Producer Licensing, and Other Regulations
Minimum amount of time LTC coverage lasts
12 consecutive months
term of producer appointment
2 years
LTC education requirement
8 hours one-time. 4 hours ongoing every 24 months.
Required producer education for annuity suitability training
One-time, 4-hour course
allowed value for prizes, goods or merchandise not to be considered rebating
$25 per 12 month period
If payment of an additional premium is required to provide coverage for a newborn, the agreement may require that notification of newly born child and payment of required premiums must be be furnished to the HMO. The notification period for this is
60 days
In a Medicare supplement policy, issuers must pay commissions no later than how many days following the premium period
60 days
Commissioner will send appointment renewal notification within
60 days (45 days if not enrolled in online notification system)
Reinstatement process w/ fee & timeframes for health policies
60 days' worth of payment w/ reinstatement application If insurer does not respond to application in 45 days, automatically reinstated 10-day waiting period due to losses relating to sickness
The policyowner must wait how many days after submitting proof of loss before initiating legal action
60 days; must begin litigation within 3 years after proof of loss
Grace period for paying premium
7 days for weekly premium 10 days for monthly premium 31 days for any other premium mode
after receiving notice from the Commissioner, for a producer to request a hearing
90 days
within how many days of receipt of proof of death must the insurerer pay the death benefit to the beneficiary without an interest penalty
90 days
The owner of the policy must provide the insurer with a written proof of loss within
90 days of loss if reasonably possible; but no later than 1 year from the loss
How long must the health insurance coverage for the newly born be the same for the mother?
At least 3 weeks
Punishments for not conforming to requirements of policy delivery
Cease and desist order, a fine, or license suspension or revocation
Maximum punishment for false claims or concealed information under Health Care False Claim Act
Class C felony; 5 years imprisonment, $10,000 fine, or both.
Small employer:
any person, firm, corporation, or partnership with 2-50 employees; and at least 2 employees on the first day of the plan year
Minimum non-forfetiture interest rate under an annuity contract
lesser of 3% or the stated rate
Limitation of liability on a life policy to an amount not less than the full reserve of the policy in the event of death occurred as:
result of war, act of war/military service, aviation, or suicide within 2 year from policy issue
Normal fine for violating Insurance Code
up to $1000
What rate of interest might be applicable to underpayments on a disability insurance policy because of a misstatement of age or sex
up to 6% per year
For producers to maintain records of compensation disclosures
5 years
Producers must maintain compensation disclosures for
5 years
A company may use the current Buyer's Guide after approval by the NAIC for how long?
6 Months
Life insurance disclosures regulations do not apply to:
-Annuities -Credit Life -Group Life -Variable Life -Policies issued in connection with pension/welfare plans
Annuities disclosure regulation does not apply to:
-Variable/investment annuities -Immediate annuities -Group annuities -Contracts issued in connection with employee benefits
Punishment/results of a policy issued by an unauthorized insurer
-producer may be held personally liable for claims -suspension/revocation of a license -maximum fine of $25,000 -Commissioner may order replacement of policy
Grace period for life policies
1 month; but may be subject to interest charge up to 6%
when an insureer receives notification of a LIFE INSURANCE claim, it must acknowledge the receipt of such notice within
10 working days; 15 working days for group contracts
Period of time that the expense of a court-ordered chemical dependency assessment or treatment expense is the burden of the enrollee
10-30 days before treatment begins
License reinstatement period after a lapse
12 months
maximum duration of producer license suspension
12 months
for a licensee to reply to an inquiry from the Commissioner regarding the business of insurance
15 days
To appoint a producer, the insurer must file a notice of appointment with the Commissioner within how many days fromt he date the agency contract is executed/first insurance application is submitted
15 days Commissioner will verify the appointment within 15 days, or deny it within 10
license may be revoked or suspended by the Commissioner by an order delivered to the licensee within
15 days prior to the effective date, or 10 days after the date of a the order of a hearing
time frame that fines are payable for producer noncompliance with Insurance Code
15-30 days
Minimum required age for producer licensing
18 years old
Maximum length of temporary license
180 days
Time period to complete continuing education (CE) requirements
2 years
Producer licensing period
2 years beginning from the date of application
Time Limit on Certain Defenses
2 years from the policy issue
Free-look period for replacement
20 days starting from policy delivery date
Notice of disability claim
20 days, or as soon as reasonably possible
CE credit hours required each licensing period
24 hours
All individual and group health care service plans that are not grandfathered and that provide coverage for the children of the insured or subscriber must offer the option of covering any child under the age of
26 years old
CE credit hours required in ethics
3 hours
A Medicare supplement policy or certificate could not exclude or limit benefits for losses incurred more than what period of time
3 months
Amount of time an insurer must maintain disclosure documents
3 years
Cash value life insurance policies must include a policy loan provision that entitles policyowner to a policy loan after
3 years, with a maximum interest rate of 8% per annum.
an approved CE course for which a licensee has previously claimed credit may be repeated for credit after a period of
3 years; they maintain this certificate for 3 years
insurerer must complete the investigation of a claim
30 days
to notify Commissioner of termination of producer appointment
30 days
Insureres are obligated to pay the proceeds of any benefits under a group life insurance policy within how many days after insurer receives proof of death?
30 days, after which the higher of 8% or some other interest rate is payable; after 90 days, an additional 3% is added onto this rate.
Free look period for Medicare supplement insurance policy
30 days. 10% penalty added to any premium amount that is not refunded within 30 days of return (paid by insurer).
How long does an insurer have to refund premium for a life insurance policy
30 days. after which, a 10% penalty is added to premium refund due
Group life grace period
31 days
To obtain a conversion contract from group to individual coverage, a person must submit a written application and the first premium payment no later than
31 days after the eligibility for group coverage terminates; coverage is in effect immediately following termination of initial group coverage