PA Insurance License Prep
An insured may return their accident and health policy within ___ days of policy delivery: a. 10 b. 15 c. 20 d. 25
a. 10 days
Every PA insurer, upon receiving notification of a claim, must acknowledge receipt of the notice within: a. 10 days b. 15 days c. 30 days d. 45 days
a. 10 days
Which of the following is NOT an eligible dependent on an Accident and Health policy? a. 27 year old married child b. 25 year old married child c. 19 year old full time student d. Unmarried disabled child
a. 27 year old married child
What is the required renewability status of all Medicare supplement policies? a. Guaranteed renewable b. Optionally renewable c. Nonrenewable d. Conditionally renewable
a. Guaranteed renewable
According to the Affordable Care Act, any plan in existence prior to which date is considered a grandfathered plan? a. March 23, 2010 b. March 23, 2011 c. March 23, 2012 d. March 23, 2013
a. March 23, 2010
What is the required action to be taken by a PA licensee before operating under an assumed business name? a. Notify Commissioner b. Notify Governor c. Notify the insurer where employed d. Obtain a permit
a. Notify Commissioner
Which of the following is an example of a producer's fiduciary duty? a. Recording receipt and remittance of premiums due to the insurance company b. Determine the rate classification of the insured c. Reviewing policy summary of benefits d. Witnessing applicant's signature
a. Recording receipt and remittance of premiums due to the insurance company
Health Insurance advertisements that mention statistical information are required by PA law to: a. accurately convey all pertinent facts b. provide where the data was obtained c. explain how the statistics were calculated d. display which third-party verified the data
a. accurately convey all pertinent facts
A domestic insurance company in PA MUST: a. be formed under PA insurance laws b. own real estate in PA c. write insurance on risks located only in PA d. honor the charter of the National Association of Insurance Commissioners (NAIC)
a. be formed under PA insurance laws
Violations of U.S. Code Title 18 section 1033 may result in: a. fine and/or imprisonment b. Termination of appointment c. Revocation of License d. Cease and desist order
a. fine and/or imprisonment
In the state of PA, a licensed producer: a. represents the insurer b. may modify insurance contracts c. approves insurance contracts d. represents the insured
a. represents the insurer
The act of using misrepresentation to induce an insured person to terminate an existing policy and purchase a new policy is referred to as: a. twisting b. subrogation c. a life settlement d. coercion
a. twisting
According to the Affordable Care Act, what is the maximum amount an individual can contribute to a Flexible Savings Account? a. $500 b. $1,500 c. $2,500 d. $3,500
c. $2,500
In PA, a Specified disease accident and health plan must provide a minimum benefit in the amount of: a. $2,000 b. $2,500 c. $5,000 d. $10,000
c. $5,000
A producer that willfully violates any provision of PA Insurance law may be imposed to a maximum penalty set by the Commissioner at a. $1,500 per violation b. $3,000 per violation c. $5,000 per violation d. one year imprisonment
c. $5,000 per violation
If a health policy is reinstated after it had lapsed for nonpayment, there is a waiting period of __ days before a claim covering sickness will be covered. a. 6 days b. 8 days c. 10 days d. 12 days
c. 10 days
PA requires that a licensee complete ____ hours of continuing education on the subject of ethics every reporting period: a. 1 b. 2 c. 3 d. 4
c. 3
In PA, the Time Limit on Certain Defenses provision provides that no misstatements (EXCEPT fraud) made by the applicant on a heal insurance application can be used to void the policy or deny coverage after the expiration of: a. 1 year b. 2 years c. 3 years d. 5 years
c. 3 years
AAs of 1/1/14 an employer with up to 25 full time equivalent (FTE's) with an average annual wages of less than $50K may be eligible for a tax credit of ___ of the premuiums paid by the employer: a. 30% b. 40% c. 50% d. 60%
c. 50%
In PA, an employee must request spousal coverage under a group sponsored accident and health plan within ______ days of marriage: a. 10 b. 30 c. 60 d. 90
c. 60
In PA, HIPAA laws require that an individual's prior creditable coverage may reduce the maximum pre-existing condition exclusion period that a new group health plan can apply. This rule is applicable as long as there has been no gap in creditable coverage for a period greater than: a. 30 days b. 60 days c. 63 days d. 90 days
c. 63 days
Health insurance policies that provide maternity benefits must provide for a minimum of ____ hours of inpatient care following a Caesarean delivery: a. 24 b. 48 c. 96 d. 125
c. 96
What is the difference between a Long-Term Care Partnership Plan and a Non-Partnership plain? a. Pre-existing conditions b. Level of benefits c. Asset protection d. Elimination period
c. Asset protection
What is required before an insurance producer can act as a representative of an insurer? a. Producer needs to be certified by the insurer b. Producer needs to establish a sales quota c. Producer needs to be appointed by that insurer d. Producer needs to be gainfully employed by that insurer
c. Producer needs to be appointed by that insurer
In PA, no legal action may be taken against an insurer for failure to honor a valid claim after the expiration of how many years from the time proof of loss is furnished? a. One Year b. Two years c. Three years d. Four years
c. Three years
In order to solicit insurance in PA, all of the following is required EXCEPT: a. pass the state examination b. complete a prelicensing course c. be at least 21 years of age d. pay the appropriate fee
c. be at least 21 years of age
Coverage for newborns under an accident and health plan MUST include coverage for: a. lost wages of the mother b. disability of the mother c. birth abnormalities d. delivery costs
c. birth abnormalities
Which of these characteristics of an applicant is NOT taken into consideration when assessing risk for Disability coverage? a. health of applicant b. gender of applicant c. number of children d. occupation of applicant
c. number of children
A producer's fiduciary duty requires that: a. premiums are maintained in a personal bank account until remittance to insurer b. premiums be deposited in an interest-bearing account c. premiums are forwarded to the insurer on a timely basis d. premiums be commingled with personal funds
c. premiums are forwarded to the insurer on a timely basis
A(n) _______ company is owned exclusively by shareholders: a. mutual b. mixed c. stock d. interactive
c. stock
Once the insurance company receives a notice of claim, they have ___ days to send the claim form: a. 45 b. 30 c. 20 d. 15
d. 15
A PA temporary producer license may be issued for a period not to exceed: a. 30 days b. 45 days c. 90 days d. 180 days
d. 180 days
In PA, the definition of total disability changes from one's "own occupation" to "any occupation" by reason of one's education, training, and experience after what period of time? a. 6 months b. 9 months c. 12 months d. 24 months
d. 24 months
An employer may qualify for health care tax credits through SHOP Marketplace if that employer has fewer than how many employees: a. 10 b. 15 c. 20 d. 25
d. 25
Within ______ days after the policy delivery, both Medicare Supplement and Long-Term Care policies can be returned for a 100% premium refund: a. 15 b. 20 c. 25 d. 30
d. 30
A newborn is required to be covered for _____ days from the moment of birth: a. 10 b. 15 c. 30 d. 31
d. 31
In accident and health plans, premiums paid less frequent than monthly require a minimum grace period of at least: a. 7 days b. 10 days c. 20 days d. 31 days
d. 31 days
The Free Look period in PA for individual health insurance policies is __ days. a. 5 b. 10 c. 15 d. 20
b. 10
What is the MINIMUM benefit period that must be offered by a Long-Term care policy? a. 6 months b. 12 months c. 18 months d. 24 months
b. 12 months
According to PA law, post natal care must be delivered within how many days of discharge? a. 1 day b. 2 days c. 3 days d. 5 days
b. 2 days
A licensed producer must report any administrative action taken against the licensee in another jurisdiction or by another agency department in PA within how many days of the final disposition? a. 10 days b. 30 days c. 60 days d. 90 days
b. 30 days
In a Long-Term Care policy, the right-to-examine period is: a. 10 days b. 30 days c. 45 days d. 60 days
b. 30 days
Within how many days must a producer report to the Commissioner any charges made against him/her? a. 20 days b. 30 days c. 40 days d. 50 days
b. 30 days
No Long-Term Care policy may exclude pre-existing conditions for a period of more than: a. 90 days b. 6 months c. 12 months d. 18 months
b. 6 months
If a health insurance claim is not promptly paid, legal action may be taken against the insurer after: a. 30 days from the date proof of loss is furnished b. 60 days from the date proof of loss is furnished c. 90 days from the date proof of loss is furnished d. 3 years from the date proof of loss is furnished
b. 60 days from the date proof of loss is furnished
If a Medicare Supplement policy replaces another that had been in effect for at least 6 months, the replacing policy may impose which of the following time exclusions for pre-existing conditions? a. 0 months b. 63 days c. 6 months d. 12 months
b. 63 days
As classified by the Affordable Care Act (ACA), a Silver Plan offers a. 60% actuarial level of coverage provided b. 70% actuarial level of coverage provided c. 80% actuarial level of coverage provided d. 90% actuarial level of coverage provided
b. 70% actuarial level of coverage provided
All of the following may be an unfair claims practice EXCEPT: a. Turning down a claim without providing the basis of denial b. Denying an insured's fraudulent claim c. Failing to promptly acknowledge pertinent communications concerning claims d. Failing to effectuate prompt, fair, and equitable settlements of a claim
b. Denying an insured's fraudulent claim
Which of the following is a violation of PA insurance law? a. Failure to pay insurer appointment fees b. Offering insurance contracts through unlicensed entities c. Charging policy fees d. Failing to notify the Commissioner of any administrative action taken against the licensee within 10 days of the final disposition of the matter
b. Offering insurance contracts through unlicensed entities
If the Insurance Department determines that the issuance of a temporary producer license serves in the public's best interest, the license may be issued to: a. an applicant sitting for the state exam b. an executor of a deceased producer's estate c. write new business d. an applicant upon passing state exam
b. an executor of a deceased producer's estate
When soliciting insurance, a producer CANNOT: a. illustrate dividends b. emphasize Guaranty Association benefits c. execute a conditional receipt upon receipt of premium deposit d. disclosure insurer ratings
b. emphasize Guaranty Association benefits
A(n) _________ insurance company is one that was formed under the laws of a state other than PA: a. alien b. foreign c. reciprocal d. domestic
b. foreign
a non-admitted insurer: a. may sell insurance policies in this state b. is not afforded protection by the guaranty fund c. only applies to foreign insurers d. may only sell insurance policies through non-admitted producers
b. is not afforded protection by the guaranty fund
Under the Affordable Care Act, a large employer that does NOT provide health insurance and owes an employer mandate penalty MUST pay an annual penalty, which calculated by multiplying $2,000 by: a. the number of full time employees minus 20 b. the number of full time employees minus 30 c. the number of subsidized employees minus 10 d. the total number of full time employees
b. the number of full time employees minus 30
When an insurance company consistently fails to provide reasonable explanations for the denial of a claim, this is called a(n): a. breach of contract b. unfair claim settlement c. fraudulent claim practice d. unlawful insurance act
b. unfair claim settlement
Under PA statute, first year commission for long-term care insurance may not be greater than: a. 20% of the first year premium b. 30% of the first year premium c. 40% of the first year premium d. 50% of the first year premium
d. 50% of the first year premium
A temporary license may be issued without state examination to all of the following EXCEPT: a. producer's spouse b. executor of producer's estate c. Employee of the producer d. A prospective producer who is currently enrolled in a pre-licensing insurance class
d. A prospective producer who is currently enrolled in a pre-licensing insurance class
Which of these may NOT be used in a health insurance advertisement? a. A celebrity endorsement b. a statement that highlights coverage amounts c. a paid testimonial d. An insurance company's trademark instead of the company's actual name
d. An insurance company's trademark instead of the company's actual name
Which of the following is required for an insurer to conduct business in this state? a. Certificate of admission b. Certificate of domestication c. Certificate of authenticity d. Certificate of authority
d. Certificate of authority
Which of the following is required to maintain a producer's license in PA? a. Company officer or director whose activities are clerical or administrative b. A salaried full-time employee who does not sell or solicit insurance c. Home Office underwriter d. Field underwriter, who solicits insurance and earns a commission
d. Field underwriter, who solicits insurance and earns a commission
A resident producer license requires each of the following EXCEPT: a. Applicant receiving a passing score on state exam b. Satisfied prelicensing education requirements c. Fingerprint submission d. Insurer appointment
d. Insurer appointment
Under the Affordable Care Act, how would a grandfathered health plan lose its grandfathered status? a. The insurer applies a lifetime dollar limit on essential health benefits b. The insurer does not re-apply for grandfathered status c. The insurer raises premiums across the board by 50% d. The insurer significantly raises co-insurance charges, deductibles, or co-payment charges
d. The insurer significantly raises co-insurance charges, deductibles, or co-payment charges
When a Medicare Supplement insurance policy is being replaced, who must sign the notice of replacement? a. The head underwriter b. The applicant only c. The producer only d. The producer and the applicant
d. The producer and the applicant
An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called: a. a managed plan b. stop loss c. coinsurance d. a deductible
d. a deductible
Producer commissions may NOT be paid to: a. licensed and appointed producers b. licensed and appointed producers who are sharing commissions c. non-resident producers d. licensed producers not appointed by an insurer
d. licensed producers not appointed by an insurer
The Life and Health Guaranty Corporation provides funds to carry out its powers and duties by assessing: a. taxpayers b. policyowners c. beneficiaries d. member insurers
d. member insurers
