Laws and rules

Réussis tes devoirs et examens dès maintenant avec Quizwiz!

A producers failure to provide title and true nature of a policy upon solicitation is and example of

Misrepresentation

Starting in 2016, businesses with up to ___ employees will be defined by the ACA as a "small business".

100

A group health certificate for coverage issued in Connecticut MUST contain a

Summary of policy features and benefits

A life insurance policy may ONLY be contested by insurer during during the first ______ years of the contract.

Two

A licensee whose name or address changes must notify the Commissioner within

30 days

How many days notice must a producer be given prior to a scheduled hearing?

30 days

Which of the following individuals is eligible to receive a temporary producer license?

A designated employee who is replacing a deceased producer

John had a criminal record in which he was convicted of a felony that involves dishonestly. Under Federal Law, how would John be able to engage in insurance transactions?

Given written consent by the state insurance regulatory agency

Which of the following is considered to be a prosthodontics dental procedure?

Bridge work

All of these are used to prevent adverse selection in a group dental plan except

Decreased participation

Any administrative action taken against a producer MUST be reported to the commissioner within ____ days.

30

How many days notice does the Affordable Care Act require insurers to give before rescinding coverage?

30

The free look period provided in a life insurance policy is usually

10 days

In Connecticut, a producer cannot use his/her license for primarily writing controlled business. In order to confirm to this requirement, annual premiums collected on controlled business cannot exceed ________ of total premiums.

10%

Within __________ months of passing the Connecticut producer licensing exam, an individual must apply for and be issued a license or be required to retake the exam m.

12

According to federal fraud and false statements regulation, what is required for a prohibited person to transact insurance business in this state?

Written consent from the state insurance regulatory agency

Most prepaid dental plans cover

oral exams

In Connecticut, a temporary license may be issued for a period not to exceed _____ days.

180

Before soliciting insurance applications for an insurer, a producer must secure a

Appointment

An annuity contract may be returned for a full refund during the

Free look period

An insurer may NOT refuse the renewal of a small employer health insurance plan because of

Overuse of medical insurance

Twisting is

A form of misrepresentation in which an agent persuades an insured/owner to cancel, lapse, or switch policies, even when it's to the insured's disadvantage.

The commissioner is empowered to perform each of the following acts EXCEPT

Make rules that are consistent with those of neighboring state

Which of the following is an example of defamation?

Making a statement that is false or maliciously critical of the financial condition of an insurer

According to the Federal Fraud and False Statements Act, which of these is considered to be an intentional violation?

Making false entries in a company's books

According to the Affordable Care Act (ACA), the proportion of premium revenues spent on clinical services and quality improvement ls is called the

Medical loss ratio

In Connecticut, the Human Immunodeficiency Virus (HIV) consent form

Must disclose who will be receiving a copy of the test results

Which of these is NOT an Unfair Claim Settlement Practice?

Offering to settle a claim by arbitration

At what point must a producer give notification to the commissioner about using an assumed name?

Prior to using the assumed name

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

Senile dementia

What is a life insurance producer authorized to do?

Solicit, receive and forward application to the insurer

The _________________ is responsible for reporting to the commissioner any name or address change of the licensee.

Licensee

Someone who is licensed to negotiate a life settlement contract is called

Life settlement broker

All of these are common limiting factors with dental insurance EXCEPT for

Limit placed on number of teeth that may be treated annually

How can a group dental insurer discourage adverse selection?

Limit the duration of coverage

Which of the following must clearly be illustrated in all sales material for market value adjusted annuities?

The market value adjustment can be either upward or downward

An example of endodontic treatment is a

Root canal

To secure authority for soliciting insurance products in the state of Connecticut, an insurance company must secure a certificate of authority from

The Connecticut insurance commissioner

What is the best way to define life insurance replacement?

A transaction in which a new life insurance policy is purchased and an existing life insurance policy is surrendered

Prepaid dental plans differ from most other types of dental plans in what way?

Closed panel of dentists can only be used

In Connecticut, continuing education courses must be approved by the

Commissioner

Which of these is NOT a punishment for committing an unfair or prohibited insurance practice?

Community service

When evaluating an insurers financial status, the commissioner may consider each of the following EXCEPT

Comparing an insurers agency agreements to determine maximum-paid commissions

Life settlement brokers are NOT allowed to

Complete transactions prior to being approved for a license

A producer MUST notify the commissioner for

Conducting business under and assumed name

A ___________ is a licensee who charges a fee for contracted insurance advisory services.

Consultant

A(n) ____________ is a licensee who charges a fee for contracted insurance advisory services.

Consultant

Which of the following does not involve a life settlement transaction?

Converting term life coverage to whole life insurance

Life settlement proceeds may be subject to the claims of

Creditors

Which of the following would prevent a person from obtaining a Connecticut resident producer license?

Residing in a state outside of Connecticut

Security laws passed by Congress are enforced by which Federal agency?

Security and Exchange Commission

A temporary license may be issued to which of the following?

Employee of a disabled producer

Which of the following is NOT a duty of the commissioner?

Enact legislation dealing with insurance

An individual who intentionally violates a Connecticut insurance law may be subject to a MAXIMUM fine of

$5,000

After conducting a hearing, the commissioner is empowered to issue a cease or desist order. A violation of such an order is punishable by a monetary fine not to exceed

$50,000

The maximum prison sentence given under federal law for unfair and deceptive insurance practices is

15 years

After a life insurance policy has been in force for _______ years, it becomes incontestable.

2

A life insurance policy that is paid annually must contain a grace period of at least _____ days.

30

Any administrative action taken against a producer MUST be reported to the commissioner within _________ days after the final disposition.

30

Producers licensed In Connecticut must notify the insurance department within _______ days of any change of name or address.

30

What is the actuarial value of a bronze level health plan?

60

Which of the following is an example of defamation?

A producer who publicly and erroneously announced that an insurance company is insolvent

According to the Affordable Care Act (ACA), dependents children may remain on their parents plan until what age?

Age 26

A television advertisement features a health insurance product that is endorsed by a specific group. In this advertisement,

Any control by the insurer over this group must be disclosed

The Affordable Care Act (ACA) established "exchanges" in order to

Assist individuals and small businesses when making the fir health insurance purchases

Which of the following is NOT responsible of an insurer?

Assuming liability for a producers unauthorized acts

When does a family health policy's coverage for a newborn child begin?

At the moment of birth

Any agreement that unreasonably restrains the business of insurance is a violation of which unfair or prohibited insurance practice?

Boycott, coercion and intimidation

A life settlement ______________ negotiates a life settlement between a policy owner and a life settlement provider.

Broker

In regards to the Affordable Care Act (ACA), which of these is NOT a role of a health insurance exchange?

Contact the employer if an employee stops coverage under a plan offered in the exchange

According to the Affordable Care Act, new Heath insurance marketplaces are established by the

CCIIO

A group health plan covers employees in Connecticut, Massachusetts, and Rhode Island. The state regulatory jurisdiction established for this plan does not affect which plan aspect?

COBRA continuation of coverage

A producer recently replaced an existing Medicare supplement policy with a new policy. The producers compensation for the new policy

Cannot exceed the renewal commission of the original policy

A prospective client was intimidated by a producer to purchase an insurance contract. The producer could be found guilty of

Coercion

Which of the following is considered to be an example of unfair restraint of competition?

Coercion

Which term refers to insurance written on the interest of the licensee, the licensee's employer, or the licensees immediate family?

Controlled business

Health providers are compensated by a preferred provider organization (PPO) for normal dental procedures by what means?

Decreased fee schedules

Which of the following is NOT classified as an "employee" under a group employer insurance plan?

Independent comtractory

Which of the following is NOT classified as an "employee" under a group employer insurance plan?

Independent contractor

In Connecticut, false advertising is an example of

Misrepresentation

Which of the following is a requirement for an individual to receive an insurance license in Connecticut?

Passing the appropriate examination

Which of these is NOT a standard provision in qualified long-term care policies sold in Connecticut?

Prior hospitalization

A life insurance producer is required to give a disclosure notice about information practices to an applicant or proposed insured

Prior to or at the time of signing the application

Under Federal Law, which of the following actions may result in a producer becoming imprisoned?

Producer embezzling finds from and insurer

A producer has indicated to a potential client that the proposed life insurance is covered by the Connecticut life and health insurance guaranty association. This action taken by the producer is

Prohibited by law

A life insurance policy owner sells her policy to a third party in a life settlement. Under this transaction, the policy owner

Receives an amount less the. The policy's death benefit

Which of the following facilitated nonresident licensing in the state of Connecticut?

Reciprocity agreement

Which of these is NOT an unfair claim settlement practice?

Refusing to pay persons bringing false or fraudulent claims

Which of the following is NOT a valid cause for termination of an employees group health coverage?

The coinsurance limits had been exceeded

If one producer provides a referral to another producer which results in the sale of an insurance contract, who will likely be paid a commission?

The commission will likely be shared between the two producers

An individual in Connecticut who charges a fee for giving advice on an insurance insurance policy must be licensed as a consultant if the advice is given to

The policy holder

Why were Exchanges implemented by the Affordable Care Act (ACA)?

To create a one-stop market for standardized health insurance plans

Why does Connecticut require insurers to maintain a minimum level of assets?

To demonstrate insurer solvency

Which of these is NOT considered a federal punishment for unfair and deceptive insurance practices?

community service

Jerry has an indemnity plan which covers dental expenses. Typically, these type of plans

cover preventative care once every six months

Which of these is typically regarded as a major treatment in an indemnity dental plan?

dentures

Which of these is NOT considered a preventative service in a dental plan?

fillings

A producer sold a life insurance policy but did NOT provide the applicant with a basic illustration. In this situation, the insurer is required to provide the applicant with a policy summary no later than the

lol I delivery date

Beginning January 1, 2014, the restricted annual limit for plans under the affordable care act will be

no limit

All of these are considered to be a violation of the Federal Fraud and False Statements Act EXCEPT

Claims reimbursement

Life insurance policies cannot be backdated more then ______ months from the date of issue.

6

A(n) _______ insurer operates in the U.S. but is headquartered outside the U.S.

Alien

A(n) _____________ insurer operates in the U.S but is headquartered outside the U.S.

Alien

An insured has been ordered by the court to provide a child's health insurance. Upon this order, the insurer must allow the enrollment of this child

At any time

A consultant derives their income from which source?

Clients

Medical cost in birthing centers are lowered by using

Certified nurse midwives

An order issued by the commissioner that prohibits a specific practice listed in order is called a

Cease and desist order

Which of the following actions may result in a producers license being suspended by the commissioner?

Debating part of a commission to an applicant

Insurance producer Kelly offers insured a $500 shipping card if they purchase an insurance product through her. What is this and example of?

Debating, which is an unfair trade practice

If a life insurance applicant is shown future premiums are to be paid out of non-guaranteed values, the illustration used in the sales presentation must

Disclose that premium payments may need to be resumed depending on actual results

Group life plans sold in Connecticut typically contains a conversion option. If the insurers elects this option, the new policy

Does NOT require evidence of insurability

A(n) _______________ insurer is incorporated and formed in Connecticut.

Domestic

An example of an unfair claim settlement practice is

Failing to promptly investigate and settle legitimate claims

Which of the following is considered to be a prohibited insurance practice?

Failing to submit premiums to the insurer

A producer is meeting with a client to determine whether an annuity will be suitable for purchase. Which of the following topics needs to be discussed with the client?

Financial status of the client

A(n) ___________ insurer writes business in a state other than the one in which it is domiciled.

Foreign

A(n) _____________ insurer writes business in a state other than the one in which it is domiciled.

Foreign

According to the Affordable care act, insurers can no longer deny health coverage due to pre-existing conditions unless that plan is a

Grandfathered plan

A producers license may only be suspended or revoked if the producer

Has been afforded a right to a hearing

A life insurance applicant is tested for the Human Immunodeficiency Virus (HIV). The applicant MUST be informed that the testing

Helps determine the insurability of the applicant

Which of the following situations would qualify an insured to receive funds from an accelerated (living) benefit rider?

Insured is expected to remain in a nursing home for life

Who is required to notify the producer in the event of appointment termination?

Insurer

Which of the following is not information needed to determine the suitability of an annuity recommendation?

Level of education

An insurance applicant has made a false statement on the application that will affect the insurers decision on weather or not to issue the policy. This false statement is considered to be a

Material misrepresentation

Which of the following is considered to be and unfair claim settlement practice?

Misrepresentation pertinent policy provisions relating to cordage after a lose

Which of the following BEST defines the illegal act of twisting?

Misrepresenting a policy for the purpose of inducing a policyholder to change or replace and existing policy

Which of the following is not a valid reason for an insurer to contest a life insurance policy during the policy's first two years of existence?

Misstatement of age

All of the following are covered under most dental plans EXCEPT for

Mouth cancer

If the commissioner requests access to a producers business records, the producer

Must provide access to the records upon request

James the producer has sold a life insurance contract to a client without using an illustration, even though his insurer offers one. For this particular transaction l, the applicant

Must sign a statement that no illustration was provided

What must be disclosed when a producer advertises a life insurance policy?

Name of the actual insurer

During the sale of a life insurance policy, a producer may provide an incomplete illustration

Never

How would preventative care be encouraged in a dental plan?

No deductible on routine examinations

What is considered interstate travel under the federal fraud and false statements act?

Puerto Rico

In regards to technology and the ACA, which of the following statements is correct?

States which operate with an exchange must offer and internet-based portal

An insureds statement of a policy's benefits which is to be used in marketing materials is called a

Testimony

Which of the following is the BEST candidate for a temporary insurance license?

The executor of the estate of a deceased licensed producer

What is the primary reason for the commissioner's examination of a producer's insurance records?

To determine compliance with state insurance laws and regulations

All of the following are typically covered under dental insurance EXCEPT

Treatment which began before the eligibility date

Insurance crimes which affect interstate commerce are prosecuted by the

US Attorney General

Charging different premiums to policyholders in the same risk classification is referred to as

Unfair discrimination

When an individual buys insurance under a threat made by a producer, a violation has occurred under the

Unfair trade practice act

Mentally or physically handicapped dependent children MUST be covered under an individual health insurance policy

Until they become self-supporting

Misrepresentation on the application is

material


Ensembles d'études connexes

Chapter 12 Managing Individuals and a diverse Workforce

View Set

Management (Griffin) - Chapter 20

View Set

Bio 106 Exam Study Guide Chapter 4

View Set

Chapter 20 Trauma and Surgical Management

View Set

Section 4 Module 3 - Kiddie Tax, Charitable Contributions, AMT, Imputed Interest

View Set

Microsoft AZ-900 Cloud Concepts - Principles of cloud computing

View Set