Georgia Stuff for LHA

The Guaranty Fund provides coverage for the cash value under a life insurance policy up to:

$100,000

What must each Medicare Supplement policy state on the first page of the policy?

"Notice to buyer: This policy may not cover all of your med expenses"

Under Georgia's Guaranty Fund system, if a work comp Insurer is insolvent, claims will be covered up to a max of:

$250,000

Generally speaking, a group health policy may be converted to an individual policy within how many days after termination of coverage under the group policy?

30 days

The Guaranty Fund provides coverage for unpaid health insurance claims up to:

300,000

What do LTC applicants need to be given?

Shoppers Guide and policy unique Outline of Coverage

Who issues a probationary license?

The Commissioner

Which of the following may subpoena witnesses and documents at a hearing?

The Commissioner only.

Where do Medicare Supplements need to submit their ads to be submitted for review?

The Insurance Commissioner

If a medicare supplement policy replaces another of its own, what must the insurer waive?

preexisting conditions, waiting periods, elimination periods, and probationary periods

The purpose of the Georgia Assignment System is to:

provide coverage for persons unable to obtain insurance in the voluntary market.

The Commissioner may issue a fine for each intentional violation of the law up to:

$5,000.

After being notified of the possible policy replacement, the Existing Insurer has how many days to comply with a request to delivery a copy of the Policy Summary to the existing policyholder?

10 days

How long does the existing insurer have to furnish a copy of the policy summary to the existing policyholder?

10 days

A person who has held an insurance license in Georgia for 20 years or more must complete how many hours of continuing education per year?

10 hours

How many months must LTC provide coverage to recognized as one?

12 months

A person with both Property/Casualty and a Life/Health licenses must complete how many hours of continuing education?

15 hours per year.

The Commissioner may issue a fine for each unintentional violation of the law up to:

1k

An agent cannot hold a license for the purpose of buying insurance at a discount for the agent or associates. Such insurance is referred to as "controlled business" if it constitutes more than what percentage of the agent's total volume of business per year?

25%

Upon receiving notice from its agent that a policy is being replaced, the Replacing Company must notify the Existing Company within:

3 days

What is the time span for a replacing insurer to send the existing insurer of a copy of the replacement notice?

3 days

Both the Replacing life insurer and the Existing life insurer must keep copies of all replacement documents for at least:

3 years

How long do insurers need to keep copies of all replacement documentation for?

3 years

After appointing an agent, the appointment must be registered in the Insurer's register of appointed agent's within

30 days

Persons licensed to sell Long Term Care Partnership Insurance must complete how many hours of specialized continuing education as part of the annual continuing education requirement?

8 hours

Defamation involves making false statements about the financial condition of:

Any Insurer

A Replacing Agent must give a copy of the Replacement Notice to the:

Applicant and Replacing Insurer

The Georgia policy life and annuity replacement rules apply to:

Individual life policies

An agent's appointment letter may be revoked by the:

Insurer

The coverage under a Medicare Supplement policy:

Must be more than coverage under a Medicare policy

Medicare Supplement policies:

Must provide a 30 day Free Look provision.

What does an insurer need to provide to the insured before they give an application for life insurance?

NAIC Buyer's Guide AND policy summary

For LTC PP, what protection plan does the ages 76 and older have?

No purchase of inflation protection

A Georgia Medicare Supplement policy may duplicate what percentage of the coverage provided by a Medicare policy?

None

What must the LTC partnership policy be accompanied by when delivered?

Partnership Disclosure Notice (tells that policy is Georgia qualified and it does not qualify them for Medicaid?

What does an insurer offering to sell an LTC partnership policy need to provide an applicant with?

Partnership Program notice with Outline of Coverage

If a replacement situation exists, the Replacing Agent must send the Replacing Insurer each of the following EXCEPT:

Policy Summary; replacing insurer already has copy of policy for new policy

The purpose of the Long Term Care Insurance Partnership is to encourage people to:

Preserve a portion of their personal assets and at the same time be eligible for Medicaid long term care coverage.

The purpose of the Replacement rules is to:

Provide more information for Insureds when replacing policies

Assume that coverage under a group policy has terminated. The former Insured knows that she has 31 days to request conversion. She decides to not convert but fails to notify the Insurer. On day 28, she dies.

The Insurer must pay the death benefit less the due premium and interest.

Medical malpractice Insurers must notify which of following of claim payments within 30 days?

The composite State Board of Medical Examiners

Using different rates for persons of approximately the same rate and hazard classification is:

Unfair discrimination

What do direct response insurers need to give to each applicant?

a replacement notice with a request that the applicant furnish the name of existing insurers

A Producer may share a commission with:

a resident Producer

When the Guaranty (Insolvency) Fund pays claims, the Fund is replenished by:

an assessment against the remaining Insurers' premiums

Each of the following may receive an agency licence EXCEPT:

an unlicensed corporate officer

What does topics do not apply to replacement rules?

annuity contracts, credit life, group life, guaranteed issue policies

Who can apply to Georgia Health Benefits Assignment System for coverage?

any person who used an HMO

Who can apply to Georgia Health Insurance Assignment System for coverage?

any person who used something other than an HMO

What is the maximum premium?

cannot be more than 150% of average premium charged by all insurers in GA for similar policies

For LTC PP, what protection plan does the ages 60 and younger have?

compound annual inflation protection

An Insurer may pay commissions directly to the agency rather than to the agents only if:

each person who sells insurance is a licensed agent.

The Georgia Commissioner of Insurance is:

elected

1st step of replacing life insurance

fill out replacement notice

The Commissioner may:

fine a Producer $10,000 for violating a Cease and Desist order

What is a Shoppers Guide?

general discussion of LTC

3rd step of replacing life insurance

give replacing insurer the app and copy of replacement notice

An agent pays an unlicensed person for each referral leading to the sale of insurance. Such a relationship is:

illegal

4th step of replacing life insurance

include signatures and list of policies in replacement notice

2nd step of replacing life insurance

leave original replacement notice with applicant

A resident Georgia Producer will lose her resident Producer license if she:

moves to a nearby state

What does the guaranteed acceptance system of Georgia's Assignment system accomplish?

provides for equitable assignment of eligible individuals to health insurers offering coverage in the individual market

Molly is a Georgia Accident and Sickness producer. She offers a client a Medicare Supplement Policy which provides several of the same benefits provided by the basic Medicare policy. Molly should:

recognize that Georgia law prohibits duplicating Medicare benefits.

For LTC PP, what protection plan does the ages 61 to 75 Have?

some level of inflation protection

When do applicants for LHA not to be competent parties?

spouse for spouse who is incompetent, any person who has insurable interest, app for family life, publicly owned corporation on its employees,

When submitting an app for life to insurer, what must the agent include?

statement signed by applicant regarding replacement and statement signed by agent as to situation with replacment

Who makes the initial determination of whether a life insurance applicant is going to replace an existing policy?

the replacing agent

What is the goal of using a LTC Partnership Policy?

to avoid Medicaid's spend down requirements

What is purpose of assignment system?

to provide coverage for persons unable to obtain health insurance in open market

When can an agent sell a LTC Partnership Policy?

when the agent has completed an initial 8 hour training program and ongoing continuing 4 hour training every 24 months thereafter

If an agent of an existing insurer uses written advertisements in a CONVERSATION EFFORT, do they need to leave a copy with the applicant?

yes