Ch7 Laws and Rules
An agent must report to the Commissioner of Insurance any administrative action or criminal charges taken against the agent within __ days of the conviction date.
10
An agent that has been or is engaged in conduct that violates the Insurance Information and Privacy Protection Act shall be issued and served a statement of charges and notice of hearing by the Commissioner of Insurance. The date of such hearing shall be AT LEAST how many days after service of charges?
10
The policyholder has how many days to return an Accident/Health Insurance Policy and receive a full refund on premiums?
10
AT LEAST how many days before the effective date of a rate increase must an insurer provide written notice to individual accident and health policyowners?
30
According to the Information and Privacy Protection Act, when access to recorded personal information is requested following an adverse underwriting decision, the insurer must make the information available within how many business days?
30
If after satisfactory proof of loss, an insurer fails or refuses to pay death proceeds, the insurer must pay interest on the proceeds after how many days?
30
Under a Group Health Insurance Policy, continuation shall be available only to an employee who has been insured immediately prior to the date of termination for a period of AT LEAST
30 days
Every insurance agent/broker MUST maintain all records, books, and documents for insurance transactions for a period of not less than
5 years
Eligible employees must be added to group health coverage NO LATER than how many days after their first day of employment?
90
An agent who sells an individual life insurance policy in North Carolina MUST deliver to the policyowner
A Policy Summary and Buyer's Guide
What do Dread Disease policies cover?
A specific disease or illness
Before a Health Policy is issued or delivered, the form, classification or risks, and premium rates MUST be filed with the
Commissioner of Insurance
Insurance agents MUST obtain a license from North Carolina's
Commissioner of Insurance
According to the Affordable Care Act (ACA), which of the following coverages is NOT required?
Coverage for cosmetic surgery
A vacancy that occurs during the North Carolina Commissioner of Insurance's term of office MUST be filled by the
Governor
Which of the following requires that an applicant for an individual Health Policy be notified of an investigation into his personal character, general reputation, and mode of living?
Insurance Information and Privacy Protection Act
Which of the following BEST describes Credit Life insurance?
Insurance issued on a debtor to cover outstanding balances on installment loans
When an existing life insurance policy is being reissued with a reduction in cash value, the agent must sign the
Notice Regarding Replacement of Life Insurance or Annuity
One of the stated purposes of the Life and Health Insurance Guaranty Association is to
One of the stated purposes of the Life and Health Insurance Guaranty Association is to
Which of the following terms is defined as any transaction in which new life insurance or a new annuity is to be purchased and existing life insurance or annuity is to be terminated or discontinued?
Replacement
A written agreement to provide a Life Insurance Policy holder immediate cash in exchange for the sale and transfer of a Life Insurance Policy is a
Viatical Settlement
According to the Affordable Care Act (ACA), a dependent child's eligibility status is determined by:
age
The following acts are examples of unfair methods of competition and deceptive practices in the business of insurance EXCEPT the use of
comparisons showing that a policy has higher benefits
Circulation of any oral or written statement or any pamphlet, circular, article, or literature that is false or maliciously critical of or derogatory to the financial condition of an insurer is known as
defamation
Insurers organized under the laws of North Carolina are called
domestic companies
An example of an unfair claims practice would be
failing to effectuate prompt, fair, and equitable settlements of a claim
When L applies for a Health Insurance Policy, L unintentionally fails to list a previous visit to a cardiologist. If the insurance company contests the policy, it MUST do so within 2 years
from the date of issue
The Life and Health Insurance Guaranty Association is
funded by admitted insurance companies through assessments
An insurance broker in North Carolina is a representative of the
insured
Inducing or attempting to induce any insured person through misrepresentation to lapse, forfeit, or surrender insurance is
twisting
Under the North Carolina insurance code, an insurance company must pay death benefits for suicide if the policy has been in force for a MINIMUM of
two years
To be licensed as an accident and health insurance agent in North Carolina, the applicant MUST
have successfully completed at least 20 hours of instruction approved by the Commissioner of Insurance
Continuation of coverage of a group Hospital, Surgical, and Major Medical Policy MUST include
hospital expenses
An insurance company MUST clearly specify questions designed to obtain information solely for marketing research
in any insurance transaction
The Insurance Information and Privacy Protection Act is designed to limit or direct the information collection activities of all of the following EXCEPT
insurance regulators
An agent who signs a blank contract application or policy of insurance
is guilty of a misdemeanor
Companies in North Carolina may transact solicitations for insurance ONLY through
licensed agents
The funds used by the Life and Health Insurance Guaranty Association to carry out its purpose are obtained from the
member companies
Every Group Health Policy providing benefits for chemical dependency treatments must include, for the life of the contract, a
minimum benefit of $16,000
If a company accepts a renewal premium payment that would extend coverage beyond the policy's MAXIMUM age limit, the company
must continue the coverage to the end of the period of time for which the premium was accepted
The amount received for a life insurance policy in a viatical settlement is
Less than the death benefit
The fund that assures policyholders payment of death benefits on Life Policies, if the company is insolvent at the time of the claim, is called the
Life and Health Insurance Guaranty Association
The rules and regulations of the Life and Health Insurance Guaranty Association in North Carolina apply to
Life and Health Policies issued by companies authorized in North Carolina
Under the Affordable Care Act (ACA), health coverage is provided for dependents up to the age of:
26
North Carolina requires that an insurance agent must complete __ hours of continuing education on the subject of law and ethics every two years.
3
Approved premium rates for group health insurance shall be guaranteed by the insurer for an initial period of not LESS than how many months?
12
A person is required to be AT LEAST how old before he or she is licensed as an agent in North Carolina?
18
A temporary license may be issued for a MAXIMUM period of how many days?
180
An insured MUST submit a proof of loss on a health insurance claim within how many days after the date of loss?
180
K works for XYZ Clothing Store from September through December each year. K works 45 hours a week for this period of time. The employer's Group Policy would consider K
not eligible for the insurance because as a seasonal employee K does not meet the definition of "employee" under North Carolina law
If an insurer has been notified by the Commissioner of Insurance that an individual Health Policy form does not comply with the state's laws, the insurer may
not issue the form in connection with any new application
No insurer shall refuse to insure an individual because of
race
All of the following actions are considered rebating EXCEPT
sharing commissions with other licensed and appointed agents
If the Commissioner of insurance finds that a licensed person has used fraudulent, coercive, or dishonest practices or has proved to be incompetent, untrustworthy, or financially irresponsible, the law allows the Commissioner to
suspend, revoke, or refuse to renew the agent's license
Essential Benefits without annual and lifetime limits are required on any health policy purchased:
through the Federal Marketplace
