Pennsylvania Laws and Rules

Every Pennsylvania insurer, upon receiving notification of a claim, must acknowledge receipt of the notice within

10 days

The free look period provided in a life insurance policy is usually

10 days

A Pennsylvania temporary producer license may be issued or a period not to exceed

180 days

According to Pennsylvania law, postnatal care must be delivered within how many days of discharge?

2 days

In Pennsylvania, 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?

24 months

In Pennsylvania, the Time Limit on Certain Defenses provision provides that no misstatements (EXCEPT fraud) made by the applicant on a health insurance application can be used to void the policy or deny coverage after the expiration of

3 years

In a long-term care policy, the right-to-examine period is

30 days

In accident and health plans, premiums paid less frequent than monthly require a minimum grace period of at least

31

In Pennsylvania, accident and health plans are required to provide mammograms for women starting at age

40

In Pennsylvania, a Specified disease accident and health plan must provide a minimum benefit in the amount of

5000

The Medicare Supplement open enrollment period is the

6 month period that begins with the month in which enrollment in Part B Medicare occured, typically age 65

If a health insurance claim is not promptly paid, legal action may be taken against the insurer after

60 days from the date proof of loss is furnished

In Pennsylvania, 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

63 days

In order to solicit insurance in Pennsylvania, all of the following is required EXCEPT

Being 21 years old

According to Pennsylvania law, which of the following is NOT considered to be personally identifiable financial information?

Blind trust data that does not include names and addresses

In Pennsylvania, who is responsible for Continuing Education (CE) course content approval?

Commissioner

A form of medical health insurance covering the treatment and care of gum disease is called

Dental expense insurance

Which of the following is required to maintain a producer's license in Pennsylvania?

Field underwriter, who solicits insurance and earns a commission

In Pennsylvania, completion of continuing education is required upon license renewal for which of the following?

Licensed individuals qualified in major lines of insurance

Viatical settlement brokers are permitted to do all of the following EXCEPT

Make the first transaction up to 30 days before approved for a license

During the first two years a life insurance policy is in force, the insurer may contest a policy for all of the following reasons EXCEPT

Misstatement of age in the application

What is the required action to be taken by a Pennsylvania licensee before operating under an assumed business name?

Notify Commissioner

What is required before an insurance producer can act as a representative of an insurer?

Producer needs to be appointed by that insurer

A life insurance producer licensed in the Commonwealth of Pennsylvania is authorized to

Solicit, receive and forward applications to the insurer

Which of the following statements about the contestability of a life insurance policy is true?

The policy can be contested by the insurer only during the first two years of the contract

A life insurance illustration showing future premiums being paid out of nonguaranteed values must disclose that

The policyowner may need to resume premium payments depending on actual results

Agreements made by terminally ill persons to sell their life insurance policies at a discount in order to pay medical expenses are called

Viatical settlements

In Pennsylvania, what's the requirement for a minor to receive proceeds from a death benefit?

a guardian must be appointed

A producer's license CANNOT be revoked without

a hearing given to the producer

Life insurance may make an immediate benefit payment before the insured dies in which transaction?

a viatical settlement

Holding premium funds for timely submission to the insurer is an example of

acting in fiduciary capacity

For Pennsylvania Insurance Code violations, the Commissioner may assess a(n)

adminstrative penalty

If the Insurance Department determines that the issuance of a temporary producer license serves the public's best interest, the license my be issued to

an executor of a deceased producer's estate

What is the difference between a Long-Term Care Partnership Plan and a Non-Partnership Plan?

asset protection

What are the levels of coverage as defined by the Affordable Care Act?

bronze, silver, gold, platinum

Which of the following does restorative dental treatment cover?

crowns

A Medicare Supplement policy's outline of coverage MUST include a(n)

description of policy benefits

For licensing purposes, if an applicant has a home or office location in the state of Pennsylvania, this would be consistent with which of the following?

home state

A producer who offers 10% of his commission to a potential client as an inducement to purchase an insurance policy is committing the act of

inducement

Violating Pennsylvania insurance law may result in which of the following Insurance Department actions?

issuance of cease and desist order after a hearing

Commissions may be shared by

licensed and appointed producers

A producer who sells insurance in Pennsylvania but resides in another state is called a(n)

nonresident producer

Which of the following is a person who negotiates an insurance contract on behalf of an insurer?

producer

The branch of dentistry which deals with the replacement of missing parts is called

prosthodontics

The Commissioner is responsible for all of the following EXCEPT

recommending insurers

All statements in an insurance application, in the absence of fraud, are considered

representations

Which Accident and Health policy provision allows the policyowner a stated amount of time to return a newly-delivered policy for a full refund of premiums if not satisfied for any reason?

right to examine

Long-term care policies must provide coverage for claims arising from

senile dementia

Which of the following is the Pennsylvania Insurance Department NOT responsible for?

shareholders

A licensee can have his/her license denied or revoked by the Commissioner if

the licensee has committed insurance-related fraud or dishonesty

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 is calculated by multiplying $2,000 by

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)

unfair claim settlement

Viatical settlement brokers send packets of information to potential viatees. These information packets normally include existing policy terms and which of the following?

viator's medical prognosis

Pennsylvania law requires that an insurer must notify the Commissioner of a producer appointment termination

within 30 days of termination