Missouri Laws and Rules Pertinent to Insurance
31
The grace period for group life policies is ____ days.
A fine, only after a hearing
A Missouri insurance producer has violated an unfair trade practice. The Director may penalize the producer in which of the following manner?
Delivery Receipt
A _______ _______ is the signed document that starts the free-look period.
debtor
A credit life insurance policy covers the life of the
a certificate of authority to transact business in Missouri
A foreign insurance company CANNOT conduct business in Missouri without
applicant
A health insurance policy application may ONLY be altered with the written consent of the
is found guilty of misrepresentation or fraud in obtaining the license
A license may be denied, suspended, or revoked if the licensee
16
A licensee must complete ______ hours of continuing education every two years.
8%
A life policy loan in Missouri cannot charge a fixed rate of interest higher than
30
A producer must notify the Director within _____ days of a felony conviction
failing to effectuate prompt, fair, and equitable settlements of a claim
An example of an unfair claims practice would be
offering a client something of value not stated in the contract in exchange for their business
An example of rebating would be
returning a portion of a premium as inducement to purchase insurance
An example of rebating would be
Producer
An individual who has a contract with an insurance company to represent it is called a(n)
Comprehensive major medical
Chemical dependency coverage is required in which type of policy?
Misrepresentation
Convincing a prospective insured to buy an insurance policy based on exaggerations is called
Group comprehensive health policies
Coverage for human leukocyte antigen testing for bone marrow transplant is REQUIRED to be provided in all
Notify the Director of the replacement
During the course of a Medicare supplement sale T the agent determines there is an existing policy being replaced. Which of these actions is T not required to perform?
with each issued health policy
Health insurance policies in Missouri are REQUIRED to contain coverage for human leukocyte antigen testing for bone marrow transplant
50%
Health policies that contain coverage of low protein modified food products for treatment of PKU or any inherited disease of amino and organic acids require a reasonable coinsurance NOT to exceed _______ of the cost of the formula or food products.
Every two years
How often must an insurance producer's license in Missouri be renewed?
15
Once the insurance company receives a notice of claim, they have _____ days to send the claim form
nonresident
P is a producer who is licensed in Missouri but a resident of Nebraska. P is a(n) ______ producer.
12 months
What is the MINIMUM benefit period that must be offered by a Long-Term Care policy issued in Missouri?
12 months
What is the MINIMUM benefit period that must be offered by a Long-Term Care policy?
Ensures that claims filed against insolvent insurance companies will be paid
What is the purpose of the Missouri Life and Health Insurance Guaranty Association?
Guaranteed Renewable
What is the required renewability status of all Medicare supplemnt policies?
Notice Regarding Repplacement
What must a producer sign when an existing life insurance policy is being reissued with a reduction in cash value?
Selling shares of stock
Which of the following is NOT an example of "conducting insurance business"
Sharing commissions with a producer licensed in the same line of business
Which of the following is NOT considered rebating?
Completing the required continuing education
Which of the following is a requirement for a producer's license renewal?
Pay a $100 license fee
Which of the following is a requirement for obtaining a resident producer license in Missouri?
Be licensed as an producer in the producer's state of domicile
Which of the following is a requirement to attain a nonresident producer license?
The producer's state of residence must have reciprocity with this state.
Which of the following is a requirement to attain a nonresident producer license?
issued in an amount not to exceed the amount of indebtedness
Credit Life insurance is
Outline
When a Medicare Supplement insurance policy is delivered, disclosure standards require that a(n) ___ of Coverage be provided to the insured
31 days
When an employee is terminated, how long does this employee have to convert group life coverage to an individual plan?
50%
When an insured receives chiropractic service, the co-payment may NOT exceed _____ of the total cost of providing the service
cease and desist order
When an unfair trade practice has been discovered, the Director may issue a
age, annual income, financial experience
When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain suitability information. Suitability information includes
Misrepresentation
Which Unfair Trade Practice involves an agent telling a prospective client that a policy's dividends are guaranteed?
Licensee who commingles monies belonging to policyholders with personal funds
Which licensee faces possible license revocation by the Director of Insurance
Producer sells a replacement policy that causes an insured to lapse an existing policy
Which of the following actions by a producer would NOT result in a license suspension or revocation?
Producer is insolvent
Which of the following is NOT a reason for the Director to revoke a producer's license?
Accidental Death and Dismemberment
Which of the following is NOT a required provision in a group life policy?
Maintaining an existing policy and applying for a new one
Which of the following is NOT a situation that involves life insurance policy replacement?
Issuing an additional Medigap policy to ensure no out-of-pocket exposure for the insured
Which of the following is NOT allowed in regards to a Medigap (Medicare Supplement) policy?
Collect premiums and remit to the insurance company as soon as reasonably possible
Which of the following is considered a producer's fiduciary responsibility?
A producer guaranteeing a policy's dividends
Which of the following is considered to be misrepresentation?
Credit life
Which of the following types of individual policies does NOT require a policy summary be given?
a licensed producer not appointed by the company
Which of these individuals may NOT be compensated from an insurance company?
Resident Producer
Which of these individuals would require continuing education?
The Director may establish guidelines for continuing education
Which of these is a TRUE statement regarding the regulatory authority of the Director?
A producer stating that a policy's dividends are guaranteed
Which of these is considered an unfair trade practice?
The dependent must have been over ten years of age when the handicap was incurred
Which of these statements regarding health coverage for physically handicapped dependents is FALSE?
When an producer discusses annuities in general with a client but no specific recommendation is made
Which situation does NOT require a producer to provide a suitability statement to the annuity company?
Insured
Who may assign benefits from a group life insurance policy?
Producer and applicant
Who signs a Notice Regarding Replacement form when an application is taken for a new life insurance policy that replaces an existing one?
To determine the solvency of the company
Why would the Director of insurance examine the records of an insurance company?
Policy must be issued to xyz, and a certificate must be issued to each employee
Xyz corp was issued a group health policy for its employees. Under this plan a
Rebating
______ is the act of offering an applicant something of value as an inducement to purchase an insurance policy.
Malign another insurer
Defamation occurs when a producer makes a false statement intended to
malign another insurer
Defamation occurs when a producer makes a false statement intended to
Covered children less than six years of age
For treatment of PKU a health plan must cover formula and low protein modified food products for
credit life
Insurance issued on a debtor to cover outstanding balances on installment loans is called
unfair discrimination
Insureds in the same risk classification are being charged different premiums by an insurance company. This insurer is committing the illegal act of
Coercion
J is an producer who recently told a claimant that his rights might be impaired if he does not complete a release form within a specified time. What could this producer be found guilty of?
the Director
Michael the insurance producer is acting in a fiduciary capacity when conducting business with all of these principles EXCEPT
race
No one may be denied coverage by an insurance company due to
written notice to the producer
Prior to a producer's license being revoked, a hearing must be held. Prior to this hearing, the Director of Insurance is REQUIRED to give
transacting insurance
T the producer is selling a life insurance contract to a client. T is engaging in
Gubernatorial appointment
The Missouri Insurance Director attains office in which of the following ways?
funded by insurance companies through assessments
The Missouri Life and Health Insurance Guaranty Association is
is mandated by state requirements
The conversion provision in a group health insurance policy is
Subsequent increases in benefits
The suicide provision for life policies would apply to
the succeeding carrier shall give credit for the satisfaction of any deductibles or waiting periods satisfied or partially satisfied under the prior carrier's plan
Under Missouri law, when one group health plan's contract replaces a existing group health plan of similar benefits,
When the enrollee's life or health is jeapordized
Under which circumstance MUST a health insurer have an expedited grievance review procedure?
65
A nondisabled individual is first eligible for a Medicare Supplement policy at age
It pays the same benefits as the group policy
A person covered by a group major medical policy leaves the group and converts the coverage to an individual policy. Which of the following statements is INCORRECT about the new policy?
misrepresentation
A producer is circulating incorrect information about the benefits of a policy. This producer may be found guilty of
2
After a life insurance policy has been in force for a MAXIMUM of ______ year(s), it becomes incontestable
Cover childhood immunization services
Any state-regulated health insurance plan issued in Missouri MUST
Offer coverage for prosthetic devices
At the time of application, major medical health plans (including hmos) are required to
After being properly appointed by an insurer
At what point may a producer sell insurance for an insurer?
to an individual policy for a stated period of time
Group Life policies in Missouri are required to contain a conversion privilege that allowed for conversion
Medically necessary treatment in accordance with a treatment plan
Health insurance coverage of autism spectrum disorder treatments may be limited in which way?
is greater than the copay for primary care office visits
Health insurance plans that cover physical therapy visits may NOT impose a copay that
60
How many days must the insured wait to take legal action against a health insurer after submitting written proof of loss if the insurer refuses to pay?
Every 5 years
How often must the Director examine each domestic insurance company?
Notify the replaced insurance company
If the sale of a Medicare Supplement involves replacement, all of these actions must be performed by the producer EXCEPT
Guaranteed renewable
In Missouri, a Long-Term Care policy must be renewable in which of the following ways?
Apply the same deductible and copays to covered diabetic supplies as other medical conditions
In Missouri, all health policies must address diabetes coverage in which way?
Coercion
In Missouri, which of the following is considered an Unfair Trade Practice?
Entire Contract
In a life insurance contract, the policy, application, and riders or endorsements are considered to be the
Soliciting insurance policies
Jasmine is a salaried employee of an insurance company. Which of the following duties would require her to be licensed as an insurance producer?
policyowner
Life insurance replacement regulation protects the interests of
