Health Only

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Cobra termination-extension of benefits

60 days

Legal action (cannot take legal action until a certain amount of days from submitted proof of loss)

60 days

Grace period weekly premium

7 days

Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within

90 days

Proof of loss

90 days

Free look for health policy

10 days

Grace period Monthly premium

10 days

For how many days of skilled nursing facility care will Medicare pay benefits?

100 days

How many consecutive months of coverage (other than in an acute care unit of a hospital) must LTC insurance provide in this state?

12

Claim forms

15 days

Disability income policies- highest premium

15 days waiting period/10 year benefit period

Continuation of coverage under a group health -termination

18 months

What is the maximum elimination period in long term care policies issued in Florida?

180 days

Cobra employers

20

Medicare pay full benefit if hospitalized in an accident

20 days

Notice of claim (loss)

20 days

Pay out of pocket Medicare A and B outpatient basis

20%

If a parent would like to enroll a child over the age of 5 into the Florida Healthy Kids program, their family income must be under a certain percentage of the federal poverty level.

200%

Relation of earning to insurance (look at the average earn to earn that benefit)

24 months = 2 years

In order for an employee to be considered eligible for small group insurance, he/she must work at least how many hours per week?

25

Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained?

3 days

Retain advertisement for its long term care policies

3 years

What is the maximum age for qualifying for a catastrophic plan?

30

Free look period LTC and Medical Supplement (senior disability after 65)

30 Days

An agent has been convicted of a crime punishable by a 1-year imprisonment. Within how many days must the agent notify the department of insurance?

30 days

Elimination Period

30 days

If a licensee changes his or her residence address, within how many days must the department be notified?

30 days

Conversion from group to employee

31 days

Grace period all other modes (annually) premium

31 days

Proof of dependency -child

31 days

What is the period of coverage for events such as death or divorce under COBRA?

36 months (full amount + 2% interest)

Time of payment of claims (pay after notification and proof of loss)

45 days

Hours of continuing education on ethics and regulatory updates

5

If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?

5 days

What is the statue of limitation on lawsuits for health insurance policies?

5 years

Benefit period for individual short term disability policies will usually continue from

6 months to 2 years

eyes

One exam, one glasses, every 12 months


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