Chapter 10

What is the required minimum percentage of employee participation for a noncontributory group health insurance plan according to Florida law?

0%

What percentage of eligible persons must a policy cover in a noncontributory group?

100%

A person insured under a health policy is required to give the insurance company a Notice of Claim within how many days after a covered loss?

20

Eligibility for coverage under the Florida healthy kids corporation requires a family to be within _ of the federal poverty level

200%

Within how many days after policy delivery can a Medicare supplement policy be returned for a 100% premium refund?

30

The free-look period for all qualified long-term care policies sold in Florida is _ days.

30 days

A __ day notice to the policyholder is required for any health insurer that wishes to cancel a health insurance policy

45

The waiting period for a pre-existing condition under a Medicare supplement policy may not go beyond

6 months

What do families pay that are covered by the Florida Healthy Kids Corporation?

A portion of the premium

Which of the following is considered to be misrepresentation?

An agent guaranteeing a policy's dividends

Which of the following is the best description of insurer?

Any person, corporation, association, or society that writes insurance contracts

According to Florida law, when must an agent deliver the Outline of Coverage to a Medicare Supplement applicant?

At the time of application

Which of the following acts is an agent not authorized to do on behalf of the insurer?

Authorize claim payment

Can be defined as "using the contract values of an existing policy to purchase a new policy with an existing insurer"

Churning

Which of the following areas of state registration is not protected by the savings clause in ERISA?

Commerce

An applicant who pays the initial premium at the time of application is typically given a(n)

Conditional receipt

All of the following are eligibility requirements for an association group expect

Contributory plans require a minimum of 25 participants

In Florida, which agency is responsible for the rehabilitation or liquidation of insurers?

Department of Financial Services (DFS)

Any violations of the Florida financial institutions code may be investigated by the

Department of financial services (DFS)

An insurance company incorporated under the laws of the state in which its home office is located is called an _ company.

Domestic

The department may request all of these during licensing application process expect

Drug test

S takes out a health insurance policy which contains a provision that states that the agent does not have the authority to change the policy or waive any of its provisions. Which health policy provision is this?

Entire Contract

Which organization was established to provide funds to protect an insured in the event of an insurers insolvency?

Florida Life and Health Insurance Guaranty Association

The insurance guaranty fund association is

Funded by admitted insurance companies through assessments

What would be an accurate definition of controlled business?

Insurance business that is written on the agent's own life, property, or interests

Under Florida law, which of the following provisions is NOT required in a Medicare Supplement policy?

Limitation on pre-existing conditions for up to 12 months

Asset protection can be provided by a long-term care partnership policy if the policyholder qualifies for

Medicaid

Convincing a prospective insured to buy an insurance policy based on exaggerations is called

Misrepresentation

Which Unfair Trade Practice involves an agent suggesting that an insurance policy is like a share of stock?

Misrepresentation

Which Unfair Trade Practice involves an agent telling a prospective client that a policy's dividends are guaranteed?

Misrepresentation

Which Unfair Trade Practice involves making a false statement on an insurance application in order to receive money from an insurer?

Misrepresentation

Which of the following is not an unfair claim settlement practice?

Needing written documentation of claim details

Which entity approves the insurance policy forms used in Florida?

Office of Insurance Regulation (OIR)

An example of sliding would be

charging for an additional product without the applicant's consent

A long term care lapse notice must be delivered to both the applicant and

secondary addressee

Association Plans that are designed to provide health benefits to their members are regulated by the state because

they are insured by an authorized insurer

An example of an unfair claims settlement practice is

turning down a claim without providing the basis of denial

An agent who makes misleading statements that lead to the termination of an existing insurance policy so that a new policy with another insurer can be taken out has committed

twisting

J is an agent who has induced an insured through misrepresentation to surrender an existing insurance policy. What is J guilty of?

twisting

An agent's license can be suspended or revoked by

writing primarily controlled business

What type of insurance company is domiciled in England but conducts business in Florida?

alien

An example of an unfair trade practice is

an agent making a material misrepresentation to the insured

A stock insurance company

is owned exclusively by its shareholders

Of a policyowner does not pay the premium by the due date the

Policyowner can make the premium payment during the grace period

What is the purpose of the insurance guaranty fund association?

Protects policyowners against insolvent insurance companies

Which of these is not a legal entity for selling life insurance in Florida?

Risk management advisers

Which of the following provisions is not required in HMO contracts/certificates?

Seven-day grace period

Which of the following is not considered rebating?

Sharing commission with an agent licensed in the same line of business

What is required in the Florida employee health care access act?

Small group benefit plans are to be issued on a "guarantee-issue" basis

A mutual insurance company and a stock insurance company have one main difference between them. What is this major contrast?

Stock company is owned by its shareholders. Mutual company is owned by its policyholders.

An agent selling Medicare Supplement policies must provide every applicant with a(n)

Suitability form

Which of the following must be included in a Medicare supplement policy's outline of coverage?

The policy's limitations And exceptions

Which of the following is considered an accurate statement of an unfair trade practice?

Twisting involves an agent using misrepresentation to convince a policyowner to cancel their current policy so that they can purchase a new life insurance policy with another company

One definition of replacement is "the act of replacing an existing insurance policy with another". Replacement is

closely regulated and requires full disclosure

As a condition for a loan, a bank requires the borrower to purchase credit insurance from a specific company. What is the bank guilty of?

coercion

In Florida, which of the following is considered an unfair trade practice?

coercion

J is an agent who recently told a claimant that his rights might be impaired if he does not complete a release form within a specified time. What could this agent be found guilty of?

coercion

If an agent combines premiums collected with their personal funds they have engaged in

commingling

An example of an unfair claims practice would be

failing to effectuate prompt, fair, and equitable settlements of a claim

The act of an insurance company publishing misleading information about its policy's provisions is called

false advertising

In Florida, an insurer licensed to conduct business in Florida, but domiciled in New Jersey, is called a(n)

foreign company

Defamation occurs when an agent makes a false statement intended to

malign another insurer

K made a fraudulent statement on her health insurance policy application. In the event of a claim on this policy, the insurance company is required to pay

nothing

In Florida, agents are allowed to engage in rebating if

offered to all insureds in the same actuarial class

An example of rebating would be

offering a client something of value not stated in the contract in exchange for their business

An example of unfair discrimination would be

offering different terms of coverage for different policyowners having the same risk classification