Laws and rules
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
