Florida Insurance health insurance law
An agent licensed for 6 years or more must complete the 5-hour update course and a minimum of ---hours of elective CE courses every 2 years, for a total of 20 hours.
15 years
nagent who has been licensed for at least 25 years, has a CLU or CPCU, or holds a Bachelor of Science degree in risk management must complete the 5-hour update and a minimum of 5 hours of elective CE courses every -- years, for a total of 10 hours.
2 years
Upon receiving a consumer complaint, the Division may request information from a person licensed or issued a certificate of authority, how long do they have to respond
20 days of receipt
The total amount of Continued education required is
24 hours for every 2 years
New appointments that became effective in a licensee's birth month will expire
24 months later on last day of birth month
A sales person who knowingly makes a false statement can be found guilty of a 2nd degree misdemeanor
2nd degree misdemeanor
The licensee must preserve books, accounts and records pertaining to premium payment for at least
3 years
he insurer must file written notice of termination of the appointment to the Department within -----after terminating the appointment
30 DAYS
A licensee must report any administrative action taken against them to the Department of Financial Services within ___ days after disposition.
30 days
A new residence address, principal business street address, mailing address, contact telephone numbers, including a business telephone number or email address, must be reported to the Department of Financial Services within
30 days
An agent who has plead guilty, nolo contendere to, has been convicted or found guilty of a felony or any crime punishable by imprisonment of 1 year or more must report the action to the Department within ----, whether or not the agent was convicted by the court having jurisdiction
30 days
Every agent transacting any insurance policy must maintain in his/her office or have readily available records of policies transacted for a period of at least --
5 years
The Market Investigation division must examine domestic insurers at least once every
5 years
each licensee (except title insurance agents) licensed within the past--- years must complete a 5-hour update course, which is specific to the license held
5 years
Agent
A general lines agent, life agent, health agent, or title agent. This includes an insurance producer, but does NOT include a customer service representative, limited customer representative, or service representative.
Unaffiliated Agent
A licensed agent, except a limited lines agent, who is self-appointed and practices as an independent consultant in the business of analyzing insurance policies, providing insurance advice or counseling or making specific recommendations of insurance policies for a fee in advance by a written contract signed by the parties
Which of the following actions is the responsibility of the Office of Insurance Regulation
Monitoring the financial condition of all regulated insurance entities
How often may the Office of Financial Regulation make investigation
As often as necessary
Which department Report alleged violations of law by persons licensed by the DFS, OIR, or OFR to the appropriate regulator
Division of Consumer Services
Enforcing the financial institution codes provides for and promotes
The safe and sound conduct of the business of financial institutions Prudent conservation of the assets of financial institutions Maintenance of public confidence Protection of the public interest in the safety, soundness, and preservation of financial institutions Protection of the interests of the depositors and creditors of financial institutions
Guaranteed Insurability Rider
This rider, which may also be referred to as the Future Insurability Option, is commonly found in disability income and long-term care policies.
Risk retention groups
Risk Retention Groups are group-owned insurers that primarily assume and spread the liability-related risks of its members.
The Florida Life and Health Insurance Guaranty Association
The purpose of the Association is to protect policyowners, insureds, beneficiaries, annuitants, payees, and assignees of insurance policies and contracts against the failure of an insurer to perform its contractual obligations due to its impairment or insolvency.
What is the purpose of insurance laws
The purpose of the licensing laws is to require a minimum level of insurance knowledge and for the applicant to be familiar with the Florida insurance laws.
Agents must recertify license
every 2 years
If a foreign/alien insurer is insolvent,Florida Life and Health Insurance Guaranty Association
l take action similar to what it will do for an insolvent domestic insurer. However, it will only do so if it has been determined that jurisdiction where the foreign/alien insurer is domiciled provides, by law, similar protection
if appointment expires in birth month it ends?
last day of the month and is valid for 24 months
DFS(Department of Financial Services) What do they Supervise
supervises methods of obtaining business, including agent licensing and control of unfair trade practices
Which state entity is responsible for issuing a Certificate of Authority for an insurance company?
Office of Insurance Regulation(OFR)
agent Ethics can be summarized by the principle in the Golden Rule:
"Conduct business with a client as you would want business to be conducted with you."
failure to notify the department of move from state within 30 days will result in a-- fine for the first offense and at least ---or suspension or revocation of the license for a subsequent offense.
$250 1st offense/$500 fine 2nd offense
Insurer must give at least------- advance written notice, by delivery in person via mail with postage prepaid or by email, to the appointee of its intention to terminate the appointment.
60 DAY
emergency cease and desist order remains effective for ---- days
90
Insurance Agency
A business location at which an individual, firm, partnership, corporation, association, or other entity, but not an employee, that engages or employs individuals to engage in any activity that by law may be performed only by a licensed insurance agent. The term "agency" does not include an insurer or adjuster.
Probationary Period Provision-pre existing condition
A specified period of time before coverage goes into effect for preexisting conditions
Elimination Period
A waiting period often found in disability insurance and long-term care policies before benefits are payable after a loss occurs.
Insurance Contract
An agreement enforceable by law in which the insurer agrees to pay a certain amount of money upon the death of the insured, and the policyholder agrees to pay the premium
Unlicensed Entities
Any entity that is operating without the proper authorization.
churning
Churning is the practice whereby policy values (such as cash value) in an existing life insurance policy, annuity contract, and/or any riders, are used to purchase another insurance policy or annuity contract with that same insurer for the purpose of earning additional premiums, fees, commissions, or other compensation.
Failure to comply with an order granting a petition for enforcement of a subpoena
Contempt of court
Applicants are required to submit a set of fingerprints to the
Department of Law Enforcement and the FBI as part of the investigation of the applicant's qualifications
Coercion
Entering into any agreement to commit any act of boycott, coercion, or intimidation resulting in an unreasonable restraint of, or monopoly in, the business of insurance.
Insurer
Every person engaged as indemnitor, surety, or contractor in the business of entering into contracts of insurance or of annuity
All Life, Health, and Annuity insurers authorized to conduct business in Florida must be members
Florida Life and Health Insurance Guaranty Association
Twisting
Knowingly making any misleading representations or incomplete or fraudulent comparisons or material omissions with respect to any insurance policy for the purpose of inducing a person to lapse a policy
Certificate of Authority
No person can act as an insurer and no insurer or its agents, attorneys, subscribers, or representatives can directly or indirectly transact insurance in Florida unless authorized by a Certificate of Authority, issued to the insurer by the Office of Insurance Regulation
Which state entity oversees the regulation of securities representatives and mortgage brokers within the state
Office of Financial Regulation
A subpoena requires
Persons to appear before the office at a specified time and place and to bring books, records, and documents for inspection.
Paying any valuable consideration or inducement to a client that is not specified in the contract is known as:
Rebating
The OIR is responsible for
Receiving and reviewing all company applications prior to granting approval and licensing a company to sell insurance in the state of Florida Establishing initial financial requirements for new companies Monitoring the financial condition of all regulated insurance entities through the use of internal financial analysis and on-site examinations Tracking reserves, restricting investments to prudent vehicles and confirming accuracy of financial statements to limit insolvency Taking over insolvent companies and attempting to restore financial integrity Protecting the public against unauthorized insurance activities and behavior Conducts examinations and investigations of insurers and related parties regarding business practices and patterns of alleged violations of the Florida Insurance Code Monitoring marketing activity to avoid unfair trade practices such as twisting, unsupported replacement, and illegal rebating Order hearings to discover unfair competition, unethical marketing practices, nonconformity to license requirements and if the public trust has been violated
Reinsurance
Reinsurance companies operate to accept all or a portion of the financial risk of loss from the primary (or "ceding") insurance company
An examination is not required for any of the following:
Renewal of an appointment (unless deemed necessary by the Department) Applicant for a limited lines license An applicant for reinstatement of a license if suspended within 4 years before the request for reinstatement An applicant for a temporary license An applicant a CLU designation (life or health insurance) or a CPCU designation (general lines, personal lines, all-lines adjuster) Applicant who has received a degree from an accredited institution of higher learning approved by the Department An applicant applying for a license transfer A nonresident agent who holds a comparable license with similar requirements in another state
Sliding
Representing to the applicant that a specific coverage or product is: Required by law in conjunction with the purchase of insurance when such coverage or product is not required Freely included in the policy when in fact there is a charge requiRED
To qualify as a health agent, an applicant must, within the 4 years immediately preceding the date of application, file with the Department that he or she has done one of the following
Successfully completed 40 hours of coursework in health insurance along with 3 hours of ethics as approved by the Department, instruction on unauthorized entities engaging in the business of insurance, Florida Nonprofit Multiple-Employer Welfare Arrangement Act and ERISA as it applies to health insurance Successfully completed a minimum of 60 hours of coursework in multiple areas of insurance, which includes health insurance, 3 hours of ethics, and instruction on unauthorized entities (for example, a combined life and health course only requires 60 hours of prelicensing instead of 40 hours per line) Earned or maintained an active designation as a Registered Health Underwriter (RHU), Chartered Healthcare Consultant (ChHC), Registered Employee benefits Consultant (REBC), Certified Employee Benefit Specialist (CEBS), or Health Insurance Associate (HIA) Held an active license in life insurance in another state, as long as that state grants reciprocity to licensees formerly licensed in this state Been employed by the Department or Office for at least 1 year, full time in health insurance regulatory matters and was not terminated for cause—the application for examination must be made within 4 years after the date of termination with the department
To qualify as a life agent, an applicant must,
Successfully completed 40 hours of coursework in life insurance, annuities, and variable contracts along with 3 hours of ethics as approved by the Department and instruction on unauthorized entities engaging in the business of insurance Successfully completed a minimum of 60 hours of coursework in multiple areas of insurance, which includes life insurance, annuities, and variable contracts, 3 hours of ethics, and instruction on unauthorized entities Earned or maintained an active designation as a Chartered Financial Consultant (ChFC) from the American College of Financial Services; or Fellow, Life Management Institute (FLMI) from the Life Management Institute Held an active license in life insurance in another state, as long as that state grants reciprocity to licensees formerly licensed in this state Been employed by the Department or Office for at least 1 year, full time in life insurance regulatory matters and was not terminated for cause—the application for examination must be made within 4 years after the date of termination with the department
Office of Financial Regulation
Supervise all state financial institutions, subsidiaries, and service corporations Access all books and records of persons being supervised as necessary to carry out the duties of the office Issue orders, disseminate information, and otherwise carry out the purposes, policies, and provisions of the financial institutions codes
IF a domestic insurer is insolvent,Florida Life and Health Insurance Guaranty Association
The Association will take action to ensure the insurer is able to meet its contractual obligations.
What is the Financial Services Commission known as
The Commission
Separate Account Requirements
The agent must keep the funds belonging to each insurer for which the agent is not appointed in a separate account to allow the Department or Office to audit the funds. In the regular course of business, the agent must account for and pay the same to the insurer, insured, or other entitled party.
What is the Department of Financial Services known as
The department
if OFR issues a complaint in court against financial institutions and it is found information is correct what will be ordered
a cease and desist
Agents doing business with unlicensed entities are subject to what
a felony
To become licensed, an applicant must file a written application with the Department, meet the qualifications, and pay all applicable nonrefundable fees in-------
advance
impaired insurer
a member insurer that is deemed by the department to be potentially unable to fulfill its contractual obligations, but is not insolvent
an agent, as a fiduciary does what?
accepts premiums, return premiums, or other funds on behalf of the insurer or others. These trust funds are received and handled in a fiduciary capacity.
What pays the agent commissions
agent commissions are made of 1st year premium, a percentage of subsequent renewal premiums
Unless termination is due to suspension or revocation of a license, an insurer may terminate its appointment with a licensee
anytime
What is the Division of Consumer Services Responsible for?
assisting consumers, answering general insurance and financial questions from its toll-free helpline, regional service centers, and website. The division provides consumer education and outreach assistance, as well as the following:
Any individual who willfully obstructs the department, the office, or the examiner in the examinations or investigations authorized
guilty of misdemeanor
What can the Department of Financial Services investigate when agent is under investigation?
investigation of the applicant's character, experience, background, and fitness for the license or appointment, and require the applicant's fingerprints to be checked by local and federal law enforcement agencies
Insolvent Insurer
is a member insurer authorized to transact insurance either when a policy was issued or a loss occurred, and a liquidation order finding insolvency was entered against by a court.
Office of Insurance Regulation (OIR)
is responsible for all activities concerning insurers and other risk-bearing entities in the following areas: Insurance company licensing Rates Policy forms Market conduct and investigations Claims Issuance of Certificates of Authority Insurance company solvency Viatical settlements Premium financing Administrative supervision
Office of Financial Regulation (OFR)
is responsible for all activities of the Financial Services Commission relating to the regulation of the following: Banks, credit unions, and other financial institutions Financial service companies Securities industry
An applicant must complete at least 40 hours of coursework for one area of insurance (such as life-only or health-only) and 60 hours for --------- of insurance (life and health combined).
multiple
does the term "agency" does not include an insurer or adjuster.
no
who conduct investigations as it deems necessary of the accounts, records, documents, and transactions pertaining to or affecting the insurance affairs of
oir office of insurance regulation
An applicant who has been found guilty or has pleaded guilty or nolo contendre (no contest) to a felony involving money laundering, embezzlement, or a felony that is otherwise related to financial services business is
permanently barred from licensure.
Any unpaid claims by an unlicensed entity will become
personal responsibility (liability) of any person who knew or should have known that it is a violation to enter into a contract to transact insurance on behalf of an unlicensed entity
new rates and forms must be filed and approved by the Office of Insurance Regulation
prior to use
Commissions may be shared with a person who is licensed and appointed in the
same line of business
Insurance Transaction
solicitation, negotiations, or effectuation of a contract
A fiduciary holds a position of
special trust and confidence
If a domestic insurer is impaired,Florida Life and Health Insurance Guaranty Association
the Association can guarantee/cover all applicable policies and loan money to the impaired insurer to make it whole.
appointment
the authority given to a licensee to transact insurance or adjust claims on behalf of an insurer or employer
If appointment does not expire in birth month it is valid for ?
up to 36 months
Appointments that became effective in any month other than the licensee's birth month will be valid
will be valid not less than 24 months and no longer than 36 months
Does Unaffiliated agents get the same pay the same appointment fee required of agents appointed by insurers?
yes
If your insurance license expire more that 48 months
you have to apply again as a 1st time appliciant