Chapter 11 part 2

An insurance producer who convinces a prospective insured to purchase a policy by exaggerating the benefits of the policy may be found guilty of

misrepresentation

All of the following actions are considered rebating except

sharing commissions with other licensed and appointed agents

All of the following are considered to be fraud expect

Collecting a charge for insurance that is less than the charge applicable to the insurance

A form or medical heath insurance covering the treatment and care of gum disease is called

Dental expense insurance

A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance?

Dental treatment is needed to repair an injury

an application for individual health insurance must be

In writing, and normally becomes part of the contract

All advertisements for health insurance shall make clear the identity of the

Insurer

One or more necessary or appropriate diagnostic preventive therapeutic rehabilitative maintenance or personal care service in a setting other than an acute care unit of a hospital is provided by

Long term care insurance

A producers who is licensed in Louisiana but resident in another state is called

Nonresident producers

The marketing of Medicare Supplements is regulated to prevent all of the following EXCEPT

Replacement of any existing coverage

What is the minimum number of employees needed for a small employer medical expense plan in Louisiana

1

According the the affordable care act (ACA) of 2010, what is the maximum allowable time from the date of service that a claim can be submitted to Medicare?

12 months

A licensed producer who changes a residential or business address must notify the commissioner within how many days

30

As classified by the Affordable Care Act (ACA), a Silver Plan offers

70% actuarial level of coverage provided

When a small employer health insurance plan is offered, it must be available

To all eligible employees who apply

All of the following services Typically are considered maternity care in a health maintenance organization HMO except

Well-baby care

A person who is responsible for payment to an HMO is knows as

A provider

In the Health insurance policy When should the written notice Of claims be given to the insurer

Within 20 days after the occurrence or commencement of any loss covered by the policy

Any individual may satisfy part of the eligibility requirements for the Louisiana health plan by providing evidence of

An insurers refusal to provide comparable insurance for the heath reason

To reserve and insurance license an applicant must

Apply for a license after passing the appropriate examination

Under Louisiana law, the agreement between an insurance producer and insurer under which the insurance producer, for compensation, may sell, solicit, or negotiate policies issued by the insurer is defined as

an appointment

Am appointing insurer has who many days to file a notice appointment with the commissioner

15 days

The purpose of the Life and Health Insurance Guaranty Association is to

Ensure the claims filed against insolvent insurance companies will be paid

In Louisiana, when an individual is covered under a small employer's accident and health plan, the pre-existing conditions exclusion period may be partially or wholly satisfied by

having creditable coverage with a previous employer

The Louisiana Life and Health Insurance Guaranty Association was established to protect consumers in the event of an insurer's

insolvency

As of January 1, 2014, an employer with up to 25 full time equivalent (FTE's) with average annual wages of less than $50,000 may be eligible for a tax credit of ___ of the premiums paid by the employer.

50%

Which of the following is considered to be controlled business

Selling most of the insurance policies to family members

A nonresident of Louisiana who has satisfied the licensing requirements for a line of insurance in the licensee's state and who wishes to sell that line of insurance in Louisiana, must meet all of the following requirements EXCEPT:

Take the appropriate Louisiana licensing examination

A medical supplement policy must disclose all the following except

The approval of the policy by Medicare

When a Medicare Supplement insurance policy is being replaced, who must sign the notice of replacement?

The producer and the applicant

In Louisiana who is primarily responsible for determining the appropriateness of a Medicare supplement policy for a proposed insured

The producer who solicits the application

An insurer, in general business practice, fails to promptly provide a reasonable explanation for the denial of a claim. This is considered to be

an unfair claim settlement practice

When a Medicare supplement policy is purchased during the open enrollment period

the policy must be issued regardless of health status

A producer is required to give an applicant for long-term care

An outline of coverage

In health insurance the insured must furnish written proof of loss to the insurer within

90 days of the occurrence of the loss

A producers license in Louisiana must be renewed every

2 years

Every licensed must notify the Louisiana insurance commissioner of personal or business changes

30 Days

A common exclusion or limitation on a dental policy is

Endodontic