Quizzes-IP 181 REGULATION OF INSURANCE PRODUCTS

______________ for an insurance product wouldn't typically be included in a rate filing.

Advertising material

Some filings submitted to a state can be an insurer's response to material filed on its behalf by the company's______________________.

Advisory Organization.

Advisory Organizations are entities authorized under state laws to make insurance filings on behalf of their members and subscribers.

Advisory Organizations

Under the __________________, the general purpose of an exchange is to provide comparisons of health insurance coverage options and facilitate the enrollment into coverages.

Affordable Care Act

Enacted in 2008, which Act prohibits the denial, conditioning, or discrimination in the pricing of a Medicare supplement policy on the basis of genetic information?

GINA

Cargo that is hauled by truck across the country would most likely be covered by what type of insurance?

Inland/Ocean Marine

The Reinsurer, or the insurance company that provides insurance to another insurance company, would be the _____.

assuming company

The amount of total losses paid by an insurance company during a specified time interval are _____.

paid losses

When there are few insurance company insolvencies and rates are fairly steady, this would be an example of a _____.

stable market

Each ___________________ establishes the benefits for Workers' Compensation insurance.

state's legislature

One important concept of HIPAA is Guaranteed Issue, which means _____.

that an insurer must enroll you in the plan if you apply for enrollment

What is the premier speed to market tool to process rate, rule, and form filings and the review of those filings?

SERFF

A small group employer must have no more than _____ employees.

50

An individual may be exempt from the Affordable Care Act's Individual Mandate if the cost for their coverage exceeds _________ of their household income.

8%

A benefit trigger for Long-Term Care insurance coverage must be applicable within the last ____ days.

90

Which of these is NOT a good purpose for buying life insurance?

An investment strategy

Which of the following is an insurance product that is required by law in most states?

Auto

A life insurance company may have a branch office where a _______________ is paid a salary instead of a commission for the sale of products.

Branch Manager

Within the RBC structure, underwriting risk or any type of internal business risk is classified as _____.

C2

Which federal law enables an employee who loses his/her job to continue group health coverage from their employer for a specified timeframe, as long as the termination was not gross misconduct?

COBRA

The underwriting process ________ include actions such as evaluating a person's driving record.

Can

What would be a reason an insurance company would need reinsurance?

Catastrophic events

As a regulatory reviewer, where would you find a list of the documents that are included with a product form filing?

Declaration or Transmittal Document

When something is generally fixed, it is considered _____.

Deterministic

Which of the following provides coverage in the form of income to the insured if the insured is unable to work because of illness or injury?

Disability Income coverage

All state insurance regulatory agencies must have a designated person with the title of Filing Clerk to review the initial completeness of the filing.

False

In a group Health Insurance policy the employee is a policyholder and the employer is a certificate holder.

False

The more complete a filing, the longer it takes to review and get approved and ready for the consumer.

False

True or False: Inadequate rates could cause an insurance company to gain too much profit over its competitors.

False, its the opposite

What role is directly responsible for making sure that the policy coverages in the filing comply with all state laws?

Filing Reviewer

Which of the major medical plans is typically the most restrictive with respect to the choice of a provider?

HMO

What are the TWO ways an annuity is categorized?

How benefits are paid

If a filer fails to supply any missing or correct deficient information, what happens to the filing?

It is denied, or not approved

A life insurance benefit that allows a policyholder to surrender the policy for a percentage of the total death benefit because of a terminal illness is a _____.

Living Needs Benefit

_____________________ coverage has a limited number of standardized benefits specified by regulation.

Medicare insurance

Which Medicare plan part covers the costs for a Physician?

Part B

A dividend that is converted to an amount that is added to the value of the life insurance policy is called a _____.

Paid Up Addition

What speed to market tool provide consistent product naming conventions, consistent terminology, a numerical coding system, and descriptions for use in product filings?

Product Coding Matrices

Which of the following describes the purpose of the Product Filing Review Handbook?

Provides uniformity and consistency of regulatory processes, while maintaining laws and regulations that address the state-specific needs of the nation's insurance consumers.

Which of the following establishes a hypothetical minimum capital level that is compared to a company's actual capital level?

RBC

Which type of filing would include expected loss percentages as part of the filing documentation?

Rate Filing

What tool is used by the filer to determine if the filing is ready to be submitted to the regulatory authority?

Review Standards Checklist

Annual filings of rates is required by the __________________________.

Small Employer and Individual Health Insurance Availability Model Act.

________ states prohibit the use of a person's credit history in the underwriting process.

Some

_______________ large group health insurance plan rates are regulated at the state level.

Some

What type of health insurance coverage would include Dental insurance?

Specified Medical Expense

If you wanted a life insurance policy that only covers your family until your children reach the age of 21, what type of policy would you get?

Term

The ___________________ can make reasonable rules and regulations regarding rates and filings.

The Commissioner

Why is an insurance contract considered a contract of adhesion?

The insurer controls the wording of the contract

An insurance company told Jane that her property insurance claim was not a covered loss based on language in the insurance policy. Jane sued the insurance company and the court ruled that the insurance policy language was ambiguous. What is the expected court ruling?

The court would give favor to Jane because the policy is a contract of adhesion.

_____________insurance is a coverage that is required by lenders in most states.

Title

From an insurer's perspective, when is a claim settled?

When the claim is denied or paid

What type of life insurance policy allows the policyholder to borrow money against the cash value in the policy?

Whole Life

The Affordable Care Act mandates that _____ must be set up in each state to facilitate enrollment in exchanges, but they may not advise consumers as to what specific plans to enroll in or actually enroll consumers.

a Navigator

A form filing for a new auto liability product _______ be filed using IIPRC, as long as the state is a member state.

can not

An insurer must obtain a _____ in order to write business in a state.

certificate of authority

File and Use and Use and File are examples of ___________________

competitive rating laws.

A _____ states that a filing is considered approved within a stated period of time if the insurance department neglects to act on a filing.

deemer provision

A _________________ annuity pays out sometime in the future, but immediately starts accumulating in value until it is payed.

deferred

Risk-Based Capital ________________ require all insurers to have the same amount of capital reserves on hand.

does not

Once a health insurance model law is adopted by a state, it ________________ contain the same wording as all other states.

does not need to

Life insurance premiums are not directly regulated because ____________________________

enough competition exists in the market.

A __________________ is a type of Health Insurance policy provision.

grace period

An individual would be eligible for continuation of group health insurance coverage under COBRA if the individual is terminated from his or her job except for_______________

gross misconduct

An Advisory Organization ______________ permitted to mandate that certain rates are used.

is not

An example of a Loss Adjustment Expense (LAE) would be _____.

legal expenses

Laws are generally ______ detailed and specific than regulations.

less

The two main groupings of Auto insurance coverage are___________________

liability and physical damage

In a competitive insurance market, a stronger economy generally tends to _______ insurance premiums.

lower

A _______________ insurance system of insurance coverage limits your right to sue.

no-fault

Because of _____________________, a life insurance company must account for the cash value of a policy in their reserves.

nonforfieture benefits

Instead of using a formula of mortality and interest rates to determine reserves, the ____________________________ uses a process measuring and documenting risks to determine reserve amounts.

principle-based system

With a Variable Life policy, ______________ gets to determine the type of investments.

the insurer (company)

Speed to Market benefits ______________ since they get their product to market faster.

the insurer AND the insured

The frequency of a claim incidence is evaluated by______________

the number of claims divided by the number of exposers.

If a policyholder stops paying on a life insurance policy, the default nonforfieture benefit is ________________ a cash surrender value.

very rarely

The total premiums generated from all policies written by an insurance company within a given period of time are the _____.

written premiums