NC Health Insurance - North Carolina Regulations for Health

In North Carolina, statutes, rules, and regulations that govern insurance companies, insurance transactions, and insurance agents are known as the A. Insurance Code B. State Constitution C. State Administrative Rules D. Code of Conduct

A. Insurance Code In North Carolina, the legislature has made and implemented state statutes which, collectively, are known as the Insurance Code

After appointing an agent, how long does an insurer have to file with the Commissioner the form detailing the agent's name, address, and other needed information? A. 15 days B. 30 days C. 45 days D. 60 days

B. 30 days Insurers have 30 days to file, in a form prescribed by the Commissioner, the names, addresses, and other information required by the Commissioner for its newly appointed agents.

What is a license suspension period for a second offense of violating state rules regarding records or reports A. Up to 6 months B. Up to 1 year C. Up to 3 years D. Permanently

B. Up to 1 year For the first offense, a person may have his or her license suspended or revoked for between 1 and 6 months. For the second offense, a license may be suspended for 1 year.

The required privacy disclosure notice must be provided by the insurer to current policyholders at least once in any period of A. 3 months B. 6 months C. 12 months D. 24 months

C. 12 months In the case of a policy holder, the notice required must be provided at least once in any period of 12 consecutive months during which the policy is in effect.

The commissioner report any violations of insurance laws and regulations to the A. Guaranty Association B. Governor C. NAIC D. Attorney General

D. Attorney General The Insurance Commissioner is required to repot any violation of insurance law to the Attorney

An insurance company is domiciled in Montana and transacts insurance in Wyoming. Which term best describes the insurer's classification in Wyoming? A. Alien B. Domestic C. Unauthorized D. Foreign

D. Foreign A foreign insurer is domiciled in one state and transacts insurance in another. A domestic insurer transacts insurance in the domicile state (in this case, Montana). An alien insurer is domiciled in one country and transacts insurance in another.

Which one of the following is an eligibility requirement for social security disability income benefits? A. Currently employed status B. Fully insured status C. Experiencing at least one year of disability D. Being at least 50 years of age

B. Fully insured status -only available if the worker is fully insured( 5 month waiting period)

An agent in Ohio wants to become an agent in North Carolina. The Commissioner will waive certain examination requirements, provided that Ohio would waive these same requirements if a North Carolina agent sought licensure in Ohio. What term does this describe? A. Rebating B. Indemnity C. Reciprocity D. Residency

C. Reciprocity Reciprocity occurs when the state in which the person resides accords the same privilege to residents of North Carolina

Under which of the following circumstances would a pretext interview be permissible? A. a third party is conducting the interview B. the insurer needs to obtain confidential info C. the insurer suspects criminal activity and fraud D. the applicant for insurance fails to provide pertinent info to underwriters

C. the insurer suspects criminal activity and fraud A pretext interview may be used to obtain information from a person for the purpose of investigating a claim where, based upon specific information available for review by the Commissioner, there is a reasonable basis for suspecting criminal activity, fraud, material misrepresentation, or material nondisclosure in connection with the claim.

Under the L&H Guaranty Association, the maximum benefit one contract holder may receive in benefits, regardless of the number of contracts held is A. $5,000,000 B. $100,000 C. $300,000 D. $1,000,000

A. $5,000,000 With respect to any one contract holder covered by unallocated annuity contract $5,000,000 in benefits, regardless of the number of contracts held by that contract holder

How is the Commissioner of Insurance selected for the office? A. Elected in a general election for a 4-year term B. Elected in a general election for a 2-year term C. Appointed by the Governor for a 4-year term D. Appointed by the Governor for a 2-year term

A. Elected in a general election for a 4-year term The Commissioner of Insurance is the chief officer of the Insurance Department and is elected by the people of the state to serve a 4-year term

As it pertains to group health insurance, COBRA stipulates that A. Group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense B. Retiring employees must be allowed to convert their group coverage to individual policies C. Terminated employees must be allowed to convert their group coverage to individual policies D. Group coverage must be extended for terminated employees up to a certain period of time at the former employer's expense

A. Group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense COBRA required employers with 20 or more employees to continue group medical insurance for terminated workers and dependents for up to 18 months to 36 months. The employee can be required to pay up to 102% of the coverage's premium

Which of the following is true regarding coverage for a disabled child that has reached the limiting age? A. The child must be allowed to remain a dependent upon his or her parent's policy B. The insurer may not require proof of the dependent child's incapacity C. The insurer may require proof of the dependent child's incapacity every 6 months. D. The child is no longer eligible to be a dependent

A. The child must be allowed to remain a dependent upon his or her parent's policy Life and heath insurance policies may not be allow for coverage of a dependent child to end when the child reaches the limiting age state in the policy if the child is incapable of self-sustaining employment because of a handicap and depends on the policyholder for support and maintenance. The insurer may require proof of the dependent child's incapacity as often as necessary, but not more frequently than once each year after the child reaches the limiting age.

Agents who persuade insureds to cancel a policy in favor of another one when it might not be in the insured's best interest are guilty of A. Misrepresentation. B. Rebating. C. Twisting. D. Defamation.

C. Twisting. Twisting is a misrepresentation that persuades an insured or a policyowner, to his or her detriment, to cancel, lapse, or switch policies.

the commissioner has the power to examine and investigate the affairs of every insurance institution or agent doing business in North Carolina to determine which of the following? A. If the insurer stays active and conducts certain percent of business annually B. If the insurer has engaged in solicitations that include advertising and illustrations C. If the insureds have engaged in any conduct in violation of the General Statutes D. If the insurer remains solvent and conducts business in compliance with state laws and regulations

D. If the insurer remains solvent and conducts business in compliance with state laws and regulations The Commissioner has the power to examine and investigate the affairs of every insurance institution or agent doing business in North Carolina to determine if the insurer remains solvent and conducts business in compliance with state laws and regulations