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Xcel Solutions Cram Course review Chapter 8 -INDIANA Laws and Rules pertinent to Insurance
Terms in this set (206)
An insurer that terminates a producer's appointment must notify the commissioner within _____days of the date of termination?Answer: 30 daysWhich of the following is NOT a situation that involves life insurance policy replacement?Answer: Converting a term policy to a permanent policy with the same insurerS takes out a health insurance policy which contains a provision that states that the agent does not have the authority to change the policy or waive any of its provisions. Which health policy provision is this?Answer: Entire ContractHow long does an insurance company appointment remain in force?Answer: Until terminatedLife insurance coverage will frequently contain an Accelerated Benefits Rider attached to the policy. What would be considered a qualifying event under these riders?Answer: Medical condition resulting in a significantly shortened lifespan.What is the minimum Grace period for an individual Health policy that is paid monthly?Answer: 10 daysAt the very least, an admitted insurance company shall be examined once every ____years?Answer: 5 yearsAn insurer distributes public brochures that contain a false statement regarding a competitors ability to pay claims. This act is considered an example of:Answer: DefamationAccording to Indiana Law, how long can statements made by the applicant on a Health Insurance policy be contested?Answer: 2 yearsIndiana's 10-day free-look period for life insurance policies begins on the:Answer: Date of deliveryWhich of the following statements is correct about the insurance commissioner's authority to examine the business records of a producer?Answer: The commissioner may exam them whenever its deemed necessaryWhy would the Insurance Commissioner issue a temporary license?Answer: To allow the personal representative of a deceased producer to provide service to existing policyownersJ is a producer who has induced an insured through misrepresentation to surrender an existing insurance policy. What is J guilty of?Answer: TwistingWhat is the purpose of the Indiana Life and Health Insurance Guarantee Association?Answer: Ensures that claims filed against insolvent insurance companies will be paidWhat would be an accurate definition of "controlled business"?Answer: insurance business that is written on the producer's own life, property, or interestsHow many days is a temporary producer's license valid?Answer: 180 daysWhy would the commissioner examine the records of an insurance company?Answer: To determine the solvency of the companyA life policy loan in Indiana cannot charge a fixed rate of interest higher thanAnswer: 8 %When an existing life insurance policy is terminated so that a new life insurance policy can be purchased, this transaction is referred to as?Answer: ReplacementIn a Medical Expense Health insurance policy, what is considered to be the limiting age?Answer: The age in which dependent children can be taken off an insurance policyIf a producer commits an act of coercion or intimidation, how would the producer's insurance company be held responsible for this act?Answer: If the insurer approves of the actAn applicant for a resident insurance producer's license MUST meet which of the following requirements?Answer: Complete a pre-licensing examinationT is covered by a group major medical policy with his employer. He leaves his employer and coverts the coverage to an individual policy. All of these statements about the new policy are true, Except?Answer: New policy pays the same benefits as the group policyWhich of the following is NOT considered Rebating?Answer: Sharing commissions with a producer in the same line of businessA domestic insurance company in Indiana MUST?Answer: be organized under Indiana insurance lawsWho is responsible for determining if Long-term care coverage is appropriate to meeting an applicant's needs?Answer: ProducerThe coordination of Benefits (COB) provision exists in order to?Answer: Avoid duplication of benefit paymentsWhich of the following is a requirement to attain a nonresident producer's license in Indiana?Answer: Be licensed as a producer in the producer's state of domicileGroup Life policies in Indiana are required to contain a conversion privilege that allows for conversion?Answer: To an individual policy for stated period of timeIn order to terminate a producer's appointment, the insurer MUST?Answer: Send notice of the termination to the commissionerIn Indiana, which of the following is considered an Unfair competition practice?Answer: CoercionAccording to Indiana law, group life insurance conversion privileges Must NOT?Answer: Require evidence of insurabilityWhich of the following plans is NOT required to meet Minimum Essential Coverage (MEC) standards under the Affordable Care Act (ACA)Answer: Worker's CompensationHow often must an insurance producer's license in Indiana be renewed?Answer: Every two yearsThe Affordable Care Act (ACA) provides health coverage to dependents up to the age of?Answer: 26 years oldInsurance companies that are organized in countries outside the united states are referred to as?Answer: AlienThe insurance commissioner may suspend, revoke, or refuse to renew a producer's license for which of the following reasons?Answer: Producer has used fraudulent, coercive, or dishonest practicesAccording to Indiana Law, group life insurance conversion privileges MUST Not?Answer: Require Evidence of InsurabilityAn applicant MUST receive an Outline of Coverage when an application is taken for a(n)Answer: Medicare Supplement PolicyA life insurance policy can be backdated before the application date up to?Answer: 6 monthsA(n) _________license may be issued in cases where a producer has become disabled or dies, requiring a replacement to service the producer's business?Answer: TemporaryWhich of the following is NOT a required provision in group life polices?Answer: Right to LoanUnder the Patient Protection and Affordable Care Act (PPACA), consumers have access to health coverage that is?Answer: Guaranteed available and renewableDuring the course of an insurance transaction, who does the producer legally represent?Answer: Insurance companyAn example of an unfair claims settlement practice isAnswer: Turning down a claim without providing the basis of denialIf a new life insurance policy is replacing an existing one, the insured is given the right to return for a full refund at least ____ days after policy delivery.Answer: 20 daysAccording to Indiana's Mammography coverage statute, which of these benefits are considered mandatory in every medical expense policy?Answer: One mammogram every year for women age 40 and olderDuring the course of an insurance business transaction, who does the producer legally represent?Answer: Insurance companyAll of these are powers of the commissioner Except?Answer: Incarcerate a producerWhich of the following employees may Not be excluded from a group life plan?Answer: Full time employees after the probationary periodAn existing life insurance policy is being replaced by a new one. A notice of replacement must be provided by the ________ to be signed by the applicant.Answer: ProducerWhich of the following statements is CORRECT about the Indiana Life and Health Insurance Guarantee Association?Answer: It protects Indiana insurance policyowners in the event an insurance company becomes insolventAccording to Indiana Law, how long is the Free look period for Medicare Supplement policy?Answer: 30 daysAn example of Rebating would be?Answer: Splitting commissions with a policyholderAn insurer is NOT required to provide information on fraudulent claims if requested byAnswer: An insuredAn example of unfair discrimination would beAnswer: offering different terms of coverage for different policyowners having the same risk classificationAll Long-term care polices purchased in Indiana Must contain a free look period of?Answer: 30 daysThe Indiana Children's Health Insurance Program (CHIP) provides children of need with health benefits until the child reaches age ______ or becomes financially ineligible, whichever is earlier.Answer: 19 yearsWhich of the following is Not a required provision in a group life policy?Answer: Accidental Death and DismembermentAt what point may a producer sell insurance for an insurer?Answer: After being properly appointed by the insurerThe free-look period for life insurance policies issued in Indiana is___days?Answer: 10 daysA producer must notify the commissioner within____ days an address change?Answer; 30 daysAn example of rebating would beAnswer: offering a client something of value not stated in the contract in exchange for their businessAn example of unfair claims settlement practice isAnswer: Failing to effectuate prompt, fair, equitable settlements of a claimWhich of the following is a requirement to be eligible for a group health policy?Answer: Group must be formed for a purpose other than obtaining insuranceWhat type of insurance company is domiciled in England, but conducts business in Indiana?Answer: AlienT is a producer who forgot to renew her license. She may reapply for a license without an examinationAnswer: Within one year after no renewalWhich of the following is considered to be misrepresentation?Answer: A producer guaranteeing a policy's dividendsWhich of the following permits an insurance company to transact business in Indiana?Answer: Certificate of authorityXYZ Corp was issued a group health policy for its employees. Under this plan aAnswer: Policy must be issued to XYZ, and a certificate must be issued to each employeeA licensed business entity acting as an insurance producer must:Answer: Notify the department of insurance of any fictitious name usedWhat is Indiana's definition of Life Insurance replacement?Answer: A transaction in which a new policy is bought, and an old policy is terminatedAn individual who in any manner sells, solicits, or negotiates insurance on behalf of insurance companies for compensation is an insurance:Answer: ProducerWhen a life insurance policy application is completed, a Policy Summary must be given to the applicant. The policy summary must include?Answer: The premium cost for basic coverage applied forA producer who makes misleading statements that lead to the termination of an existing insurance policy so that a new policy with another insurer can be taken out has committed:Answer: TwistingWhich of these statements regarding health coverage for physically handicapped dependents is False?Answer: The dependent must have been over 10 years of age when the handicap was incurredAn individual covered under a Group life insurance policy is considered to be a(n)?Answer: Certificate holderA person insured under a health policy is required to give the insurance company a Notice of Claim within how many days after a covered loss?Answer: 20 daysKathy has a family Health insurance policy where any dependent children she has are removed from the policy once they have reached a certain age. This policy is known as:Answer: Limiting ageAccording to Indiana Law, group life insurance conversion privileges must NOT?Answer: Require evidence of insurabilityConvincing a prospective insured to buy an insurance policy based on exaggerations is calledAnswer: MisrepresentationsThe _____must provide the insured with proper disclosure concerning the replacement of a life insurance policy?Answer: ProducerIf an insurer offers health coverage to an employee, the insurer MUST inform the employer of all of the following information EXCEPT:Answer: The terms of the insurer's provider agreementsA(n) _______ of authority permits an insurance company to transact business in Indiana?Answer: CertificateWhich of the following is a requirement to attain a nonresident producer license in Indiana?Answer: The producers state of residence must have reciprocity with Indiana.An example of rebating would be?Answer: Returning a portion of a premium as inducement to purchase insuranceInsureds in the same risk classification are being charged different premiums by an insurance company. This insurer is committing the illegal act ofAnswer: Unfair discriminationMaternity coverage is required in which type of policy?Answer: Medical expense policyWhich of the following is a requirement to be eligible for a group life policy in Indiana?Answer: Group must be formed for a purpose other than obtaining insuranceConsumers who purchase Health insurance through a Marketplace/Exchange?Answer: Do not have their health history taken into accountAn example of false advertising would be?Answer: An insurer exaggerating its dividends in a magazine advertisementIndiana's Long Term Care Partnership Program requires a Producer to have:Answer: 15 hours of additional education after they receive their licenseWhich of the following actions by a producer would NOT result in a license suspension or revocation?Answer: Producer represents a foreign insurance companyWhat is required for Producers to sell Long Term Care (LTC) in Indiana?Answer: Eight hours of post licensing education specifically devoted to LTCIn Indiana, what is the maximum percentage of controlled business a producer may produce over a twelve-month period?Answer: 25%Which of the following is a requirement to be eligible for a group life policy in Indiana?Answer: Group must be formed for a purpose other than obtaining insurance.Life insurance coverage will frequently contain an Accelerated Benefits rider attached to the policy. What would be considered "a qualifying event" under these riders?Answer: Medical condition resulting in a significantly shortened lifespanAn example of a Unfair Claims settlement would be?Answer: Failing to effectuate prompt, fair, and equitable settlement of a claimWhich of these is an example of Twisting?Answer: A producer misrepresents a policy to induce a policyowner to surrender an existing policyA(n)______insurance company is one formed in a country other than the United States?Answer: AlienA life policy loan in Indiana cannot charge a fixed rate of interest higher thanAnswer: 8 %A foreign insurance company doing business in Indiana?Answer: Is a company that was formed under the laws of another stateA business entity acting as an insurance producer MUST?Answer: Designate at least one licensed producer to be responsible for the entity's compliance with the insurance laws and rulesAn example of an unfair claims settlement practice would be?Answer: Misrepresenting insurance policy provisions affecting a lossP's individual health policy is now in the Grace Period. P's coverage will remain in force if:Answer: The premium is paidWhy would the commissioner examine the records of an insurance company?Answer: To determine the solvency of the companyWhat is required for a producer to be in compliance with Rule 13, Life Insurance Advertising?Answer: A potential applicant must be told that Life Insurance is the exclusive subject of the saleIn Indiana, an insurer licensed to conduct business in Indiana, but domiciled in Texas, is called a(n)?Answer: Foreign companyAn insurance company that has qualified and received a Certificate of Authority from the Department of Insurance to sell insurance in this state is considered to be a(n) ________ insurer?Answer: AdmittedLife insurance replacement regulation protects the interests of?Answer: PolicyownerAll of these statements concerning individual Medical Expense policies sold in Indiana are true, Except?Answer: A provision must be contained that guarantees reinstatementLong-term care polices sold in Indiana may exclude coverage for pre-existing conditions for?Answer: 6 monthsUnder a Small Group Health plan, babies are covered:Answer: At birthProducers must complete__ hours of continuing education every two years to keep their license?Answer: 24 hoursWhich of the following is NOT an Unfair Claims settlement practice?Answer: Needing written documentation of claims detailsIn the event of employment termination, a person covered by a group policy also has the right to convert such coverage to an individual policy within ____ days without proving insurabilityAnswer: 31 daysTo continue health coverage for a newborn, the policyowner must notify insurer of birth and provide the first premium payment within ____ days of birth?Answer: 31 daysA domestic insurance company in Indiana Must?Answer: Be incorporated and formed in IndianaA hearing must be held before a producer's license can be suspended or revoked. Prior to the hearing, the Commissioner of Insurance is required toAnswer: Give written notice to the producerThe Legal Action provision in Indiana stipulates that the:Answer: Insured must wait 60 days after submitting proof of loss to initiate a lawsuit and has up to three years to fileHealth policies sold in Indiana are REQUIRED to begin medical coverage of a newborn beginning at?Answer: The moment of birthWhich of the following would be a valid reason for suspending or revoking an insurance producer's license?Answer: Writing primarily controlled businessIn the event of employment termination, a person covered by a group policy also has the right to covert such coverage to an individual policy within ___ days without proving insurability??Answer: 31 daysP is a producer who is licensed in Indiana, but a resident of Michigan. In Indiana, P is considered to be a(n) ________ producer.Answer: NonresidentT is an employee covered under a Group Life policy. If T's employment is terminated, the conversion privilege gives T the right to convertAnswer: To an individual policy upon employment terminationThe Life and Health Guaranty Association is:Answer: Funded by admitted insurance companies through assessmentsLife Insurance replacement regulation protects the interests of?Answer: PolicyownerIn Indiana, the MAXIMUM fine that the commissioner can impose on a producer or company who violates a cease and desist order is _____ per violation?Answer: $25,000B the producer sold an insurance contract to a client. B has engaged inAnswer: Transacting InsuranceWhich of the following is a standard provision of the conversion privileges in a Group Life Policy?Answer: Group life coverage can be converted to an individual policy at regular rates on an attained age basisAs a condition for a loan, a bank requires the borrower to purchase credit insurance from a specific company. What is the bank guilty of?Answer: CoercionAn example of an unfair claims settlement practice would beAnswer: Denying a insured's claim without indicating the basis of denialUnder the Indiana Long-Term Care Partnership Program(LTCP), producers are required to have an additional____ hours of education after they receive their license in order to sell policies under this program.Answer: 15 hoursAn Indiana resident insurance producer must perform which of the following actions to continue with their license?Answer; Meet continuing Education requirementsWhich of the following is NOT required in the outline of coverage for a health insurance policy?Answer; Projection of the policy's future costsA producer must notify the Commissioner within _____days of a felony conviction.Answer: 30 daysAt what point may a producer sell insurance for an insurer?Answer: After being properly appointed by the insurerWhich of the following is an example of false advertising?Answer: An insurance company publishing misleading information about it's policy provisionsA producer's license may be denied, suspended, or revoked if the licensee ?Answer: Is found guilty of misrepresentation in obtaining the licenseP is a producer who is licensed in Indiana, but a resident of Michigan. In Indiana, P is considered to be a(n) ________ producer.Answer: NonresidentWhich of the following provides funding for the Indiana Life and Health Insurance Guaranty Association?Answer: Member company assessmentsIn Indiana, what is the Maximum percentage of controlled business a producer may write in a twelve- month period?Answer: 25%All of these statements are true regarding a child qualifying for coverage under the Indiana Children's Health Insurance Program, Except?Answer; Must have been born in the United States to qualifyWhich of these correctly describes the purpose of the Indiana Comprehensive Health Insurance Plan?Answer: Provides high- risk insurance coverage for people who are uninsurableWhich of the following is NOT a reason for the Commissioner to revoke a producer's license?Answer: Producer is insolventWith whom may a producer share commissions with?Answer: A licensed producer with the same license typeWhich of these provisions are NOT required in individual life insurance policies sold in Indiana?Answer: Extended termWhich Unfair Competition Practice involves a producer suggesting that an insurance policy is like a share of stock?Answer: MisrepresentationA Medicare Supplement policy may be returned for a 100% premium refund within _____ days after policy delivery?Answer: 30 daysA group life insurance policy can be converted to an individual whole life policy under which circumstance?Answer: Employment terminationAn individual life insurance policy sold in Indiana can be contested by the insurer only during the first____ years of the contract.Answer: 2 yearsWhich of the following groups may NOT be insured by a group life insurance policy?Answer: Individuals who are related by bloodHow many days is a temporary producer's license valid?Answer: 180 daysWhich of these actions does NOT constitute life insurance policy replacement?Answer: Convert term coverage to a whole life policyWhat is Indiana's definition of Life insurance replacement?Answer: A transaction in which a new policy is bought and an old policy is terminatedWhich of the following is NOT a reason for the Commissioner to revoke a producer's license?Answer: Producer is insolventT is an insurance license applicant who intends to primarily engage in insurance transactions on himself and his family. If the insurance department is made aware of this, T will most likelyAnswer: Not be issued a licenseWhich of the following would be a valid reason for suspending or revoking an insurance producer's license?Answer: The producer has misappropriated money held in a fiduciary capacityA(n) _________ sells insurance advice for a fee?Answer: consultantUnder the ACA, consumers must have health insurance as of January 1, 2014 that contains Minimum Essential Coverage (MEC). Individuals who are exempt from this law include:Answer: Those who cannot afford or have religious objectionsABC insurance company fails to pay death proceeds after satisfactory proof of loss was submitted. ABC must then begin paying interest on the death proceeds after ______days of receiving proof of loss.Answer: 30 daysEligible employees must be added to group health coverage NO LATER than how many days after their first day of employment?Answer; 90 daysWhich of the following actions by a producer would NOT result in a license suspension or revocation?Answer: Producer represents more than one insurance company.When does the Free-Look provision for health insurance begin?Answer: Date the policy is delivered to the insured.A Long-Term Care policy sold in Indiana must provide benefits for a minimum of?Answer: 12 monthsWhat must a producer sign when an existing life insurance policy is being reissued with a reduction in cash value?Answer: Notice Regarding ReplacementThe Insurance Commissioner is authorized to?Answer: Enforce state laws relating to insuranceThe conversion provision in a group health insurance policy?Answer: Is mandated by state requirementsAn example of rebating would be?Answer: Returning a portion of a premium as inducement to purchase insuranceA newly licensed producer must complete 24 hours of continuing education every______years?Answer: 2A producer inducing an insured to lapse, forfeit, or surrender insurance through misrepresentation is committing the illegal act of?Answer: TwistingMarketing procedures for Long-Term Care and Medicare Supplement polices should ensure that:Answer: Policy comparisons are fair and accurateJ owns a business and has a Group Life policy covering her employees. J decides to cancel the policy by letting it lapse on the renewal date. What action must be taken?Answer: All of the employees must be notified of the cancellation either by the insurance company or by J.A producer must complete ____ hours of continuation education biennially to maintain the licenseAnswer: 24 hoursAn example of rebating would be?Answer: offering a client something of value not stated in the contract in exchange for their businessWhich of the following actions does the Insurance Commissioner Not have power to conduct?Answer: Activate insurance companies' financial reserves.A licensee must notify the commissioner within_____days of an address change?Answer: 30 daysA group life insurance policy can be converted to an individual whole life policy under which circumstance?Answer: Employment terminationAccording to Indiana Law, which party is responsible for determining the appropriateness of a Long-Term policy presented to a potential applicant?Answer: ProducerWhat does a certificate of authority allow?Answer: An insurance company to conduct insurance business in IndianaAccording to Indiana law, how long is the right of return for a Long-term care policy?Answer: 30 daysWhat is the purpose of the Indiana Life and Health insurance Guaranty Association?Answer: Ensures that claims filed against insolvent insurance companies will be paidWhat does the Indiana Life and Health insurance Guaranty association provide?Answer: Claim payments of admitted, insolvent insurance companies.To be classified as a small employer, an employer must employ?Answer: 2-50Which of the following is not considered rebating?Answer: Sharing commissions with a producer licensed in the same line of businessIf an existing Accidental and Health policy is being replaced with a new policy, the decision to replace should NOT be based on?Answer: Commissions to be paidAn example of false advertising would be?Answer: An insurer exaggerating its dividends in a magazine advertisementWhich of the following will happen if a licensed resident insurance producer moves to another state?Answer: Producer's license shall terminate immediatelyA disabled dependent's continued coverage under a family health plan would be discontinued if?Answer: documentation of the disability is not provided to the insurerThe commissioner is appointed by the ?Answer: GovernorJill is covered under two Group Health policies, one through her employer and one through her
husband's employer. If Jill suffers a loss, which policy provision dictates the primary coverage?Answer: Coordination of BenefitsIn order for a domestic, foreign, or alien insurance company to conduct business, it must be authorized by whom?Answer: The state where they are conducting businessUpon reaching the limiting age, a handicapped child can extend their health insurance coverage as a dependentAnswer: Only if the child is incapable of employment and chiefly dependent on the policyownerS is a life insurance policyowner who enters into a written agreement to receive immediate cash in exchange for the sale and transfer of her life insurance policy. This agreement is referred to as a(n):Answer: Viatical settlementIn a Viatical settlement, how much does the policyowner receive for a life insurance policy?Answer: Amount less than the death benefitHow often does the commissioner examine each domestic insurance company?Answer: Every 5 years
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