215B law (3)

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When does Medicare cover nursing home care?

Only if it is part of treatment for a covered illness or injury

The Florida Health Insurance Coverage Continuation Act requires insurers that sell health plans to small employers to offer in those plans a right to elect to continue coverage, without providing evidence of insurability, to employees who lose their coverage and are unable to replace it. The premium rate for this coverage may NOT exceed

115% of the regular group rate.

Under special circumstances, continuing education requirements may be extended beyond the 2-year period for a maximum period of

12 months.

In order for an employee to be considered eligible for small group insurance, he/she must work at least how many hours per week?

25

Medicare supplement policies, by law, must provide a free-look provision of

30 days.

What is the statute of limitation on lawsuits for health insurance policies?

5 years

In the state of Florida, it is illegal for a licensee's commissions from controlled business to exceed what percentage of the total in a given year?

50%

An employee will be taxed on the cost of group life insurance paid by the employer if the amount of coverage exceeds

50,000

How often must domestic insurance companies be examined by the Chief Financial Officer in Florida?

At least every 5 years

HMOs that contract with outside physicians to provide health care service to their subscribers compensate those providers on a

Capitation basis

What term is used for replacing insurance policies for the sole purpose of making commissions?

Churning

Which of the following was designed to ensure continued access to affordable health insurance coverage for employees of small employers, their dependents, and other qualified beneficiaries not currently protected by COBRA?

Florida Health Insurance Coverage Continuation Act

In insurance transactions, fiduciary responsibility means

Handling insurer funds in a trust capacity.

Which of the following entities must approve all Medicare supplement advertisements?

Insurance Commissioner or Director

The Florida Employee Health Care Access Act serves which of the following purposes?

It regulates group health insurance provisions provided by insurers or HMOs to small employers.

Which term describes the benefits of a life insurance policy that the policyowner does not automatically relinquish even if the policy lapses?

Nonforfeiture values

On a participating insurance policy issued by a mutual insurance company, dividends paid to policyholders are

Not taxable since the IRS treats them as a return of a portion of the premium paid.

Which of the following factors would be an underwriting consideration for a small employer carrier?

Percentage of participation by the employees

An agent offers his client free tickets to a sporting event in exchange for the purchase of an insurance policy. The agent is guilty of

Rebating

What method do insurers use to protect themselves against catastrophic losses?

Reinsurance

An employer offers group life insurance to its employees for the amount of $10,000. Which of the following is true?

The cost of coverage is a deductible expense by the employer.

A person insured under a group life insurance policy can make an assignment of all or any part of the incidents of ownership conferred on the insured by the policy or by law, to any of the following EXCEPT

The policyholder.

If a life insurer holds the proceeds of any policy it issues, which of the following is true?

The proceeds may be exempt from any creditor's claims against a beneficiary other than the policy owner.

All of the following are correct about life insurance policy loan interest rate EXCEPT

There are no restrictions or limitations on policy loan rates.

Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in the

Notice Regarding Replacement.


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