Laws and Rules
An intermediary must complete how many hours of approved training in order to sell long-term care products?
8 hours
Which provision makes the application part of the annuity contract?
Entire Contract clause
The PRIMARY purpose of the replacement rule is to
protect policyowners from misrepresentations and loss of benefits
An insured's statement of a policy's benefits which is to be used in marketing materials is called a(n)
testimony
A person who intentionally commits a criminal violation of an insurance law may be subject to a MAXIMUM fine of
$5,000
How long is the free-look period for individual health insurance policies in Wisconsin?
10 days
Starting in 2016, businesses with up to ___ employees will be defined by the ACA as a "small business".
100
Long-term care policies issued in Wisconsin must provide benefits for at least
12 months
The Commissioner can issue a temporary license as an intermediary for a period of
12 months
The maximum prison sentence given under federal law for unfair and deceptive insurance practices is
15 years
What is the minimum number of employees needed for a small employer medical expense plan in Wisconsin?
2
A life insurance policy becomes incontestable after it has been in force for
2 years
EXCEPT for fraud, the time after issuance of a policy during which an insurance company may contest a health insurance claim due to the statements on an application is
2 years
A small employer group is an employer that employs how many?
2-50 employees
How many hours of continuing education is required every two years for license renewal?
24
How many days notice does the Affordable Care Act require insurers to give before rescinding coverage?
30
Individual Medicare Supplement policies must allow an insured a MINIMUM of how many days after policy delivery to return the policy and receive a refund of premium?
30
A licensee whose name or address changes must notify the Commissioner within
30 days by written notice
The grace period for a life insurance policy with an annual premium is usually
31 days
A Medicare Supplement insurance policy may EXCLUDE coverage for preexisting conditions for a maximum period of how many months after the policy goes into effect?
6
A life insurance policy can be backdated before the application date for up to
6 months
How long can an insurer exclude coverage for a preexisting condition on a Medicare Supplement Policy?
6 months
How long can pre-existing conditions be excluded in long-term care policies?
6 months
Screening for lead poisoning is required for disability (accident & health) policies for children under
6 years old
What is the actuarial value of a bronze level health plan?
60
A notice of intent to nonrenew a policy by the insurer requires at least how many days written notice before policy expiration
60 days
How long must all health plans provide coverage for newborn children?
60 days
An insurance company writing business in a state other than the one in which it is domiciled is called
A foreign
Life settlements between a policyowner and a life settlement provider are negotiated through
A life settlement broker
Which of the following individuals is required to be licensed as an intermediary in Wisconsin?
A person who advises others about insurance needs and coverages and is compensated by an insurance company
Which of these is considered to be an intermediary?
A person who sells insurance on behalf of an insurer
Wisconsin requires advertisements for accident and health insurance policies covering ONLY a specified illness to prominently display
A statement that the policy is limited
Which of the following is available ONLY if the consumer purchases coverage in the health insurance exchange?
Access to premium tax credits and reduced cost sharing
According to the Affordable Care Act (ACA), dependent children may remain on their parent's plan until what age?
Age 26
Which of the following is NOT one of the 10 essential health benefits that must be provided under a comprehensive health plan under the Affordable Care Act?
An annual CAT scan
All of the following are unfair claims settlement practices EXCEPT
An attempt to settle a claim by arbitration
Under Wisconsin law, which of the following is NOT required to be licensed?
An employee of a collection agency who collects delinquent premiums
Which of the following persons is required to have an intermediary's license?
An individual listed as a salesperson by an insurance company
Which of the following statements is TRUE about an insurer's right to screen applicants for HIV?
An insurer can require a blood test for HIV
Which statement is true regarding Wisconsin's continuing education requirements for licensed intermediaries?
An intermediary must meet specified course requirements within a two-year period
Misrepresenting pertinent policy provisions relating to coverage after a loss is
An unfair claims settlement practice
To receive an insurance license an applicant must
Apply for the license after passing the appropriate examination
In order to act as an insurance agent, a producer must hold a valid insurance license and
Be appointed by an authorized insurance company
An intermediary must secure an appointment with an insurer
Before soliciting insurance applications for that insurer
Health insurance that covers special groups of persons is called what type of insurance?
Blanket
An intermediary who makes an agreement that unreasonably restrains the business of insurance may have violated regulations against
Boycott, coercion and intimidation
Which of the following is considered to be a prosthodontic dental procedure?
Bridgework
According to the Affordable Care Act, new Health Insurance Marketplaces are established by the
CCIIO
For group health plans covering employees in more than one state, the state regulatory jurisdiction established for the plan may affect any of the following aspects EXCEPT
COBRA continuation of coverage
For policyholders in the same risk classification, it is unlawful to
Charge different premiums
All of these are considered to be a violation of the Federal Fraud and False Statements Act EXCEPT
Claims reimbursement
Prepaid dental plans differ from most other types of dental plans in what way?
Closed panel of dentists can only be used
Which of these is NOT considered a Federal punishment for unfair and deceptive insurance practices?
Community service
The Insurance Commissioner has the right to issue which of the following orders?
Compliance
When the Commissioner examines an intermediary's insurance records, the purpose will primarily be to determine:
Compliance with state insurance laws and regulations
Which event must a producer report to the Commissioner?
Conducting business under an assumed name
In regards to the Affordable Care Act (ACA), which of these is NOT a role of a health insurance exchange?
Contact the employer if an employee stops coverage under a plan offered in the exchange
Which term refers to insurance written on the interests of the licensee, the licensee's employer, or the licensee's immediate family?
Controlled business
The business of life settlements may include all of the following EXCEPT
Conversion of Term Life insurance contracts
All of these are used to prevent adverse selection in a group dental plan EXCEPT
Decreased employee participation
Health providers are compensated by a preferred provider organization (PPO) for normal dental procedures by what means?
Decreased fee schedules
Which of these is typically regarded as a major treatment in an indemnity dental plan?
Dentures
Wisconsin law requires the Human Immunodeficiency Virus (HIV) consent form to
Disclose the types of individuals or organizations that may receive a copy of the test results
Which of these is NOT considered a preventative service in a dental plan?
Fillings
John has a criminal record in which he was convicted of a felony that involved dishonesty. Under Federal law, how would John be able to engage in insurance transactions?
Given written consent by the state insurance regulatory agency
Which type of Medicare Supplement information can be used without prior State approval?
Government publications
According to the Affordable Care Act (ACA), insurers can no longer deny health coverage due to pre-existing conditions unless that plan is a(n)
Grandfathered plan
An agent who misrepresents a life insurance product in the state of Wisconsin
Has committed an illegal act
In Wisconsin, a long-term care policy may offer coverage
In which benefits are based on an individual's ability to perform the activities of daily living
All of the following are covered under most dental plans EXCEPT for
Mouth cancer
The Wisconsin Insurance Security Fund was established to protect consumers in the event of an insurer's
Insolvency
Who determines the suitability of a disability (accident & health) policy to a potential insured?
Intermediary
An intermediary's authority to bind an insurer to an insurance contract may be granted in the:
Intermediary's appointment with the insurance company
Which of the following statements is CORRECT about an insured's failure to report a claim in a timely manner based on the advice of an intermediary?
It does not affect the insurance company's obligations
The amount received for a life insurance policy in a life settlement is
Less than the death benefit
All of the following is information that is reasonably appropriate to determine the suitability of an annuity recommendation EXCEPT
Level of education
Agreements made by terminally ill persons to sell their life insurance policies at a discount in order to pay medical expenses are called
Life settlements
What licenses MUST an intermediary have to market variable life insurance products?
Life, variable, and securities
All of these are common limiting factors with dental insurance EXCEPT for
Limit placed on number of teeth that may be treated annually
How can a group dental insurer discourage adverse selection?
Limit the duration of coverage
When determining the suitability of an annuity for a consumer, the insurance provider is obligated to
Make reasonable efforts to fit the annuity with the consumer's needs
According to the Federal Fraud and False Statements Act, which of these is considered to be an intentional violation?
Making false entries in a company's books
Misrepresentation on the application is
Material
According to the Affordable Care Act (ACA), the proportion of premium revenues spent on clinical services and quality improvements is called the
Medical loss ratio
False advertising of an insurance policy is considered
Misrepresentation
If an intermediary misleads or fails to adequately disclose the title and true nature of a policy offered to a potential insured, it may be considered
Misrepresentation
During the first two years a life insurance policy is in force, the insurer may contest a policy for all of the following reasons EXCEPT
Misstatement of age in the application
Beginning January 1, 2014, the restricted annual limit for plans under the Affordable Care Act will be
No Limit
How would preventative care be encouraged in a dental plan?
No deductible on routine examinations
When must an intermediary provide a replacement notice on life insurance?
No later than at the time of taking an application
When an intermediary has a change of mailing address, the intermediary MUST notify the
Office of the Commissioner of Insurance in writing of the address change within a maximum of thirty days
Most prepaid dental plans cover
Oral examinations
Renewal of small employer health insurance plans may be denied for all of the following reasons EXCEPT
Overuse of physician and hospital services
Life insurance policies in Wisconsin must state all of the following EXCEPT
Premiums must be paid by the insured
Qualified long-term care policies must include all of the following provisions EXCEPT
Prior hospitalization
If an intermediary chooses to conduct business under an assumed name, when must notification be given to the Commissioner?
Prior to using the assumed name
Under Federal Law, which of the following actions may result in a producer becoming imprisoned?
Producer embezzling funds from an insurer
The dental specialty which deals with the replacement of missing teeth is called
Prosthodontics
What is considered interstate travel under the Federal Fraud and False Statements Act?
Puerto Rico
The Commissioner may suspend an intermediary's license when the intermediary
Rebates a portion of the commission to the insured
Splitting the commission with the buyer on a sale of insurance is known as
Rebating
An individual may become licensed as a nonresident intermediary without passing a written examination by
Reciprocal arrangement with the state of domicile
All of the following claims settlement practices could initiate a cease and desist order EXCEPT
Refusing to pay a claim without conducting a reasonable investigation of all available information where material facts are in dispute
Any of the following may be an unfair claims practice EXCEPT
Refusing to pay persons bringing false or fraudulent claims
A transaction in which a new life insurance policy is purchased and an existing life insurance policy is surrendered is called
Replacement
The marketing of Medicare Supplements is regulated to prevent all of the following EXCEPT
Replacement of any existing coverage
Under Wisconsin standards for marketing long-term care coverage, all of these are prohibited sales practices EXCEPT
Replacing existing coverage
In the process of obtaining insurance, a statement made by an applicant that becomes part of the contract is considered to be a
Representation
Security laws passed by Congress are enforced by which Federal agency?
Security and Exchange Commission
Which of these situations would NOT potentially involve a prison sentence under Federal law?
Selling insurance with a nonresident license
Long-term care insurance policies may exclude coverage for all of the following EXCEPT
Senile dementia
Unless specifically excluded in the policy, a Medicare Supplement policy must provide coverage for pre-existing conditions after the policy has been in effect for a minimum of how many months?
Six
A life insurance intermediary licensed in Wisconsin is authorized to
Solicit, receive and forward applications to the insurer
Claims settlement practices of insurers are regulated by:
State insurance departments
All of the following are typically covered under dental insurance EXCEPT
Treatment which began before the eligibility date
In regards to technology and the ACA, which of the following statements is correct?
States which operate with an Exchange must offer an internet-based portal
A copy of all Medicare Supplement advertisements must be submitted for approval to
The Commissioner
Which item must be considered by an intermediary when determining the suitability of an annuity recommendation?
The client's financial status
Under the Fair Credit Reporting Act, which statement is true?
The consumer who was investigated must be advised that credit, insurance, or employment was denied because of an unfavorable report.
An applicant for life insurance must be informed that testing for Human Immunodeficiency Virus (HIV) infection is used to help determine
The insurability of the proposed insured
Which statement is NOT true regarding the ability of an insured to return a disability (accident & health) policy?
The insured can return the policy at anytime for a full refund
Who reports an intermediary's termination of appointment to the Commissioner?
The insurer
Which of the following statements regarding an examination of an insurer's books and records by the Commissioner is true?
The insurer must not impede an examination and is required to assist in the examination procedures
In Wisconsin, an insurer providing small employer group medical plans may discontinue an employer's coverage if
The insurer no longer offers the plan to any employer
Illustrations used in the sale of life insurance contain a statement that must be signed by
The intermediary
If an intermediary's license is revoked by the Insurance Commissioner, which of the following statements is CORRECT?
The intermediary may be paid compensation for services performed as an agent during the revocation period
No existing insurance license will be revoked until
The licensee has been afforded a right to a hearing on the charges
Under Medicare Supplement insurance, what form provides information about services, benefits, copayments, deductibles, exclusions, premiums, and the insurer?
The outline of coverage
A life insurance illustration showing future premiums being paid out of nonguaranteed values must disclose that
The policyowner may need to resume premium payments depending on actual results
An Outline of Coverage for a Medicare Supplement policy MUST be given to the applicant at which of the following times?
The time of application
Wisconsin insurance law requires intermediaries to keep policyholder records for at least how many years after termination or lapse of the policy?
Three
Why were Exchanges implemented by the Affordable Care Act (ACA)?
To create a one-stop market for standardized health insurance plans
Insurance crimes which affect interstate commerce are prosecuted by the
US Attorney General
How long does an intermediary's license remain in effect?
Until revoked or suspended by Commissioner
Under what circumstances must an intermediary provide his or her business records to the Commissioner?
Upon request of the Commissioner
If a basic illustration is not provided, an insurer MUST provide a policy summary to a prospective insured at which of the following times?
When the policy is delivered
When an insured under a group life insurance plan in Wisconsin elects the conversion option, the new policy is issued
Without requiring evidence of insurability
According to federal fraud and false statements regulation, what is required for a prohibited person to transact insurance business in this state?
Written consent from the state insurance regulatory agency
A false statement made by an applicant that would influence an insurer in determining whether or not to accept the risk is
a material misrepresentation
A temporary license may be issued to
a personal representative of a deceased or physically ill intermediary to allow time for the representative to qualify for a permanent license
The forwarding of insurance business from one intermediary to another because the forwarding intermediary cannot place the business with any of the companies with which the intermediary is listed is considered
a proper exchange of business
A policyowner's statement that promotes an insurance company and its policy by describing the policy's benefits is called
a testimonial
A prepaid dental plan has an agreement in place with a network of dentists which
accepts an established amount as payment in full for the dental services rendered
The insurer is legally protected against actions in which an intermediary and a policyholder
acted together to deceive or defraud the company
An insurer operating in the U.S. but headquartered outside the U.S. is
an alien insurer
The Affordable Care Act (ACA) established "exchanges" in order to
assist individuals and small businesses when making their health insurance purchases
When an intermediary's license is revoked for failure to meet continuing education requirements, the intermediary CANNOT
be present during the sale of insurance by another intermediary
An example of the unfair restraint of competition would be
coercion
An intermediary who attempts to intimidate is engaging in
coercion
A requirement for becoming an intermediary is to be trustworthy and
competent
Jerry has an indemnity plan which covers dental expenses. Typically, these type of plans
cover oral surgery as a result from an injury
Making a statement that is false or maliciously critical of the financial condition of an insurer is known as
defamation
Continuation privileges of insureds under group disability (accident and health) insurance policies are
designed to allow an insured to continue coverage for up to eighteen months
An intermediary may receive compensation for insuring the intermediary's self ONLY if
during the prior year the intermediary sold other insurance with the same company with total premiums exceeding the premiums on the intermediary's own risks
The Insurance Commissioner does NOT have authority to examine the business affairs and financial conditions of
group policyowners
Medicare supplement policies may not include renewal provisions less favorable to the insured than
guaranteed renewable
An insurer may cancel a policy midterm for all of the following reasons EXCEPT when the insured
has a change in marital status
The purpose of licensing insurance intermediaries is to show to the satisfaction of the Commissioner all of the following EXCEPT that the applicant
has not filed for bankruptcy within the last 3 years
When an individual is covered under a small employer's accident and health plan, the pre-existing conditions exclusion period may be partially or wholly satisfied by
having creditable coverage with a previous employer
According to the Affordable Care Act, coverage may be rescinded
if intentionally false statements were offered
Under a disability (accident and health) policy, which of the following statements is CORRECT about coverage of a physically or mentally handicapped child who has reached the limiting age in the policy?
if the child is chiefly dependent on the primary insured and is incapable of self-sustaining employment
If an intermediary's license has been revoked for nonpayment of fees, the EARLIEST the intermediary may apply for reinstatement is
immediately after the revocation
An intermediary licensed to place insurance with an unauthorized insurer is an
intermediary surplus lines agent or broker
An intermediary may receive a commission on business written on the intermediary's own life ONLY if the intermediary
is a licensed life agent in Wisconsin and has sold insurance with the same company during the prior year with total premiums exceeding the premium on the intermediary's own life
If the intermediary's biennial license fee is not paid by the expiration date, the intermediary's license
is revoked by the Insurance Commissioner
In most dental plans, a deductible typically is NOT applied to
preventative and diagnostic services
Pointing out to a prospective client that the life insurance policy you are presenting is covered by the Wisconsin Insurance Security Fund is
prohibited by law
The insured's statement that guarantees certain things will be done after the policy has taken effect is called a(n)
promissory warranty
A person who is not licensed as an intermediary may do all of the following EXCEPT
receive a commission
An example of endodontic treatment is a
root canal
Disability (accident and health) policies that cover hospital expenses for adults MUST include coverage for
skilled nursing care
At the time of application, insurers must provide prospects for Medicare supplement policies with a copy of
the Medicare supplement buyer's guide
The Insurance Commissioner's request for information from an insurance intermediary or other individual licensed under insurance law requires that
the individual reply promptly in writing or in any other designated form
An intermediary may share a commission with another intermediary if
the other intermediary is licensed in the same line of business
An insurance intermediary must maintain customer records for how many years following the completion date of the insurance transaction?
three
All newly issued group disability (accident and health) policies MUST provide coverage for
treatment of alcoholism
When using illustrations in the sale of a life insurance policy, intermediaries and insurance companies are required to
use an illustration that shows both guaranteed and non-guaranteed elements