Insurance Regulation by the Numbers

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DOI - Waiting period before rate filings go into effect

30 days

How long is the open-enrollment period under an employer group health insurance plan?

30 days

How long to notify the Department (DOI) of change of address

30 days

How long to provide a response to DOI's inquiry

30 days

How long to report action are against producer in another jurisdiction or charges of criminal conduct

30 days

The minimum number of credits required for partially insured status for Social Security disability benefits is

6 credits

What are the permissible calling hours for telemarketers?

8am until 9pm

How long after moving to Pennsylvania for nonresident to become licensed as a resident

90 days

How soon after the due date should the insurer pay the agent appointment fees?

Within 30 days

Civil penalty for each unintentional violation of insurance laws regarding unfair methods of competition

$1,000

Fine per day for failure to correct any violation

$100

License fee for nonresident insurance producers

$110

Lapsed license fee

$165

What is the maximum penalty for habitual willful noncompliance with the Fair Credit Reporting Act?

$2500

Aggregate penalties for intentional violations within 6 months

$50,000

HIPAA applies to groups of

2 or more

In order to maintain coverage under COBRA, how soon from termination of employment must an employee exercise extension of benefits?

60 days

For how long must a company maintain a complete file of all advertisements used?

At least 4 years

When is the annual open enrollment for state insurance exchanges?

November 1 through January 31

What is the civil penalty for the first violation of the Pennsylvania Insurance Fraud Prevention Act?

$5,000 ($10,000 for second, and $15,000 for every subsequent)

Civil penalty for each intentional violation of insurance laws regarding unfair methods of competition

$5000

License fee for resident insurance producers

$55

How long to reinstate a lapsed license with current effective date?

1 year

DOI - Hearing on rate filing after insurer is informed of disapproval

10 days

DOI - written notice of a hearing for a person suspected of prohibited behavior

10 days

to avoid violations of unfair claims settlement regulations, insurers are required to acknowledge the receipt of a claim within how many days?

10 days

Any licensed person whose activities affect interstate commerce and who knowingly makes false material statements related to the business of insurance may be imprisoned for up to

10 years

How long to correct the violation if a person failed to respond to the DOI's inquiry within 30 days

15 days

Age requirement for resident producer license

18

Temporary producer's license valid without written examination

180 days

License Renewal Period

2 years

How much continuing education may be carried to the next renewal period?

24 hours

How much continuing education required every 2 years

24 hours

An insured has Medicare Part D coverage. Upon reaching the initial benefit limit, what percentage of the prescription drug cost is the insured responsible for paying?

25%

How many days must the insurer inform the applicant about the request of an investigative consumer report?

3 days

Ethics education included in pre-licensing education requirements

3 hours

DOI - For Commissioner to approve or disapprove changes to a form

30 days

Employer health plans must provide primary coverage for individuals with end-stage renal disease before Medicare becomes primary for how many months?

30 months

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 elimination period for Social Security disability benefits?

5 months

DOI - Commissioner will examine each insurer

5 years

Maximum value of a gift that an agent can give to an insured without violation the regulation on rebating?

Promotional materials or articles of merchandise that have a redeemable value of $100 or less are not considered "valuable consideration"

The purpose of the Gramm-Leach-Bliley Act is to:

Protect private customer information filed with a financial institution

Insurance producers that do not have company appointments are considered a/an

Representative of the consumer - Broker

An individual was just caught acting as an exclusive general agent - even though he is not properly licensed. Assuming that this occurred in a single day, what is the maximum penalty he faces?

A third-degree misdemeanor and a $1,000 fine


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