Laws and Rules

An agent selling Medicare Supplement policies must provide every applicant with

Every agent soliciting Medicare Supplements must provide a suitability form

Florida requires that coverage for newborns beings "from the moment of birth" and continues for

18 months

Eligibility for coverage under the Florida Healthy Kids Corporation requires a family to be within__ of the federal poverty level

200%

An applicant who pays the initial premium at the time of application is typically given

A conditional receipt is normally given to an applicant who pays the initial premium at the time of application

An underwriter determines that an applicant's risk should be recategorized due to a health issue. This policy may be issued with a

exclusion for the medical condition

Which action could result in a hearing being ordered by the department of financial services?

A hearing may be conducted if anyone is suspected of engaging in the business of insurance without a license

Which of these is not a legal entity for selling life insurance in Florida

Risk management advisers do not qualify as a legal entity for selling life insurance

Which Federal law allows an insurer to obtain an inspection report on a potential insured?

Fair credit Reporting ACt

T is an agent and when hired, is reminded that he has a responsibility to handle clients' funds in an honest and ethical manner. This responsibility is referred to as

Fiduciary responsibility involves an agent funds of a client or insurance company honestly and fairly, and not using them for the agent's own purposes.

What action should a producer take if the initial premium is NOT submitted with the application?

Forward the application to the insurer without the initial premium

All of these are prerequisite for becoming a licensed agent EXCEPT

Graduating from high school is not a prerequisite for becoming a licensed agent

Which mode of payment is NOT used by health insurance policies?

Single premium

Which mode of payment is not used by health insurance policies

Single premium

A mutual insurance company and a stock insurance company have one main difference between them. What is this major contrast?

Stock company is owned by its shareholders. Mutual company is owned by its policyholders (SS&MP)

The Department may request all of these during the licensing application process EXCEPT

The Department will not request a drug test during the licensing application process

In Florida, when agents recommend changes be made for existing coverage, the agent must follow established procedures. The name of this rule is called the

The Florida Replacement Rule sets forth the requirements and procedures to be followed by insurance companies and producers when replacing existing life insurance contracts.

A prepaid application for individual disability Income insurance was recently submitted to an insurer. When the insurer received the Medical information Bureau report, the report showed that the applicant had suffered a stroke 18 months ago, something that was not disclosed on the application. which of the following actions would the insurance company not take?

The MIB does not need to be notified that coverage was denied.

Why must an Accident & Health insurance applicant answer all questions on the application?

The application statements are representations are part of the consideration for issuing a policy

What is the purpose of the insurance Guaranty Fund Association?

The insurance Guaranty Fund Association is an association that protects policy owners against insolvent insurance companies

Which of the following actions will an insurance company most likely not take if an applicant, who has diabetes, applies for a disability income policy?

The insurance company may take all of these actions EXCEPT issue the policy with an altered Time of Payment of Claims provision

In Florida, an element of an insurance transaction would be

The issuance of an insurance contract is considered to be an element of an insurance transaction

What is the main reason for regulating the insurance industry?

The primary purpose of regulation of the insurance industry is to promote the public welfare by maintaining the solvency of insurance companies

Nonprofit life insurance providers that are covered by a special section in the Florida insurance code are called

A fraternal life insurance organization is a nonprofit provider of life insurance that is covered by a special section of the Florida insurance code

What do families pay that are covered by the Florida Healthy Kids Corporation?

A portion of the premium

The first portion of a covered Major Medical insurance expense that the insured is required to pay is called the:

A provision that requires the insured to pay the first portion of covered expenses before major medical coverage applies is called an initial deductible

Before a health insurance policy is issued, which of these components of the contract is required

A signature on an application is required before a health policy will be issued

Which of the following statements about the classification of applicants is INCORRECT?

A substandard risk is below the insurer's average risk guidelines. An individual can be rated substandard for a number of reason and can even be rejected outright

All of the following will result in the suspension of an agent's license except

Actions as a fiduciary would not result in suspension of an agent's license

Which of the following employer tasks does a professional employer organization normally handle?

Administration tasks

Which of the following is NOT a consequence for placing business with an unauthorized insurer?

All of these are possible consequence for placing business with an unauthorized insurer EXCEPT the conviction of a first degree misdemeanor.

All of these are considered sources of underwriting information about an applicant, EXCEPT:

All of these are valid sources to obtain underwriting information about an applicant EXCEPT for a rating service (A.M. Best, Standard & Poor's)

Which of the following areas of state regulation is NOT protected by the savings clause in ERISA?

All of these areas of state regulation are protected by the savings clause in ERISA EXCEPT for Commerce

Which UNfair Trade Practice involves an agent telling a prospective client that a policy's dividends are guaranteed?

An agent who tells a client that dividends are guaranteed may be guilty of misrepresentation.

An agent's license can be suspended or revoked by

An agents license can be suspended or revoked by writing primarily controlled business

A licensed agent must be appointed by an insurance company to solicit insurance in Florida. the agents license will terminate if a certain period of time elapses without being appointed. How long is this period of time?

An agents license will terminate if the agents allows 48 months of elapse without being appointed for the class or classes of insurance listed on the license

Why is an applicants signature required on a health insurance application?

An applicants signature reporesents that the statements on the application are to the best of the applicants knowledge

An application for Medicare Supplement coverage may NOT be denied by the insurer if the application was submitted within __ month(s) after the applicant reaches the age of 65.

An application for Medicare Supplement coverage may NOT be denied by the insurer if the application was submitted within six months after the applicant reaches the age of 65.

Information obtained from a phone conversation to the proposed insured can be found in which of these reports?

An inspection report may include information obtained by a telephone call to the proposed insured.

What type of insurance company is domiciled in England, but conducts business in Florida?

An insurance company that is domiciled in any country other than the united states is known as an alien insurance company

Insurance companies that are organized in countries outside the United States are referred to as

An insurance company that is organized or chartered in a country other than the united states is defined as alien

An example of false advertising would be

An insurer exaggerating its dividends in a magazine advertisement

Any changes made on an insurance application requires the initials of whom?

Applicant

All of the following are eligibility requirements for an association group EXCEPT

At least 100 members must participate if the premium is contributory.

When is a group health policy required to provide coverage for a newborn child?

At the moment of birth

The coordination of benefits provision exists in order to

Avoid duplication of benefits payments

The insurer must provide a prospective buyer with a

Buyer's Guide and Policy Summary

J is an agent who recently told a claimant that his rights might be impaired if he does not complete a release form within a specified time. what could this agent be found guilty of?

Coercion

Which of the following correctly explains the actions an agent should take if a customer wants to apply for an insurance policy?

Complete the application and review the information with the customer prior to obtaining the customer's signature, then send the application off to the insurance company

Omitting information that affects the issuance or the rate of an insurance contract is called

Concealment is the omission of information which would affect the issuance or the rate of an insurance contract.

K completes an application for a disability policy but does not pay the initial premium. The company approves the policy standard and the agent delivers the policy. K then pays her initial premium 3 days later. At what point does K's policy take effect?

Date the initial premium is collected

Defamation occurs when an agent makes a false statement intended to

Defamation is an unfair trade practice involving false, maliciously critical, or derogatory statements intended to injure a person or company engaged in the insurance business.

An insurance company incorporated under the laws of the state in which its home office is located is called a __ company

Domestic

A Group plan was recently terminated. In Florida, How many days are covered individuals guaranteed coverage after a group plan's termination>

If a group plan is terminated, covered persons are guaranteed coverage for 31 days after termination.

Agent J takes an application and initial premium from an applicant and sends the application and premium check to the insurance company. The insurance company returns the check back to J because the check is made out to J instead of the insurance company. What action should J take?

If an agent receives a check made out to them instead of the insurance company, they should return the check to the customer and collect a new check made out to the insurance company

Which Unfair Trade Practice involves an agent suggesting that an insurance policy is like a share of stock?

If an agents tells an applicant that an insurance policy is like a share of stock, the agent may be guilty of misrepresentation.

An incomplete health insurance application submitted to an insurer will result in which of these actions?

If the company discovers a mistake or incompletion, it usually returns the application to the producer

Which of these actions should a producer take when submitting an insurance application to an insurer?

Inform insurer of relevant information not included on the application

An applicant's medical information received from the medical information bureau may be furnished to the

Information received from the Medical Information Buereau about a proposed insured may be released to the proposed only to the insured's physician

Which of these would Medical Information Bureau identify?

MIB report will identify marijuana use determined by a previous screening

Pre-hospitalization authorization is considered an example of :

Managed care

Which type of plan normally includes hospice benefits?

Managed care plans

Which of the following are not managed care organizations?

Medical Information Bureau

Medicare Part C is:

Medicare Part C is offered by private and available to those who are enrolled in medicare part A and Part B

Within how many days after the policy delivery can a medicare supplement policy be returned for a 100% premium refund

Medicare supplement policies may be refunded for a premium refund within a MAXIUM of 30 days

With a medical discount plan, how often would a person generally pay a fee to get a discounts on specific services?

Monthly

How can an agent-in-charge have more than one location?

Only if the agent-in-charge is present when insurance activity occurs

What is being delivered during a policy delivery?

Policy delivery refers to the delivery of the insurance contract to the applicant

Which of these do not constitute policy delivery?

Policy issued with a rating

Which of the following involves analyzing a case before admission to determine what type of treatment is necessary?

Prospective Review involves analyzing a case before admission to determine what type of treatment is necessary

An example of unfair discrimination would be

Providing different terms of coverage for different policy owners in the same risk classification would be an example of unfair discrimination

In order for a domestic, foreign, or alien insurance company to conduct business, it must be authorized by whom?

The state where they are conducting business

In Florida, the underwriting and issuance of a master group health policy requires that all employees

The underwriting and issuance of a master group health policy in Florida requires that all employees or members must be eligible to participate, regardless of their individual health history

The waiting period for a pre-existing condition under a Medicare supplement policy may not go beyond

The waiting period for pre-existing conditions may not exceed 6 months

J is an agent who has induced an insured through misrepresentation to surrender an existing insurance policy. What is J guilty of?

Twisting is the unfair trade practice of replacing an insurance policy from on insurer to another based on misrepresentation

Which of these terms accurately defines an underwriter's assessment of information on a life insurance application?

Underwriting, another term for risk selection, is the process of reviewing the many characteristics that make up the risk profile of an applicant to determine of the applicant is insurable and, if so, at standard or substandard rates.

Which of the following BEST describes how pre-admission certifications are used?

Used to prevent nonessential medical costs

An agent takes an individual disability income application, collects the appropriate premium, and issues the prospective insured a conditional receipt. The next step the insurance company will take is to:

With a conditional receipt. the insurance company will complete standard underwriting procedures before making a decision about whether to insure the applicant

A stock life insurance company that issues both participating and non participating policies is doing business on

a mixed plan

The financial Services Commission may hold hearings

for any reason deemed necessary

During the course of an insurance transaction, if an agent makes a false of incomplete statement, he/she could be found guilty of

misrepresentation