Connecticut Life and Health Insurance Exam Preparation

Vocabulary-style flashcards created from Connecticut Life & Health Insurance Exam review materials.

Needs Approach

In life insurance, a method used primarily in determining how much life insurance a client should apply for.

Insurance Consultant

A licensee who charges a fee for contracted insurance advisory services.

Employer-Sponsored Disability Plan Tax Liability

Tax obligation where, if an employer pays 75% of the premium and the employee pays 25%, taxes must be paid on 75% of the benefits received.

Powers of the Insurance Commissioner

Statutory authority to monitor insurer solvency, make rules and regulations consistent with CT laws, and monitor insurer premium rates, but NOT to make rules consistent with neighboring states.

Individually-Owned Disability Income Policy Premiums

Premiums for individually-owned disability income policies, which are not tax-deductible at all.

Paid-Up Life Insurance Policy Condition

A policy condition where dividends left with the company allow a policy to be paid up when cash value plus accumulated dividends equal the net single premium for the same face amount at the insured's attained age.

Qualified Long-Term Care Standard Provisions in CT

Standard provisions including a 30-day free look period, guaranteed renewability, and minimum coverage for 12 consecutive months, but EXCLUDING prior hospitalization.

Assignment of Benefits

A provision that makes accident and health insurance claim handling more convenient to the insured.

Specialty Care HMO Provider

A Health Maintenance Organization provider that delivers specialty care, such as a neurologist.

Reciprocity Agreement

An agreement that facilitates nonresident licensing in the state of Connecticut.

Certificate of Authority

A license secured from the Connecticut Insurance Commissioner that allows an insurance company to solicit insurance products in the State of Connecticut.

Group Health Certificate Requirements (CT)

A certificate issued for group health coverage in Connecticut MUST contain a summary of policy features and benefits.

Group Life Insurance Coverage

Insurance under which any employee in a group plan is normally covered with term life insurance.

Whole Life Insurance

A policy under which insurance coverage can continue for life.

Federal Fraud and False Statements Act Violations

Violations including overvaluing land, abstracting funds, and false entries on reports, but EXCLUDING claims reimbursement.

Eligible Expenses Provision Exclusions

A major medical policy provision covering hospital charges, physician fees, and nursing services, but EXCLUDING experimental and investigative services.

ERISA-Exempt Employee Welfare Plans

Employee welfare plans exempt from ERISA regulations, such as church plans.

Medicare Part B Excess Charges Coverage

Expenses that are covered by Medicare Supplemental insurance.

Major Medical Expense Policy Features

Policy containing deductibles, high limits of coverage, and coinsurance provisions, but typically NOT paying surgeon fees on a first-dollar basis.

Non-Qualified Health Savings Account (HSA) Distributions

HSA distributions used for non-qualified medical expenses, which are taxable and subject to a 20% penalty.

Adjustable Life Insurance Policy Changes

Features like coverage period, payment period, and plan of coverage can be adjusted, but changing the person insured requires further underwriting.

Insurer Responsibility for Producer Actions

Legal liability assigned to the insurer when a producer acts within the scope of his or her contractual authority.

Proof of Loss Legal Action Wait Period

A 60-day waiting period required after written proof of loss is submitted before an insured can bring legal action against an accident and health insurer.

Incomplete Policy Illustration Rule

Rule stating that during the sale of a life insurance policy, a producer may NEVER provide an incomplete illustration.

Capital Liquidation

The process of taking a sum of money and decreasing it in size.

Approval of Continuing Education in CT

Statutory rule requiring continuing education courses in Connecticut to be approved by the Commissioner.

Affordable Care Act (ACA) Health Insurance Exchange Roles

Roles including offering unique plan evaluation formats, certifying qualified health plans, and resolving inconsistent information, but NOT contacting employers if an employee stops coverage.

Speculative Risk

A category of risk that involves the potential for loss AND the possibility for gain.

Single Premium Whole Life Policy Duration

A whole life policy where one premium payment covers the full life of the policy.

Handicapped Dependent Children Coverage Duration

Individual health insurance requirement stating mentally or physically handicapped dependent children MUST be covered until they become self-supporting.

Respite Care Coverage

Care coverage typically found in a Long Term Care policy.

Market Value Adjusted Annuity Surrender

Surrendering cash value prior to the end of the guarantee period causes it to be subject to a market value adjustment.

Life Income Settlement Option Remaining Proceeds

Remaining death proceeds that are kept by the insurance company if a beneficiary dies after receiving only six payments.

Comprehensive Long-Term Care Policy Exclusions

Policy covering custodial care, PT, and skilled nursing care, but NOT acute care.

Time Limit on Certain Defenses

Provision stating that after a stated period of time, claims cannot be denied due to material misrepresentation on the application.

Variable Death Benefit Option

Option in a variable universal life policy where the death benefit will typically fluctuate with changes in the cash account.

Minimum Level of Assets Requirement

Connecticut requirement for insurers to maintain minimum assets to demonstrate insurer solvency.

Net Payment Cost Index

An index used when comparing life insurance policies when mainly concerned with the policy's death benefit.

Qualified Roth IRA Distribution Tax Treatment

Tax treatment where qualified distributions are received income tax free.

Earned Income (Disability Income Insurance)

Income including salary, commissions, and bonuses, but EXCLUDING dividends.

Life Settlement Proceeds Claims

Proceeds from a life settlement that may be subject to the claims of creditors.

Annuity Contract Refund Window

An annuity contract may be returned for a full refund during the free look period.

Risk Transfer

The act of insuring a risk against possible loss.

Medicare Supplement Insurance

Private insurance that covers cost-sharing amounts under Medicare.

Noncancelable Policy

An accident and health insurance policy that may not be changed in any way by the insurer up to a stated age, as long as premiums are paid.

IRA Rollover Contributions Limit

Contributions made as a rollover into an Individual Retirement Account, which are unlimited by dollar amount.

Tax Treatment of Life Insurance Death Benefits

Tax rule where a beneficiary receives policy death proceeds (e.g., $50,000) income tax-free upon the insured's death.

Non-Qualified Annuity Benefit Tax Treatment

Tax treatment under which benefit payments are always taxable.

Investigative Consumer Report Applicant Rights

Underwriting rule establishing that the applicant has a right to receive a copy of the report.

Term Life Insurance Disadvantage

The fact that no cash benefit will be provided if the insured is alive at the end of the policy period.

Newborn Child Health Coverage Timing

Coverage under a family health policy begins at the moment of birth.

Life Insurance Producer Underwriting Duties

Underwriting duties that may include seeking additional information requested by the insurance company.

Pre-Admission Testing

Outpatient diagnostic testing conducted prior to hospitalization for surgery.

Defamation Example

An illegal act where a producer publicly and erroneously announces that an insurance company is insolvent.

Individual Annuity Purchase Payments

Payments toward an individual annuity contract that are typically made by the owner.

Medicare Supplement Suited Applicant

The individual best suited for Medicare Supplement insurance is a Medicare enrollee.

Non-Qualified Annuity Cash Value Interest

Interest credited to cash values of personally-owned non-qualified annuities, which is considered tax-exempt.

Life Settlement Transaction Exclusions

Transactions involving life settlements including inducing, monitoring, and securing contracts, but EXCLUDING converting term life coverage to whole life insurance.

Payor Benefit Rider

A policy rider where premium payments are waived in the event the premium payor dies or becomes disabled.

Group Long-Term Disability Benefit Calculation

Plan structure where the specified benefit amount is a percentage of the insured's wages.

Probationary Period

The period of time during which a new employee is ineligible for group health insurance coverage.

Application Statement Status

Legal status of statements made by an insured on an accident and health insurance application, which are considered to be representations.

Producer Referral Commission Sharing

The practice where commission will likely be shared between two producers if a referral results in the sale of an insurance contract.

Universal Life Insurance Policy Loans

Feature of universal life insurance allowing policy loans, making the statement that policy loans are not permitted inaccurate.

Deferred Annuity Surrender Authorization

Requirement that when a deferred annuity is surrendered, the owner must sign authorization.

Commissioner Examination Powers

Powers granted through state statutes enabling the Insurance Commissioner to examine the records of authorized insurers.

Main Role of Health and Disability Insurance

Primary goal to protect against medical care costs and the loss of earning power.

Group Dental Adverse Selection Prevention

Methods used to prevent adverse selection, including evidence of insurability, probationary periods, and waiting periods, but EXCLUDING decreased employee participation.

Fair Credit Reporting Act Notice Requirement

Statute originating the requirement that a consumer denied insurance, credit, or employment based on an unfavorable consumer report MUST be advised as such.

Long-Term Care Benefit Period

The length of time for which claims will be paid under a long-term care policy.

Health Insurance Consideration

The insured's consideration given for a health insurance policy, consisting of the first premium payment and the application.

Conditional Receipt Effective Date

The date when an insurance policy becomes effective, occurring when the conditions of the receipt are met.

Double Indemnity Provision

A provision in travel accident insurance where benefits are doubled under certain circumstances stated in the policy.

Employer-Paid Group Health Taxability Exception

Employer-paid group health plan benefits are tax-free for HMO, vision, and major medical, EXCLUDING disability income benefits.

Free Look Period (Life Insurance)

The period provided in a life insurance policy during which the owner can examine and return the policy, usually 10 days.

Treaty Reinsurance

A reinsurance contract between two insurers involving an automatic sharing of the risk assumed.

Connecticut Insurance Law Violation

An illegal producer action, such as failure to remit premium in a timely manner.

Group Health and Medicare Primary Rule

Rule for businesses with over 20 employees where group health is available for workers over 65 and active employee group health is primary, making the statement that coverage is NOT available for workers over 65 inaccurate.

Assumed Name Notification

Requirement that a producer must notify the Commissioner prior to using an assumed name.

Vision Plan Exclusions

Group vision plan coverage including routine eye exams, corrective glasses, and contact lenses, but EXCLUDING cataract surgery.

Stockholder Life Insurance Funding

A valid business reason for small corporations to insure the lives of major stockholders to fund a buy-sell agreement.

Life Insurance Nonforfeiture Options Exclusions

Options including reduced paid-up insurance, extended term, and cash surrender, but EXCLUDING life income annuity.

Extended Term Nonforfeiture Option

A nonforfeiture option resulting in level term insurance for a stated period of time.

Custodial Care

Doctor-ordered care that assists an individual with performing basic daily activities such as bathing, dressing, and eating.

Prepaid Dental Plan Network Agreement

An agreement where a network of dentists accepts an established amount as payment in full for dental services rendered.

State Regulatory Jurisdiction Limits

State jurisdiction determines contract provisions, eligibility qualifications, and minimum enrollment, but does NOT affect COBRA continuation of coverage.

Initial Premium Handling

Procedure where the initial life insurance premium is typically obtained by the producer and forwarded to the insurer.

Immediate Annuity Inappropriateness

Financial tool inappropriate for long-term savings goals, such as a parent saving for a child's college.

Private Disability Income Supplement

Coverage purchased because worker's compensation claim benefits could be inadequate to replace total lost income.

Policy Backdating

The act of backdating a life insurance policy to obtain a premium rate based on an earlier age.

Entire Contract Provision

Standard health insurance provision stating that the policy, endorsements, and attached papers constitute the entire contract.

Pap Test Purpose

A medical test designed to detect cervical cancer.

Long-Term Care Benefit Rider Effect

Rider attached to a life insurance policy that results in a reduced death benefit.

Revocable Designation

Beneficiary arrangement giving the policyowner the right to change the beneficiary.

Insurable Interest Timing

Requirement that insurable interest must exist at the inception of the contract for a life insurance contract to be valid.

Wellness Programs

Employer-based preventative health care plans that focus on enrollee problems, such as drug abuse or stress.

Presumptive Disability Exclusions

Presumptive disability includes loss of both hands, loss of hearing, and loss of speech, but EXCLUDES loss of sight in one eye.

Accelerated (Living) Benefit Rider Qualification

Situation qualifying an insured to receive living benefit rider funds, such as being expected to remain in a nursing home for life.

CT Workers' Compensation Disability Exclusions

Causes covered include falling on the job, job-caused illness, and strokes on the job, but EXCLUDING intentional, self-inflicted injuries that occur at the worksite.