Ohio Laws and Rules
An agent's appointment has been terminated by the insurer. The insurer must then notify the superintendent within _______ days of the termination.
30 days
Long-Term Care policies or certificates issued in Ohio are required to have:
Nonforfeiture value. An insurer MUST offer a Long-Term Care Policy or certificate that has a nonforfeiture value.
An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called:
Coinsurance
In Ohio, an agent may have his/her license revoked for which of the following acts?
Failure to pay tax state income tax. it could result in license revocation.
A minor may receive a life insurance policy's death benefit ONLY:
If the minor has an appointed guardian
Pete the agent recently had his license suspended because he was found to be in violation of a state insurance law. Due to this suspension, Pete:
May be assessed the administrative costs sustained by the Department. When an agent's license is suspended or revoked because the licensee is found to be in violation of a state law, the licensee may be assessed the administrative cost incurred by the Department.
If an agent is believed to be causing considerable harm, the superintendent:
May issue a cease and desist order against the agent. But only if the superintendent believes an agent is causing substantial and material harm.
Insurance agent Kelly offers a prospect a $1,00.00 shopping card if an insurance policy is purchased through her. What illegal activity is this an example of??
Rebating is offering valuable consideration or inducement to a prospective insured that is not specified in the contract.
According the Affordable Care Act, what is the maximum amount an individual can contribute to a Flexible Savings Account?
$2,500.00
A life insurable policy's advertising material MUST contain all of the following information EXCEPT:
Agent's commission. -Exceptions include: -If the spokesperson was paid -Statement that dividends are not guaranteed -Company's name
A viatical settlement broke may NOT:
Make any transactions before being approved for a license. The exception to this would be certain eligible financial professionals.
When screening an applicant for HIV, the insurer:
May require a blood test for HIV
If health insurance benefits are not paid on a timely basis, the benefits paid shall bear simple interest from a date ______ month(s) after satisfactory proof of loss was received by the insurer.
2 months
Ohio requires a licensee to complete _____ hours of continuing education hours each licensing period.
24 hours of continuing education credit hours every 2 years.
Who is required to notify the agent in the event of appointment termination?
Insurer. The party that must notify the agent of the termination is the insurer.
Defamation occurs when an agent makes a false statement intended to:
Malign another insurer. Agents making false statements intended to malign another insurance company may be found guilty of defamation.
An insurance agent agrees to pay the first monthly premium for an insurance applicant. This is called a (n):
Rebate. Which is ILLEGAL!!!
A life insurance policyowner is allowed ________ days upon policy delivery to return the policy for a full premium refund.
10 days. The majority of companies allow a free-look period of 10 days for life insurance polices.
Mary's Medicare Supplement policy had been in effect for 12 months. She recently replaced the policy with a new one that provides better coverage. The replacing policy may only impose a ______ month time exclusion for pre-existing conditions.
0 month. Just as long as there was no gap in coverage for more than 63 days.
An insurance company advertises an accident and health insurance product in a local Ohio newspaper and refers to dollar amount benefits. This insurer must also disclose which of the following in the advertisement?
Any applicable benefit reduction
All of these are responsibilities of the superintendent EXCEPT:
Endorsing Insurers -Exceptions include: -Administering Oaths' -Subpoena a witness -Approving policy forms
A non-admitted insurer:
Is not afforded protection by the guaranty fund. A non-admitted insurer is not affordable protection by the guaranty fund.
An example of endodontic treatment is a:
Root canal. Endodontics is the branch of dentistry dealing with disease of the dental pulp.
An agent has committed an insurance crime that violated US Code (interstate commerce). Who would be responsible for the prosecution of this crime?
US Attorney General
An agent is legally permitted to share his/her commissions:
With another licensed agent. An agent may share commissions with another licensed agent that is similarly licensed.
An employer with under 20 employees must allow a terminated employee to continue accident and health coverage for a MINIMUM of _______ months.
12 months. under Ohio continuation rules, an employer with fewer than 20 employees must allow terminated employees to continue accident and health coverage for at least 12 months.
In Ohio, semiannual-premium health insurance polices must provide a grace period of at least:
31 days
An insured can exclude coverage for a preexisting condition on a Medicare Supplement policy for up to:
6 months after the effective date of coverage.
Long-term care insurance applications MUST contain plain and unambiguous health questions. The exceptions to this rule would be applications for:
All applications for long-term care insurance polices (except those that guaranteed issue) shall contain clear and unambiguous questions designed to determine the health condition of the applicant.
All of these are considered forms of advertising EXCEPT:
An insurer's Am Best rating. -Exceptions include: -Billboard announcing a new insurance product -A radio message promoting an insurer's client satisfaction -An oral presentation given by an agent.
Advertising regulations exist in order to:
Demonstrate full and truthful disclosures to the public
The superintendent determines an examination of an insurer's books and records is necessary. After receiving the notification, the insurer:
Must not impede the examination and is required to assist in the examination procedures.
An insurer may refuse to renew an employer's small group health plan due to:
Nonpayment of premium. Under a small group health benefit plans, a carrier may discontinue coverage or may refuse to renew such a plan if the employer fails to pay the premium prior to the end of the grace period.
When an agent is replacing an existing ordinary life insurance policy, the agent must take all of the following actions EXCEPT:
Obtain the beneficiary's signature. -Exceptions include: Provide the applicant with a copy of the sales proposal -Submit to the agent's insurance company a copy of the signed Notice Regarding Replacement -Provide the applicant with a Notice Regarding Replacement
Advertisements for accidental and health policies that ONLY cover a stated illness MUST display a statement that the:
Policy is limited. Ohio requires advertisements for accident and health insurance polices covering ONLY a specified illness to prominently display a statement that the policy is limited.
XYZ Corp was issued a group health policy for its employees. Under this plan a:
Policy must be issued to XYZ, and a certificate must be issued to each employee. With a group health policy, a policy must be issued to the employer and a certificate must be issued to each employee.
Unmarried children who are incapable of self support and have proof of incapacity are included under their parent's health coverage until.
Policy termination
All Health Benefit Plans issued after January 1, 2014 must provide:
Preventative health services
An advertisement for an insurance product may contain:
The insurer's name. It's permitted in advertisement for an insurance policy.
An order issued by the superintendent that prohibits a specific practice listed in the order is called a (n):
Cease and desist order
Ohio required that a licensee complete _______ hours of continuing education of the subject of ethics every reporting period.
3 Hours. A licensee who is required to take continuing education must complete 24 hours of continuing education, which includes 3 hours of ethics coursework.
A life insurance applicant in Ohio may backdate the application for up to _____ month(s).
3 months. Backdating a life insurance application in Ohio is permitted as long as it involves a period of no more than 3 months before the date the application was originally made. Most other states allow up to 6 months.
A life insurance applicant in Ohio may backdate the application for up to_______ month(s).
3 months. In order to save on premiums, a life insurance policy can legally be backdated up to 3 months.
An insurance company has just received a request for verification from a viatical settlement provider. The insurer is required to respond within ________ calendar days to this request.
30 calendar days
An employee has ______ days after the date of marriage to add a new spouse to a small group health plan.
30 days. After the date of marriage, an insurer is required to provide a minimum of 30 days for an employee to add a new spouse to a small health plan.
The first payment for newborn accident and health coverage is due ______days after the birth.
31 days
If an insurer refuses to pay a claim, how many days must the insured wait to take a legal action against a health insurer after submitting written proof of loss?
60 days. Although the Time Payment of claims provision requires the claim to be paid immediately, legal action against the insurer for failure to pay timely cannot commence until 60 days after proof of loss is furnished.
Coverage for newborns under an accident and health plan MUST include coverage for:
Birth abnormalities. This consist of injury or sickness as well.
A form of medical health insurance covering the treatment and care of gum disease is called:
Dental expense insurance
Which of the following is NOT specific power given to the superintendent?
Enact insurance legislation -Exceptions include: -Administer oaths -issue subpoenas -Approve policy forms