Chapter #19: Louisiana Laws and Rules
In order for a business entity to be licensed as a producer
A licensed producer must be designated as responsible for compliance with state insurance laws.
A licensed producer MUST be __________ by an insurer to be eligible for soliciting insurance contracts.
Appointed
Before a producer may sell, solicit, or negotiate insurance for an insurer, the producer must have a(n)
Appointment
A company that is authorized by the Commissioner to transact insurance business in Louisiana is called a(n)
Authorized insurer
A domestic insurance company in Louisiana MUST
Be organized under Louisiana insurance laws
A cease and desist order
Forbids a stated practice listed in the order
Under the Affordable Care Act, which of these plans is designed to provide coverage that is actuarially equivalent to 80% of the full actuarial value of the benefits provided under the plan?
Gold
A dependent child may remain on a parent's health insurance plan beyond 26 if the child
Has a mental or physical handicap and remains dependent on the parent
Which license is REQUIRED in order to solicit Long Term Care insurance in the State of Louisiana?
Health Insurance Producer License
Maria the producer would like to advertise an annuity product on a highway billboard. Which of the following must be included in the advertisement?
Her name
Which of the following is NOT information found in a life insurance buyer's guide?
How to take legal action against an insurance company
Terminally-ill life insurance policyowners may sell their policy at a discount to a third party. This type of agreement is called a(n)
Viatical settlement
What happens if the insurer discovers that the insured's age was accidentally misstated on an application for an individual life insurance policy?
Benefits will be calculated according to how much coverage the premium paid would have purchased for the correct age
Coverage for newborns under an accident and health plan MUST include coverage for
Birth abnormalities
What is the purpose of the Louisiana Life and Health Insurance Guaranty Association?
Ensures that claims filed against insolvent insurance companies will be paid
How often must the Commissioner examine each domestic insurance company?
Every 5 years
How often must an insurance producer's license in Louisiana be renewed?
Every two years
An example of an Unfair Claims Settlement Practice is
Failing to promptly provide reasonable explanations for the denial of claims
An alien insurer
Is an insurer operating in the U.S. but headquartered outside the U.S.
Which of the following is NOT a requirement to obtaining a Louisiana insurance producer license?
Must be age 21
Charles is a producer who is licensed in Louisiana but resides in Mississippi. Charles is considered to be a(n)
Nonresident producer
A business entity wishing to act as an insurance producer MUST
Obtain a producer's license
When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT
Obtain the beneficiary's signature
An Arkansas resident producer who would like to solicit insurance in Louisiana MUST obtain a nonresident license in Louisiana. Which of these is NOT a requirement for obtaining a nonresident license?
Pass Louisiana's state licensing exam
All Medicare Supplement policies MUST contain which provision?
Pre-existing conditions may be excluded from coverage for a maximum of 6 months
An insurance producer decides to conduct business under an assumed name. The Commissioner MUST be notified of this change
Prior to using the assumed name
An existing life insurance policy is being replaced by a new one. A notice of replacement must be provided by the ________ to be signed by the applicant.
Producer
An individual who has a contract with an insurance company to represent it is called a(n)
Producer
The branch of dentistry which deals with the replacement of missing parts is called
Prosthodontics
Karen the producer pays for her client's initial premium payment as an incentive for purchase. This act is considered a(n)
Rebate
A nonresident producer from a state outside of Louisiana may become licensed in Louisiana IF a(n)
Reciprocal arrangement exists with the state of domicile
Sharon the producer intentionally submitted a false statement in support of a claim. This is considered a form of
fraud
What is the MINIMUM benefit period that must be offered by a Long-Term Care policy?
12 months
To be classified as a small employer in Louisiana, an employer must emply
1-50 employees
A policyowner has _____ days after policy delivery to return a major medical policy.
10
How long is the free-look period for a life insurance policy sold in Louisiana?
10 days
An insurer has _____ days to file a notice of appointment to the Commissioner.
15
An eligible employee can be excluded from group health coverage for up to _____ months if he/she is considered a "late enrollee"
18
How many days is a temporary producer's license valid?
180
After an annuity has been in force for _____ year(s), it becomes incontestable.
2 years
How long after its effective date will an individual life insurance policy become incontestable?
2 years
Individual health policies sold in Louisiana require dependent children coverage up to age
26
After ____ years from date of issue, a policy can no longer be cancelled by the insurer for misstatements (except for fraud).
3
After a disability policy has been in force for ____ year(s), it is considered incontestable
3
Within how many days must a producer submit a change in address?
30
What are the levels of coverage as defined by the Affordable Care Act?
Bronze, Silver, Gold, and Platinum
Which of these is NOT considered a form of life insurance advertisement?
Buyer's guide
Which of the following permits an insurance company to transact business in Louisiana?
Certificate of Authority
Which of he following permits an insurance company to transact business in Louisiana?
Certificate of authority
An example of unfair discrimination would be
Charging different premiums for policyholders in the same risk classification
All of the following are considered to be fraud EXCEPT
Collecting an insurance charge that is less than what is required
Jim recently sold his life insurance policy under a viatical settlement contract. The proceeds of this contract could be subject to the claims of
Creditors
Which of the following unfair trade practices involves a producer who makes malicious public statements regarding an insurer's financial condition?
Defamation
Advertising regulations exist in order to
Demonstrate full and truthful disclosures to the public
A Medicare Supplement policy's outline of coverage MUST include a(n)
Description of policy benefits
A common exclusion or limitation on a dental policy is
Endodontics
A viatical settlement broker may NOT
Make any transactions before being approved for a license
Under the Louisiana Health Plan, comprehensive health benefits are provided to
Medically uninsurable residents
Long-term care policies sold in Louisiana may NOT exclude coverage for
Senile dementia
Which of these is NOT an Unfair Claims Settlement Practice?
Settling a claim by arbitration
All of the following actions are considered rebating EXCEPT
Sharing commissions with other producers
Kiara filled out a life insurance application and was given a policy illustration that showed future premiums being paid out of nonguaranteed values. This illustration MUST disclose that
She may need to resume premium payments, depending on actual results
A pre-existing condition is a condition for which medical advice or treatment was recommended by or received from a provider of health care service within _____ months preceding a healthy policy's effective date.
Six
Which entity regulates claim settlement practices?
State insurance departments
A life insurance replacement transaction could result in a(n)
Surrender charge
The Fair Credit Reporting Act protects consumers
With guidelines regarding credit reporting and distribution
In order for a business entity to be licensed as a producer,
a licensed producer must be designated as responsible for compliance with state insurance laws
A producer who sells most of his/her insurance policies to family members is said to be engaging in
controlled business
A producer must notify the Commissioner within _____ days of a felony conviction.
30
The required grace period for a life insurance policy sold in Louisiana is ____ days
30
In Louisiana, a small employer may not consist of more than how many eligible employees?
50
A life insurance applicant in Louisiana may backdate the application for up to ______ month(s).
6
An insurer may exclude preexisting conditions on a Medicare Supplement policy for ______ months.
6
Proof of loss on a health insurance claim must be submitted to an insurer within _______ days after the insured's date of loss.
90
When a small employer health insurance plan is offered, it must be available
To all eligible employees who apply
A producer license is NOT required when
Underwriting insurance
When the Commissioner of Insurance requests a producer's business records, the must be produced
Upon request