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Producer
An individual appointed by an insurance company to represent the company and present policies on its behalf.
Licensed Insurance Producer
An individual authorized to solicit, receive, and forward applications to the insurer and receive commissions.
Resident License
A license for individuals residing in Pennsylvania to sell insurance.
Prelicensing Course
A 24-hour course that must be completed by Pennsylvania residents seeking an insurance license in a specific line of authority.
Temporary License
A license that may be issued to replace a disabled or deceased producer, valid for a maximum of 180 days.
Continuing Education Credits
24 hours of required education that producers must complete every two years to renew their licenses.
Insurer
The company that provides insurance coverage and policies.
Reciprocal Agreement
An arrangement allowing producers licensed in one state to apply for a license in another state without additional education or exams.
Commissioner
The appointed official responsible for enforcing insurance laws and regulations.
Disciplinary Actions
Actions that the Insurance Commissioner may take against a licensee, including suspension or revocation of a license.
Financial Examination
An inspection conducted by the Insurance Commissioner to ensure an insurer's financial compliance.
Certificate of Authority
A certification required for an insurance company to conduct business in a state.
Policy Forms Regulation
The requirement that policy forms must be submitted to and approved by the Insurance Commissioner.
Unfair Discrimination
Prohibited practice of assessing insurance rates based on race, religion, or national origin.
Fiduciary Responsibility
Producers’ obligation to responsibly manage funds collected from clients.
Viatical Settlement
An agreement allowing terminally ill policyholders to sell their life insurance policy for a percentage of its face value.
Long-Term Care Insurance
Insurance that covers care for individuals needing assistance with daily activities over an extended period.
Free Look Period
A designated time (usually 10 days) during which a policyholder can return their policy for a full refund.
Gramm-Leach-Bliley Act
A law that allows financial institutions to offer a combination of banking, insurance, and securities product.
HIPAA
Health Insurance Portability and Accountability Act; provides guidelines to protect health insurance coverage for workers and their families when they change jobs.
Medicare Supplement Insurance
Plans that help cover costs that Medicare does not, including co-payments, coinsurance, and deductibles.
Accident Insurance
Coverage that provides benefits for injuries resulting from accidents.
Exchanges (ACA)
Platforms created by the Affordable Care Act to help individuals and small businesses acquire health insurance.
Critical Illness Insurance
Insurance providing coverage for specific illnesses, usually with a lump-sum payment upon diagnosis.
Insurance Fraud
Any intentional act to deceive or misrepresent facts in the course of insurance business.
Right to Examine Provision
The clause in insurance policies allowing consumers a set period to review and cancel without penalty.
Grace Period
A time frame (often 30 days) during which a policy remains in force after premium due.
Claim Forms
Documents insurance companies are required to send to clients within a certain time frame after a claim notice.
Proof of Loss
Written evidence required by an insurance company to validate a claim.
Incontestability Clause
Provision that limits the time period during which an insurance policy can be contested.
Notice of Claim
Written notification to an insurance company about a claim that must be filed within a specified timeframe.
Reinstatement of Policy
The process of reviving a lapsed insurance policy under certain conditions.
Long-Term Care Partnership Program
A program allowing individuals with long-term care insurance to protect assets while qualifying for Medicaid.
Consumer Financial Information Privacy
Regulations ensuring that licensed providers protect sensitive consumer data.
Disability Income Insurance
Insurance designed to replace income lost due to a disabling injury or illness.
Health Insurance Portability
The ability for individuals to keep health coverage when changing employers.
Shopper's Guide
A guide provided to potential insured individuals to help compare insurance policies.
Insurance Application
The formal request submitted to an insurance company seeking coverage.
Life Insurance Disclosure
Mandatory information about life insurance policies to be provided to the policyholder.
Long-Term Care Insurance Requirements
Conditions mandated by Pennsylvania law regarding long-term care insurance policies.
Penny Cost Index
A comparison tool used to compare the costs between various types of life insurance policies.
Mental Health Coverage
Required health insurance benefits for serious mental illnesses.
Fixed Life Insurance
Policies which provide a guaranteed death benefit and fixed premiums.
Variable Life Insurance
Insurance policies that offer returns based on the performance of specific investments.
Nonrenewable Insurance Policies
Policies that are not renewable, typically limited in duration.
Federal Trade Commission (FTC) Regulation
Federal guidelines regulating telemarketing practices, including those used by insurance producers.
Annual Maximum Benefit
The maximum amount an insurer will pay within a policy year.
Insurance Lapse
The termination of insurance coverage due to nonpayment of premiums.
Claim Denial
The insurer's formal refusal to pay a claim under the policy.
Nominee Beneficiary
Beneficiary chosen to receive benefits upon the policyholder's death.
Insurance Rate LEveling
The method of maintaining steady premiums over time for policyholders.
Insured's Rights
The rights of policyholders to understand and appeal claim decisions made by their insurer.
Market Conduct Violation
Failure of an insurance entity to adhere to fair practices in the insurance market.
Underwriting Guidelines
Standards set by insurers to assess risk and determine eligible coverage.
Maternity Benefits
Coverage for expenses related to pregnancy and childbirth.
Children's Coverage
Insurance benefits provided for dependents under the policyholder's plan.
Self-funded Plans
Insurance plans funded directly by employers to cover employees.
Mental Health Parity
Laws requiring insurance companies to provide equal coverage for mental and physical health conditions.
Consumer Protection Act
Legislation protecting consumers against unfair, deceptive practices in insurance.
Unfair Practices Act
Laws aimed at regulating unethical behavior in the insurance industry.
Accidental Death Riders
Policies providing additional benefits in the event of death caused by an accident.
Lapsed Policy Reinstatement
The process by which policyholders can reinstate their insurance coverage after it has lapsed.
Total Disability Definition
The criterion that defines the extent of disability required to qualify for benefits.
Annuity Exchange Regulation
Requirements governing the exchange of one annuity for another.
Fraudulent Insurance Practices
Any deceptive or fraudulent activity related to insurance transactions.
Health Coverage Continuation
The extension of health insurance benefits for individuals after job loss.
Chronic Illness Insurance
Coverage specifically designed to help patients with long-term medical conditions.
Interactive Benefits analysis
An assessment tool that helps consumers compare different health care plans.
Health Claims Adjudication
The process of evaluating and paying health insurance claims.
Financial Impairment of Insurers
A condition where an insurer fails to meet its financial obligations.
