kentucky health insurance

consultant license

A consultant is an individual or business entity who, for a fee or compensation advises any person about his or her insurance annuity contract existing or proposed, regarding the coverage, advisability, rights, or interest under the contract, or relative to the retention, exchange, surrender, or exercise of right stipulated under the contract. The required qualifications for a consultants license must include the following; - be at least 18 years of age - have the minimum five years of actual experience as a license agent with respect to currents of insurance and contracts to be covered by the license - have a thorough knowledge of the kinds of insurance contracts to be covered under the license - has a written examination and demonstrate minimum competence qualifications for the license - be competent, trustworthy under highest standards, financially responsible, and a good personal and business repute - file the bond required for the license

Nonresident license

A non-resident individual or business entity can receive an agent license if the applicant meets the following criteria; - is currently licensed and in good standing in his or her home state - has submitted an application and paid the fee - has submitted to the commissioner the original application for his or her home state or completed uniform application or uniform business entity application - complied with the Home States contributing education requirement - lives in a state that grants nonresident licensing to Kentucky recipients A nonresident agent who changes his or her home state to one other than Kentucky must file a change of address and provider certification from one new home state within 30 days of the move no the application or fees required.

false financial statements

Are those that are intended to deceive the public officials were the general public about the financial condition of an insurer. This often occurs when an important fact about the financial status of an insurer is deliberately with held in order to present the company in a more favorable light

administrative hearings

The commissioner may hold a hearing for any of the following reasons; - The insurance code requires it - A person submits a written request for a hearing because of a complaint about an act, regulation, or order of the commissioner - The commissioner determines that a hearing is necessary A complaint requesting a hearing must generally file the request within 60 days of the act giving rise to the grievance. The commissioner may conduct a hearing for any purpose within the scope of the insurance code. The commissioner must give written notice of the hearing at least 20 days in a Vance and identify the location, time, date, and the purpose of the hearing. If the issues to be raised in the hearing would affect the monetary interest of more than 30 persons, the commissioner may publish a notice of the hearing in a newspaper of general circulation. if an injury results from violation of the insurance code and statute or regulation, the commissioner may order that a person may be compensated for any loss. every order of the commissioner must be dated and state the purpose and intent, the grounds on which is is based, the provisions of the insurance code under which the order is entered, and all other matters required by law.

temporary license

The commissioner may issue a temporary license for up to 180 days without requiring an examination or pre-licensing course to study for any of the following reasons; - The surviving spouse or court appointed personal representative of a licensed agent who dies or becomes mentally or physically disabled to allow Time for any of the following; - The sale of business - recovery or return of the agent to the business - training in licensing of a new personnel to operate the business - A member or employee of a business entity licensed as an agent, upon the death or disability of the sole individual designated in the business into the application license - a designee of a licensed agent entering the Armed Forces - anyone whose licensing the commissioner believes will service the publics interest A temporary license cannot continue after the owner or the owners representative disposes of the business

Limited lines agent license

The commissioner may issue an agents license with the line of authority limited in the following ways; - to surety Insurance only - to travel insurance, incidental to the transportation of persons or to the storage or transportation of property only, and solicited or sold by persons representing common carriers in the course of that representation - to limited line credit insurance only - to crop-hail Insurance only - two other limited line insurance only, as specified by the commissioner The commissioner will no longer issue an agent license with a limited line of authority for motor vehicle physical damage or for mechanical breakdown insurance. However, an agent license with a limited line of authority for motor vehicle physical damage or mechanical breakdown insurance that is already in fact will continue to be in effect until surrendered or otherwise terminated

suspension, revocation, and refusal of license

The commissioner may suspend a license for up to 24 months or revoke or refuse to continue any license if the license was obtained through misinterpretation, fraud, or cheating on an examination. This includes providing incomplete or untrue information on any license application. a license may be revoked, suspended, or considered non-renewable is the license has participated in unfair trade practices including any of the following; - violated any insurance laws or administrative regulations, subpoena, or order of the commissioner or of another state insurance commissioner - improperly withheld or converted monies or properties received in the course of doing insurance - intentionally misinterpreted the terms of a proposed insurance contract for application for insurance - been convicted or pled guilty or to any felony in addition to suspending, revoking, or refusing to renew her license, the commissioner may also levy a civil penalty or do both

Unfair claim settlement practices

The following are improper claims practices if committed and conscious disregard for the law or if committed with such frequency as to indicate a general business practice to engage in that type of conduct; - misrepresenting to insureds, pertinent fax or policy provisions relating to coverage at issue - failing to acknowledge and act reasonably promptly upon communications regarding an insurance claim - failing to adopt an implement reasonable standards for the prompt investigation and proceedings of insureds claims - failing to affirm or deny any coverage of claims within a reasonable time after proof of loss statements are completed and submitted by insured's - not attempting in good faith to affect prompt, fair, and equitable settlements of claims on which liability has become reasonably clear - compelling insurance to initiate suits in order to recover amounts due under an insurance policy by offering substantially less than the amount ultimately recovered in those suits

unfair trade practices

The following have been defined as unfair methods of trade and competition in Kentucky. The commissioner may investigate unfair trade practices in fine, suspend, or revoke violators license if the practice continues.

administrator license

administrator is an individual or business entity who collects or charges premiums from or who address or settlers claims on residents of the stay in connection with life insurance, health insurance, annuities, nonprofit hospital, medical surgical, dental, health service corporation contracts, health maintenance organization contracts, or other life, health, or annuity benefit plans. no individual or business entity may be or act as an administrator in Kentucky unless specifically licensed by the commissioner

content of policies

all contracts of insurance, except Surety contracts, title insurance policies, and group insurance contracts, must contain the following general information; - name of the insurer and the insured - subject of the insurance - risk injured against - effective day and time of the insurance in the duration of coverage - premiums to be paid - conditions or provisions pertaining to the insurance - benefits to be paid

continuing education

all license producers are required to complete 24 hours of approved continuing education within each two-year year period. do you specific areas of study are the following; - three hours of ethics - A minimum of six hours directly related to the agents active line of authority The required CE hours may be completed in the classroom, as a self study, or any combination of both. They continuing education compliance. Begins the first day of the month following the licensees birth month, and ends on the last day of the licensees birth month two years later. I licensee born in an even numbered year must complete these requirements on or before the last day of his or her birth month in an even numbered year, and present prove to the commissioner within 60 days of the compliance day. However, it's a license he has not yet had the license for one year, the compliance day is delayed until the next even numbered year. The same is true of licensees born on odd number years, the adjusted for a number years. after 12 access credit hours can be carried over to the subsequent continuing education period for a good car Sharon, the commissioner may grant an extension of time during which the CEU requirement may be completed, but the extension of time cannot exceed two years. The following licensees are exempt from fulfilling the continuing education requirements; - holding a limited lines of authority license - license for less than one full year - holding a nonresident license who has met a continuing education requirements of his or her home state - maintaining a license for the sole purpose of receiving renewal or deferred commissions

adjuster license

an adjuster is any person, who for a fee or compensation as an employee of an insurer or an independent contractor, investigate or settles claims arising under insurance contract solely on behalf of either the insurer or the insured. This definition does not include a license is not required of the following; - attorneys at law admitted to practice in the state, when acting in the professional capacity as attorneys -licensed agents of the insurer to whom claim authority has been granted by the insurer if the agent receives no compensation for performing adjusting services - salaried traveling representatives of a mutual or reciprocal insurer - persons employed only for the purpose of obtaining fax surrounding a loss or furnishing technical assistance to a licensed adjuster - persons performing adjusting services under their limited insurance agents license for crop-hail Insurance to be licensed as an adjuster, applicants must meet the following criteria; - be at least 18 years of age - reside in Kentucky or a state that permits Kentucky residents to act as adjusters in that state - be trustworthy, reliable, and a good reputation - have not committed any act that can ground for a probation, suspension, license revocation or refusal - have passed written examination for the adjuster license and the applicable line of authority - have paid the required fees - be financially responsible to exercise the license an applicant for an adjusters license who meets all the requirements except the experience, special education, or training requirements may be issued a temporary license as a apprentice adjuster for up to 12 months, without passing the written examination

penalties for violations

any person who willingly violates any role, regulation, order of the commissioner or any of it's provisions of the insurance code will be subject to suspension or revocation I have a certificate of authority or license, and administrative fine, or both

orders and notices

commissioners orders and notices must be issued in accordance with the regulations of the insurance code in the stake, and are considered effective only went in writing and signed by the commissioner we're by the commissioners authority. Every order must be dates and consistently state; - it's purpose - The grounds in which it is based - appropriate provisions from the law for taking action - any other information required by law

unfair discrimination

discrimination in rates, premiums, or policy benefits for a person within the same class or with the same life expectancy is illegal. No discrimination may be made on the basis of an individual's marital status, race, national origin, gender identity, sexual orientation, creed, or ancestry unless the distinction is made for a business purpose or required by law

license examination

each individual applying for an examination must remit a nonrefundable test fee. Applicants are permitted to take a retake and examination within 120 days of the commissioners receipt of an application. The commissioner may grant as an extent for a good cause shown

place of business and records

every agent must maintain a place of business in Kentucky that is accessible to the public, and the address of which must appear on the license. An agent may use his or her home as a designated place of business. The license must conspicuously displayed at the place of business. The agent must keep complete records of all insurance transactions at his or her business location for at least five years. These records must be available for renew by the commissioner whenever necessary

persons holding professional designations in insurance (CLU, CPCU, or CIC) Are exempt from the pre-licensing qualifications requirement

generally, individuals who do not receive commissions related to the transaction of insurance are not required to be licensed as producers. As such, insurance insurance producers license is not required of the following; - an officer, director, or employee of a producer Who does not receive commission - an individual who provides information for a group insurance - an employer or its employee administering a program of employee benefits - employees of insurers inspecting, writing or classifying risks - employees of insurers training procedures - an individual whose activities are limited to advertising - an employee who advises his/her employer relative to insurance interest A business entity acting as an agent is required to obtain an agents license

appointment of agents

in order for an agent to represent an insurer he or she must be appointed by the insurer. The commissioner must approve all agent appointments. an agent may represent an insurer without first obtaining approval of the appointment 15 days from the date the insurance application is executed by the agent. If the agent does not obtain confirmation of appointment from the commissioner within 15 days, the agent must immediately discontinue acting on behalf of the insurer. before January 31, the commissioner will distribute to each Insurer A list of all agents whose appointments were in effect during the preceding calendar year. Any appointment will remain in effect unless expressly terminated. if an insurer terminates an agent appointment, the insured must notify the commissioner within 30 days of the effective date of termination. The insured then, must notify the agent who's appointment is terminated within 15 days

qualifications for agent licensing

in order to receive an agent license, and individual must meet the following criteria; - be at least 18 years of age - fufill the residency requirements (where is a non-resident who is not eligible for a nonresident license based on reciprocity) - not have committed any act that is grounds for denial, suspension, or revocation of a license - demonstrate that he/she is trustworthy, reliable, and a good reputation - be competent to exercise the license and complete 20 hours of approved pre-licensing education per single line of authority applied for, or 40 hours for a combination license, such as life and health, or property and casualty - successfully passed a license examination for the lines of authority which the individual has applied -pay the required fees - be financially responsible enough to exercise the license and file the following; 1: a certificate from an authorized insurer State that the insurer Will maintain a liability policy on the agent of $20,000 for a single occurrence and $100,000 for aggregate occurrences in a year 2: A bond with the commissioner executed by an authorized insurer of $20,000 to cover legal liability of the licensee 3: an agreement with the commissioner between the licensee and the insurer stating that the insurer well as soon legal responsibility for the erroneous acts of the licensee committed while I licensed agent, up to $20,000 per act

property and casualty consultant

is an individual license as a consultant specializing in property insurance contracts, casualty insurance contracts, health insurance contracts issued by property and casualty insurance, and surety contracts

illegal inducement

is any unlawful to pay, offer, or except any of the following as inducement to buy insurance; - any special favor or advantage in dividends or benefits - any stocks, bonds, securities, or accrued dividends or profits - anything of value not specified in the insurance contract in the state of Kentucky, offering, promising or giving any prizes, goods or merchandise in the excess of $25 is considered illegal inducement

rebating

is defined as any inducement offered to the insured's in the sale of insurance product that is not specified in the policy. Both the offer and acceptance of a rebate are illegal. Rebates may include but are not limited to the following; - rebates of premiums payable on the policy - special favors or services - advantages in the dividends or other benefits - stocks, bonds, securities, and other dividends or profits

Life and health consultant

is dividual licensed as a consultant specializing in life insurance contracts, annuity contracts, and health insurance contracts

misinterpretation

it is illegal to publish, issue, or circulate any illustration or sales material that is false, misleading, or deceptive as to the policy benefits or terms, the payment of dividends, Etc. there's also refers to oral statements. Committing this illegal act is called misinterpretation

changes of address or name

licensees must inform the commissioner in writing of any change in address within 30 days of the change

Defamation

occurs when an oral or written statement is made that is intended to injure a person engaged in the insurance business. This applies to statements that are maliciously critical of the financial condition of any person or a company

twisting

twisting is a misinterpretation, or incomplete or fraudulent comparison of insurance policies that persuade the insured/owner, to his or her detriment, to cancel, lapse, switch policies, or take out a policy with another insured. Twisting is prohibited

all license issued are property of the state of Kentucky

upon suspension or revocation of a license, the license must be promptly returned to the commissioners office. If the license for a person or business has been revoked twice, that person or business will not be eligible for a license again

cease and desist order

whenever it appears at the person is violating an insurance law of Kentucky or any rule or regulation made by the commissioner, the commissioner may issue a desist order. This order serves as a request for the person to stop committing the violation. Those who fail to comply with the order will be subject to penalties determined by state law

Insurance company licensing

with your exceptions, no company can conduct business in Kentucky without being properly licensed and supervised by the commissioner. Insurance companies must obtain a certificate of authority in order to transact insurance business in Kentucky. To qualify for such certificate, the insurer must be in compliance with a kentucky and Insurance code and its own corporate character. In addition, the insurer must be operating as a stock or mutual insurer, combined stock and mutual insurer, reciprocal insurer or Lloyd's Association. Other requirements for insurer licensing include the following ; - directors, officers, and other management personnel must be competent, honest, and trustworthy and have sufficient managerial experience to ensure that the company's business operation will be in the best interest of the citizens of the state - Capital funds and required surplus must be maintained as prescribed by the insurance code each insurer license to do business in the state must file a financial statement by March 1 of each year. This statement will accurately reflect the insurers financial conditions and affairs as of the preceding December 31 an insurers certificate of authority will continue in affect unless suspended or revoked by the commissioner, assuming that the insured pays it's renewal fee by March 1 and files it's annual statement