SC Laws and Rules
A life policy loan in South Carolina cannot charge a fixed rate of interest higher than 7% 8% 9% 10%
8%
Proof of loss on a health insurance claim must be submitted to an insurer within _______ days after the insured's date of loss. 30 60 90 120
90
Which of the following is the BEST example of insurance fraud? Purposely withholding material information from an insurer Suggesting an insurance policy is like a share of stock Telling a prospective client that a policy's dividends are guaranteed A deliberate lie by an insured to the insurer to obtain a lower premium
A deliberate lie by an insured to the insurer to obtain a lower premium
Tia the producer is recommending to a prospect that an existing life insurance policy be replaced with a new one from her insurer. If this transaction moves forward, which of the following does NOT need to be provided to the prospect at or before the policy is delivered? Notice Regarding Replacement Replacement insurer's financial statements Buyer's Guide Policy Statement
Replacement insurer's financial
Which of these individuals would require continuing education? Claims administrator Resident producer Nonresident producer Head underwriter
Resident producer
According the the affordable care act, What metal tier is required to have an actuarial value of 70% with covered individuals paying 30% through deductibles, co-pays, and other cost sharing features? Bronze plan Silver plan Gold plan Platinum plan
Silver plan
Which of the following actions is REQUIRED by a producer who is replacing an exciting life insurance policy? Keep replacement records on file for at least 10 years Notify the existing insurer of the proposed replacement Submit tot he replacing insurer a list of the policies to be replaced offer the insurer a 60-day free-look period
Submit tot he replacing insurer a list of the policies to be replaced
Under which circumstance may a commission be shared between two producers? Only if they are nonresident producers Never When they are both licensed in any line of business When they are both licensed in the same line of business
When they are both licensed in the same line of business
According to the Affordable Care Act, what is the maximum amount an individual can contribute to a Flexible Savings Account? $500 $1,500 $2,500 $3,500
$2,500
If a Medicare Supplement policy replaces another that had been in effect for at least 6 months, the replacing policy may impose which of the following time exclusions for pre-existing conditions? 0 months 63 days 6 months 12 months
0 months
The free look period in South Carolina for individual health insurance policies is _______ days. 5 10 15 20
10
The typical free look period for life insurance policies sold in South Carolina is ____days. 5 10 15 20
10
Within _______ days after policy delivery, an individual life insurance policy can be returned for a 100% premium refund. 5 10 15 20
10
The free look period provided in a life insurance policy is usually 10 days 31 days 45 days 60 days
10 days
An eligible employee can be excluded from group health coverage for up to _____months if he/she is considered a "late enrollee" 6 12 18 24
18
A temporary license is valid for a maximum of _______days 30 60 90 180
180
A temporary producer license issued in South Carolina is valid for up to 90 days 180 days 270 days 365 days
180 days
After _______ year(s) from date of issue, a policy can no longer be cancelled by the insurer for misstatements (except for fraud). 1 2 3 4
2
After a disability policy has been in force for _________ year (s), it is considered incontestable. 1 2 3 4
2
South Carolina requires that a licensee completes ___ hours of continuing education on the subject of ethics every reporting period 1 2 3 4
3
A life insurance REPLACEMENT transaction gives the policy owner the right to return the policy for a 100% refund within ______days of policy delivery. 7 10 20 30
30
Prior to a disciplinary hearing, the Director is required to give a LEAST _________ days notice. 20 30 40 50
30
In South Carolina, the grace period for a life insurance policy is ______ days 14 30 31 45
31
All producers shall maintain full and correct transaction records of the business done by them for a period of AT LEAST 1 year 3 years 5 years 7 years
5 years
An insurer may exclude preexisting conditions on a Medicare Supplement policy for _____ months 6 8 10 12
6
An insurer may legally defer payment of cash surrender value for up to 6 months 9 months 12 months 15 months
6 months
If a health insurance claim is not promptly paid, legal action may be taken against the insurer after 30 days from the date proof of loss is furnished 60 days from the date proof of loss is furnished 90 days from the date proof of loss is furnished 3 years the date proof of loss is furnished
60 days from the date proof of loss is furnished
If a new enrollee to a group health plan has had previous credible coverage for up to _______ days prior to enrollment, the Pre-existing Condition Provision will apply. 43 53 63 73
63
As classified by Affordable Care Act (ACA), a Silver plan offers 60% actuarial level of coverage provided 70% actuarial level of coverage provided 80% actuarial level of coverage provided 90% actuarial level of coverage provided
70% actuarial level of coverage provided
Which of the following statements regarding the Fair Credit Reporting Act is TRUE? An insurer does NOT need to notify the applicant if an application is denied An insurer does NOT need to discuss an credit history inconsistencies with the applicant An insurer does NOT need to inform the applicant about the scope of an investigation An insurer does NOT need to inform the applicant that an investigation is being conducted
An insurer does NOT need to discuss an credit history inconsistencies with the applicant
Which of the following is a valid reason for an insurer to refuse the insurance of an insurance policy? Applicant's health condition Applicant's religion Applicant's race Applicant's gender
Applicant's health condition
What are the levels of coverage as defined by the Affordable Care Act? 1st, 2nd, 3rd, and 4th Bronze, Silver, Gold, and Platinum Substandard, Standard, Preferred and Premium PPO, HMO, POS, and MET
Bronze, Silver, Gold, and Platinum
Which of the following is required for an insurer to conduct business in this state? Certificate of admission Certificate of domestication certificate of authenticity Certificate of authority
Certificate of authority
Which of the following does restorative dental treatment cover? X-rays Cleanings Dentures Crowns
Crowns
A form of medical health insurance coverage that treatment and care of gum disease is called Medicaid Mejor Medical Franchise health policy Dental expense insurance
Dental expense insurance
A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance? After the annual limit of dental policy's coverage is reached Dental treatment is needed to repair an injury Cosmetic dental treatment is performed If treatment is performed at a in-network provider
Dental treatment is needed to repair an injury
When licensee's address has changed, who must be notified of this change? The licensee's client Beneficiaries Department of Insurance Chamber of Commerce
Department of Insurance
A certificate of authority is issued by the Department of insurance NAIC Governor U. S. Attorney General
Department of insurance
A common exclusion or elimination on dental policy is Endodontics Tooth extractions Flouride treatments X-rays
Endodontics
Which of the following is NOT a duty of the Director? Establish rates for the insurer Enforce insurance laws and regulations Oversee the licensing of producers and insurers Administer oaths and affirmations
Establish rates for the insurer
How often does the Director examine each domestic insurance company? Every year Every 3 years Every 5 years Every 7 years
Every 5 years
Which of these is NOT subject to false advertising Gifts Brochures Billboards Letters
Gifts
All of the following are considered an example of illegal inducement EXCEPT Giving a gift to a client with a value of $75 Giving a gift of less that $25 in value to a client Offering special terms of a stock purchase to a client Offering employment to a client
Giving a gift of less that $25 in value to a client
During the course of an Insurance transaction, which of the following is NOT a duty of the producer? Highlight the protection guaranteed by the Guaranty Association Be fair and honest Do not misrepresent the provision of the policy Submit premiums collected to the insurers in a timely manner
Highlight the protection guaranteed by the Guaranty Association
An insurer is REQUIRED to offer which of the following to each long-term care applicant at the time of purchase? Lifetime level premium Conditional renewability Inflation protection Deflation protection
Inflation protection
Victoria's producer license was initially issued on July, 18, 2017. Her birthday is June 9, 1982. Her license will renew July 31, 2018 June 30, 2018 June 30, 2019 July 31, 2019
June 30, 2019
According to the Affordable Care Act, any plan in existence prior to which date is considered a grandfathered plan? March 23, 2010 March 23, 2011 March 23, 2012 March 23, 2013
March 23, 2010
All of the following are typically included in a life insurance policy illustration EXCEPT Premium of the policy Names of the beneficiaries Interest charged for policy loans Cash surrender value in 20 years
Names of the beneficiaries
Which of the following actions by producer would NOT result in a license suspension or revocation? Producing an insufficient amount of new premium Found guilty of misrepresentation in obtaining the license Misrepresenting the terms of an existing insurance contract Misappropriating an insured's premium payment
Producing an insufficient amount of new premium
The branch of Denistry which deals with the replacement of missing parts is called Endodontics Periodontics orthodontics Prosthodontics
Prosthodontics
What is the purpose of the South Carolina Life and Health Insurance Guaranty Association Approves policy forms Enforces South Carolina's insurance regulations Underwrites high-risks insurance applicants Provide policy owner protection if an insurer becomes insolvent
Provide policy owner protection if an insurer becomes insolvent
Which of the following is NOT an Unfair Claim Settlement Practice? Failing to acknowledge and act promptly with respect to insurance claims Compelling insureds to initiate lawsuits by offering less on an insurance claim Failing to accept or deny claims within reasonable time after proof of loss is submitted Providing claim payments to insureds according to the policy's coverage guidelines
Providing claim payments to insureds according to the policy's coverage guidelines
Under which circumstance may a commission be shared between two producers? Only if they are nonresident producers Never When they are both licensed in any line of business When they are both licensed in the same line of business
When they are both licensed in the same line of business
A licensee MUST notify the Department of a legal name change upon the licensee's next license renewal Upon the licensee's next insurance transaction Upon changing his or her legal name Notification is not required
Upon changing his or her legal name
A licensed producer MUST be ________ by an insurer to be eligible for soliciting insurance contacts. admitted approved authorized appointed
appointed
If the cause of death appears to be accidental, an insurer may require a(n) police report background check hospital check autopsy
autopsy
A domestic insurance company in South Carolina MUST be former under the laws of South Carolina own real estate in South Carolina Write insurance on risks located only in South Carolina Honor the charter of the National Association of Insurance Commissioners (NAIC)
be former under the laws of South Carolina
AN indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called a managed plan stop loss coinsurance a deductible
coinsurance
One role of the Director is to set sales quotas enforce state insurance laws arbitrate claims establish new insurance laws
enforce state insurance laws
An example of an Unfair Claim Settlement Practice is making it mandatory that proof of loss be provided for each claim failing to provide a reasonable basis for the denial of a claim upon request requiring a time limit for submitting a claim paying a claim in a timely matter
failing to provide a reasonable basis for the denial of a claim upon request
A carrier for a small group health plan may refuse to renew the plan if the employer exceeds a specified number of claims fails to generate minimum revenues fails below a minimum AM Best rating fails to pay the premium
fails to pay the premium
Twisting is BEST defined as making a false written or oral statement for the purpose of replacing an existing policy to the detriment of the insured offering something of value not stated in the insurance contract as an inducement to purchase an insurance policy unfairly discriminating against a person in any way on an insurance-related matter making any public statement or advertisement that contains false or malicious information about an insurance company.
making a false written or oral statement for the purpose of replacing an existing policy to the detriment of the insured
When the Director is examining an insurer's books and records, the insurer is NOT required to assist in the examination can determine which records to make available has the authority to stop the examination at any time. must NOT impede an examination
must NOT impede an examination
A Medicare Supplement policy can be cancelled by the insurer for excessive filling claims poor health smoking nonpayment
nonpayment
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 income if an insured is unable to work for a period of over six months coverage for excess charges not paid under Medicare a lump sum payment upon first diagnosis of cancer, heart attach, or stoke
one or more diagnostic, preventative, therapeutic, rehabilitative, maintenance, or personal care services in a setting other than an acute care unit of a hospital
In order to conduct insurance transactions in South Carolina, a (n) ___________ MUST be appointed. administrator consultant Producer adjuster
producer
In order to conduct insurance transactions in South Carolina, a(n) ___________ MUST be appointed. administer consultant producer adjuster
producer
An insurance producer is BEST described as someone who sells, solicits, or negotiates insurance contracts for compensation on behalf of a client sells, solicits, or negotiates insurance contracts for compensation on behalf of a insurer offers to examine any policy (for free) for the purpose of giving advise or recommendations investigates insurance claims to determine the extent of the insurers liability
sells, solicits, or negotiates insurance contracts for compensation on behalf of a insurer
If a producer had broken a state insurance statute, the Director may issue a cease and desist order. This order demands that the producer be incarcerated stop engaging in the act pay a fine have his/her appointment terminated
stop engaging in the act
Long-term care insurance policies sold in South Carolina are NOT required to cover substance addiction dementia Alzheimer's disease custodial care
substance addiction
Long-term care policies sold in South Carolina may exclude coverage related to injuries substance addiction dementia Alzheimer's disease
substance addiction
A producer does NOT have a fiduciary responsibility to applicants insureds insurers the South Carolina Guaranty Association
the South Carolina Guaranty Association
All long-term care policies sold in South Carolina are REQUIRED to pay the SAME daily benefit amount for "at home" care as compared to the daily amount paid for disability coverage the daily amount paid for physical therapy the daily amount paid for muring home care the daily amount paid for respite care
the daily amount paid for muring home care
A licenses can have his/her license denied or revoke by the Director if the licensee miscalculates a policy's premium the licensee does not meet his/her sales quota the licensee accidentally misinterprets a policy's provision the licensee has committed insurance-related fraud or dishonesty
the licensee has committed insurance-related fraud or dishonesty
The Fair Credit Reporting Act protects consumers from insolvent insurers by recommending insurers with good AM Best ratings with guidelines regarding credit reporting and distribution by providing consumers credit counseling
with guidelines regarding credit reporting and distribution
When must a claim on a life insurance policy be paid after proof of loss has been received by the insurer? immediately within 30 days Within 60 days within 90 days
within 30 days