Law Texas Life and Health

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How long is a newborn covered without notification to the insurer?

A newborn is not covered without notification to the insurer

An insured in a group policy has misstated his age on the insurance application. As a result the insurer will most likely

Adjust the premium.

Which of the following is the closest term to an authorized insurer?

Admitted

Anyone who violates the Insurance Code of Texas may be fined up to

$25,000

In all health care plans under the Affordable Care Act (ACA), how many essential benefit categories are there?

10

The Commissioner of Insurance issues a Cease and Desist Order and immediately receives a request for the changes to be reviewed in a hearing. Within what number of days must the hearing be held?

10

An insurer must acknowledge receipt of a Notice of Claim within how many days?

15

Within how many days must an insured notify the insurer of a child's birth and pay any required fees?

31 days

What percentage of continuing education hours must be in a classroom setting?

50%

If a policyowner surrenders his life insurance policy that has been in force for 5 years within 60 days after the premium due date, what will the insurer be required to pay?

A cash surrender value

In Texas, the Commissioner of Insurance is

Appointed by the Governor.

All of the following would be considered except?

An agent misrepresents policy benefits to convince a policyowner to replace policies.

The insurers are allowed to disclose the HIV-related test result to all of the following EXCEPT

Another insurer.

All of the following information must be disclosed to the viator prior to the execution of a viatical settlement contract EXCEPT

Availability of stranger-originated life insurance (STOLI).

To become elibible for tax credits under the ACA, individuals must have income that is what percent of the Federal Poverty Level?

Between 100% and 400%

A banker is ready to close on a customer's loan. The bank is prepared to offer the loan but only if the customer purchases a life insurance policy from the bank in the amount of the loan. This is an example of

Coercion

Which of the following is a specific dollar amount or a percentage of the cost of care that must be paid by an HMO member?

Copayment

Which of the following is the specified dollar amount or a percentage of the cost of care that must be paid by the member?

Copayment

Which of the following is used to compare the cost of one life insurance policy against another in order to guide prospective purchasers to policies that are competitively priced?

Cost comparison methods

The Commissioner has full power and authority to do all of the following EXCEPT

Draft insurance laws.

What is the minimum renewability standard for long-term care policies issued in this state?

Guaranteed renewable.

The usage of words or symbols that are similar to what entity is prohibited in life insurance advertisements?

Federal government

Which of the following must be included in all life insurance advertisements?

Identity of the actual insurer

Which of the following is NOT considered a misrepresentation as it pertains to unfair trade practices?

Making comparisons as it pertains to different policies

An insured purchased an insurance policy 5 years ago. Last year, she received a dividend check from the insurance company that was not taxable. This year, she did not receive a check from the insurer. From what type of insurer did the insured purchase from the policy?

Mutual

On a participating insurance policy issued by a mutual insurance company, dividends paid to policyholders are

Not taxable since the IRS treats them as a return of portion of the premium paid.

When a policy must the HMO insurer provide information about the HMO's name, address, and toll-free number?

On the face page

All of the following are to be included in the application for a certificate of authority to act as an HMO EXCEPT

Records of previous insurers.

Which of the following would be required to obtain a Certificate of Authority?

The HMO

Who do agents represent?

The insurance company

An individual applies for a life policy. Two years ago he suffered a head injury from an accident, so he cannot remember parts of his past, but is otherwise competent. He has also been hospitalized for drug abuse, but does not remember this when applying for insurance. The insurer issues a policy and learns of his history one year later. What will probably happen?

The policy will not be affected.

An agent holds an insurance license in the state of Kansas and would like to transact insurance in Texas. The agent became licensed before written examinations were required. Therefore, the agent has not actually passed any kind of examination. Which of the following is true?

The written examination requirement will be waived.

Which of the following is true regarding Medicare supplement policies?

They must be guaranteed renewable

Is it illegal for an insurance company to advertise that it is the leader of the financial industry and therefore pays the most claims each year?

Yes; advertisements must not mislead the public in terms of financial standing.

What is the major difference between a stock company and a mutual company?

Ownership

A participating insurance policy may do which of the following?

Pay dividends to the policyowner

Which of the following provisions states the insurer's right to change premium amounts?

Premium Provision

If a person is compensated for a testimonial in an advertisement, which of the following statements should be included in the advertisement?

Paid endorsement


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