Laws and rules

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Which of the following is included in the entire contract according to the entire contract provision

Application

In New York, and insurance agent cannot sell, solicit or negotiate policies for an insurer unless there is an agreement in place between the agent and ensure this agreement is called a

Appointment

No insurance company may transact business in New York without A certificate of

Authority

A domestic insurance company in New York must

Before made under the laws of New York

If an agent would like to start using an assumed name, at what point my superintendent be notified

Before using the assumed name

Coverage for newborns under an accident and health plan must include coverage for

Both abnormalities

The entire contract provision includes all of the following except

Change is made by the agent

All of these are considered to be a violation of the federal fraud and false statements act except

Claims reimbursement

And indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called

Coinsurance

Which of the following is an example of an agent fiduciary duty

Collecting premiums and remitting them to the insurer

An outline of _________ is required for long-term care policies and provide a brief description of important features of the policy

Coverage

Which of the following does restorative dental treatment cover

Crowns

Which of the following is not a duty of the superintendent

Establish rates for the insurers

How often must the superintendent examine each admitted insurance company

Every six years

Which of these is not a characteristic of a fraternal benefit society

Exists for profit

In New York, a Medicare supplement policy must be __________ renewable

Guaranteed

In New York, long-term care policy must be ____renewable

Guaranteed

And agents license may only be suspended or revoked if the agent

Has been afforded a right to a hearing

Who is required to notify the agent in the event of appointment termination

Insured's

The identity of the ____ must be made clear and every health insurance advertisement

Insurer

A foreign insurance company doing business in New York

Is a company that was formed under the laws of another state

The amount received for a life insurance policy in a life settlement is ____ then the death benefit

Less

A policy owner and a life settlement Provider can have a life settlement negotiated through a

Life settlement broker

If an agent is believed to be causing considerable harm, the superintendent

May issue a cease and desist order against the agent

A type of policy that would help pay for uncovered Medicare claims is called

Medicare supplement

Tim's individual life insurance policy has just recently lapsed. His policy may be reinstated at any time within

Three years

An insurer may pay commission in which of the following scenarios

To a license producer who is appointed with the insurer

Tom the agent replaced a client insurance policy when it was not in the clients best interest. Tom can be found guilty of

Twisting

An individual life insurance policy becomes incontestable after it has been in force for

Two years

Under which circumstance me commission be shared between two agents

When they are both licensed in the same line of business

An agent is legally permitted to share her commissions

With another licensed agent

Violations of US code title 18 section 1033 may result in

fine or imprisonment

An insurance agent agrees to pay the first monthly premium for an insurance applicant this is called a

rebate

Which of the following is not covered under workers comp

Pain and suffering

Replacement regulation is designed to protect

Policyowners from misrepresentations and lots of benefits

Under federal law, which of the following actions may result in a producer becoming in prison

Producer embezzling funds from an insurer

The branch of dentistry which deals with the replacement of missing parts is called

Prosthodontics

An agent license is not required when

Referring insurance

An agent may be disciplined by the superintendent for which of the following actions

Misappropriation of premium funds

All Medicare supplement Policies must contain which provision

Pre-existing conditions may be excluded from coverage for a maximum of six months

All health benefit plans issued after January 1, 2014 must provide

Preventative health services

When A health policy requires payment of an additional premium to provide coverage for a newborn, how many days after the birth is the first payment due

30 days

An insurer may exclude pre-existing conditions on a Medicare supplement policy for ____ months

6

A temporary license is valid for a maximum of

90 days

XYZ Corp. was issued a group health policy for its employees. Under this plan a

A policy must be issued 2XYZ, and a certificate must be issued to each employee

And example of rebating is

A producer who shares commissions with a client

Group accident and health insurance policies issued in New York much generally include an unmarried dependent child who is ___ years old or younger

19

After _____ years from the date of issue, and individual health insurance policy can no longer be canceled by the insurer from his statements

2

Employees are required to work at least ____ hours per week to become eligible for a small employer health plan

20

And agents commission for the sale of a Medicare supplement policy in the first year following it's effective date cannot exceed ______ of the commission paid for selling or servicing the policy in the second year

200%

And employer may qualify for healthcare tax credits through SHOP marketplace if the employer has fewer than how many employees

25

If an insurer terminates an agent appointment, it must notify the superintendent within ____ days of the termination

30

Agents must complete ___ hours of continuing education biannually

15

The _____ is responsible for determining the appropriateness of a Medicare supplement policy for an applicant

Agent

The superintendent must give a minimum of how many days notice of a disciplinary hearing

10 days

The standard grace period for a life insurance policy sold in New York is

31 days

The superintendent serves a term of ___ years

4

As of January 1, 2014 and employer with up to 25 full-time equivalent with average annual wages of less than $50,000 maybe eligible for a tax credit of _______ of premiums paid by the employer

50%

And insurance company that has qualified and received a certificate of authority from the superintendent to sell insurance in this state is called

Admitted insurer

When does a family health Policies coverage for a newborn child begin

At the moment of birth

With a schedule dental policy, how are covered expenses paid

Benefits are limited to a specific maximum dollar amount per procedure

To be classified as a small employer in New York, and employer must employ

Between two and 50 employees

John the agent made public statements that falsely portrayed and ensure as insolvent. John would be found likely of

Defamation

Which of the following unfair trade practices involves an agent who makes public, malicious statements about an inch or's financial condition

Deformation

A form of medical health insurance covering the treatment and care of gum disease is it called

Dental expense insurance

A Common exclusion or limitation on a dental policy is

Endodontics

And example of an unfair claim settlement practice is

Failing to probably provide reasonable explanations for the denial of claims

A carrier for a small group health plan may refuse to renew the plan if the employer

Fails to pay the premium

In New York an agent may have her license revoked for which of the following acts

Failure to pay state income tax

The renewability provision for an individual long-term care insurance policy must be located on the policy forms

First page

Maria the insurance agent complete sale by collecting the required signatures on the application and obtaining the initial premium. Afterwords she deposited the check into her personal checking account. Maria has committed what crime

Fraud

An alien insurer

Is an insurer operating in the US but headquartered outside of the US

And insurance company may only pay commissions to a

Licensed agent appointed by the insurer

John the policy owner sells his life insurance policy to help pay for the cost of his terminal illness this transaction is called a

Life settlement

Life settlement brokers are permitted to do all of the following except

Make the first transaction up to 30 days before approved for a license

According to the federal fraud and false statements act, which of these is considered to be an intentional violation

Making false entries in a company's books

An agent secretary who solicit prospects on the telephone

Must be licensed as an agent

Benefits for a Medicare supplement policy

Must not duplicate Medicare benefits

During the examination of an insurer's books and records by the superintendent, the insurer

Must not impede the examination

Long-term care insurance provides

One or more diagnostic preventative therapeutic rehabilitative maintenance or personal care services in a setting other than an acute care unit of a hospital

Replacement regulation is designed to protect the interests of

Policyowners

Which of the following is not a circumstance to which a temporary agent license can be issued

Prospective agent who is waiting to take the state licensing exam

Twisting is

Replacing an insurance policy from one insurer. To another based on misrepresentation

An example of an endodontic treatment is a

Root canal

Security laws passed by Congress are enforced by which Federal agency?

Security and Exchange Commission (SEC)

All agents shall maintain full incorrect transaction of records of business done by then for a period of at least

Six years

A _______ company is owned by a shareholders

Stock

Long-term care policy sold in New York makes glued coverage related to

Substance addictions

An agent has recently died and leaves behind a spouse. In order for the agents insurance business to continue, the superintendent may issue to the agent spouse

Temporary insurance license

Under the affordable care act, how would a grandfathered health plan lose it grandfathered status

The insurer significantly raises coinsurance charges, deductibles, or copayment charges

An advertisement for an insurance product making teen

The insurers name

Under the affordable care act, a large employer that does not provide health insurance and always an employer Mandy penalty must pay an annual penalty, which is calculated by multiplying $2000 by

The number of full-time employees -30

Life insurance replacement can be best to find as

Transaction with a new life insurance policies purchased and an existing life insurance policy is surrendered

A life insurance policy becomes incontestable after it has been in force for

Two years

Insurance crimes which affect interstate commerce are prosecuted by the

US attorney general

The fair credit reporting act protects consumers

With guidelines regarding credit reporting and distribution

Which of these is not considered of federal punishment for unfair and deceptive insurance practices

community service

When an agent is replacing an existing ordinary life insurance policy, the agent must take all of the following actions except

obtain the beneficiary's signature

A licensee who is required to take continuing education must complete ____ hours of continuing education course work

15

The maximum prison sentence given under federal law for unfair and deceptive insurance practices is

15 years

An agent has days to report a felony conviction to the superintendent

30

Every agent licensed in New York must notify the superintendent within _____days of any change of address

30

As classified by the affordable care act a Silver Plant offers

70% actuarial level of coverage provided

If an insurer refuses to pay a clean, how many days must be insured wait to take legal action against the health insurance after submitting written proof of loss

60

The required grace period for an accident and health policy is ___ days for weekly Premium Policies

7

Group dental plans will frequently place a limit on annual benefits in order to minimize

Adverse selection

And insurance consultant is best to find as a

Agent who charges fees for advice

One roll of the superintendent is to

Enforce state insurance laws

Which of these may not be used in a health insurance advertisement

And insurance companies trademark instead of the companies actual name

A client told an intentional lie to ensure in order to receive a favorable premium. This is an example of

Fraud

Janice forgot to make her insurance premium payment by the due date. The specified period after the due date where she can still make payment and avoid discontinuance Of her coverage is called the

Grace period

All of the following are typically included in a life insurance policy illustration except

Names of the beneficiaries

When an agent is determining the suitability of an annuity for a client, which of these is not usually taken into consideration

Number of dependents

Prior to conducting an HIV test, the ensure is Required to

Obtain a written authorization from the proposed insured

Which of the following is not covered by New York Worker's Compensation loss

On the job injury that was both intentional and self-inflicted

An example of misrepresentation is

Providing incorrect misleading incomplete or materially untrue information in the license application

What is considered interstate travel under the federal fraud and false statements act

Puerto Rico

Which of the following situations were not potentially involve a prison sentence under federal law

Selling insurance with a nonresident license

Carol filled out a life insurance application and was given a policy illustration that showed future premiums being paid out of non-guaranteed values. This illustration must disclose that

She may need to resume premium payments depending on actual results

According to the affordable care act what metal tear is required to have an actuarial value of 70% with covered individuals paying 30% through deductibles co-pays and other cost sharing features

Silver plan

What does SHOP stand for in shop exchange

Small business health options program

Which of the following is not considered to be an act of fraud

Collecting a charge for insurance that is less than the charge applicable to that insurance

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 the client

Financial objectives

Which of the following provide affordable health insurance coverage to small employers

Healthy New York program

Which of the following is not information found in a life insurance buyers guide

How to take legal action against an insurance company

Which of these is not an unfair claims settlement Practice

Providing Claim payments to insured under the guidelines of the insurance contract

The promise of a discount and premium as an inducement to purchase insurance is known as

Rebating

A disability policy where the premiums or do monthly require a grace period of

10 days

Which of these individuals would require continuing education

Resident agent

According to the affordable care act, what is the maximum amount an individual can contribute to a flexible savings account

$2500

The free look period In New York for individual health insurance policies is

10 days

The free look. Provided and a life insurance policy is usually

10 days

After a disability policy has been in force ___ years it is considered incontestable

2

Written notice of a health insurance claim should be given to the insurer within ___ days after the occurrence of any loss covered by the policy

20

A licensed agent must report any administrative action taken against the licensee in another jurisdiction or by another agency department in New York within _____days of the final disposition

30

Greg had recently been terminated from his job that covered him for group life insurance. How long does he have to convert his coverage to an individual policy without needing to prove insurability

31 days

An individual who has a contract with an insurance company to represent it is called

Agent

If the cause of death appears to be accidental, and ensure may require

An autopsy

How are health plans classified according to the affordable care act

Bronze, Silver, Gold, Platinum

And example of replacement is

Canceling a term life policy to buy a whole life policy

How often must an insurance agents license in New York be renewed

Every two years

Which of the following is considered to be an act of misrepresentation

Falsifying the terms benefits advantages or conditions of an insurance policy

An insurer is required to offer which of the following to each long-term care applicant at the time of purchase

Inflation protection

And ensure would be committing unfair discrimination if coverage was denied based upon

Marital status

Suitability is best described as

Obtaining information from the applicant to determine whether an insurance or annuity product is appropriate

Upon meeting company requirements, a lapsed life insurance policy may be reinstated within___ years

3

Under Worker's Compensation laws, a permanent disability will be most likely caused by a

Loss of a foot

If an agent is advertising a life insurance policy the agent must disclose the

Name of the actual insurer

Long-term care policies sold in New York may not exclude coverage for

Senile dementia

New York disability benefits law provides cash payments to workers unable to work because of

Injury or illness that occurred on the job

Which of the following is required for an insurer to conduct business in the state

Certificate of authority

A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance?

Dental treatment is needed to repair an injury

When screening an applicant for HIV, the insurer

May require a blood test for HIV

An agent does not have a fiduciary responsibility to

New York guarantee association

Charles is an agent who is licensed in New York but resides in New Jersey. Charles is considered to be a

Non-resident agent

A life insurance agent is required to give a disclosure notice about information practices to an applicant or proposed insured

Prior to or at the time of signing the application

Insurance agent Kelly offers a prospect a $1000 Shopping card if an insurance policy is purchased through her. What is illegal activity is this an example of

Rebating

When a Medicare supplement insurance company is being replaced, who must sign the notice of replacement

The agent and the applicant

The right to examine period is _____ days for a long-term care policy sold in New York

30

If a new enrollee to a group health plan had previous credible coverage for up to _____ days prior to enrollment, the pre-existing condition provision will apply

63

A life settlement intermediary is a

Association which maintains a facility that displays offers and counter offers for purchasers or sellers of life settlement contracts

What happens if the insure discovers that the insured's age was accidentally missed stated on an application for an individual life insurance policy

Benefits will be calculated according to how much coverage the premium paid would've been purchased for the correct age

What enables applicants to compare different life insurance policies and helps him choose which party is best for their needs

Buyers guide

According to the affordable care act, any plan in existence prior to which day is considered a grandfathered plan

March 23, 2010

An agent who sells an individual life insurance policy in New York must deliver to the policyowner

Policy summary and buyers guide

An agent who sells an individual life insurance policy in New York must deliver to the policyowner a

Policy summary and buyers guide

Jermaine's individual health policy had recently lapsed. Upon reinstatement, he must wait _____ days before coverage for illness is Available

10

What is the minimum benefit. That must be offered by a long-term care policy

12 months

Which of the following is not an eligible dependent on an accident and health policy

27 year old married child

Proof of loss on a health insurance claim must be submitted to ensure within ___ days after the insured's date of loss

90

Which of the following statements regarding the fair credit reporting act is true

And insured does not need to discuss any credit history inconsistencies with the applicant

Which of the following is required for the renewal of an agents insurance license

Continuing education

Proceeds of the life settlement contract could be subject to the claims of

Creditors

All of these are responsibilities of the superintendent except

Endorsing insurers

John has a criminal record in which he was convicted of a felony that involved dishonesty. Under Federal law, how would John be able to engage in insurance transactions?

Given written consent by the state insurance regulatory agency

Under the affordable care act which of these plans is designed to provide coverage that is actually equivalent to 80% of the full actuarial value of the benefits provided under the plan

Gold

The amount received for a Life insurance policy in a life settlement is _____ than the death benefit

Less

A life settlement broker is someone who is

License to negotiate a life settlement contract

An agent who is licensed in New York but resident in another state is called a

Non-resident agent

When replacing a life insurance policy, an agent must provide the applicant with a

Notice regarding replacement

What is the required action to be taken by a New York license see before operating under an assumed business name

Notify superintendent

An example of misrepresentation is

Providing incorrect miss leading incomplete or materially untrue information in the license application

An agent has committed and insurance crime that violates US code 1033. Who would be responsible for the prosecution of this crime

US Attorney General

Failing to promptly provide reasonable explanation for the denial of claims is considered to be a

Unfair claim settlement practice

According to the federal fried and false statements regulation, what is required for a prohibited person to transact insurance business in the state

Written consent from the state insurance regulatory agency

In most dental plans, a deductible typically is not applied to

preventative and diagnostic services


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