Missouri Laws and Rules Pertinent to Insurance
A foreign insurance company CANNOT conduct business in Missouri without?
a certificate of authority to transact business in Missouri
Which of these individuals may NOT be compensated from an insurance company?
a licensed producer not appointed by the company
Which of these is considered an unfair trade practice?
a producer stating that a policy's dividends are guaranteed
Jasmine is a salaried employee of an insurance company. Which of the following duties would require her to be licensed as an insurance producer?
solicitating insurance policies
The suicide provision for life policies would apply to
subsequent increases in benefits
What is the purpose of the Missouri Life and Health Insurance Guaranty Association?
ensures that claims filed against insolvent insurance companies will be paid
In an insurance contract, the policy, application, and riders or endorsements are considered to be
entire contract
The Director may
examine insurer solvency
Life insurance and annuity replacement can be BEST described as ?
exchanging an existing policy for a new policy
What is the required renewability status of all Medicare supplement policies?
guaranteed renewable
Michael the insurance producer is acting fiduciary capacity when conducting business with all of these principles EXCEPT?
the director
Under Missouri law, when one group health plan's contract replaces an existing group plan with similar benefits?
the succeeding carrier shall give credit for the satisfaction of any deductibles or waiting periods satisfied or partially satisfied under the prior carrier's plan
Which licensee faces possible license revocation by the Director of Insurance?
Licensee who commingles monies belonging to policyholders with personal funds
In Missouri, all health policies must address diabetes coverage in which way?
apply the same deductible and copays to covered diabetic supplies as other medical conditions
When must a producer deliver a Notice Regarding Replacement of Life insurance?
at the time of the application
Health insurance coverage of autism spectrum disorder treatments may be limited in which way?
medically necessary treatment in accordance with a treatment plan
Which of the following activities may NOT be granted as credit for continuing education units?
meeting sales quotas
A producer is circulating incorrect information about the benefits policy. This producer may be found guilty of?
misrepresentation
can be defined "as making an unfair comparison of two insurance policies"?
misrepresentation
Insureds in the same risk classification are being charged different premiums by an insurance company. This insurer is committing the illegal act of?
unfair discrimination
Which of the following types of life insurance policies involves an investment account that is separate from the insurer's general account?
variable life
Which of these may NOT be issued after the Director of Insurance finds an insurance code violation committed by licensee?
warrant for arrest
Health insurance policies in Missouri are REQUIRED to contain coverage for human leukocyte antigen testing for bone marrow transplant
with each issued health policy
In Missouri, a health insurance policy that is not exempt from state-mandated benefits must cover child immunizations and shall not charge any deductible or copayment. The EXCEPTION to this would be?
HMO's that exclude coverage to subscribers who obtain services by a non-participating provider
Which of the following is NOT a required provision in a group life policy?
accidental death and dismemberment
When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain suitability information. Suitability information includes?
age, annual income, financial experience
Which of the following would a Medicare Supplement policy cover?
allowable amounts under Medicare Part B
A health insurance application may ONLY be altered with the written consent of the?
applicant
An individual covered under a Group Life Insurance policy is considered to be a(n)?
certificate holder
In Missouri, which of the following is considered an Unfair Trade Practice?
coercion
J is a producer 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 producer be found guilty of?
coercion
For the treatment of PKU, a health plan MUST cover formula and low protein modified food products for?
covered children less than 6 years of age
Insurance issued on a debtor to cover outstanding balances on installment loans is called?
credit life
Which of the following types of individual policies does NOT require a policy summary be given?
credit life
Which entity issues Medicare Supplement insurance?
insurance companies
Who may assign benefits from a group life insurance policy?
insured
A license may be denied, suspended, or revoked if the licensee
is found guilty of misrepresentation or fraud in obtaining the license
Health insurance plans that cover physical therapy visits may NOT impose a copay that?
is greater than the copay for primary care office visits
What must a producer sign when an existing life insurance policy is being reissued with a reduction in cash value?
notice regarding replacement
During the course of a Medicare Supplement sale, T the producer determines there is an existing policy being replaced. Which of these actions is the producer NOT required to perform?
notify the Director of the replacement
If a sale of Medicare Supplement involves replacement, all of these actions must be performed by the producer EXCEPT?
notify the replaced insurance company
At the time of application, major medical health plans (including HMOs) are REQUIRED to?
offer coverage for prosthetic devices
Which of the following is a requirement for obtaining a resident producer license in Missouri?
pay a $100 license fee
A licensee must complete ____ hours continuing education every 2 years?
16
After a life insurance policy has been in force for more than _____ years the policy is considered incontestable.
2
What is the MINIUM benefit period that must be offered by a Long-Term Care Policy issued in Missouri?
12 months
J's application for a producer's license has been denied. He may request a hearing within days after receipt denial?
30
Within how many days must a licensee notify the Director of Insurance of a change in address?
30 days
Prior to a universal life insurance policy being terminated, written notice must be given to the policyowner at least?
30 days prior of termination date
Health policies that contain coverage for low protein modified food products for treatment of PKU or any inherited disease of amino and organic acids require a coinsurance NOT to exceed of the cost of the formula or food products?
50%
When an insured receives chiropractic service, the co-payment may not exceed of the total cost providing the service?
50%
An insurer may exclude pre-existing conditions coverage on a Medicare Supplement policy for up to?
6 months
A nondisabled individual is first eligible for a Medicare Supplement policy at age?
65
An applicant for a nonresident producer license MUST?
be a producer of good standing in their home state
To be eligible for a group health policy, a group MUST comply with which of the following?
be formed for a purpose other than obtaining insurance
A group life insurance policy can be converted to an individual whole life policy under which circumstance?
employment termination
The Missouri Life and Health Insurance Guaranty Association is?
funded by insurance companies through assessments
Coverage for human leukocyte antigen testing for bone marrow transplantation is REQUIRED to be provided in all
group comprehensive health policies
The conversion provision in a group health insurance policy
is mandated by state requirements
Credit life insurance is?
issued in an amount not to exceed the amount of indebtedness
Which of the following is NOT allowed in regards to a Medigap (Medicare Supplement) policy?
issuing an additional Medigap policy to ensure no out of pocket exposure for the insured
Whose interest is being protected by the enactment of " The Replacement of Life Insurance and Annuities" regulation?
policyowner
Who signs a " Notice Regarding Replacement" form when an application is taken for a new life insurance policy that replaces an existing one?
producer and applicant
Which of the following actions by a producer would NOT result in a license suspension or revocation?
producer sells a replacement policy that causes an insured to lapse an existing policy
An example of rebating would be
returning a portion of a premium as inducement to purchase insurance
Which of these is NOT a required group life policy provision?
right to loan proceeds
When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain?
suitability information
In Missouri, an A&H policy that is paid on a monthly basis requires a grace period of at LEAST?
ten days
Which of these is a TRUE statement regarding how Missouri law recognizes an association eligible for group coverage?
the association must NOT have been organized for the purpose of obtaining insurance
Under which circumstance could a child be denied enrollment into a health plan in Missouri?
the child is not related to and is not adopted by the plan member
Which of these statements regarding health coverage for physically handicapped dependents is FALSE?
the dependent must have been over 10 years of age when the handicap was incurred
Why would the Director of Insurance examine the records of an insurance company?
to determine the solvency of the company
The Director of Insurance is authorized?
to enforce state laws relating to insurance
ABC Insurance company failed to accept a valid Proof of Loss statement. This is considered a(n) ?
unfair claims practice
