Chapter 14 MO State laws
Under the Cancer Screening Provision of Missouri law, which of the following must be covered?
A pelvic examination and Pap smear for any non-symptomatic woman, in accordance with the current American Cancer Society guidelines
Choose the false statement about LTC provisions.
A non-qualified LTC contract includes an IRS disclosure regarding tax implications
Which of the following is not true about a nonresident producer?
The home state is not obligated to insure nonresident producers licensed in Missouri
According to Missouri's suicide exclusion, under what circumstances would the insurer be required to refund premium payments?
The insurer must refund all premiums if the insured dies by suicide within 1 year of the policy issue date
A health policy must cover which of the following services, upon a physician's recommendation if a woman, her mother, or her sister has a history of breast cancer?
mammogram
A producer must notify the Director of Insurance of any change of residence address within ______ days.
30
Each insurer must maintain a register of all producers it has appointed and notify the Director within how many days of appointment?
30
Insurers must notify insureds at least how many days in advance of any covered drug being deleted from coverage?
30
An insurer may cancel a policy at any time, but must give the insured at least how many days advance notice before the cancellation becomes effective?
30 days
What is the maximum limit of coverage provided by the Association for the death benefits under a life insurance policy?
300,000
If disciplinary action against a producer resulted in monetary relief of $200 or less, the producer's record will be expunged after ______ years.
5
For a life insurance policy other than a group or term policy, how many days after defaulting on a premium payment does the insured have to elect a nonforfeiture option?
60
For an expedited review of the insurer's determination of a grievance, within how many hours must the insurance company notify an enrollee?
72
What is the maximum life insurance policy loan interest rate in this state?
8%
How many days does a licensed producer who moves to Missouri from another state have to submit an application to become a resident producer?
90
If treatment for mental illness disorders is provided by a health policy, how long is treatment for inpatient hospitalization per benefit period?
90 days
Every insurer writing business in Missouri must receive a __________ from the Director.
Certificate of Authority
Life insurance policies in Missouri may contain a suicide exclusion for up to:
1 year after the policy's issue date
Health policies in Missouri must offer breast cancer chemotherapy treatment if all requirements are met, and the maximum lifetime benefit can be no less than what amount?
100,000
Health policies in Missouri may exclude pre-existing conditions within what period of time, prior to the effective date of coverage?
12 months
Which of the following statements regarding coverage of low-protein formula and food products is TRUE?
Coinsurance or copayment may be required, but may not exceed 50% of the cost of the items
Health policies must provide coverage for all of the following, except:
Dental care for children up to age 18
An insurer must obtain which of the following about an applicant age 80 or older?
Medical records
If a life policy providing graded death benefits must be guaranteed issue, which of the following must also apply?
Must have a 30 day free look period, subject to full premium refund
In order for an insurer to pay a commission to a producer for services, which of the following must occur?
Producer or agency must be currently licensed and appointed
In Missouri, which entity acting as an insurance producer is NOT required to submit a Registration of Fictitious Name?
Sole proprietorship
If a group changes its health insurance carrier and the new plan contains deductibles or waiting periods, which of the following applies?
The new plan shall give credit for the satisfaction or partial satisfaction of the same or similar provisions under a prior plan providing similar benefits
A converted policy is not required under each of the following circumstances, except:
The terminated employee has a spouse who was covered under the original group policy
Medicare supplement marketing standards must be established to assure all of the following, except:
To promote the use of cold lead advertising/prohibited
A producer who makes a derogatory statement about a competing insurer's financial condition is guilty of what unfair trade practice?
defamation
Which of the following is defined as an unfair trade practice and could be considered fraudulent?
defamation
