Chapter 14

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In Colorado, for health policies offering coverage on an expense-incurred basis, how must hospice and home health care coverage be provided?

Policies must offer the opportunity to buy coverage for medically necessary home health and hospice care but the insurer can establish eligibility requirements for care benefits

Group health plans in Colorado cannot exclude maternity and childbirth coverage unless which of the following occurs?

All group health policies must insure against normal pregnancy and childbirth expenses or cover maternity care in the same manner as any other condition.

In Colorado, all small employer insurers are required to actively market health plans to which of the following?

Eligible small employers in the state

At least how many CE credit hours must be in Ethics?

3

If a producer is the subject of criminal prosecution in any jurisdiction, the producer must report to the Commissioner after the initial pretrial hearing date within what time period?

30 days

A producer must complete a _____ credit hour training course in order to sell annuity products.

4

In Colorado, how long must an insurer maintain files containing the advertisements it has used?

5 Years

Continuation of group health coverage applies to employees who have had continuous coverage under the policy or a similar plan for what period of time?

6 months

In Colorado, how long can group health plans exclude or limit preexisting conditions?

6 months

How many credit hours of continuing education must a producer complete every renewal period?

A producer must complete 24 credit hours of continuing education every renewal period with at least 3 hours in ethics and 18 hours in the licensed line of business.

The Commissioner of Insurance is the head of the Division of Insurance and which of the following is correct?

Appointed by the Governor and confirmed by the State Senate

Each applicant for an insurance license must provide evidence to the Commissioner of completion of the following:

At least 50 hours of an approved course including 3 hours of ethics

As it relates to life insurance, when must insurable interest exist?

At the time of policy issue

All insurers must file financial statements by what date and how often?

By March 1 of every year

Procuring insurance on the life or property of one's own self, one's spouse, or one's employer refers to which of the following?

Controlled Business

In Colorado, how is diabetes covered on health plans covering hospital, surgical, or medical expenses?

Diabetes must be covered, including equipment, supplies, and when administered by a professional diabetes expert, outpatient self-management training and education

In Colorado, which of the following benefits are included in the wellness and prevention program?

Disease Management

The Commissioner may assign penalties in addition to those authorized by law, including:

Fine the producer up to $3,000 for the violation

When must the Buyer's Guide and disclosure document be delivered to an applicant for the purchase of an annuity, if the producer meets with the applicant in person?

Immediately

What is the penalty for violating a cease and desist order?

License suspension or revocation, or both fine and action against the licensee

If a producer violated a LTC regulation, the producer would be monetarily fined up to __________.

$10,000

The maximum penalty for a knowing violation of Unfair Trade Practices law is:

$750,000

In Colorado, the Free Look period for life policies is set at how many days?

15

How many hours of continuing education are required to maintain an insurance license in Colorado?

24 hours every 2 years

In Colorado, if death is due to suicide, benefits are payable after the policy has been in force for how long?

1 year

Which of the following defines an eligible employee for a small group employer?

An employee whose regular work week is at least 30 hours

Who among the following doing business in Colorado is required to prepare, implement, and maintain an insurance anti-fraud plan?

Every licensed insurer

Which of the following is true of unauthorized entities?

Every person acting as an advisor, counselor, or analyst must report every unauthorized policy or contract to the Commissioner

Insurance Commissioner's duties

Examining Insurers Conducting investigations Issuing Certificates of Authority

Regulations governing replacement of life insurance policies would apply to which of the following policy types?

Term life

An insurer must pay or deny a health claim as follows:

Within 30 days for a clean claim if submitted electronically


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