Chapter 10
What is the required minimum percentage of employee participation for a noncontributory group health insurance plan according to Florida law?
0%
What percentage of eligible persons must a policy cover in a noncontributory group?
100%
A person insured under a health policy is required to give the insurance company a Notice of Claim within how many days after a covered loss?
20
Eligibility for coverage under the Florida healthy kids corporation requires a family to be within _ of the federal poverty level
200%
Within how many days after policy delivery can a Medicare supplement policy be returned for a 100% premium refund?
30
The free-look period for all qualified long-term care policies sold in Florida is _ days.
30 days
A __ day notice to the policyholder is required for any health insurer that wishes to cancel a health insurance policy
45
The waiting period for a pre-existing condition under a Medicare supplement policy may not go beyond
6 months
What do families pay that are covered by the Florida Healthy Kids Corporation?
A portion of the premium
Which of the following is considered to be misrepresentation?
An agent guaranteeing a policy's dividends
Which of the following is the best description of insurer?
Any person, corporation, association, or society that writes insurance contracts
According to Florida law, when must an agent deliver the Outline of Coverage to a Medicare Supplement applicant?
At the time of application
Which of the following acts is an agent not authorized to do on behalf of the insurer?
Authorize claim payment
Can be defined as "using the contract values of an existing policy to purchase a new policy with an existing insurer"
Churning
Which of the following areas of state registration is not protected by the savings clause in ERISA?
Commerce
An applicant who pays the initial premium at the time of application is typically given a(n)
Conditional receipt
All of the following are eligibility requirements for an association group expect
Contributory plans require a minimum of 25 participants
In Florida, which agency is responsible for the rehabilitation or liquidation of insurers?
Department of Financial Services (DFS)
Any violations of the Florida financial institutions code may be investigated by the
Department of financial services (DFS)
An insurance company incorporated under the laws of the state in which its home office is located is called an _ company.
Domestic
The department may request all of these during licensing application process expect
Drug test
S takes out a health insurance policy which contains a provision that states that the agent does not have the authority to change the policy or waive any of its provisions. Which health policy provision is this?
Entire Contract
Which organization was established to provide funds to protect an insured in the event of an insurers insolvency?
Florida Life and Health Insurance Guaranty Association
The insurance guaranty fund association is
Funded by admitted insurance companies through assessments
What would be an accurate definition of controlled business?
Insurance business that is written on the agent's own life, property, or interests
Under Florida law, which of the following provisions is NOT required in a Medicare Supplement policy?
Limitation on pre-existing conditions for up to 12 months
Asset protection can be provided by a long-term care partnership policy if the policyholder qualifies for
Medicaid
Convincing a prospective insured to buy an insurance policy based on exaggerations is called
Misrepresentation
Which Unfair Trade Practice involves an agent suggesting that an insurance policy is like a share of stock?
Misrepresentation
Which Unfair Trade Practice involves an agent telling a prospective client that a policy's dividends are guaranteed?
Misrepresentation
Which Unfair Trade Practice involves making a false statement on an insurance application in order to receive money from an insurer?
Misrepresentation
Which of the following is not an unfair claim settlement practice?
Needing written documentation of claim details
Which entity approves the insurance policy forms used in Florida?
Office of Insurance Regulation (OIR)
An example of sliding would be
charging for an additional product without the applicant's consent
A long term care lapse notice must be delivered to both the applicant and
secondary addressee
Association Plans that are designed to provide health benefits to their members are regulated by the state because
they are insured by an authorized insurer
An example of an unfair claims settlement practice is
turning down a claim without providing the basis of denial
An agent who makes misleading statements that lead to the termination of an existing insurance policy so that a new policy with another insurer can be taken out has committed
twisting
J is an agent who has induced an insured through misrepresentation to surrender an existing insurance policy. What is J guilty of?
twisting
An agent's license can be suspended or revoked by
writing primarily controlled business
What type of insurance company is domiciled in England but conducts business in Florida?
alien
An example of an unfair trade practice is
an agent making a material misrepresentation to the insured
A stock insurance company
is owned exclusively by its shareholders
Of a policyowner does not pay the premium by the due date the
Policyowner can make the premium payment during the grace period
What is the purpose of the insurance guaranty fund association?
Protects policyowners against insolvent insurance companies
Which of these is not a legal entity for selling life insurance in Florida?
Risk management advisers
Which of the following provisions is not required in HMO contracts/certificates?
Seven-day grace period
Which of the following is not considered rebating?
Sharing commission with an agent licensed in the same line of business
What is required in the Florida employee health care access act?
Small group benefit plans are to be issued on a "guarantee-issue" basis
A mutual insurance company and a stock insurance company have one main difference between them. What is this major contrast?
Stock company is owned by its shareholders. Mutual company is owned by its policyholders.
An agent selling Medicare Supplement policies must provide every applicant with a(n)
Suitability form
Which of the following must be included in a Medicare supplement policy's outline of coverage?
The policy's limitations And exceptions
Which of the following is considered an accurate statement of an unfair trade practice?
Twisting involves an agent using misrepresentation to convince a policyowner to cancel their current policy so that they can purchase a new life insurance policy with another company
One definition of replacement is "the act of replacing an existing insurance policy with another". Replacement is
closely regulated and requires full disclosure
As a condition for a loan, a bank requires the borrower to purchase credit insurance from a specific company. What is the bank guilty of?
coercion
In Florida, which of the following is considered an unfair trade practice?
coercion
J is an agent who recently told a claimant that his rights might be impaired if he does not complete a release form within a specified time. What could this agent be found guilty of?
coercion
If an agent combines premiums collected with their personal funds they have engaged in
commingling
An example of an unfair claims practice would be
failing to effectuate prompt, fair, and equitable settlements of a claim
The act of an insurance company publishing misleading information about its policy's provisions is called
false advertising
In Florida, an insurer licensed to conduct business in Florida, but domiciled in New Jersey, is called a(n)
foreign company
Defamation occurs when an agent makes a false statement intended to
malign another insurer
K made a fraudulent statement on her health insurance policy application. In the event of a claim on this policy, the insurance company is required to pay
nothing
In Florida, agents are allowed to engage in rebating if
offered to all insureds in the same actuarial class
An example of rebating would be
offering a client something of value not stated in the contract in exchange for their business
An example of unfair discrimination would be
offering different terms of coverage for different policyowners having the same risk classification