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