Chapter 9

failing to submit an insurance application within the time period expressly specified by the insurer, or within 7 days after the insurance agent accepts a premium, or an order to bind coverage, but does not include improperly misappropriating money or property received in the course of doing insurance business or selling insurance policies for or on behalf of any entity not authorized to transact business in Ohio, as these are Class A offenses.

A Class B offense includes

When the application is submitted prior to or during the 6-month period beginning with the first day of the first month in which an individual is both aged 65 or older and the applicant is enrolled for benefits under Medicare Part B

A Medicare supplement policy cannot be denied, conditioned, or priced because of the health status, claims experience, receipt of health care, or medical condition of an applicant:

$3,500 for each violation but not to exceed an aggregate penalty of $35,000 in a 6 month period

In addition, each violation the insurance code, a civil penalty of up to

A consumer must consent to any fee before any insurance business is conducted

In order to charge consumer fees, agents take which of the following actions? Agents may never collect consumer fees Have permission from the insurer to make the fee part of the policy premium A consumer must consent to any fee before any insurance business is conducted Structure the fee so that its collection is contingent on a future event like a policy lapse

An agent, other than a business entity, who is no longer engaged in insurance in any capacity that requires a license, may apply to the Superintendent for inactive status. The Superintendent may grant inactive status only if satisfied that the person is no longer engaged in and has no intent to engage in any activity that requires an agent's license for at least 24 months.

Inactive Status

An agent may do any of the following:

Pay commissions to an agent licensed for the appropriate line of business who is not appointed with the same insurer Assign commissions to an unlicensed person or entity under a written agreement as long as the assignment is not a mere pretext for an unlawful commission or fee payment An agent or insurer may pay an unlicensed person or organization: For rendered administrative services as long as the payment is reasonable and does not reflect sales production To cover the production costs for an endorsement

The agent must notify the Superintendent before using the name

What must agents do when they wish to do business under an assumed name?

Failing to provide a written response to the Department of Insurance within 21 calendar days after receipt of any written inquiry from the Department

Which of the following is considered a Class B offense? Failing to provide a written response to the Department of Insurance within 21 calendar days after receipt of any written inquiry from the Department Failing to submit an insurance application within the time period expressly specified by the insurer, or within 30 days after the insurance agent accepts a premium, or an order to bind coverage Improperly misappropriating money or property received in the course of doing insurance business Selling insurance policies for or on behalf of any entity not authorized to transact business in Ohio

The child is the natural child, stepchild, or adopted child of the insured

Once an unmarried child has attained the limiting age for dependent children, the insured may request the insurer to cover such child until he/she attains age 26, provided that:

A fee may be based on a percentage of the premium

Which of the following is incorrect with regard to consumer fees? A fee may be based on a percentage of the premium A fee may not be contingent upon a future event A consumer must consent to any fee charged by an agent A fee may not be charged in conjunction with an changes to a personal lines policy

An applicant with law degree from Ohio State

Which of the following people would be required to meet the prelicensing education requirements established for agents by the state of Ohio? An applicant with law degree from Ohio State A Chartered Property and Casualty Underwriter A Chartered Life Underwriter An applicant with a bachelor's degree in insurance

Upon application for a life insurance policy containing accelerated LTC benefits Life insurance policies or riders containing accelerated LTC benefits are not required to furnish the Shopper's Guide.

Which of the following situations does not require the delivery of the Shopper's Guide? Upon application for an individual long-term care policy Upon application for a life insurance policy containing accelerated LTC benefits Upon application for a group long-term care policy Upon application for an individual long-term care policy on a direct response basis

Temporary License

A license to operate for up to six months or 180 days

Time of Payment of Claims provision

According to the ___________ indemnities payable under individual accident policies will be paid immediately, or within 30 days at the latest, upon receipt of due written proof of loss.

Applicants must provide written consent in advance of an HIV test being conducted

In Ohio, which of the following statements apply to HIV testing?

In order to transact insurance in Ohio, a person must request a criminal background check * A person is not required post a bond. In order to transact life insurance in Ohio, a person must have a license for a life line of authority.

Which of the following is a licensing requirement? In order to transact insurance in Ohio, a person must post a fidelity bond with the state In order to transact insurance in Ohio, a person must post a surety bond with the state In order to transact life insurance in Ohio, a person must have a license for any line of authority In order to transact insurance in Ohio, a person must request a criminal background check

The OLHIGA may not be used to solicit or sell life insurance

Which of the following statements regarding the Ohio Life and Health Insurance Guaranty Association (OLHIGA) is correct?

Must conduct a financial examination of an insurer at least once every 3 years

With regard to financial examinations, the Superintendent:

July 1st of each year

Unless terminated by the insurer, appointments automatically renew on:

The licensee's name The license's number, issue date, and expiration date The lines of authority granted Any other information the Superintendent requires

A license must state:

Penalties

Failing to meet CE requirements will result in license suspension. The suspension becomes effective when the Superintendent mails a notice of 60 days.

24 hours every 2 years, due on the last day of their birth month

How many hours of CE must life and health agents complete in the state of Ohio?

The course is 30 hours or longer The Superintendent acknowledges, in writing, that the content of the course would qualify for CE credit The number of continuing credit hours requested by the provider and approved by the Superintendent is less than the total number of course hours

A licensee may not be required to complete the entire course if all of these conditions are met:

30 days

An agent must notify the Superintendent of administrative action taken or criminal prosecution within:

Assumed Business Name

An insurance agent that intends to do business in Ohio under any name other than the agent's legal name must notify the Superintendent prior to using the assumed name.

If the Superintendent determines that a violation described in this section has occurred, the Superintendent may take one or more of the following actions:

Assess a civil penalty of up to $25,000 per violation Assess administrative costs to cover the expenses incurred by the department in the administrative action Suspend all of the person's licenses Permanently revoke all of the person's licenses for all lines of insurance Refuse to issue a license Refuse to renew a license Impose a minimum of a 2-year suspension on all of the person's licenses for all lines of insurance Accept a surrender for cause offered by the licensee, which would be for at least 5 years and prohibit the licensee from seeking any insurance license

If a licensed agent changes his/her address within his/her state or residence, he/she must file a change of address with the Superintendent within 30 days after making the change. This includes nonresident licensees who change their state of residence.

Change in Name, Address, Email, Telephone Number

An insurer may request a proposed insured for individual or group life and health insurance to take an HIV test, provided the insurer obtains the individual's written consent * An insurer who obtains the required written consent may request a proposed insured for individual life and health insurance to take an HIV test, but not an applicant for group insurance, unless the group is a membership organization.

Which of the following is false regarding HIV testing? One of the items that the consent form must disclose is information about the tests to be performed An insurer may disclose the results of a positive HIV test only to the applicant, the applicant's physician or other designated person, or a medical information exchange An individual applying for group life insurance through a membership organization may be requested to take an HIV test An insurer may request a proposed insured for individual or group life and health insurance to take an HIV test, provided the insurer obtains the individual's written consent

A small employer insurer is not required to actively market health benefit plans to small employers

Which of the following statements is NOT correct concerning small employer coverage? Coverage must be available on a guaranteed issue basis A small employer insurer must actively market health benefit plans to small employers A small employer insurer is not required to actively market health benefit plans to small employers A pre-existing condition exclusion may be imposed for up to 12 or 18 months (for late enrollee) following the date of enrollment

Any sale of Medicare supplement coverage that will provide an individual more than one Medicare supplement policy or certificate is prohibited

Which of the following statements is correct? Any sale of Medicare supplement coverage that will provide an individual more than one Medicare supplement policy or certificate is prohibited Medicare supplement policies and certificates may be returned within 10 days for a full premium refund A Buyer's Guide, for other than direct response sales, must be provided at the time of policy delivery Insurers may issue a Medicare supplement policy or certificate to an individual enrolled in Medicare Part C

A surplus lines broker obtains insurance on property or life insurance persons in Ohio from insurers not authorized to transact business in this state * A surplus lines broker does not obtain life insurance.

Which of the following statements is false regarding surplus lines brokers? An applicant for a surplus lines broker license must be a resident of the United States A surplus lines broker obtains insurance on property or life insurance persons in Ohio from insurers not authorized to transact business in this state An applicant for a surplus lines broker license must hold both a Property and Casualty license An applicant for a surplus lines broker license must post a $25,000 penal bond

The insurer must mail a copy of the notification to the agent within 30 days after notifying the Superintenden *insurer must mail a copy of the notification to the agent within 15 days after notifying the Superintendent.

Which of the following statements is false with regard to notification of termination of an appointment? The insurer must notify the Superintendent within 30 days after the termination effective date The insurer must mail a copy of the notification to the agent within 30 days after notifying the Superintendent The agent may file written comments with the Superintendent within 30 days after receiving a copy of termination notification The insurer must provide any additional information, documents, records to the Superintendent

Abbreviated notices may not be given

Which of the following statements is false, regarding the regulations governing insurance information privacy?

Notices regarding the scheduling of hearings may be sent by ordinary mail A hearing opportunity notice must be served by certified mail, return receipt requested. Notices may be published in a newspaper if service by mail fails.

Which of the following statements is not true with regard to hearings pursuant to disciplinary action procedures? Notices may be published or made public A licensee subject to license denial, suspension or revocation is eligible for a hearing Notices regarding the scheduling of hearings may be sent by ordinary mail A hearing opportunity notice may not be provided verbally

If an insured's employment is terminated, the insured is eligible for continuation of coverage for 6 months if such insured has been covered under the group policy for at least 3 months

Which of the following statements is true regarding continuation of coverage under a group health insurance policy? If an insured's employment is terminated, the insured is eligible for continuation of coverage for 3 months if such insured has been covered under the group policy for at least 6 months If an insured's employment is terminated, the insured is eligible for continuation of coverage for 12 months if such insured has been covered under the group policy for at least 3 months If an insured's employment is terminated, the insured is eligible for continuation of coverage for 6 months if such insured has been covered under the group policy for at least 3 months If an insured's employment is terminated, the insured is eligible for continuation of coverage for 12 months if such insured has been covered under the group policy for at least 6 months

A limited lines license may be issued for credit insurance or title insurance * Neither a prelicensing exam or education is required for a limited lines license. A limited lines license may not be issued for variable contracts.

Which of the following statements is true regarding limited lines licensing? A limited license may be issued after the applicant achieves a passing score on the applicable prelicensing examination A prelicensing exam is not required for limited lines, but evidence of completion of prelicensing education is required A limited lines license may be issued for variable contracts A limited lines license may be issued for credit insurance or title insurance

The Superintendent will call a hearing within 15 days when a cease and desist order is issued

Which of the following statements regarding cease and desist orders is true? The Superintendent will call a hearing within 15 days when a cease and desist order is issued The Superintendent must hold a hearing prior to issuing a cease and desist order Cease and desist order must be presented in person by a process server The maximum fine for a cease and desist order is $500

Requires a premium for children from families with incomes up to 300% above the federal poverty line * The program automatically covers children from families at 150% or less of the federal poverty limit. Through a federal waiver, families with incomes up to 300% above the federal poverty line can receive coverage for their children by paying a premium.

Which statement does not describe the Ohio Children's Health Insurance Program? Requires a premium for children from families with incomes up to 300% above the federal poverty line Requires a premium for children from all families with incomes above the federal poverty line Is limited to the children of families with incomes at or below the federal poverty line Provides coverage for children of families with incomes above 200% of the federal poverty line with a waiver

A handicapped dependent child may be covered under a parent's policy up to age 23

With respect to dependent handicapped children, which of the following is incorrect? Once a handicapped child has been covered for 2 years beyond the limiting age, insurers cannot require proof of incapacity more frequently than annually A handicapped dependent child may be covered under a parent's policy up to age 23 The insurer may require the enrollee to provide proof within 31 days before the child attains the limiting age, and once per year thereafter, to continue the child's coverage A health policy must continue coverage for a dependent child after the child attains any limiting age if the child is incapable of self-sustaining employment due to a physical/mental handicap and continues to be dependent on the insured