Chp. 8 Missouri Laws and Rules Pertinent to Insurance

To be eligible for a group health policy, a group MUST meet which of the following A.) Be formed for a purpose other than obtaining insurance B.) Designate one of its members to be the named insured C.) Include at least ten individuals at the date of issue D.) Include at least two employers

A.) Be formed for a purpose other than obtaining insurance

To be eligible for a group life policy, a group MUST meet which of the following requirements? A.) Be formed for a purpose other than obtaining insurance B.) Designate 1 of its members to be the named insured C.) Include at least 10 individuals at the date of issue D.) Include at least 2 companies

A.) Be formed for a purpose other than obtaining insurance

Which of the following types of polices does NOT require a policy summary be given? A.) Credit life B.) Universal life C.) Term life D.) Whole life

A.) Credit life

Which of these statements regarding health coverage for physically handicapped dependents is FALSE? A.) The dependent must have been over ten years of age when the handicap was incurred B.) The dependent must have been covered under the insured's policy at the time the handicap was incurred C.) The dependent must rely chiefly on the policyowner for support and maintenance D.) The dependent must agree to periodic medical examinations at the request of the insurance company

A.) The dependent must have been over ten years of age when the handicap was incurred

Which of the following may NOT be issued after the Director of Insurance finds an insurance code violation committed by a licensee? A.) Warrant B.) Cease and desist order C.) Consent order D.) Suspension

A.) Warrant

If the sale of a Medicare Supplement involves replacement, all of these actions must be performed by the producer EXCEPT A.) notify the replaced insurance company B.) give the insured a written replacement notice C.) submit a written replacement notice to the replacing insurance company D.) give a list of all health policies the producer sold to applicant in the past

A.) notify the replaced insurance company

Which licensee faces possible license revocation by the Director of Insurance?

Licensee who misappropriates monies belonging to policyholders

Life insurance and annuity replacement can be BEST described as

exchanging an existing policy for a new policy

Who may assign benefits from a group life insurance policy?

insured

An insurance producer who convinces a prospective insured to purchase a policy by exaggerating the benefits of the policy may be found guilty of

misrepresentation

At the time of application, major medical health plans (including HMOs) MUST

offer coverage for prosthetic devices

After a life insurance policy has been in force for a MAXIMUM of __ year(s), it becomes incontestable.

2

Jay's application for a producer's license has been denied. He may request a hearing within ___ days after receipt of the denial.

30

A producer is required to file notice of any change of address within how many days?

30 days

Within how many days of a pre-trial hearing must a producer report to the Director any felony charges or crimes of moral turpitude?

30 days

Continuing education (CE) providers must report to the Director a licensee's earned credit hours within

30 days of course completion

Prior to a universal life insurance policy being terminated, written notice must be given to the policyowner at least

30 days of termination date

The co-payment for a chiropractic service cannot exceed how much of the total cost of providing the service?

50%

A life policy loan in Missouri cannot charge a fixed rate of interest higher than

8%

What is the MAXIMUM fixed interest rate for life insurance policy loans?

8%

Under a Group Life insurance policy, an insured may assign a MAXIMUM of what percentage of the insured's coverage?

100%

All of these statements concerning a licensee's responsibility for premiums received are true EXCEPT A.) Diverting or appropriating them for personal use could subject the licensee to disciplinary action B.) The licensee must hold them in a separate account at a commercial bank or established financial institution before transmitting them to the insurance company C.) The licensee shall hold them in a fiduciary capacity D.) The licensee must remit them to the insurance company within a time specified in the contract with the insurance company

B.) The licensee must hold them in a separate account at a commercial bank or established financial institution before transmitting them to the insurance company

Replacement is involved in all of the following situations EXCEPT when A.) an ordinary life insurance policy is terminated and a new policy is purchased with a different insurance company B.) a Term policy is converted to a permanent plan with the same insurance company C.) an ordinary policy is surrendered for its cash value, which is then used to purchase a new Universal Life policy D.) a policy is changed to a reduced paid-up basis, and a Term policy is issued

B.) a Term policy is converted to a permanent plan with the same insurance company

Which of the following is considered a producer's fiduciary responsibility?

Collect premiums and remit to the insurance company as soon as reasonably possible

Which of these individuals may NOT be compensated from an insurance company? A.) A retired insurance agency owner B.) A managing general producer of the company C.) A licensed producer not appointed by the company D.) A salaried employee of the company

C.) A licensed producer not appointed by the company

Which of these is a TRUE statement regarding the regulatory authority of the DIrector? A.) The Director may mandate the financial restructuring of insolvent producers B.) The Director may levy fines on policy applications to defray operating costs C.) The Director may establish guidelines for continuing education as a part of the producer's license renewal procedure D.) The Director may require adjacent states to adopt reciprocal agreements for non resident producer's licenses

C.) The Director may establish guidelines for continuing education as a part of the producer's license renewal procedure

Which of the following is NOT a required provision in a group life policy? A.) Grace period provision B.) Incontestable period C.) Conversion period D.) Accidental Death and Dismemberment provision

D.) Accidental Death and Dismemberment provision

Which of the following policies MUST provide coverage for human leukocyte antigen testing for bone marrow transplantation?

Group Comprehensive Health Insurance

Which of the following limits may be applied to coverage of autism spectrum disorder treatments?

Medically necessary treatment in accordance with a treatment plan

Which Medicare product requires use of specific hospitals and physicians for non-emergency care?

Medicare Select policies

What must a producer sign when an existing life insurance policy is being reissued with a reduction in cash value?

Notice Regarding Replacement of Life Insurance or Annuity

Which of the following is a requirement for obtaining a resident producer license in Missouri?

Pay $100 license fee

Jasmine is a salaried employee of an insurance company. Which of the following duties would require her to be licensed as an insurance producer?

Soliciting insurance policies

Disclosure standards require that which of the following be delivered with a Medicare Supplement policy?

The Outline of Coverage

Under which circumstance could a child be denied enrollment into a health plan in Missouri?

The child is no relation to, and is not placed for adoption or adopted by the plan member

What is the purpose of the Insurance Guaranty Fund?

To ensure that claims filed against insolvent insurance companies will be paid

A major medical plan (including an HMO) must cover formula and low protein modified food products for treatment of PKU or any inherited disease of amino and organic acids for

a child covered under the policy and less than six years of age

When a group accident and health policy is issued to an employer,

a policy must be issued to the employer and a certificate must be issued to each employee

An applicant for a nonresident producer license MUST

be a producer in good standing in their home state

Health coverage for the administration of general anesthesia and hospital charges for dental care MUST be provided to a(n)

child under the age of 5

Under Missouri law, a state regulated health benefit plan must

cover, with no prior authorization necessary, childhood immunization services whether provided in a medical physician's regular office or a qualified hospital emergency room

A credit life insurance policy covers the life of the

debtor

The act of offering an applicant something of value as an inducement to purchase a policy of insurance is

rebating

Under Missouri law, a health carrier shall have expedited grievance review procedures for

situations in which the standard time frames for grievance procedures could seriously jeopardize the enrollee's life or health

The suicide provision for life policies would apply to

subsequent increases in benefits

Under Missouri law, when one group health plan's contract replaces a plan of similar benefits of another group health plan,

the succeeding carrier shall give credit for the satisfaction of any deductibles or waiting periods satisfied or partially satisfied under the prior carrier's plan

The Director of Insurance is authorized

to enforce state laws relating to insurance

Health insurance policies in Missouri are REQUIRED to contain coverage for human leukocyte antigen testing for bone marrow transplant

with each health insurance policy issued

Prior to a producer's license being revoked, a hearing must be held. Prior to this hearing, the Director of Insurance is REQUIRED to give

written notice to the producer