INSURANCE SECTION 103 QUESTIONS
Defined benefit plan - Answer -the employer specifies amount of benefits promised to
the employee
Defined contribution plan - Answer -focuses on contributions rather than on the benefits
they will pay out
Tax deductible - Answer -a qualified expense that may reduce the amount of income
subject to taxation
Attained Age - Answer -the insured's age at the time the policy is issued or renewed
Benefit Period - Answer -a period of time during which benefits are paid under the
policy
Cost sharing - Answer -sharing of expenses between the insured and the insurance
company through deductibles, copays and coinsurance
Enrollee - Answer -a person enrolled in a health insurance plan, an insured (doesn't
include dependents of the insured)
HMO - Answer -Health maintenance organization. A prepaid health insurance plan in
which patients receive health care from designated providers
Nonforfeiture benefits - Answer -a cash or insurance benefit received by a policyholder
who no longer wishes to make payments after making premium payments for at least
the minimum period
Medicare - Answer -federal government plan for paying certain hospital and medical
expenses for persons who qualify
Available to anyone regardless of age
Part A: (Hospital Insurance) - Answer -financed through a portion of the payroll tax
(FICA)
*impatient hospital care
*skilled nursing facility care
*home health care
*hospice care
,Part B: (medical insurance) - Answer -is financed from monthly premiums paid by
insureds and from the general revenues of the federal government
*doctor services
*outpatient hospital services
*home health visits
*other medical and health services
Part C: (medicare advantage) - Answer -allows people to receive all of their health care
services through available provider organizations
Part D: (prescription Drugs) - Answer -for prescription drug coverage
Deductible - Answer -The portion of the loss that is to be paid by the insured before any
claim benefits may be paid by the insurer.
Medicaid - Answer -a. Medical benefits program jointly administrated by the individual
states and the federal government
Long-term care insurance - Answer -provide coverage for at least 12 months in a
setting other than an acute care unit of a hospital
Advertising - Answer -the insurance company must retain all advertisements for at least
3 years from the date that the advertisement was first used
Skilled care - Answer -daily nursing and rehabilitative care provided by medical
personnel
Home health care - Answer -provided by RN, licensed practical nurses, or hospice
Respite care - Answer -relief for a caregiver
Authorized insurer - Answer -insurer who has received a Certificate of Authority from
the department of insurance to transact insurance in this state
Commissioner - Answer -head of the state department of insurance
Reciprocity - Answer -mutual exchange of rights and privileges
Producers - Answer -individuals or business entities. That are licensed to sell, solicit, or
negotiate. Insurance
The renewal window begins _____ days before expiration - Answer -90
Every licensee must notify the commissioner of any changes to the licensee's
residential, mailing, business, or email address within - Answer -30 days
, If an insurer terminates a producers appointment, the commissioner must be notified
within _____ days after the effective date of the termination - Answer -30
Life insurance policy illustration must include the following information - Answer --
name and business address of the insurer and the producer
- name, age, and sex of. The proposed insured
- underwriting or rating classification upon which the illustration is based
Cease and desist order - Answer -specifies the practice. In violation and legally
requires the person to stop committing. It
If the commissioner decides to suspend or revoke a license it must - Answer -be
notified In writing
- is also able to request a hearing on the matter within 30 days of receiving the notice
Rebating - Answer -Any inducement offered in the sale of insurance products that is not
specified in the policy.
Coercion - Answer -use of force to get someone to obey
Defamation - Answer -Act of harming or ruining another's reputation
Discrimination - Answer -no discrimination may be made on the basis of an individuals
marital status, race, national origin, gender identity, sexual orientation.
Fair Credit Reporting Act - Answer -A federal law that established procedures that
consumer-reporting agencies must follow in order to ensure that records are
confidential, accurate, relevant and properly used.
Consumer Reports - Answer -Written and /or oral statements regarding a consumer's
credit, character, reputation, or habits collected by a reporting agency from employment
records, credit reports, and other public sources.
Investigative Consumer Report - Answer -Similar to consumer reports in that they also
provide information on the consumer's character, reputation, and habits.
Gramm-Leach-Bliley Act - Answer -requires financial institutions to ensure the security
and confidentiality of customer data
National Do Not Call Registry - Answer --before 8am and after 9pm
-Federal Trade Commision
-established business relationships last 18 months from the date of the sale or
transaction