Life and Health PA Supplement
What is an insurance company's license to do business in PA called?
A certificate of authority
What are the parameters for the PA accelerated death benefit (%)?
At least 25%, no more than 100%
When must rates be filed?
At least 30 days before use
How often must a Commissioner conduct an examination of each licensed insurer?
At least once every 5 years
How often must a Commissioner examine rating organizations?
At least once every 5 years
Any attempt by the existing insurer or it's producer's to dissuade a policyholder from replacing an existing insurance policy is known as?
Conservation
What do ratings signify?
Financial Standing
What is the maximum first year compensation for Medicare supplements?
No more than 200% of servicing compensation
What is the LTC pre-existing condition exclusion period for the Affordable Care Act?
Not allowed
What is it called when an insurance purchaser receives commission or anything of value as an inducement to purchase a policy?
Rebating
Who approves life, accident or health insurance policy forms?
The Commissioner
Who examines insurer records to check for compliance with state law?
The Commissioner
Who issues certificates of authority, enforces provisions, and conducts insurer investigations?
The Commissioner
Who executes the PA insurance laws?
The Insurance Commissioner
Who makes producer appointments?
The insurer
Who regulates the U.S Insurance industry?
The states
Misrepresentation to induce any person to lapse, forfeit, surrender, exchange or replace a policy is known as?
Twisting
How does PA define chronically ill?
Unable to perform two ADLs or requiring substantial supervision due to cognitive impairment.
Once appointed, how long does a producer's appointment extend?
Until the appointment is terminated
What is the penalty for violating LTC regulations?
Up to 3 times the amount of commissions paid for each policy or $10,000. (Whichever is greater)
Who is the chronically ill original owner of a life insurance policy?
Viator
When does the free look period begin?
When the policy is delivered to the client
When must first party claims be settled?
Within 15 days
To be chronically ill when must you be expected to die?
Within 24 months
When must a n insurer provide explanation to the insured of a claim cannot be completed?
Within 30 days
When is Medicare supplement open enrollment?
Within 6 months of enrolling in Medicare Part B and being 65 or older.
Once forms are filed, when are they considered approved?
after 30 days unless the Commissioner rejects them
How much is the LTC minimum offered inflation protection?
5%
LTC first year commissions must not be greater than?
50% of premium
A pre-existing condition is a condition for which medical advice was sought in what time period?
6 months
What is the maximum LTC pre-existing exclusion period?
6 months
What is the maximum benefit period for disability income insurance policy?
6 months
What is medicare supplement guaranteed enrollment?
63 days if you had prior group health coverage
What is the maximum policy annual fixed interest rate?
8%
What are the health insurance maternity requirements for a C-section?
96 hours
What is the non-willful violation fine?
$1,000
If you are found guilty of fraud what is the penalty for your second violation?
$10,000
What is the aggregate penalty for a non-willful violation?
$10,000
If you are found guilty of fraud, what is the penalty for every subsequent violation after your second?
$15,000
If you are found guilty of fraud what is the penalty for your first violation?
$5,000
What is the maximum producer fine for a violation of insurance code?
$5,000
What is the overall aggregate benefit limit of a specified disease coverage in PA?
$5,000
What is the per penalty willful violation fine?
$5,000
What is the aggregate penalty for willful violations?
$50,000
When can a lapsed license be reinstated?
1 year
How long is an A&H free look period?
10 days
How long is the free look for life insurance?
10 days
When must a Commissioner give notice of a hearing?
10 days
When must an insurer acknowledge a claim and send forms?
10 working days
LTC Renewal commissions must not be greater than?
10% renewal premium
How long is the minimum LTC benefit period?
12 months
What is the pre-existing exclusion period for groups that are not governed by the ACA?
12 months
When must an insurer respond to a Commissioner inquiry?
15 days
How old do you have to be to obtain a producer's license?
18 years old
How long does a temporary license last?
180 days
How long is a producer's license term?
2 years
How long is the free look period for external replacement of life insurance?
20 days
How long is the prelicensing education requirement?
24 hours
How long do replacement transaction records need to be kept?
3 years
How long is the PA L&H incontestability period?
3 years
How long is an Accident and Health probationary period?
30 days
How long is the Medicare Supplement free look period?
30 days
How long is the PA grace period?
30 days
How long is the free look for Medicare supplements?
30 days
When must you notify of your change of address, administrative actions or criminal charges?
30 days
When does the viator have the right to rescind a contract?
30 days from the contract date and for atleast 15 days after recieving viatical statements
When must a conversion privilege under a group health insurance plan generally be exercised?
31 days
How long is the free look period for internal replacement of life insurance?
45 days