Once a producer's license has been revoked, the producer must wait a MINIMUM of how many years to reapply?
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| Term | Definition |
|---|---|
Once a producer's license has been revoked, the producer must wait a MINIMUM of how many years to reapply? | 3 |
Which action is NOT required when replacing a Medicare Supplement policy? | Notify the replaced insurer |
What is a valid reason for an HMO to cancel an enrollee? | Nonpayment of coverage |
Stating that dividends are guaranteed is considered what? | Misrepresentation |
Who issues Medicare Supplement policies? | Insurance companies |
Under a group health policy, what is issued to the employer and employees? | Policy to employer, certificate to employees |
A business entity must notify the Director of an address change within how many days? | 30 days |
Which type of insurance may a limited lines producer sell? | Industrial life |
What is the free-look period for long-term care policies? | 30 days |
Producer license fees are deposited into what fund? | Insurance Producer Administrative Fund |
Which action is the Director empowered to do? | Administer insurance licensing exams |
What is the Medicare Supplement free-look period? | 30 days |
What is required for a nonresident producer license? | Hold a similar license in the home state |
Which is NOT an unfair method of competition? | Replacing coverage written by another producer |
The HMO Guaranty Association protects enrollees against what? | Insolvency of the health plan |
When must the Outline of Coverage be delivered to a Medicare Supplement applicant? | At the time of application |
Which provision is required in an individual Accident and Health policy? | Renewal, continuation, or nonrenewal provision |
Which statement would be prohibited in an Accident and Health advertisement? | All hospital bills will be paid by your policy |
In a Medicare Supplement replacement, which action is NOT required? | Notify the replaced insurer |
Each long-term care policy sold in Illinois must include a free-look of how many days? | 30 days |
How long must an insured wait after proof of loss before taking legal action? | 60 days |
If a Medicare Supplement policy involves replacement, this must be verified where? | On the application |
In Illinois, long-term care insurance must do what? | Offer inflation protection |
Long-term care policies issued in Illinois must be what? | Guaranteed renewable |
Newborn children must initially be provided health coverage for how many days? | 31 days |
A brochure with an untrue statement about a competitor’s ability to pay claims is what? | Defamation |
Once notice of claim is received, the insurer has how many days to send claim forms? | 15 days |
A lapsed producer license may be reinstated without an exam within how many months? | 12 months |
A producer must refund a prorated fee within how many days after cancellation notice? | 30 days |
Pre-existing conditions may be excluded on a Medicare Supplement policy for up to how long? | 6 months |
A temporary insurance license is valid for up to how many days? | 90 days |
Travel Accident insurance may be sold by what type of producer? | Limited lines producer |
The maximum pre-existing exclusion period in LTC policies is what? | 6 months |
Which is NOT considered an insurance advertisement? | A memo from an employer announcing coverage availability |
Which item is NOT required on a producer’s license? | Appointing insurance company |
An entity that acts as an insurance producer must meet what requirement? | Same bond requirements as an individual producer |
What is the required free-look period in a Medicare Supplement policy? | 30 days |
Which is an example of an unfair claims practice? | Failing to effectuate prompt, fair, and equitable claim settlements |
The waiting period for pre-existing conditions on Medigap policies is how many months? | 6 months |
Before applying for an Illinois resident producer license, an applicant must do what? | Complete a prelicensing course |
To be considered a small employer in Illinois, the employer must have how many employees? | 2 to 50 employees |
To continue newborn coverage, the policyowner must notify the insurer and pay within how many days of birth? | 31 days |
It is acceptable to discriminate benefits only between individuals of different what? | Different classes |
How many temporary licenses may one person hold in a lifetime? | One |
What is the minimum benefit period that must be offered by an LTC policy? | 12 months |
When does the free-look period begin for any health policy? | Date of policy delivery |
When must the pre-existing condition clause be waived in an LTC policy? | When replacing existing coverage with the same insurer |
Which type of injury is NOT covered under a health insurance policy? | Work-related |
A doctor who accepts Medicare Assignment agrees to what? | Cannot charge more than Medicare’s approved amount |
The insured’s consideration for a health insurance policy is what? | The application and the first premium |
What does the time limit on certain defenses mean? | Claims cannot be denied after a stated period due to material misrepresentation |
Who is protected by the “other insurance with this insurer” provision? | Insurance company |
After submitting written proof of loss, the insured must wait 60 days before what? | Bringing legal action against the insurer |
If an insured changes to a more hazardous occupation, what happens under the change of occupation provision? | Benefit level is reduced |
Which provision reduces the opportunity for overinsurance? | Coordination of benefits |
A health insurer must provide a proof of loss form within how many days of receiving notice of loss? | 15 days |
A $500 claim with a $200 past due premium results in what payment? | $300 |
If the insured changes to a less hazardous occupation, what may happen? | Benefits can be increased |
The factor used most often when underwriting disability income is what? | Annual earnings |
Which is NOT included in the waiver of premium provision? | Future premiums are waived after recovery |
If Mark continues working after age 65 and has employer coverage, Medicare is what? | Secondary payer |
Which of the following does NOT affect health insurance premium rates? | Residential address |
Which is NOT a function of the insuring clause? | Describes the free-look period |
Power not specifically stated in the contract is what kind of authority? | Implied authority |
The entire contract provision does NOT include what? | Changes made by the producer |
Under COBRA, terminated employee benefits must be what? | Same benefits, premium cannot exceed 102% |
Who is typically NOT eligible for coverage under a group health policy? | Temporary employee |
Who is usually the applicant and policyholder for group health benefits? | Employer |
If a claim is reduced because of overdue premiums, which optional provision applies? | Unpaid premium |
Statements by the applicant about occupation, hobbies, and health history are what? | Representations |
After Bob dies, who receives his policy proceeds if Tom is the named beneficiary? | Tom |
In which situation would the insurer be liable for a loss? | Injury as an innocent bystander during a bank robbery |
When does a health insurance policy typically become effective? | When the premium is collected and the policy is issued |
Which provision caused a $500 claim to be reduced by a $200 past-due premium? | Unpaid provision |
Which disability allows benefits even if the insured can continue to work? | Presumptive disability |
A policy renewable only at the option of the company is what? | Optionally renewable |
What is the grace period for a monthly premium health policy? | 10 days |
Why is disability income limited to a percentage of income? | To avoid overinsurance |
The reinstatement provision in a health policy is what? | Mandatory |
The entire contract includes the policy and what else? | The application |
A field underwriter’s main task is what? | Ensure the applicant’s information is accurate and complete |
Which is an example of the insured’s consideration? | A paid premium |
Which is NOT considered an element of an insurance policy? | Claim forms |
Which plan is best for someone on Medicare worried about excess charges? | Medicare Supplement Plan F |
An indemnity plan does what? | Provides the insured a specific dollar amount for services |
Which is NOT included under a health benefit plan? | Hospital indemnity plan |
Which statement is NOT true of a Critical Illness Plan? | Coverage is limited to a single devastating disease |
A fee-for-service plan normally covers what? | A disease |
Medical Expense Insurance would cover what? | An injury occurring at the insured’s residence |
In a major medical plan with first-dollar coverage, what happens? | No deductible is required |
A report based on creditworthiness and personal characteristics is called what? | Consumer report |
If a premium check is made payable to the agent instead of the insurer, what should the agent do? | Get a new check made payable to the insurer |
Who usually delivers the policy to the new policyowner? | The sales agent |
A person not acceptable at standard rates because of health, hobbies, or occupation is what? | Substandard risk |
Which underwriting source focuses specifically on medical history? | MIB |
A PPO has all of these characteristics except what? | Unlimited services |
Under HIPAA, a person cannot have more than how many days without prior coverage to avoid a pre-existing issue? | 63 days |
HIPAA creditable coverage helps reduce what? | Waiting period for pre-existing conditions |
Who is paid on a fee-for-service basis? | Provider |