Chapter #19: Louisiana Laws and Rules

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In order for a business entity to be licensed as a producer

A licensed producer must be designated as responsible for compliance with state insurance laws.

A licensed producer MUST be __________ by an insurer to be eligible for soliciting insurance contracts.

Appointed

Before a producer may sell, solicit, or negotiate insurance for an insurer, the producer must have a(n)

Appointment

A company that is authorized by the Commissioner to transact insurance business in Louisiana is called a(n)

Authorized insurer

A domestic insurance company in Louisiana MUST

Be organized under Louisiana insurance laws

A cease and desist order

Forbids a stated practice listed in the order

Under the Affordable Care Act, which of these plans is designed to provide coverage that is actuarially equivalent to 80% of the full actuarial value of the benefits provided under the plan?

Gold

A dependent child may remain on a parent's health insurance plan beyond 26 if the child

Has a mental or physical handicap and remains dependent on the parent

Which license is REQUIRED in order to solicit Long Term Care insurance in the State of Louisiana?

Health Insurance Producer License

Maria the producer would like to advertise an annuity product on a highway billboard. Which of the following must be included in the advertisement?

Her name

Which of the following is NOT information found in a life insurance buyer's guide?

How to take legal action against an insurance company

Terminally-ill life insurance policyowners may sell their policy at a discount to a third party. This type of agreement is called a(n)

Viatical settlement

What happens if the insurer discovers that the insured's age was accidentally misstated on an application for an individual life insurance policy?

Benefits will be calculated according to how much coverage the premium paid would have purchased for the correct age

Coverage for newborns under an accident and health plan MUST include coverage for

Birth abnormalities

What is the purpose of the Louisiana Life and Health Insurance Guaranty Association?

Ensures that claims filed against insolvent insurance companies will be paid

How often must the Commissioner examine each domestic insurance company?

Every 5 years

How often must an insurance producer's license in Louisiana be renewed?

Every two years

An example of an Unfair Claims Settlement Practice is

Failing to promptly provide reasonable explanations for the denial of claims

An alien insurer

Is an insurer operating in the U.S. but headquartered outside the U.S.

Which of the following is NOT a requirement to obtaining a Louisiana insurance producer license?

Must be age 21

Charles is a producer who is licensed in Louisiana but resides in Mississippi. Charles is considered to be a(n)

Nonresident producer

A business entity wishing to act as an insurance producer MUST

Obtain a producer's license

When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT

Obtain the beneficiary's signature

An Arkansas resident producer who would like to solicit insurance in Louisiana MUST obtain a nonresident license in Louisiana. Which of these is NOT a requirement for obtaining a nonresident license?

Pass Louisiana's state licensing exam

All Medicare Supplement policies MUST contain which provision?

Pre-existing conditions may be excluded from coverage for a maximum of 6 months

An insurance producer decides to conduct business under an assumed name. The Commissioner MUST be notified of this change

Prior to using the assumed name

An existing life insurance policy is being replaced by a new one. A notice of replacement must be provided by the ________ to be signed by the applicant.

Producer

An individual who has a contract with an insurance company to represent it is called a(n)

Producer

The branch of dentistry which deals with the replacement of missing parts is called

Prosthodontics

Karen the producer pays for her client's initial premium payment as an incentive for purchase. This act is considered a(n)

Rebate

A nonresident producer from a state outside of Louisiana may become licensed in Louisiana IF a(n)

Reciprocal arrangement exists with the state of domicile

Sharon the producer intentionally submitted a false statement in support of a claim. This is considered a form of

fraud

What is the MINIMUM benefit period that must be offered by a Long-Term Care policy?

12 months

To be classified as a small employer in Louisiana, an employer must emply

1-50 employees

A policyowner has _____ days after policy delivery to return a major medical policy.

10

How long is the free-look period for a life insurance policy sold in Louisiana?

10 days

An insurer has _____ days to file a notice of appointment to the Commissioner.

15

An eligible employee can be excluded from group health coverage for up to _____ months if he/she is considered a "late enrollee"

18

How many days is a temporary producer's license valid?

180

After an annuity has been in force for _____ year(s), it becomes incontestable.

2 years

How long after its effective date will an individual life insurance policy become incontestable?

2 years

Individual health policies sold in Louisiana require dependent children coverage up to age

26

After ____ years from date of issue, a policy can no longer be cancelled by the insurer for misstatements (except for fraud).

3

After a disability policy has been in force for ____ year(s), it is considered incontestable

3

Within how many days must a producer submit a change in address?

30

What are the levels of coverage as defined by the Affordable Care Act?

Bronze, Silver, Gold, and Platinum

Which of these is NOT considered a form of life insurance advertisement?

Buyer's guide

Which of the following permits an insurance company to transact business in Louisiana?

Certificate of Authority

Which of he following permits an insurance company to transact business in Louisiana?

Certificate of authority

An example of unfair discrimination would be

Charging different premiums for policyholders in the same risk classification

All of the following are considered to be fraud EXCEPT

Collecting an insurance charge that is less than what is required

Jim recently sold his life insurance policy under a viatical settlement contract. The proceeds of this contract could be subject to the claims of

Creditors

Which of the following unfair trade practices involves a producer who makes malicious public statements regarding an insurer's financial condition?

Defamation

Advertising regulations exist in order to

Demonstrate full and truthful disclosures to the public

A Medicare Supplement policy's outline of coverage MUST include a(n)

Description of policy benefits

A common exclusion or limitation on a dental policy is

Endodontics

A viatical settlement broker may NOT

Make any transactions before being approved for a license

Under the Louisiana Health Plan, comprehensive health benefits are provided to

Medically uninsurable residents

Long-term care policies sold in Louisiana may NOT exclude coverage for

Senile dementia

Which of these is NOT an Unfair Claims Settlement Practice?

Settling a claim by arbitration

All of the following actions are considered rebating EXCEPT

Sharing commissions with other producers

Kiara filled out a life insurance application and was given a policy illustration that showed future premiums being paid out of nonguaranteed values. This illustration MUST disclose that

She may need to resume premium payments, depending on actual results

A pre-existing condition is a condition for which medical advice or treatment was recommended by or received from a provider of health care service within _____ months preceding a healthy policy's effective date.

Six

Which entity regulates claim settlement practices?

State insurance departments

A life insurance replacement transaction could result in a(n)

Surrender charge

The Fair Credit Reporting Act protects consumers

With guidelines regarding credit reporting and distribution

In order for a business entity to be licensed as a producer,

a licensed producer must be designated as responsible for compliance with state insurance laws

A producer who sells most of his/her insurance policies to family members is said to be engaging in

controlled business

A producer must notify the Commissioner within _____ days of a felony conviction.

30

The required grace period for a life insurance policy sold in Louisiana is ____ days

30

In Louisiana, a small employer may not consist of more than how many eligible employees?

50

A life insurance applicant in Louisiana may backdate the application for up to ______ month(s).

6

An insurer may exclude preexisting conditions on a Medicare Supplement policy for ______ months.

6

Proof of loss on a health insurance claim must be submitted to an insurer within _______ days after the insured's date of loss.

90

When a small employer health insurance plan is offered, it must be available

To all eligible employees who apply

A producer license is NOT required when

Underwriting insurance

When the Commissioner of Insurance requests a producer's business records, the must be produced

Upon request


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