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Temporary License Exception
A temporary license may be issued without state examination to all of the following EXCEPT a prospective producer who is currently enrolled in a pre-licensing insurance class.
Specified Disease Minimum Benefit in Pennsylvania
In Pennsylvania, a Specified disease accident and health plan must provide a minimum benefit in the amount of 5000.
Personally Identifiable Financial Information
According to Pennsylvania law, which of the following is NOT considered to be personally identifiable financial information? Blind trust data that does not include names and addresses.
Group Life Insurance Conversion
According to Pennsylvania law, group life insurance conversion privileges must NOT require evidence of insurability.
Mammograms Coverage Age Requirement
In Pennsylvania, accident and health plans are required to provide mammograms for women starting at age 40.
Advertising Exclusion
All of these are considered a form of advertising EXCEPT an insurer's A.M. Best rating.
Life Insurance Advertising Requirements
Advertising material for a life insurance policy does NOT need to contain which of the following? Producer's commission rate.
Spousal Coverage Request Timeline
In Pennsylvania, an employee must request spousal coverage under a group sponsored accident and health plan within 60 days of marriage.
Creditable Coverage Gap
In Pennsylvania, HIPAA laws require that an individual's prior creditable coverage may reduce the maximum pre-existing condition exclusion period provided there is no gap in creditable coverage for a period greater than 63 days.
Purpose of Advertising Regulations in Insurance
Advertising regulations exist in order to demonstrate full and truthful disclosures to the public.
Statements in Insurance Application
All statements in an insurance application, in the absence of fraud, are considered representations.
Total Disability Definition Change Period
In Pennsylvania, the definition of total disability changes from one's 'own occupation' to 'any occupation' after 24 months.
Time Limit on Certain Defenses Provision
In Pennsylvania, the Time Limit on Certain Defenses provision provides that no misstatements (EXCEPT fraud) on a health insurance application can be used to void the policy after 3 years.
Incontestable Annuity Period
After an annuity has been in force for 2 years, it becomes incontestable.
Rebate Definition
Charging a client less premium than what is stated in their insurance policy is called: a rebate.
Long-Term Care Policy Coverage
Long-Term Care policies must provide coverage for claims arising from senile dementia.
Lapsed Life Insurance Policy Reinstatement
Carmen's individual life insurance policy has recently lapsed. She may reinstate her policy within 3 years.
Pre-existing Condition Exclusion Period Limit
No Long-Term Care policy may exclude pre-existing conditions for a period of more than 6 months.
Shared Omissions by Producers
Omissions may be shared by licensed and appointed Producers.
Branch of Dentistry for Replacement
The branch of dentistry which deals with the replacement of missing parts is called: Prosthodontics.
Group Life Insurance Conversion Period
Greg has recently been terminated from his job that covered him for group life insurance. He has 31 days to convert his coverage to an individual policy.
Home Location for Licensing Purposes
For licensing purposes, if an applicant has a home or office location in the state of Pennsylvania, this would be consistent with which of the following? Home state.
Outline of Coverage Definition
The document that describes policy features, benefits, exclusions and riders in a Long-Term Care policy is known as the Outline of Coverage.
Administrative Penalty for Insurance Violations
For Pennsylvania Insurance Code violations, the Commissioner may assess an administrative penalty.
Medicare Supplement Open Enrollment Period
The Medicare Supplement open enrollment period is the 6 month period that begins with the month in which enrollment in Part B Medicare occurred, typically at age 65.
First Year Commission Limit
Under Pennsylvania statute, first year commission for long-term care insurance may not be greater than 50% of the first year premium.
Fiduciary Capacity in Premium Handling
Holding premium funds for timely submission to the insurer is an example of acting in a fiduciary capacity.
Affordable Care Act Coverage Levels
What are the levels of coverage as defined by the Affordable Care Act? Bronze, Silver, Gold, and Platinum.
Name Requirement in Annuity Advertising
Maria the producer would like to advertise an annuity product on a highway billboard. Which of the following must be included in the advertisement? Her name.
Temporary Producer License Issuance
If the Insurance Department determines that the issuance of a temporary producer license serves in the public's best interest, the license may be issued to an executor of a deceased producer's estate.
Long-Term Care Partnership vs. Non-Partnership Plan
What is the difference between a Long-Term Care Partnership Plan and a Non-Partnership Plan? Asset protection.
Soliciting Insurance Age Requirement
In order to solicit insurance in Pennsylvania, all of the following is required EXCEPT be at least 21 years of age.
Right to Examine Provision
Which accident and health policy provision allows the policyowner a stated amount of time to return a newly-delivered policy for a full refund of premiums? Right to examine.
Insurable Interest Without Economic Interest
On occasion, insurable interest may exist in the absence of economic interest. This pertains to a husband and wife.
Producer License Revocation Grounds
In Pennsylvania, a producer may have their license revoked for signing a prospect's name without their knowledge.
Life Insurance Guaranty Association Coverage
The Pennsylvania Life and Health Guaranty Association protects life insurance death benefit claims up to $300,000.
Life Insurance Advertisement Exclusion
Which of these is NOT considered a form of life insurance advertisement? Buyer's Guide.
License Denial for Insurance Producers
In Pennsylvania, an insurance producer license can be denied for failure to pay property tax.
Life Insurance Illustration Disclosure
A life insurance illustration showing future premiums being paid out of nonguaranteed values must disclose that the policyowner may need to resume premium payments depending on actual results.
Insurance License Renewal Requirements
In Pennsylvania, which of the following is NOT something a licensee must do to renew their insurance license? Confirm previous exam scores.
Life Insurance Contestability Period
A life insurance policy becomes incontestable after it has been in force for 2 years.
Continuing Education Content Approval
In Pennsylvania, who is responsible for Continuing Education (CE) course content approval? Commissioner.
Life and Health Producer Authorization
A life insurance producer licensed in the Commonwealth of Pennsylvania is authorized to solicit, receive, and forward applications to the insurer.
Continuing Education Credits Requirement
Producers must complete a total of 24 Continuing Education credits for each two-year licensing period.
Life Insurance Replacement Definition
A transaction in which a new life insurance policy is purchased and an existing policy is surrendered is called Replacement.
Illegal Inducement in Commission Sharing
Sharing 50% of a producer's commission with the insured is an example of illegal inducement.
Viatical Settlements Definition
Agreements made by terminally ill persons to sell their life insurance policies at a discount in order to pay medical expenses are called Viatical settlements.
Commissioner Duties
The Commissioner has the right and duty to audit insurer financial reports and conduct market studies.
Accelerated Death Benefit Percentage
An Accelerated Death Benefit in Pennsylvania must be at least 25% of the total death benefit.
Commissioner Responsibilities
The Commissioner is responsible for all of the following EXCEPT recommending insurers.
Medicare Supplement Policy Cancellation
A Medicare Supplement policy may be cancelled by an insurer for material misrepresentation.
Unfair Claims Practice Example
Any of the following may be an unfair claims practice EXCEPT refusing to pay persons bringing false claims.
Pennsylvania Department of Insurance Actions
The Pennsylvania Department of Insurance may take each of the following actions EXCEPT incarceration.
Medicare Supplement Policy Outline Requirement
A Medicare Supplement policy's outline of coverage MUST include a description of policy benefits.
Pennsylvania Insurance Department Responsibilities
The Pennsylvania Insurance Department is responsible for each of the following EXCEPT shareholders.
Newborn Coverage Requirement
A newborn is required to be covered for 31 days from the moment of birth.
Certificate of Coverage Receiver
Acme Corporation recently purchased a group health plan for its employees. Who would receive a certificate of coverage? Employees.
Violating Insurance Law Consequences
Violating Pennsylvania insurance law may result in issuance of a cease and desist order after a hearing.
US Code Title 18 Violations Penalty
Violations of US Code Title 18 section 1033, may result in fine and/or imprisonment and up to 50,000 for violation.
Policy Contestation Limitation
During the first two years a life insurance policy is in force, the insurer may contest a policy for all the following reasons EXCEPT misstatement of age.
Insurer Action on Cause of Death Confirmation
An insured dies from what appears to be accidental causes. When confirming the cause of death, the insurer must conduct an autopsy.
Producer Appointment Requirement
What is required before an insurance producer can act as a representative of an insurer? The producer needs to be appointed by that insurer.
Guaranty Association Purpose
What is the purpose of the Pennsylvania Life and Health Insurance Guaranty Association? Provide policyowner protection if an insurer becomes insolvent.
Policy Backdating Limit
In Pennsylvania, an insurer may backdate policy issue not more than 6 months from the application date.
Policy Return Period After Delivery
An insured may return their accident and health policy within 10 days of policy delivery.
Guaranteed Offer Requirement
An insurer is REQUIRED to offer inflation protection to each long-term care applicant at the time of purchase.
Assumed Business Name Requirement
What is the required action to be taken by a Pennsylvania licensee before operating under an assumed business name? Notify Commissioner.
Minor Payment Title Requirement
In Pennsylvania, what's the requirement for a minor to receive proceeds from a death benefit? A guardian must be appointed.
Medicare Supplement Benefits
Benefits for a Medicare Supplement policy must not duplicate Medicare benefits.
Immediate Life Insurance Payment Transaction
Life insurance may make an immediate benefit payment before the insured dies in a Viatical Settlement.
Creditors and Viatical Settlement Proceeds
Proceeds of a viatical settlement contract could be subject to the claims of creditors.
Prohibited Sales Practice Inducement
When a producer offers something of value in return for the purchase of an insurance policy, this constitutes inducement.
Newborn Coverage Under Accident and Health Plan
Coverage for newborns under an accident and health plan MUST include coverage for birth abnormalities.
State Definition for Licensing Purposes
When an applicant for a producer's license has a principal place of residence or business location in Pennsylvania, the State of Pennsylvania is known as the home state.
Free Look Period for Individual Policies
The free look period provided in a life insurance policy is usually 10 days.
Unreasonable Claim Denial Exemption
When an insurance company consistently fails to provide reasonable explanations for the denial of a claim, this is an unfair claim settlement.
Health Insurance Ads Statistical Information Requirement
Health insurance advertisements that mention statistical information are required by Pennsylvania law to accurately convey all pertinent facts.
Viatical Settlement Broker Limitations
Viatical settlement brokers are permitted to do all of the following EXCEPT make the first transaction up to 30 days before approved for a license.
Timely Premium Submission Requirement
When collecting insurance premiums from a client, a producer MUST forward premiums to the insurer on a timely basis.
Soliciting Insurance Restrictions
When soliciting insurance, a producer CANNOT emphasize Guaranty Association benefits.
Maternity Benefits Minimum Hours Requirement
Health insurance policies that provide maternity benefits must provide for a minimum of 96 hours of inpatient care following a Caesarean delivery.
Viatical Settlement Information Packets
Viatical settlement brokers send packets of information to potential viatees, which include a viator's medical prognosis.
Life Insurance Policy Contestability Note
The policy can be contested by the insurer only during the first two years of the contract.
Incontestability Protection Provision
Which of following provisions protects a Pennsylvania policyowner from an innocent mistake made on the application over 2 years ago? Incontestability provision.
Health Policy Reinstatement Waiting Period
If a health policy is reinstated after a lapse for nonpayment, there is a waiting period of 10 days before a claim for sickness will be covered.
Producer License Suspension Grounds
Which of the following constitutes grounds for suspending a Pennsylvania producer's license? Felony conviction.
Producer Definition
Which of the following is a person who negotiates an insurance contract on behalf of an insurer? Producer.
Violation of Pennsylvania Insurance Law
Offering insurance contracts through unlicensed entities is a violation of Pennsylvania insurance law.
Producer License Maintenance Requirement
Which of the following is required to maintain a producer's license in Pennsylvania? Field underwriter who solicits insurance and earns a commission.
Long-Term Care Policy Renewability Requirement
In Pennsylvania, a Long-Term Care policy must be guaranteed renewable.
Health Insurance Advertisement Company Name Requirement
In Pennsylvania, health insurance advertisements are required to contain the insurance company's name.
Long-Term Care Policy Services Coverage
Long-term care insurance provides one or more diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services.
Pennsylvania Insurance Department Non-Responsibilities
Which of the following is the Pennsylvania Insurance Department NOT responsible for? Shareholders.
Illegal Personal Use of Client Premiums
The prohibited act involving a producer spending a client's insurance premiums for personal use is called embezzlement.
Producer Commission Eligibility
Who can receive an insurance commission? Producer.
Producer Reporting Requirement
Within how many days must a producer report to the Commissioner any charges made against him/her? 30 days.
Long-Term Care Policy Exclusion
Long-term care policies sold in Pennsylvania may exclude coverage related to substance addictions.
Insurance Claim Validity Action Timeframe
In Pennsylvania, no legal action may be taken against an insurer for failure to honor a valid claim after 3 years from the time proof of loss is furnished.
Claim Form Sending Requirement
Once the insurance company receives a notice of claim, they have 15 days to send the claim form.
Long-Term Care Coverage Requirement
A Long-Term Care plan must provide inflation protection rider options.
