Iowa laws, rules, and regulations

What is the purpose of insurance guaranty associations?

To protect policyowners, insureds and beneficiaries from financial losses caused by insolvent insurers

If the commissioner believes in individual is involved in unfair trade practices and delivers to the individual a notice of hearing the hearing may be no sooner than? 10 days after receipt of notice 15 days after receipt of notice 30 days after receipt of notice 5 days after receipt of notice

10 days after receipt of notice

If insurance company fails to pay a covered claim within 30 days of the receipt of the claim they are required to pay interest on that claim at the rate of

10% per annum

A group life insurance policy issued to an employer to insure employees of that employer must cover how many employees at the date of issue

2

How long is the free look. For replacement Medicare supplement policies

30 days

How soon after the receipt of a properly completed claim form and proof of loss must a health insurance company except and pay or deny a claim

30 days

Within how many days must an employee elect continuation of health coverage under COBRA after the termination of employees group policy

31

What are the most common penalties for violations of insurance statutes

A cease and desist order, a fine, and license suspension or revocation

Who is an insurance agent?

A person authorized to sell, solicit and negotiate insurance contracts

All of the following are essential benefits required to be included in all health plans purchased in the market place except

Adult dental care

An insured woman who wants to know when insurance will start covering mammograms without referral from a physician what would you tell her

Age 35

If an insured chooses not to renew all plans the commissioner and must be given notice how many days prior

At least 3 days

to be eligible for tax credits under the ACA, individuals must have income that is what percent of the federal poverty level?

Between 100% and 400%

In Iowa Medicare supplement insurance policies must be issued as which type of policy

Guaranteed renewable

The healthy and well kids in Iowa program (Hawk-I) is funded by?

Jointly by the state of Iowa and the federal government

Which types of services may not be provided under the long-term care's assisted living care

Visits by a registered nurse

When is controlled business legal?

When the commissions from controlled business do not exceed the aggregate commissions on all the other business (specific limits may vary from state to state)

Which of the following is the closest term to an authorized insurer? Legal Admitted Certified Licensed

admitted

What type of licensee represents the insurance company?

agent

If a producer makes maliciously critical statements about another insurer, what is this illegal practice called?

defamation

Two individuals who are in the same risk and age class are charged different rates for their insurance policies due to an insignificant factor. What is this called

discrimination

Insurers are classified according to their domicile what are the three types of insurers?

domestic, foreign, alien

A group insurance policy issued to a nonprofit industrial association must cover at least how many employees at the date of issue

1000

And I want to be marked as a long-term care policy the policy certificate or writer must be designed to provide coverage for at least

12 months

If an insurance company writing Individual health benefit plans and I would decides to nonrenew all written health benefit plans in Iowa they will be prohibited from reentering the market for a period of at least

5 years

Which of the following medical conditions must be covered by a long-term care policy

Alzheimer's

Who is considered a nonresident agent?

An agent who resides in another state, but is licensed to write insurance in this state.

Who must be a member of insurance guaranty associations?

Any authorized insurer within a state

In Iowa group insurance may be written to provide insurance coverage for

Any group that conforms to one of the descriptions of eligible groups as established by the insurance division or that receive special approval from the commissioner

If an insurer holds a Certificate of Authority, it is known as what type of insurer?

Authorized or admitted

If an insurer meets the state's financial requirements and is approved to transact business in the state, it is considered what type of insurer?

Authorized or admitted

The individual health insurance reform act requires that insurance carriers Issuing individual health benefits plans must make available to eligible individuals who apply and agreed to pay the premium

Basic health benefits plans

If the Commissioner/Superintendent finds a licensee engaging in an unfair method of competition or an unfair practice, what order will be issued?

Cease and desist order

What document is required for an insurance company to transact insurance?

Certificate of Authority

Which of the following must an insurer obtain in order to transact insurance within a given state?

Certificate of Authority

What are producers required to do in order to renew their license?

Complete continuing education hours and pay renewal fee

A Medicare supplement may

Contain Pre existing conditions limitations

For what reason can a temporary license be issued

For continuation of business in case the licensed producer dies or becomes disabled

Long-term care policies must contain which of the following renewal provisions

Guaranteed renewable

The time payment of claims provision requires that a health insurance company pay cover losses

Immediately after the company receives a written proof of loss

In general who can be excluded from producer licensing and examination requirements

Insurance company officers, directors, or any other employees who do not transact insurance and who do not receive commissions for their services (usually, their responsibilities include administrative, executive or clerical)

Which of the following is not a mandatory coverage and health insurance policies in Iowa

Maternity benefits

The long-term care partnership program creates a partnership between the state government and which of the following? A. anyone eligible for long-term care insurance B. Social Security recipients C. Medicaid recipients D. Medicare recipients

Medicaid recipients

According to the regulations for long term care partnership policies how often must ensure provide a statement of benefits to the insured

Monthly

In Iowa if an individual wishes to bring a legal action against an insured to recover on a health insurance policy how soon can such action commence

No sooner than 60 days after written proof of loss is furnished to the insurer

Can insurers advertise the existence of the guaranty association during solicitation and sale of insurance policies?

No, advertising of the existence of the guaranty association for the purposes of solicitation and sale of insurance policies by insurers is an illegal business practice.

During replacement of Medicare supplement coverage, which of the following documents must be provided to the insured? A. Policy summary B. Replacement alternatives brochure C. Notice regarding replacement D. Buyers guide

Notice regarding replacement

Each individual and group health insurance policy must provide coverage for low-dose screening mammograms for determining the presence of breast cancer how much coverage must be provided for woman age 40 to 49

One biennial mammogram

Who may share in the commission from the sale of a life insurance policy?

Only producers properly licensed for the type of insurance transaction

All of the following are types of care that is provided under long-term care home health care except occasional visits by which of the following

Pediatric nurses

If a Medicare supplement policy contains pre-existing conditions limitations the disclosure must appear as a separate paragraph in the policy and be labeled as

Pre existing conditions limitations

In Iowa which of the following provisions is not required to be included on the first page of a Medicare supplement policy

Pre existing conditions limitations

Who can usually be granted a temporary license?

Producer's spouse or designee in case the licensed producer dies or becomes disabled

The affordable care act requires all US citizens and legal residence to a qualifying healthcare coverage this is known as

The individual mandate

Who is responsible for the contents of insurance advertisements?

The insurance company

Who is responsible for the cost associated with the examination of insurers

The insurer who is being examined

Individual health insurance policies that provide coverage for a family member of the insured must also provide that health insurance benefits applicable for children are payable for a newborn child commencing

The moment of birth

Which of the following is not a requirement for a partnership qualified long term care policy

The policy must've been issued before January 1 of 2010

Which of the following events would allow the insurance carrier to nonrenew and individual health benefit plan

The policyholder became eligible for coverage under Medicare

To whom may certificate of authority be issued?

To an insurer authorized to transact business in this state

What is the purpose of a cease and desist order?

To prevent a producer or insurer from further violating laws for transacting insurance

When can the Commissioner or Director examine insurers?

Whenever deemed necessary, but at least once every few years (please check your state regulations for specific time requirement)

What type of licensee represents the insured?

broker

On its advertisement a company claims that it has funds in its possession that are, in fact, not available for payment of losses or claims. what is the company guilty of?

misrepresentation

What illegal act does a producer commit when the producer represents a policy in a more favorable light than the policy really is?

misrepresentation

Who must be notified of a producer's change of address?

The Department of Insurance (Commissioner/Director/Superintendent)

In Iowa a group insurance policy issued to trustees of a fund established by two or more employers must cover how many eligible insurable employees at the time of issue

100

Which of the following statements is true regarding coverage for prescription contraceptives in group health policies issued in this state

It is a mandatory coverage

An Agent offers a client free tickets to a sportinf event in exchange for the purchase of insurance policy. What is the agent guilty of?

Rebating

What is controlled business?

Insurance on the producer's own life or property, or the lives or property of the producer's family or business associates

Which of the following statements is true regarding cancellation of a Medicare supplement policy by an insurer

It can be canceled for nonpayment of premium

Who owns stock companies?

stockholders

What type of misrepresentation persuades an insured, to his or her detriment, to cancel, lapse, or switch policies from one to another?

twisting