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Missouri Laws and Rules

Terms in this set (52)

Defamation occurs when a producer makes a false statement intended to
malign another user
an applicant for a nonresident producer license must:
be a producer in good standing in their home state
Life insurance and annuity replacement can be BEST described as
Exchanging an existing policy for a new policy
In Missouri, which of the following is considered an Unfair trade practice?
coercion
coercion
the practice of persuading someone to do something by using force or threats.
Which Medicare product requires use of specific hospitals and physicians for non-emergency care
Medicare select
Why would the Director of Insurance examine the records of an insurance company?
to determine the solvency of the company
A foreign insurance company cannot conduct business in Missouri without...
a certificate of authority to transact business in Missouri
what is an annuity?
refers to an insurance contract issued and distributed by financial institutions with the intention of paying out invested funds in a fixed income stream in the future.
which of these is a TRUE statement regarding the regulatory authority of the director?

A.) The Director may mandate the financial restructuring of insolvent producers

B.) The Director may levy fines on policy applications to defray operating costs

C.) The Director may establish guidelines for continuing education as a part of the producer's license renewal procedure

D.) The Director may require adjacent states to adopt reciprocal agreements for non resident producer's licenses
The Director may establish guidelines for continuing education as a part of the producer's license renewal procedure
Which of these is NOT required in group life insurance policy?
Conversion

The conversion privilege allows an individual to leave the group term plan and continue his or her insurance without providing evidence of insurability.
Health insurance coverage of autism spectrum disorder treatments may be limited in which way?
Medically necessary treatment in accordance with a treatment plan
When a group accident and health policy is issued to an employer,
A policy is issued to the employer and a certificate is issued to each employee
which of these is considered an unfair trade practice?

A producer replacing an old life insurance policy with a new one

A producer stating that a policy's dividends are guaranteed

A producer who does not meet the annual sales quota

A producer that sells insurance outside of Missouri
A producer stating that a policy's dividends are guaranteed
what must. a producer sign when an existing life insurance policy is being reissued with a reduction in cash value?

Buyer's summary

Policy Guide

Replacement summary

Notice regarding replacement
Notice regarding replacement
A producer has influenced an existing policy owner to convert an existing whole life policy to reduced Paid - up insurance. the producer then sells the policy owner a new universal life policy. This transaction is called:

Misrepresentation

Conversion

replacement

asset roll over
replacement
The waiting period for pre-existing conditions on Medicare Supplement polices is _____ months

6

8

12

16
6
Who signs a "Notice Regarding Replacement" form when an application is taken for a new life insurance policy that replaces an existing one?

Producer only

Applicant only

Producer and applicant

Beneficary
producer and applicant
which of these individuals may NOT be compensated from an insurance company?

A producer appointed by the company

An administrator assistant to the CEO of the insurer

A licensed producer not appointed by the company

A retired insurance agency owner
A licensed producer not appointed by the company
Whose interest is being protected by the enactment of "The Replacement of Life Insurance and Annuities" regulation?

Policy owner

Insurance company

Insurance producer

Board of Directors
Policy owner
which entity issues Medicare supplement insurance?

insurance companies

Medicaid

Medicare

NAIC
insurance companies
Health coverage for the administration of general anesthesia and hospital charges for dental care MUST be provided to a(N)
Child under the age of 5
A producer must notify the director within _____ days of a felony conviction
30
If an insurer receives a cash payment in excess of ________, it must report this act as stated by the USA Patriot Act

$10,000

$8,000

$6,000

$4,000
$10,000
Which of the following may NOT be issued after the Director of Insurance finds an insurance code violation committed by a licensee?
Warrant for arrest
A producer is circulating incorrect information about the benefits of a policy. This producer may be found guilty of:
misrepresentation
When making a recommendation to a consumer to purchase an annuity, the producer must make reasonable efforts to obtain suitability information. Suitability information includes...

gender, place of employment, credit score

credit score, age, health history

annual income, gender, criminal background

age, annual income and financial experience
age, annual income and financial experience
The waiting period for a pre-existing condition under a Medicare Supplement policy may NOT go beyond
6 months
A health insurance policy application may ONLY be altered with written consent of the

head under

producer

applicant

insurer
applicant
if the sale of medicare supplement involves replacement, all of these actions must be preformed by the producer except:

notify the replaced insurance company

give the insured a notice regarding replacement

indicate on the application that replacement is involved with this transaction

give a list of all health policies the producer sold to applicant in the past
notify the replaced insurance company
A credit life insurance policy covers the life of the..

Producer

beneficary

debtor

creditor
debtor
who may assign benefits from a group life insurance policy?

producer

insured

insurance company

beneficiary
insured
After a life insurance policy has been in force for a MAXIMUM of __ year(s), it becomes incontestable.
2 years
which of the following types of life insurance policies involves an investment account that is separate from the insurer's general account?
variable account
under which circumstance MUST a health insurer have an expected grieveance review procedure
When the enrollee's life or health is jeapordized
Under which circumstance MUST a health insurer have an expedited grievance review procedure?
When the enrollee's life or health is jeapordized
At the time of application, major medical health plans (including HMOs) are REQUIRED to
Offer coverage for prosthetic devices
Which licensee faces possible license revocation by the director of insurance?
Licensee who commingles monies belonging to policyholders with personal funds
an example of an unfair claims settlement practice is:

Making it mandatory that proof of loss be provided for each claim

requiring a time limit for submitting a claim

Paying a claim in a timely matter

turning down a claim without providing the basis of denial
turning down a claim without providing the basis of denial
A hearing must be held before a producer's license can be suspended or revoked. Prior to this hearing, the director is required to give:

Oral notice to the producer

written notice to the producer

oral notice to the producer's insurance company

written notice to the NAIC
Written notice to the producer
For treatment of PKU a health plan must cover formula and low protein modified food products for
Covered children less than 6 years of age
An insured recently took out a cancer insurance policy. The time limit on certain defenses provision in this policy allows the insurer
To deny the amount of a claim for misstatement on the application occurring prior to the expiration of the first 2 policy years
Under Missouri law, when one group health plan's contract replaces an existing group health plan with similar benefits
The succeeding carrier shall give credit for the satisfaction of any deductibles or waiting periods satisfied or partially satisfied under the prior carrier's plan
What is the MAXIMUM fixed interest rate for life insurance policy loans?
8%
A producer must report any personal felony charges within ___ days of pre-trial hearing.
30 days
under which circumstance could a child be denied enrollment into a health plan in Missouri?
The child is no relation to, and is not placed for adoption or adopted by the plan member
an insurer man not transact insurance unless authorized by the
Director of Insurance
Chemical dependency coverage is required in which type of policy?
comprehensive major medical
the director of insurance is authorized to
to enforce state laws relating to insurance
Life insurance replacement regulation protects the interests of..
the policy owner
Each life insurance applicant in Missouri is expected to be provided with a(n)
buyer's guide and policy summary
which of the following is a requirement for obtaining a resident producer license in missouri?
...
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