State Laws Flashcards
Which of the following is not a duty of the Commissioner?
A
Make state insurance laws
B
Handle insurance-related consumer complaints
C
Enforce state insurance laws
D
Issue an insurance license for a producer
A
Make state insurance laws
With respect to advertising requirements in Texas, all of the following are allowable unless the insurer:
A
Advertises preferred rates to classes of policyholders based on certain qualifications
B
Includes the terms investment, savings plan, or profit sharing
C
Uses the term “invitation to contract”
D
Solicits nonpaid testimonials representing the personal opinion of the author
B
Includes the terms investment, savings plan, or profit sharing
In Texas, all the following are required to be included in a life insurance illustration, except:
A
Initial death benefit
B
Rating classification upon which the illustration is based
C
Company specific mortality tables
D
Proposed insured’s name
C
Company specific mortality tables
An individual life insurance policy issued in TX must have a grace period of at least how many days?
A
90
B
31
C
60
D
45
B
31
In TX, all the following statements about life insurance policy provisions are correct, except:
A
If it is discovered that an insured’s age is misstated at the time of a loss, the amount payable is based on the amount of coverage the premiums paid would have purchased at the correct age
B
An individual may assign up to 100% of policy ownership
C
Suicide may not be used as a defense to deny payment after the second year
D
If a policy lapses due to unpaid premiums, it may only be reinstated up to 2 years after lapse
If a policy lapses due to unpaid premiums, it may only be reinstated up to 2 years after lapse
*All life insurance policies that provide nonforfeiture benefits must include a provision that states if the policy lapses due to unpaid premiums, the policy may be reinstated within 3 years.
Which of the following does not describe an eligible group for group life insurance in TX?
A
A group consisting exclusively of persons related by marriage or blood
B
An employer group with at least 2 employees covered under the policy
C
Creditor groups insuring its debtors
D
Labor unions that insure members actively engaged in the same occupation
A
A group consisting exclusively of persons related by marriage or blood
Under Texas Nonforfeiture Law, a cash surrender payment may be deferred up to:
A
3 months
B
6 months
C
12 months
D
2 years
B
6 months
Under TX law, coverage for newborns must begin:
A
14 days after birth
B
After evidence of insurability is provided and the first premium is paid
C
At birth
D
31 days after birth
C
At birth
All Medicare Supplement policies must offer coverage for all of the following, except:
A
Physicians’ services
B
Hospitalization
C
Disability income
D
The reasonable cost of the first 3 pints of blood
C
Disability income
When taking an application for a Medicare Supplement policy, an agent must provide the applicant with a(n):
A
Summary of Benefits
B
Outline of Coverage
C
Certificate of Authority
D
Copy of the agent’s insurance license
B
Outline of Coverage
If an insurer requires an individual to be tested for the AIDS virus, all of the following are required, if applicable, except:
A
Obtain notice of the requirement to test and written authorization from a parent or guardian of a proposed insured
B
Notice to the proposed insured of the requirement prior to testing
C
Gather statistical information that identifies the applicant to share with other insurers
D
Written authorization from the applicant on a Notice of Consent form
C
Gather statistical information that identifies the applicant to share with other insurers
A long-term care policy issued in Texas must, at a minimum, be offered as:
A
Conditionally renewable
B
Optionally renewable
C
Noncancellable
D
Guaranteed renewable
D
Guaranteed renewable
In Texas, a small employer health insurer may not offer coverage to an eligible employee unless the employee has:
A
Satisfied a pre-existing condition waiting period of 6 months
B
Satisfied the applicable waiting period
C
Paid 100% of the first year’s premium to the employer
D
Been eligible for at least 6 months
B
Satisfied the applicable waiting period
Which of the following is a method used by an HMO to compensate a physician or provider for providing a defined set of health care services and is based on a predetermined payment per enrollee:
A
Capitation
B
Copayment
C
Enrollment fee
D
Fee-for-service
A
Capitation
All the following regarding an HMO’s evidence of coverage issued in TX are correct, except:
A
The evidence of coverage must be delivered in writing
B
The name, address, and phone number of the HMO must be included
C
Health care services and benefits available must be stated
D
Approval by the Commissioner of Insurance is required before delivery
A
The evidence of coverage must be delivered in writing
An enrollee in Texas may have coverage cancelled or nonrenewed by an HMO for which of the following?
A
Being diagnosed with heart disease
B
Excessive claims
C
Failing to quit smoking
D
Nonpayment of premium
D
Nonpayment of premium
An HMO in Texas must hold an open-enrollment period at least annually for:
A
31 days
B
45 days
C
10 days
D
60 days
A
31 days
Under the ACA, a catastrophic plan may be purchased by any of the following, except an individual:
A
Enrolled in Medicaid
B
Under age 30
C
With a hardship exemption
D
Unable to afford other coverage
A
Enrolled in Medicaid
According to the ACA, which of the following is not included in a Summary of Benefits and Coverage?
A
Premiums
B
Deductibles, copayments and coinsurance
C
Covered benefits
D
Limitations
A
Premiums
An agent must submit to the replacing insurer all of the following, except:
A
A copy of the notice regarding replacement
B
A statement identifying insurer-approved sales materials used
C
A copy of the existing policy
D
A signed statement indicating if replacement is involved
C
A copy of the existing policy
The Texas Commissioner has all the following powers, except:
A
Issue a cease and desist order
B
Administer oaths
C
Revoke a license prior to a hearing
D
Conduct investigations
C
Revoke a license prior to a hearing
What is the purpose of the Texas Life and Health Guaranty Association?
A
To regulate insurance laws
B
To pay the claims of an insolvent insurer
C
To control healthcare costs and expand health insurance coverage
D
To provide insurance for those who cannot secure insurance in the regular market
B
To pay the claims of an insolvent insurer
An individual life insurance policy issued in TX must have a grace period of at least how many days?
A
45
B
90
C
60
D
31
D
31
Which of the following is considered false advertising?
A
An insurance applicant misrepresents material information on an application for a license
B
An insurer exaggerates its dividends in statements published in a newspaper
C
An agent misrepresents a policy provision relating to coverage at the time of issue
D
A counselor charges a fee for advice in addition to commission for the sale of a policy
B
An insurer exaggerates its dividends in statements published in a newspaper
Which one of the following scenarios would not require a person to pass a written exam in Texas in order to receive a license?
A
An applicant who has decided to change careers and enter into the insurance business on a full-time basis
B
Any applicant who wants to sell insurance on a part-time basis only
C
An applicant who is seeking to obtain a temporary license
D
An applicant who is re-entering the insurance business after 10 years
C
An applicant who is seeking to obtain a temporary license
For a life insurance policy issued in Texas, which of the following statements is correct?
A
Failure to pay the policy loan will void the policy
B
The policy does not have to be assigned to qualify for a loan
C
The premiums must be paid for 3 years before the insured qualifies for a policy loan
D
A policy loan does not have to be secured by the policy
C
The premiums must be paid for 3 years before the insured qualifies for a policy loan
