CHAPTER 8 HEALTH INSURANCE
providing referrals A license is NOT required when you are providing referrals.
A license is NOT required when you are
2-year term
The licensing period for a producer's license is a
customer service representatives The requirements for continuing education apply to all of the following EXCEPT customer service representatives.
The requirements for continuing education apply to all of the following EXCEPT
One formed under the laws of Oklahoma
Which one of the following is a domestic insurer?
Civil penalty of not less than $100 and not more than $5,000 For any violation of the Unfair Claims Settlement Practices Act, the Insurance Commissioner may subject an insurer to a civil penalty of not less than $100 and not more than $5,000.
For violating the Unfair Claims Settlement Practices Act, the Insurance Commissioner may subject an insurer to which of the following penalties?
24 hours every 2 years Oklahoma has a continuing education requirement of 24 hours every 2 years for license renewal.
In conjunction with an Oklahoma insurance license renewal, which one of the following is the continuing education REQUIREMENT?
credit life Insurance that is designed to pay the balance of a loan if the insured dies before the loan has been repaid in full is credit life.
Insurance that is designed to pay the balance of a loan if the insured dies before the loan has been repaid in full is
pay a cash surrender value Upon surrender of a whole life policy, which has been in force for AT LEAST 3 full years, and within 60 days after the date the premium payment is due and unpaid, the insurer will pay a cash surrender value.
Upon surrender of a whole life policy, which has been in force for AT LEAST 3 full years, and within 60 days after the date the premium payment is due and unpaid, the insurer will
defamation Making or publishing any oral or written statement that is FALSE or maliciously critical of the financial condition of an insurer, and is calculated to injure any person engaged in the business of insurance is known as defamation.
Making or publishing any oral or written statement that is FALSE or maliciously critical of the financial condition of an insurer, and is calculated to injure any person engaged in the business of insurance is known as
protect consumers with guidelines regarding credit reporting and distribution The primary purpose of the Fair Credit and Reporting Act is to protect consumers with guidelines regarding credit reporting and distribution.
The PRIMARY purpose of the Fair Credit and Reporting Act is to
Exists For profit A Fraternal Benefit Society is a nonprofit entity.
A Fraternal Benefit Society has each of the following characteristics EXCEPT
terminal illness settlement benefit A form of an accelerated death benefit is a terminal illness settlement benefit.
A form of an accelerated death benefit is a
48 hours for vaginal birth or 96 hours for caesarean section A health benefit plan provides maternity benefits must provide at least 48 hours of inpatient care for vaginal birth, or 96 hours for caesarean section, for the mother and newborn infant following delivery.
A health benefit plan that provides maternity benefits must provide at least how many hours of inpatient care for the mother and newborn infant following delivery?
Licensed and duly appointed producers According to Oklahoma Statute, commissions may be paid to licensed and duly appointed producers.
According to Oklahoma Statute, commissions may be paid to
Fraud Deliberately lying in order to achieve a lower premium rate is considered insurance fraud.
An applicant for health insurance deliberately lies in order to obtain a lower premium rate. This is an example of
3 years An insurance producer is required to maintain the usual and customary records pertaining to authorized transactions for 3 years.
An insurance producer is required to maintain the usual and customary records pertaining to authorized transactions for how long?
This violation is a felony and can result in a fine of up to $5,000 Any person performing insurance transactions without a producer's license or under a license that has been suspended or revoked can be penalized up to $5,000 and charged with a felony.
An insurance producer whose license has been revoked continues to provide insurance services. Which of the following is TRUE?
30 Following military service, an insured must submit a request for reinstatement to a private health insurer no later than 30 days following deactivation.
Following military service, an insured must submit a request for reinstatement to a private health insurer no later than how many days following the deactivation?
Not greater than $1,000 If it is discovered that a producer cheated on their examination for an insurance license, the Commissioner may place on probation, censure, suspend, revoke, or refuse to issue the producer's license, as well as assess a fine of no more than $1,000.
If it is discovered that a producer cheated on their examination for an insurance license, the Commissioner may place on probation, censure, suspend, revoke, or refuse to issue the producer's license, as well as assess a fine of
Rebating, which is an unfair trade practice This is an example of rebating, which is prohibited.
Insurance producer Kate offers insureds a $250 shopping card if they purchase an insurance product through her. What is this an example of?
marital status It is the responsibility of the producer to report all of these to the insurance commissioner EXCEPT changes of his or her marital status.
It is the responsibility of the producer to report all of the following information to the insurance commissioner EXCEPT changes of his or her
All individual or group health contracts or agreements According to Oklahoma law, all individual or group health contracts or agreements must include coverage for equipment, supplies, and related services for the treatment of Type I and Type II diabetes when prescribed by a physician or other licensed health care provider.
According to Oklahoma law, which of the following must include coverage for equipment, supplies, and related services for the treatment of Type I and Type II diabetes when prescribed by a physician or other licensed health care provider?
gathering prospective buyer information Transacting insurance includes any of the following EXCEPT gathering prospective buyer information.
Transacting insurance includes any of the following EXCEPT
24 months Under an Unfair Claims Settlement Practices Act, an insurer CANNOT request a refund of an overpayment paid to a claimant after 24 months.
Under an Unfair Claims Settlement Practices Act, an insurer CANNOT request a refund of an overpayment paid to a claimant after
A high school diploma Having a high school diploma is not a qualification to be licensed as a producer or adjuster.
Which of the following is NOT a qualification to be licensed as a producer or adjuster?
Sharing commissions with an applicant Sharing commissions with a client (applicant) is considered a form of rebating and is prohibited.
Which of the following is considered an example of rebating?
Individual Major Medical Expense policy A disclosure notice must be given to an applicant in the event of replacing an existing individual major medical expense policy with a new one.
Which of the following plans require a replacement disclosure notice be given to the applicant in the event of policy replacement?
The existing policy no longer meets the needs of the insured An advantage of replacing an existing health insurance policy with a new would would be when the existing policy no longer meets the needs of the insured.
Which of the following would be the advantage of replacing an existing health insurance policy with a new one?
8% A life insurance policy loan shall bear interest at a specified rate, NOT in excess of 8%.
A life insurance policy loan shall bear interest at a specified rate, NOT in excess of
40 and older Group and individual health insurance policies must cover annual mammography screenings for women aged 40 and older.
Group and individual health insurance policies that provide coverage to women must cover annual mammography screenings for women aged:
issue a cease and desist order If the Commissioner has received a complaint that an individual has committed an Unfair Trade Practice, the Commissioner may immediately issue a cease and desist order.
If the Commissioner has received a complaint that an individual has committed an Unfair Trade Practice, the Commissioner may immediately
Joe cannot be denied reinstatement to his original individual health plan An Oklahoma resident activated for military service cannot be denied reinstatement into the same individual health insurance coverage that lapsed while the person was on active duty.
Joe is a military retiree after having served 20 years of active duty. Upon retiring, he requests reinstatement of his lapsed individual health policy and is denied. Which of the following is correct?
5 years The Oklahoma Insurance Commissioner is REQUIRED to examine domestic insurers AT LEAST every 5 years.
The Oklahoma Insurance Commissioner is REQUIRED to examine domestic insurers AT LEAST every
having been convicted of a misdemeanor The Oklahoma Insurance Commissioner may place on probation, censure, suspend, revoke, or refuse to issue to an applicant for all of the following causes EXCEPT having been convicted of a misdemeanor.
The Oklahoma Insurance Commissioner may place on probation, censure, suspend, revoke, or refuse to issue to an applicant for all of the following causes EXCEPT
Non-payment of premium A Medicare Supplement policy may be cancelled for nonpayment of premiums due.
A Medicare Supplement policy may be cancelled for which of the following reasons?
giving the applicant merchandise worth $75 for the purchase of insurance A life insurance producer would be found guilty of inducing a customer to purchase insurance in all of these situations except giving the applicant merchandise worth $75 for the purchase of insurance.
A life insurance producer would be found guilty of inducing a customer to purchase insurance in all of the following situations EXCEPT:
Must have residence in Oklahoma for 6 months prior to submitting the license application There is not a 6-month residence requirement in Oklahoma to qualify for a resident producer license.
In the state of Oklahoma, to qualify for a Resident Producer license each of the following is required EXCEPT?
15 Any person of competent legal capacity may contract for life and health insurance at a minimum age of 15.
Any person of competent legal capacity may contract for life and health insurance at a minimum age of
50 employees In Oklahoma, a small employer may not consist of more than 50 eligible employees.
In Oklahoma, a small employer may not consist of more than how many eligible employees?
3 years A life insurance policy must be in effect for 3 years before the policyowner may use the nonforfeiture provision.
How long must a life insurance policy be in effect before the policyowner may use the nonforfeiture provision?
Request for a blood test to detect presence of HIV virus HIV disclosure to an insurance applicant may include the request for a blood test to detect presence of HIV virus.
HIV disclosure for an insurance applicant may include which of the following?
age 65 Medicare Supplement coverage permits an open enrollment period on a guaranteed issue basis upon reaching age 65.
Medicare Supplement coverage permits an open enrollment period on a guaranteed issue basis upon reaching
two years of issue The contestable period for health policies in Oklahoma is 2 years.
In Oklahoma, claims for a medical expense health plan may be denied due to a material misrepresentation within
Misappropriation of premium funds Disciplinary action may be taken by the Commissioner for misappropriation of premium funds.
A producer may be disciplined by the Commissioner for which of the following actions?
180 days A temporary producer's license issued by the Insurance Commissioner without examination is valid for a period of no longer than 180 days.
A temporary producer's license issued by the Insurance Commissioner without examination is valid for a period of no longer than
Immunization benefits may not be subject to a schedule Immunization benefits may be subject to a schedule for each child listed as a dependent on a health benefit plan.
All of the following are true regarding required immunization benefits for each child listed as a dependent on a health benefit plan EXCEPT:
An oral injury that requires repair A medical expense plan will normally provide dental coverage for an oral injury that requires repair.
Dental coverage in an employer-sponsored medical expense insurance policy will typically cover which of the following?
group dental plans help to minimize adverse selection Dental health plans are typically underwritten as group coverage because group dental plans help to minimize adverse selection.
Dental health plans are typically underwritten as group coverage because
Gift whose value is under $100 Gifts whose value is OVER $100 is considered to be a form of inducement and prohibited.
In Oklahoma, all of these are considered forms of inducement EXCEPT
becomes financially insolvent Insurers do business in Oklahoma only after a thorough financial review. MOST insurance policies written in Oklahoma are protected by the Guaranty Association established to protect policyowners in the event an admitted company becomes financially insolvent.
Insurers do business in Oklahoma only after a thorough financial review. MOST insurance policies written in Oklahoma are protected by the Guaranty Association established to protect policyowners in the event an admitted company
accelerated benefits Proceeds payable to a policyowner under a life insurance contract in anticipation of death or upon the occurrence of specified life-threatening conditions as defined by the policy are best described as accelerated benefits.
Proceeds payable under a life insurance contract to a policyowner in anticipation of death or upon the occurrence of specified life-threatening conditions as defined by the policy are best described as:
Health Maintenance Organizations (HMOs) The Oklahoma Life and Health Insurance Guaranty Association provides financial policyholder protection for all of the following EXCEPT Health Maintenance Organizations (HMOs).
The Oklahoma Life and Health Insurance Guaranty Association provides financial policyholder protection for all of the following EXCEPT
school In this situation, the address on the envelope may NOT include any combination of words which imply that the correspondence is from the school.
The envelope in which insurance solicitation material is contained may be addressed to the parents of students. The address may NOT include any combination of words which imply that the correspondence is from the
Giving a gift of more than $100 value to a client as an inducement to purchase insurance Under the Oklahoma Insurance Code, a licensed insurance producer is prohibited from giving a gift of more than $100 value to a client as an inducement to purchase insurance.
Under the Oklahoma Insurance Code, a licensed insurance producer is prohibited from which of the following?
20 days When a life insurance or annuity replacement policy is sold, the policyowner has a right to return the policy for a full refund of premium within 20 days.
When a life insurance or annuity replacement policy is sold, the policyowner has a right to return the policy for a full refund of premium within