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85 terms

Georgia State Life & Health Insurance Laws

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Elected
How does the Insurance Commissioner get into office.
4 years
What is the term of the Ins. Commissioner
What are the powers of the Commissioner
Regulation, Examination of Records, Investigation, Hearing and Judicial Review, Issuing Penalties
5 years
how often does the commissioner examine domestic insurers
30 days
length of time the commissioner has to hold a hearing if a person has complained and the commissioner feels a hearing is warranted
10 days
length of time a violater has to request a hearing regarding a penalty from the commissioner
stock companies
do not pay dividends
mutual companies
does pay dividends
30 days
length of time a company has to pay final restitution on a judgement rendered against it in Ga.
$5,000 per act
fine for a willful violation of the insurance code
$1,000
fine for an unintended violation of the insurance code
18
age you have to attain to receive an ins. license
6 months
lenth of time of residence in Ga. that you must maintain in order to receive and Ins. license
10 quarter hours of insurance related courses within the last 12 months
what could exempt you from taking the pre-licensing course
15 hours
amount of continuing education needed each year for agents licensed less than 20 years
10 hours
amount of continuing education needed each year for agents licensed more than 20 years
probation
you can play but we will be watching you
suspension
you are in time out, but will be able to play when i say so
revocation
you can no longer play
refuse to issue
you can never play
refuse to renew
you used to play, but can play no more
6 months
length of time a temporary license can be issued without requiring an examination
15 months
maximum length of time a temporary license will be issued
5 years
length of years experience needed to become an insurance counselor
15 days
length of time the insurer has to get claims forms to the customer
15 days
length of notice commissioner has to give in advance of a hearing to insurers
$10,000
penalty for each violation of a cease and desist order from commissioner
commingling
depositing premium money into your business checking account
commingling over $500
considered a felony
What policies does the replacement regulation not apply to
annuities
credit life
group life
life ins connected with a pension or profit sharing
three things you must submit with replacement application
statement signed by applicant regarding replacement of ins
statement signed by you regarding your knowledge of ins replacement, signed copy of replacement notice
at time of application
when must the replacement notice be given to the applicant
who signs the replacement notice
you, the applicant, and a copy must be left with the applicant
list of existing life insurance being replaced
what else must you obtain at the time of replacement and turned in with the application
original or copy of written or printed material used for the replacement sales presentation
what must you leave with the applicant at the time of the application for replacement
conservation
the attempt by the existing company to convince the applicant that replacement is not in his best interest
3 years
length of time copies of replacement notices, copies of communications, and signed statement regarding replacement must be kept in office
10 days
length of time the existing insurer being replaced has to furnish the policyholder a policy summary statement if requested
within 3 working days of the receipt of the application by your company company or the date the proposed
policy is issued whichever is sooner.
length of time the replacing company has to mail notification to the existing company regarding replacement
Georgia Life and Health Insurance Guaranty Association
created to protect policyowners, insureds, and beneficiaries of life insurance policies, health insurance policies, and annuities against companies becoming insolvent
payment of benefits and continuation of coverage
what is guaranteed by the Ga. Life and Health Ins. Guaranty Assoc.
medicare part A
automatic, covers hospital expense
medicare part B
optional, covers doctors expense
$100,00 in cash value, or $300,000 total
maximum the Guaranty association will pay on any one life
Medicare Supplement Insurance (Medigap)
coverage that pays what Medicare does not
When is the only time the Medicare Supplement company must accept an applicant regardless of a pre-existing conditions
within the first 6 months of enrollment in Medicare Part B
person who seeks coverage
who is considered the applicant in an individual Medicare Supplement policy
certificate holder
who is considered the applicant in a group Medicare Supplement policy
greater than 63 days
length of lapse time that would knock a policy out of the creditable coverage definition
group health plan
creditable coverage
individual health insurance
creditable coverage
Part A or B of Medicare
creditable coverage
medicaid
creditable coverage
Champus
creditable coverage
Medicare program of the Indian Health Service or tribal organization
creditable coverage
any risk pool
creditable coverage
Federal Employee Health Benefits Program
creditable coverage
Health Benefits Plan of the Peace Corps
creditable coverage
Accident and Disability insurance
not creditable coverage
supplement to liability insurance
not creditable coverage
general liability or auto liability ins
not creditable coverage
workers comp
not creditable coverage
auto med pay
not creditable coverage
credit only insurance
not creditable coverage
on site medical clinic coverage
not creditable coverage
any coverage that makes its coverage secondary to another policy
not creditable coverage
limited dental or vision in a separate policy
not creditable coverage
Benefits for Long Term Care, nursing home care, home health care, community-based care in a separete policy
not creditable coverage
coverage for a specified disease
not creditable coverage
hospital indemnity or any other fixed indemnity policy
not creditable coverage
separate Medicare Supplemental Health policy
not creditable coverage
any other group medicare supplemental health policy
not creditable coverage
12 consecutive months
length of time for coverage to be defined as a Long Term Care policy
not to exceed 6 months
length of time that can separate recurrent confinements and still qualify for a LTC policy
LTC Partnership Program
program that allows consumers to avoid the "spend down" of assets to qualify for Medicaid
insured must be a resident of the State of Georgia
when coverage first became effective under the policy
requirement for a LTC
policy is qualified Long Term Care insurance policy as defined by the Internal Revenue Code and was not issued prior to January 1, 2007
requirement for LTC
policy meets all the applicable requirements of this Rule and the requirements of the NAIC Long Term Care insurance model act
requirement for LTC
policy provides inflation protection
requirement for LTC
LTC Partnership Program Notice
outlines the requirements and benefits of a partnership policy. Must be given to the prospective applicant.
8 hour initial training class and 4 hours every 24 months
training needed to sell LTC policies, including Partnership policies
5 years
length of time partnership training records must be kept on agents
United States Secretary of Health and Human Resources
agency that requires reporting on partnership policies, benefits paid, etc.
"THIS IS A LIMITED POLICY DESIGNED TO COVER ONLY THOSE
EXPENSES WHICH MEDICARE DOES NOT COVER."
statement required to be in advertisements relating to Medical Supplemental Insurance
5 years
length of time advertisement files must be kept on file