Life & Health Insurance Comprehensive Practice

Chapter 1 Introduction to Insurance

  • Insurance Definition: A protection against the uncertainty of the future. It is a contract activated by an unforeseen event causing a loss. The risk is transferred to the insurer through benefits (payments) based on policy terms.

  • Risk: The uncertainty concerning a loss. It is a condition where a chance, likelihood, or probability of potential loss exists.

  • Pure Risk: Results in a loss or no change; there is no possibility for gain. This is the only type of risk insurance is designed to protect against.

  • Speculative Risk: May result in a gain, loss, or no change (e.g., gambling/stock market). These are not insurable.

  • Loss: A reduction, decrease, or disappearance in value affecting property or financial position. It acts as the basis for a claim.

  • Exposure (Loss Exposure): The condition of being at risk for a loss, regardless of whether an actual loss occurs.

  • Peril: The cause of a loss (e.g., fire, lightning, death, injury, sickness).

  • Hazard: Specific conditions increasing the likelihood of a loss from a peril.

    • Physical Hazard: Physical conditions (e.g., flammable material near a furnace, icy sidewalks).

    • Moral Hazard: Dishonest tendencies (e.g., faking an injury, intentional arson). These are excluded from coverage.

    • Morale Hazard: Indifference toward risk (e.g., leaving a car unlocked with keys in the ignition).

  • STARR Methods of Managing Risk:

    • Sharing: Distributing risk among multiple risk-takers (e.g., condominium associations, coinsuring).

    • Transfer: Shifting risk to another party, primarily through insurance policies or business incorporation.

    • Avoidance: Eliminating risk by not participating in activities (e.g., not driving).

    • Reduction: Minimizing risk (e.g., installing fire sprinklers, diet/exercise).

    • Retention: Maintaining responsibility for a loss (e.g., self-insurance, deductibles).

  • Elements of Insurable Risks:

    • Large number of homogeneous (similar) units to help predict future losses.

    • Statistically predictable losses for premium calculation.

    • Uncertain, accidental, and due to chance.

    • Measurable (definite amount, cause, place, and time).

    • Causes financial hardship.

    • Non-catastrophic (excludes war, nuclear hazards, or illegal activity).

  • Law of Large Numbers: A probability theory stating that as the sample size increases, the accuracy of predicted losses increases. Homogeneous units are similar units used in this theory.

  • Adverse Selection: The principle where people with higher risks seek insurance more frequently than average risks. Insurers counter this by charging higher premiums or declining coverage.

  • Reinsurance: Insurance for insurers. The primary company is the ceding insurer; the company assuming risk is the reinsurer.

    • Treaty Reinsurance: Automatic transfer of an entire class of risks.

    • Facultative Reinsurance: Negotiation for a single specific risk.

  • Types of Insurers:

    • Stock Company: Owned by stockholders who share in profits via taxable dividends. Usually issue nonparticipating policies.

    • Mutual Company: Owned by policyholders (members) who may receive non-taxable dividends as a return of premium. Usually issue participating policies.

    • Fraternal Benefit Societies: Social/nonprofit organizations providing life insurance to members (e.g., religious/lodge groups).

    • Reciprocal Insurance: Unincorporated group where members (subscribers) exchange insurance via an attorney-in-fact.

    • Risk Retention Groups (RRGs): Group-owned insurers spreading liability-related risks of members in a common trade.

    • Lloyd’s Associations: Syndicates of individual underwriters individually liable for risks.

    • Captive Insurance: Owned and controlled by the parent corporation it insures.

  • Insurer Domicile:

    • Domestic: Formed under the laws of the current state.

    • Foreign: Formed under the laws of another U.S. state/territory.

    • Alien: Formed under the laws of a jurisdiction outside the United States.

  • Admittance: An admitted (authorized) insurer has a Certificate of Authority; a non-admitted (unauthorized) insurer does not.

  • Insurer Departments:

    • Actuarial: Determines probability of loss and premium rates. A rate is the dollar amount per unit (e.g., 55 per 1,0001,000).

    • Underwriting: Selects risks and determines the final premium.

  • Marketing Distribution Models:

    • Exclusive/Captive Agency: Represents only one company; insurer owns the business.

    • Independent Agency: Represents multiple insurers; agency owns the business.

    • Direct Writing: Agents are employees of the insurer.

    • Mass Marketing: Targets specific groups (e.g., AARP) via direct mail/media.

  • Law of Agency: Relationship between Principal (Insurer) and Agent (Producer).

    • Express Authority: Specifically granted in the contract.

    • Implied Authority: Necessary to carry out express duties (e.g., using company logo on cards).

    • Apparent Authority: Created by the agent's actions that the public assumes are authorized and the principal fails to counter.

  • Fiduciary Duty: Legal/ethical trust regarding handling principal money and reporting material facts.

  • Insurance Regulation:

    • McCarran-Ferguson Act of 1945: Established state-level regulation of insurance.

    • NAIC (National Association of Insurance Commissioners): Promotes uniformity but does not make laws.

    • Fair Credit Reporting Act (FCRA): Protects consumer privacy. Adverse information is excluded after 7 years7\text{ years}; bankruptcies after 10 years10\text{ years}.

    • Gramm-Leach-Bliley Act (GLBA): Protects nonpublic personal information via Financial Privacy and Safeguards Rules.

    • USA PATRIOT Act: Anti-money laundering (AML) training and reporting of suspicious activities (e.g., single-premium cash payments).

    • Fraud and False Statements (18 USC 1033103418\text{ USC } 1033-1034): Penalties include up to 10 years10\text{ years} in prison; (15 years15\text{ years} if the activity jeopardizes an insurer). Embezzlement under 5,0005,000 allows up to 1 year1\text{ year}.

    • Violent Crime Control and Law Enforcement Act of 1994: Prohibits felons involving dishonesty from insurance work without a 10331033 waiver.

  • Insurance Contract Concepts:

    • Principle of Indemnity: Restoring the insured to the same financial/physical condition as before the loss; the insured should not profit.

    • Insurable Interest: Required at the time of application for life/health insurance. Based on financial hardship from a loss.

    • Elements of a Legal Contract: Competent Parties (no minors/intoxicated), Legal Purpose (insurable interest), Offer and Acceptance (Agreement), and Consideration (premium payment vs. promise to pay).

    • Contract of Adhesion: Written by one party (insurer) with no negotiation. Ambiguities are ruled in favor of the insured.

    • Unilateral Contract: Only one party (insurer) is legally bound to future performance.

    • Conditional Contract: Both parties must perform duties (e.g., pay claim if conditions are met).

    • Aleatory Contract: Unequal exchange of value due to uncertainty.

    • Personal Contract: Cannot be transferred (except life insurance, which can be assigned).

    • Utmost Good Faith: Parties act honestly without misleading.

    • Representations: Statements believed to be true. Material misrepresentations can void a policy.

    • Warranties: Guaranteed statements of fact. Breach of warranty voids the contract.

    • Waiver and Estoppel: Waiver is voluntary surrender of a right; Estoppel is judicial denial of a right based on prior actions.

Chapter 2 Life Insurance Basics

  • Definitions:

    • Policyowner: Applicant who controls the policy and rights.

    • Insured: Individual whose life is covered.

    • Third-party Ownership: Policy owned by someone other than the insured (e.g., spouse/employer).

    • Beneficiary: Receives death benefits; cannot be the insured.

  • Classifications of Policies:

    • Group vs. Individual: Group covers many via a Master Policy/Certificates of Insurance; Individual covers one person and requires evidence of insurability.

    • Permanent vs. Term: Permanent (e.g., Whole Life) accumulates cash value to age 100100; Term is temporary protection with no cash value.

    • Participating vs. Nonparticipating: Participating (Mutual) pays dividends; Nonparticipating (Stock) does not.

    • Fixed vs. Variable: Fixed has guaranteed returns (general account); Variable has investment risk (separate account).

  • Personal Uses:

    • Survivor Protection: Income for dependents.

    • Estate Creation: Providing an immediate lump sum assets.

    • Estate Conservation: Funds to pay taxes/fees to save estate assets.

    • Cash Accumulation: Living benefit via cash value.

    • Liquidity: Immediate funds for final expenses.

  • Determining Amount of Life Insurance:

    • Human Life Value Approach: Calculates the present value of future earnings (factors age, income, retirement age).

    • Needs Analysis Approach: Based on survivor needs (burial, debt, education, spouse retirement).

    • Blackout Period: Time when a surviving spouse is ineligible for Social Security benefits (youngest child age 1616 until spouse age 6060).

    • Capital Retention vs. Liquidation: Retention maintains the principal and pays interest as income; Liquidation spends down the principal and interest.

  • Business Uses:

    • Buy-Sell Agreement: Contractual intent to purchase assets of a business at a partner's death.

    • Cross Purchase: Each partner buys policies on others (Number of policies = n×(n1)n \times (n-1), where nn is the number of partners).

    • Entity Plan: Business buys policies on each owner.

    • Stock Redemption: Corporate version of an entity plan.

    • Key Person Insurance: Business is owner and beneficiary to cover loss of a critical employee.

    • Executive Bonus Plan: Nonqualified plan where employer pays premiums for employee-owned life insurance as a tax-deductible bonus.

  • Sales and Solicitation:

    • Buyer’s Guide: General info for consumers.

    • Policy Summary: Specific details of the applied-for policy.

    • Policy Illustration: Nonguaranteed values/dividends.

    • Replacement: Transaction where existing policies are lapsed/surrendered for a new one. Requires a Notice Regarding Replacement.

  • Underwriting Sources:

    • Application: Part I (General info) and Part II (Medical history).

    • Medical Exam: Paramedic/RN check, vital stats.

    • MIB (Medical Information Bureau): Non-profit exchange for adverse medical info; cannot be the sole basis for denial.

    • Attending Physician Statement (APS): Physician report on specific conditions.

    • Agent’s Report: Confidential producer observations.

  • Risk Classifications:

    • Standard: Average life expectancy.

    • Preferred: Ideal health; lower premiums.

    • Substandard (Rated): Poor health/habits; surcharges apply.

    • Graded (Lien): Death benefit increases over time.

    • Rated-up Age: Premiums based on an older age.

    • Flat Rate: Constant dollar surcharge (e.g., +55 per 1,0001,000).

    • Tabular: Based on table of impairments.

  • Premium Determination: Formula is MortalityInterest+Expenses=GrossPremiumMortality - Interest + Expenses = Gross Premium.

  • Net Single Premium: MortalityInterestMortality - Interest.

  • Delivery:

    • Constructive Delivery: Policy mailed from insurer to producer.

    • Statement of Good Health: Required if premium is not paid at application.

    • Conditional Receipt: Coverage starts on date of application or medical exam (whichever is later) if issued as applied for.

Chapter 3 Types of Life Insurance

  • Term Life Insurance (Temporary):

    • Pure protection; no cash value; low initial cost.

    • Level Term: Death benefit and premium stay level.

    • Annual Renewable Term (ART): Renewable each year without proof of health; premium increases based on attained age.

    Chapter 8 Health Insurance Basics

    • Perils Covered:

      • Accidental Injury: Involves unforeseen events that result in injuries. The term "Accidental Means" applies a stricter definition, requiring both the cause and effect to be unexpected.

      • Sickness: Refers to illnesses that manifest after the policy has been issued.

    • Types of Losses:

      • Medical Expense: Costs associated with doctor visits, hospital stays, and surgeries.

      • Dental Expense: Inclusive of routine cleanings and other dental treatments like fillings and surgeries.

      • Disability Income: Compensation for lost wages due to a disability.

      • Long-term Care: Support services for individuals with chronic illnesses or disabilities requiring assistance.

    • Classes of Health Insurance:

      • Individual vs. Group: Individual plans necessitate health evidence; group plans are provided by employers or organizations with no medical exams for eligible members enrolled during the open enrollment period.

      • Private vs. Government: Covers plans like Medicare, Medicaid, and TRICARE, among others.

      • Limited vs. Comprehensive Coverage: Limited plans restrict benefits to specific occurrences, while comprehensive plans provide broader coverage.

    • Limited Policies (Notice of Limited Policy required):

      • Accident-Only: Fixed benefits for injuries due to accidents only.

      • AD&D (Accidental Death and Dismemberment): Provides lump-sum payments in case of accidental death or dismemberment.

      • Hospital Indemnity Insurance: Covers a daily cash benefit for hospitalization up to a predetermined limit (e.g., 100100/day).

      • Dread Disease Insurance: Specifically targets critical illnesses like Cancer or Stroke.

      • Credit Disability Insurance: Intended to cover loan payments during a period of disability.

    • Underwriting Factors:

      • Include age, gender, tobacco use, occupation (with hazardous jobs often incurring higher premiums), location, and medical history.

    • Morbidity:

      • Refers to the expected frequency of medical claims within a year; higher morbidity forecasts lead to higher premiums, notably as women generally exhibit higher morbidity rates than men.

    • Premium Formula:

      • Calculated as MorbidityInterest+ExpensesMorbidity - Interest + Expenses.

    • Mode of Payment:

      • Payment frequency affects overall costs; for example, choosing monthly payments usually incurs additional processing fees that elevate total annual costs.

    Chapter 9 Individual Medical and Dental Plans

    • Service Definitions:

      • Insured: Refers to individuals participating in indemnity insurance plans.

      • Subscriber: Individuals enrolled in managed care plans.

    • Managed Care Structures:

      • HMO (Health Maintenance Organization): Requires members to use contracted providers, focusing on preventive care with a primary care physician (PCP) acting as the gatekeeper.

      • PPO (Preferred Provider Organization): Provides flexibility in provider choice, often with lower out-of-pocket costs when visiting network providers.

      • POS (Point of Service): A hybrid model that allows for out-of-network services but at higher costs.

    • Cost Sharing:

      • Deductible: The amount required to be paid out-of-pocket before insurance kicks in.

      • Coinsurance: Ratio of cost-sharing post-deductible, commonly seen as 80/2080/20.

      • Copayment (Copay): A fixed charge applicable per service or visit.

      • Stop-Loss: A cap on how much an insured will pay out-of-pocket; beyond this limit, the insurer covers 100% of costs.

    • Plan Types:

      • Basic Medical Coverage: Designed to provide initial cost cover without deductibles but with lower limits.

      • Major Medical Insurance: Offers a safety net for high-cost medical events with higher deductibles.

      • Comprehensive Major Medical Coverage: Merges both basic and major medical features.

      • Corridor Deductible: Applies after basic limits are reached.

    • Mandatory Benefits:

      • Newborn Care: Coverage begins from birth, with a 31day31-day notification requirement to inform the insurer.

      • Dependent Coverage: Includes children up to age 2626.

      • Maternity Coverage: Requires minimum stay of 4848 hours for uncomplicated births and 9696 for cesarean deliveries.

    • Dental Categories:

      • Diagnostic/Preventive: Covers basic dental care like cleanings without a deductible requirement.

      • Restorative: Includes fillings and other corrective procedures.

      • Additional Services: Encompasses oral surgery, endodontics, periodontics, prosthodontics, and orthodontics with varying payment structures based on UCR (Usual, Customary, Reasonable) measures.

    • ACA (Affordable Care Act):

      • Guarantees Essential Health Benefits across ten categories, including maternity, mental health, and prescription drugs.

      • Categorizes plans into metal tiers—Bronze (coverage at 60\text{%}), Silver (70\text{%}), Gold (80\text{%}), and Platinum (90\text{%}).

      • Ensures Guaranteed Issue with no pre-existing condition exclusions for individuals under 2626 and caps annual or lifetime limits on essential benefits.

    Chapter 10 Disability Income

    • Qualifying for Benefits:

      • Distinction between Own Occupation (best for insured) and Any Occupation (more challenging criteria).

      • Elimination Period (Waiting Period): Varies from 3030 to 180180 days before benefits commence.

      • Benefit Period: Duration of payable benefits can range from a fixed number of years, up to age 6565.

    • Disability Types:

      • Total vs. Partial: Reflects the extent of disability affecting the individual's capability to work.

      • Residual Benefits: Compensation for income loss while partially employed.

      • Recurrent Disability: Reoccurrence of a similar disability within 66 months typically avoids a new elimination period.

      • Presumptive Disability: Assured qualification based on total loss of function in key areas such as limbs or senses.

    • Business Disability Coverage:

      • Business Overhead Expense (BOE) Insurance: Covers operational costs during owner disability.

      • Disability Buy-Sell Agreement: Facilitates acquisition of a partner’s business share when they become disabled.

    • Coordination of Benefits:

      • Use of the Social Insurance Supplement (SIS) Rider for income replacement until Social Security payments start.

      • SIS calculation: PolicyBenefitSocialSecurityBenefitPolicy Benefit - Social Security Benefit.

    • Workers’ Compensation Insurance:

      • Covers injuries sustained at work, taking precedence over other health insurances.

    • Social Security Disability Insurance:

      • Eligibility hinges on total disability lasting at least 1212 months or impending death, with a 55 month waiting interval before benefits are disbursed.

    Chapter 11 Senior Needs

    • Medicare:

      • Eligibility Criteria: Available at age 6565, or for specific disabilities (e.g., SSDI for two years, ESRD, ALS).

      • Benefit Breakdown:

      • Part A (Hospital Insurance): Funded through FICA taxes; involves deductibles and copays for service durations.

      • Part B (Medical Insurance): Voluntary enrollment entails premiums, covering outpatient services with a 20\text{%} coinsurance.

      • Part C (Medicare Advantage): Integrative plans combining various coverage types via private entities.

      • Part D (Prescription Drug Coverage): Involves gaps in coverage known as the "Donut Hole" preventing full benefit utilization.

    • Medigap Insurance:

      • Offers supplemental benefits covering gaps left by Medicare Parts A and B, ensuring extended hospital reach (up to 365365 extra days).

      • Guaranteed issued status during a 66 month open enrollment window at age 6565.

    • Long-Term Care Services:

      • Trigger events such as falling short of performing 22 out of 66 Activities of Daily Living (ADLs), including fundamental life functions like bathing and dressing.

      • Divided into levels: Skilled (intensive), Intermediate, and Custodial (personal assistance).

      • Provisions ensure customers can exercise a 3030 day free look option, with guarantees for renewal.

      • Benefits typically fall under tax-qualified categorizations, adhering to HIPAA standards.

    Chapter 12 Individual Accident and Health Policy Provisions

    • Mandatory Provisions:

      • Entire Contract Clause: No amendments by the agent; the contract stands as a complete document.

      • Time Limit on Defenses: Conditions against claims must be invoked within 22 years (Incontestability).

      • Grace Periods: Defines allowable late payments (ranging from 77 to 3131 days across types).

      • Reinstatement Procedures: Outlines conditions for regaining coverage after lapses.

      • Document Filing Requirements: Specific timelines for claims processing and notification (e.g., notice within 2020 days, forms sent out by the insurer within 1515).

      • Legal Procedures: Time limits and conditions governing legal action against the insurer.

    • Optional Provisions:

      • Clauses adjusting benefits based on variations such as occupation changes or age inaccuracies.

    • Renewability Clauses:

      • Ranges from noncancellable guarantees of premiums to more flexible options allowing for periodic review.

    Chapter 13 Group Health and Consumer-Driven Healthcare

    • Eligible Groups:

      • Generally comprises natural collectives like employers, multiple employer trusts (METs), and associations.

    • Multi-employer Welfare Arrangement (MEWA):

      • Arrangements enabling pooling of funds among unrelated employers in adherence to ERISA.

    • Multiple Employer Trust (MET):

      • Groups of businesses from the same sector banding together for improved rates.

    • Group Policy Provisions:

      • Coordination between different health plans to avoid over-coverage and ensure coverage during life events like divorce with COBRA.

      • Enactment of HIPAA ensuring better portability and coverage during transitions.

    • Consumer-Driven Plans:

      • Health Savings Accounts (HSA): Require High Deductible Health Plans (HDHP), allowing pre-tax contributions and carryover provisions.

      • Flexible Spending Accounts (FSA): Features a “use it or lose it” policy with limited carryover.

      • Health Reimbursement Arrangements (HRA): Exclusively funded by employers for employee reimbursements.

    • Tax Considerations:

      • Employer-funded premiums provide a tax deductions for businesses with no income tax liabilities for employees.

      • The tax implications for disability benefits vary depending on who made the premium contributions, impacting net taxable income accordingly.

  • Consumer-Driven Plans:

    • HSA (Health Savings Account): Requires HDHP (High Deductible Health Plan). Pre-tax contributions. Funds roll over. Employee-owned.

    • FSA (Flexible Spending Account): "Use it or Lose it" (except for small carryover/grace period). Funded by salary reduction.

    • HRA (Health Reimbursement Arrangement): Employer-funded only. Reimburses medical expenses.

  • Tax Considerations:

    • Employer-paid premiums are tax-deductible to business and not income to employee.

    • Disability benefits from employer-paid premiums are taxable income. Employee-paid portions are tax-free.

  • Insurance Definition: A contract for protection against future uncertainties, activated by unforeseen events causing loss.

  • Risk Types:

    • Pure Risk: Causes loss or no change; insurable.

    • Speculative Risk: Can result in gain, loss, or no change; not insurable.

  • Loss: Reduction in value that serves as the basis for claims.

  • Exposure: State of being at risk for loss.

  • Peril: Cause of loss (e.g., fire, death).

  • Hazard: Conditions increasing the chance of loss; types include physical, moral, and morale hazards.

  • STARR Methods: Strategies for managing risk—Sharing, Transfer, Avoidance, Reduction, Retention.

  • Insurable Risks: Requirements include predictability, measurability, financial hardship, and non-catastrophic causes.

  • Law of Large Numbers: Predicts accuracy increases with larger sample sizes of homogeneous units.

  • Adverse Selection: Higher risk individuals seek insurance more often, leading to higher premiums for insurers.

  • Types of Insurers: Include stock companies, mutual companies, fraternal benefit societies, and Lloyd’s associations.

  • Insurance Regulations: Governed by acts like McCarran-Ferguson and laws by the NAIC.

  • Contract Concepts: Principles include Indemnity, Insurable Interest, adhesion in contracts, representations, and waivers.