Ohio laws and rules
An Ohio insurance agent solicits a life insurance policy. In the event of a controversy between the insured and the company, the agent is considered to represent the
company
The free look period in Ohio for individual heath insurance policies is ___ days
10
What is the minimum benefit period that must be offered by a long term care policy
12 months
Ohio requires that a license complete __ hours of continuing education on the subject of ethics every reporting period
3
The first payment for newborn accident and health coverage is due ___ days after the birth
31
In Ohio semiannual premium health insurance policies must provide a grace period of at least
31 days
An insurer can be exclude coverage for a preexisting condition on a Medicare supplement policy for up to
6 month
A life policy loan in Ohio cannot charge a fixed rate of interest higher than
8%
Coverage for newborns under an accident and health plan must include coverage for
Birth abnormalities
Who is required to notify the agent in the event of appointment termination
Insurer
A foreign insurance company doing business in ohio
Is a company domiciled under the laws of another state
An example of endodontic treatment is a
Root canal
Time individual life insurance policy has just recently lapsed. His policy may be reinstated at any time within ___ years
3
An agents appointment had been terminated by the insurer. The insurer must then notify the superintendent within ___ days of the termination
30
An employee has ___ days after the date of marriage to add a new spouse to a small group health plan
30
An insurance company has just received a request for verification from a viatical settlement provider. The insurer is required to respond within ____ calender days to this request
30
Proof of loss on a health insurance claim must be submitted to an insurer within __ days after the insured dates of loss
90
Proof of loss on a heath insurance claim must be submitted to an insurer within ___ days after the insured dates of loss
90
All of these are considered forms of advertising except Billboard announcing a new insurance product An insurers am best rating A radio message promoting an insurers client satisfaction An oral presentation given by an agent
An insurers am best rating
An insurance company advertises an accident and health insurance product in a local Ohio newspaper and refers to dollar amount benefits. This insurer must also disclose which of the following in the advertisement
Any applicable benefit reduction
With a scheduled dental policy, how are covered expenses paid?
Benefits are limited to a specific maximum dollar amount per procedure
What are the levels of coverage as defined by the affordable care act
Bronze, silver, gold and platimun
An order issued by the superintendent that prohibits a specific practice listed in the order is called a(n)
Cease and desist order
Which of the following is required for an insurer to conduct business in this state
Certificate of authority
Which of the following does restorative denta treatment cover
Crowns
All of the following may be an unfair claims practice except Turning down a claim without providing the basis of denial Denying an insurers fraudulent claim Failing to promptly acknowledge pertinent communications concerning claims Failing to effectuate prompt, fair and equitable settlements of a claim
Denying an insureds fraudulent claim
Which of the following is not a specific power given to the superintendent Administer oaths Enact insurance legislation Issue subpoenas Approve policy forms
Enact insurance legislation
All of these are responsibilities of the superintendent except Administering oaths Subpoena a witness Approving policy forms Endorsing insurers
Endorising insurers
Replacement can be best described as
Exchanging a new policy for one already in force
An example of an unfair claims settlement practice is
Failing to promptly provide reasonable explanations for the denial of claims
Which of the following is considered to be an act of misrepresentation
Falsifying the terms, benefits, advantages or conditions of an insurance policy
An agent is meeting with a client to determine whether an annuity would be suitable for purchase. Which of the following topics needs to be discussed with a client
Financial objectives
A client told an intentional lie to an insurer in order to receive a favorable premium. This i'd an example of
Fraud
Tim the insurance agent collect the initial premium during an insurance transaction then deposits the check into his personal checking account. In this situation the crime of ___ has been commited
Fraud
In Ohio a long term care policy must be ___ renewable
Guaranteed
Long term care insurance applications must contain plain and unambiguous health questions. The exception to this rule would be applications for
Guaranteed issue
An agents license may only be suspended or revoked if the agent
Has been afforded a right to a hearing
A buyers guide must
Have it's content approved by the superintendent
Which of the following is not information found in a life insurance buyers guide
How to take legal action against an insurance company
A minor may receive a life insurance policy's death benefit only
If the minor has an appointed guardian
An agents appointment may only be terminated by the
Insurer
A domestic insurance company in hoio
Is formed under the laws of ohio
Non-admitted Insurer
Is not afforded protection by the guaranty fund
Pete the agent recently has his license suspended because he was found to be in violation of a state insurance w. Due to this suspension Pete
May be assessed the administrative costs sustained by the department
If an agent is believed to be causing considerable harm, the superintendent
May issue a cease and desist order against the agent
When screening an applicant for HIV the insurer
May require a blood test for HIV
The superintendent determines an examination of an insurers books and records is necessary. After receiving the notification the insurer
Must not impede the examination
Long term care policies or certificates issued in Ohio are required to have
No forfeiture value
An insurer may refuse to renew an employers small group health plan due to
No payment of premium
Carole is a licensed agent who lives in Michigan and transacts insurance in Ohio. In Ohio Carole is considered to be an
No resident agent
Advertisements for accident and health policies that only cover a stated illness must display a statement that the
Policy is limited
An agent who sells an individual life insurance policy in Ohio must deliver to the policyowner an
Policy summary and buyers guide
Ummarried children who are incapable of self support and have proof of incapacity are included under their parents health coverage until
Policy terimnation
Which of the following is not an eligible dependent on an accident and health policy
27 year old married child
A life insurance applicant in Ohio may backdate the application for up to ___ months
3
A life insurance policyowner is allowed ___ days upon policy delivery to return the policy for a full premium refund
10
An employer with under 20 employees must allow a terminated employee to continue accident and health coverage for a minimum of __ months
12
An employer with under 20 employees must allowed a terminated employee to continue accident and heath coverage for a minimum of ___ months
12
How many days is a temporary agents licenses valid
180
An insurer may deny heath insurance claims based on misstatements in the application for how long from the policy's date of issue
2 years
According to the affordable care act, what is the maximum amount an individual can contribute to a flexible savings account
2,500
Written notice of a claim must be given within___ days after a covered loss starts or as soon as a reasonably possible
20
Which of following is not a circumstance to which a temporary agent license can be issued Representative of an agent called to active military duty Prospective agent who is waiting to take the state licensing examination A widow of a deceased agent Any situation deemed by the superintendent to be in the public bests interest
Prospective agent who is eating to take the state licensing examination
Insurance agent kelly offers a prospect a $1,000 shopping card if an insurance policy is purchased through her. What illegal activity is this an example of
Rebating
An insurer may nonrenew an individual health benefit plan for all the following reasons except No payment of the required premiums Fraud or misrepresentation of material fact The individual is eligible for heath care benefits from the veterans administration If the plan is through an association the individual is no longer a member of the association
The individual is sleigh or for health care benefits from the veterans administration
Under the affordable care act, how would a grandfather health plan lose it's grandfathered status
The insurer significantly raises co insurance charges, deductibles or co payment charges
An advertisement for an insurance product may contain
The insurers name
An agent is legally permitted to share his/her commissions
With another licensed agent
An agents license has been suspended for nonrenewal. This agent may apply for reinstatement
Within 12 months of the license renewal date
Group dental plans will frequently place a limit on annual benefits in order to minimize
adverse selection
Insurance companies that are organized in countries outside in the United States are referred to as
alien