insurer for the failure to pay health insurance claims after proof of loss was submitted
3 years
A insurance producer license is required for
A business entity soliciting insurance
Twisting
A form of misrepresentation in which an agent persuades an insured/owner to cancel, lapse, or switch policies, even when it's to the insured's disadvantage.
In the Michigan insurance code, chapter 45, insurance fraud defines finically loss as all of the following except
Additional premiums
Under which circumstance do consumer privacy regulations allow an insureds financial information be released?
An authorized agency makes a written request to the insurer during an insurance fraud investigation
Which of the following is included in the entire contract according to the entire contract provision?
Application
A newborn must be covered under an existing health policy
At the moment of birth
With a scheduled dental policy, how are covered expenses paid?
Benefits are limited to a specific maximum dollar amount per procedure
Newborn coverage under health insurance policy's must include coverage for
Birth abnormalities
Which of the following is not a valid reason for an insurer to refuse renewal of a small employer group plan?
Claims were higher than expected
Any chance in address by licensee requires notice within 30 days to which of the following
Commissioner
In Michigan, a person providing insurance advice to a person or business for a fee is required to hold a
Counselor license
Nate's dependent son is psychically handicapped, but not eligible for Medicare. How long May the son remain on nates health coverage after the age of 26?
Coverage remains with written proof of disability and dependency
What does restorative dental treatment cover?
Crowns
A form of medical health insurance covering the treatment and care of gum disease is called
Dental expense insurance
A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance?
Dental treatment is needed to repair an injury
A producers license may only be revoked by the
Department of insurance and financial services (DIFS)
A common exclusion on a dental policy is
Endodontics
An example of unfair claims settlement practice is
Failing to promptly provide a reasonable explanation for the denial of claims
Paul the producer has provide a false statement in relation to an insurance claim. Which illegal act has been committed
Fraud
HMO plans are required to provide
Home health care
An insurer is required to offer which of the following to each long term care applicant at the time of purchase?
Inflation protection
Upon receiving a producer complaint, the commissioner may immediately
Issue a cease and desist order
Producer commissions may not be paid to
Licensed producers not appointed by an insurer
Which of the following is an example of the illegal act of defamation
Making a statement that is false or maliciously critical of the financial condition of the insurer
Producer's Fiduciary Duty requires
Premiums are forwarded to the insurer on a timely basis
In the state of Michigan, a licensed producer
Represents the insurer
An example of an endodontic treatment is
Root canal
A(n) ______ company is owned exclusively by shareholders
Stock
According to the Taft-Hartley act, group insurance premium payments made by the employer must be paid to the
Trust
The act of ____ insurance does not require an individual to hold an insurance producer license
Underwriting
A producers license is required for all of these activities except
Underwriting insurance
An example of intimidation is
Using threat or force to restrict fair trade in the transaction
A producer has allowed their license to lapse by failing to complete the required continuing education credits. The license may be reinstated by complete it requirement
Within 90 days
Group dental plans will frequently place a limit on annual benefits in order to minimize
adverse selection
An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called
coinsurance
In most dental plans, a deductible typically is NOT applied to
preventative and diagnostic services