Pennsylvania Laws and Regulations Flashcards
Pre-Licensing education Requirement
24 hours
Minimum age to obtain a producer’s license
Age 18
Length of temporary insurance producer license, without requiring an examination if a licensed producer dies, becomes disabled, or enters active military service
180 days
Producer licenses are issued for a term of how many years?
2 years
A lapsed producer’s license may be reinstated within ___ year(s) of the license renewal date
1 year
Producer’s time to notify the Commissioner of change to address, administrative actions, or criminal charges
30 days
Continuing Education
Requirement for each 2 year CE term
24 hours
Continuing Education
Includes ___hours of Ethics
3 hours
Continuing Education
Number of hours that may be carried forward to next CE term
24 hours
Insurance Commissioner
The Commissioner must give __ days’ notice of a hearing.
10 days
Insurance Commissioner
Maximum producer fine per violation of the insurance code
$5,000
Unfair Competition, Act, or Practice– Civil Penalties
$___ per violation for nonwillful violations
$1,000
Unfair Competition, Act, or Practice– Civil Penalties
$____ aggregate penalty for nonwillful violations
$10,000
Unfair Competition, Act, or Practice– Civil Penalties
$____ per violation for willful violations
$5,000
Unfair Competition, Act, or Practice– Civil Penalties
$___ aggregate penalty for willful violations
$50,000
The Commissioner must examine rating organizations at least once every ___ years
Rates must be filed ___ days before use
5 years
30 days
Life, accident, or health insurance policy forms must be filed and approved by the Commissioner. Once the forms have been filed, they are considered approved after ____ days unless the Commissioner rejects them.
30 days
The Commissioner must conduct and examination of every licensed insurer at least once every ___ years.
5 years
The amount of valuable consideration, other than money, an insurance producer may offer or give to an insured or a prospective insured, on an annual aggregate basis, that does not violate rebating statute.
(NOTE: An insurance producer may not make receipt of anything of value contingent on the purchase of insurance)
$100
Insurance Fraud Regulations
A person found guilty of insurance fraud is subject to the following civil penalty
$____ for the first violation
$5,000
Insurance Fraud Regulations
A person found guilty of insurance fraud is subject to the following civil penalty
$____ for the second violation
$10,000
Insurance Fraud Regulations
A person found guilty of insurance fraud is subject to the following civil penalty
$_____ for each subsequent voilation
$15,000
Claims Settlement Practices
Insurers must
Acknowledge receipt of a claim within ___ working days
10 days
Claims Settlement Practices
Insurers must
Respond to an inquiry from the Insurance Department within ___ working days.
15 days
Claims Settlement Practices
Insurers must
provide an insured with an explanation if a claim investigation cannot be completed within ____ days.
30 days
LIFE INSURANCE ONLY
The replacing insurer and the existing insurer must keep replacement transaction records for ___ years after the transaction or until the next Commissioner’s examination, whichever is sooner.
3 years
Life Insurance Policy Provisions
Maximum policy loan annual fixed interest rate
8%
Life Insurance Policy Provisions
Free Look Period
10 days
Life Insurance Policy Provisions
Free- look for internal (same insurer) replacement
45 days
Life Insurance Policy Provisions
free- look for external (other insurer) replacement
20 days
Life Insurance Policy Provisions
grace period to pay premium
30 days
Life Insurance Policy Provisions
An accelerated death benefit must be at least ___%, but no more than ____%, of the total death benefit
25%,100%
Viatical Settlements
Chronically ill is being unable to perform at least ____ activities of daily living (ADLs) or requiring substantial supervision due to severe cognitive impairment.
2 ADLs
Terminally ill is having an illness that is expected to result in death in ___ months or less.
24 months
The Viator has a right to rescind the contract for ___ days from the contract date and for at least ____ days after receiving the viatical settlement proceeds.
30 days, 15 days
Accident and Health Insurance Only
Maximum pre-existing condition exclusion period, if allowed:
Individual and group policies subject to the ACA
Not Allowed
Accident and Health Insurance Only
Maximum pre-existing condition exclusion period, if allowed:
Group policies not subject to the ACA
12 months
Accident and Health Insurance Only
Maximum pre-existing condition exclusion period, if allowed:
Individual policies not subject to ACA
3 years
Accident and Health Insurance Only
Maximum pre-existing condition exclusion period, if allowed:
Individual policies issued on a nonmedical basis
12 months
Accident and Health Insurance Only
Probationary periods must not exceed ___days
30 days
Accident and Health Insurance Only
Free-look for health insurance
10 days
Accident and Health Insurance Only
Free look for LTC insurance and medicare supplements
30 days
Accident and Health Insurance Only
Time limit on certain defenses (Incontestability) Health Policy provision
3 years
Long Term Care (LTC)
Minimum benefit period
12 months
Minimum inflation protection percentage that must be offered
5%
Long Term Care (LTC)
Permitted compensation
First year commissions may not be greater than ____% of the first year premium.
50%
Long Term Care (LTC)
permitted Compensation
Renewal commissions may not exceed ___% of the renewal premium.
10%
Long Term Care (LTC)
Maximum Pre-existing conditional exclusion period
6 months
The penalties for Violating LTC regulations are up to ___ times the amount of any commissions paid for each policy involved in the violation, or $___, whichever is greater
3, $10,000
Medicare Supplements
Permitted Compensation: Maximum First year compensation
No more than 200% of servicing compensation
Medicare Supplements
Open Enrollment within ____ of enrolling in Medicare part B, and being age 65 or older.
6 months
Medicare Supplements
Guaranteed issue is available to those who had prior group health coverage or Medicare Advantage who apply for a Medicare Supplement within ____ days after the date of termination or disenrollment of the prior coverage.
63 days.
