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Examen

Disability and Life Washington Test 2025

Puntuación
-
Vendido
-
Páginas
14
Grado
A+
Subido en
17-05-2025
Escrito en
2024/2025

Life Insurance Disability and Life Washington Test 2025 Insurance Commissioner - Correct Ans-Head of Office of Insurance Commissioner, is in charge of company supervision, consumer protection, and rates and forms. -Elected on a 4 year term -Pays 25k bond -Must examine records at least every 5 years Has Power to: -Issue rules to carryout or enforce the state insurance code -Hold investigations, -Hold examinations to see if anyone has broken the code. If commish has reason to believe someone has broken the code, they can: -Issue a cease and desist order -sue to stop the person from continuing the action -Do both If Someone found guilty commish can: -Suspend, revoke, or refuse to issue a license: Must give 15 day warning and hearing can be asked for. If hearing happens, must give 10 day warning. -Impose a civil penalty If someone doesnt have a license they can pay up to a 25k fine per infraction Filing Rates and Forms - Correct Ans--Must be filed at least 30 days before use -If not rejected automatically approved after 30 days -Commish can extend approval period by 15 days -Premiums have to be approved too Penalties for breaking insurance code - Correct Ans--It is a misdemeanor -Fine of $10-$1000 must be paid 15 to 30 days after given -Imprisonment for up to 364 days -both -Any other appropriate penalty An Insurer is: - Correct Ans— Insurance Company -Fraternal Benefit Society -Certified Health Plan -Health Maintanence Org. -Health Care Service contractor Not Insurance - Correct Ans--Travel or auto services (like AAA) Life Insurance Life Insurance -Private air ambulance -Travel emergency service "Insurance License" is called - Correct Ans--Certificate of Authority Insurance Gauranty Association - Correct Ans— Protects insureds for 500k for: Life, medical, disability, annuity -100k to gvt retirement benefit plan -Can not be advertised -Happens if insurer is not solvent Temporary License - Correct Ans— Can be granted for 180 days -To surviving spouse or court appointed beneficiary for purpose of sale of business -To member of business if owner dies -To person who will take over business while employee is on active duty for military -To serve the public interest Nonresident Producer License - Correct Ans--Currently Licensed as a producer in their home state -Fulfilled application requirements and paid fees -The applicants home state will also grant nonresident licenses on the same basis Exceptions to those who need licenses: - Correct Ans--Officer, director, etc... of an insurance company who doesn't get commission -Someone who just enrolls individuals with plans without getting commission Persons Exempt from Taking Exam: - Correct Ans--Persons who seek a license only to transact limited lines (surety, limited line credit, and travel insurance) -Persons who seek a license only to transact -Specialty lines (communications equipment or services, rental car, or self-service storage) -Persons applying for an adjuster's license who, for at least one year before the application, have been fully employed by an insurer to adjust, investigate, or report insurance claims -Persons applying for a nonresident adjuster's license who are licensed in another state and qualified for a similar license in Washington Appointing a producer - Correct Ans--Insurance company lets commish know w/in 15 days -Commish will get back in 15 days -Commish does have 30 days to determine if the applicant is not able to be approved, if so, they will let the company know in 10 days. -If company gets rid of producer, must let commish know in 30 days, and producer in 15 Refusal, Non-renewal, and revocation of license - Correct Ans--Must deliver order to licensee 15 days before it takes effect and give them the right to a hearing Life Insurance Life Insurance -Issuing an order after a hearing must take effect in 10 days and give the licensee the right to appeal to a higher court Suspension of License - Correct Ans— Can not be suspended for more than 12 months Fines - Correct Ans--Maximum fine 1k -Must pay fine between 15-30 days of getting it -If you don't pay your license will be revoked Renewals for License - Correct Ans--For individual, renewed on b-day -For company renewed every 2 years on date it was issued -If late must pay 50% more between late date and 30 days, double renewal fee between 31 days and 60 days, and triple between 61 days and 12 months. -After 12 months must apply for completely new license CE - Correct Ans--Must earn 24 hours every 24 months -3 hours must be on ethics -CE can be waived for medical issues or military service Annuities - Correct Ans--Must complete 4 hour training course LTC riders - Correct Ans--To sell LTC riders must complete 8 hour inital training -And 4 hours in addition to 24 month CE -Every march 31 businesses must affirm all their employees have this shit done Marketing Insurance - Correct Ans-- No unfair or deceptive practices: if violated 10 days after recieving order to stop, $250 fine per violation -No agreements to control rates of charged for premiums to charge a certian risk, no discriminating against anyone based on his/her insurance plan, etc...., no establishment of conditions that inhibit competition among insurers -No references to Gaurantory organizaitons -No fradulent claims, if claim over $1000 it is a felony -Must notifay claimant w/in 15 days wether claim is accepted or denied after recieving claim. If cant do that must let person know reason for delay w/in 45 days and provide update every 30 days after that. -Must pay benefits for accidental death or injury w/in a year. -If getting paid partly by fee of insured, producer must let insured know of: the amount of the fee paid by the insured, the amount of any commission paid by the insurer, additional compensation that the producer may receive from incentives paid by the insurer, including contingent commissions, awards, and bonuses. Both parties must sign, and producer must keep for 5 years -No rebates for premiums -No twisting: convincing someone to replace a policy they dont need to replace -Receipts must be issued NLT next business day after issuing a policy -Adopted kids still included in policies Life Insurance Life Insurance Replying to Requests from Insurance Commish - Correct Ans--Must deliver written reply w/in 15 days Commissions paid to producers w/lapsed license - Correct Ans--Can still get paid commissions as long as policy was bought while licensed 1033 Waiver - Correct Ans--Someone convicted of a felony involving breach of trust or dishonesty can not be an insurance producer w/out this waiver 12 Required Provisions - Correct Ans--Must be in every health insurance policy -Propogated by National Association of Insurance Commissioners (NAIC/self governing organization for insurance) They are: -Entire contract -Incontestability -Grace period: 7 day grace period for premiums paid weekly, 10 day for monthly, and 31 day for other premium modes -Reinstatement: Allows policy to be reinstated w/in 3 years if lapsed, insurer has 45 days to reject reinstatement -Physical Exam. and Autopsy -Legal Actions: Insured can take legal actions between 60 days and 3 years after filing a claim -Change of beneficiaries -Payment of claims -Notice of Claim: Insured must notify w/in 20 days of loss -Claim forms: Insurer must provide claim forms w/in 15 days of getting claim from insured. -Proof of loss: Insurer must recieve written proof of loss w/in 90 days -Time payment of claims: Insurer must pay immediatley after recieving proper proof of loss 11 Optional Provisions - Correct Ans--Also propogated by the NAIC -Change of occupation -Misstatement of Age or Sex -Other isnurance in this insurer -Other insurance with other insurer -Other insurance with other insureres -Relation of earnings to Insurance -Unpaid premiums -Cancellation: Policy must be cancelled with 45 days notice -Conformity with state statutes -Illegal occupation -Intoxicants and narcotics Types of Health Insurance Policies - Correct Ans--6 Types Life Insurance Life Insurance -Disability Income Policies -Medical Expense Policies -Accidental Death and Dismemberment Policies (AD&D): Provides benefit if person is injured or hurt because of an accident -Medical Supplement Policies: Supplement Medicaire -Long Term Care Policies: For nursing homes and such -Limited (Voluntary) Benefits Policies: Such as policies for a certain disease, for dental insurance, etc.. Medicaire - Correct Ans--Covers: Seniors 65 and older, or those collecting SS benefits for 2 years, or have End Stage Renal Disease, or have ALS -If active worker, group insurance pays first -Must pay special premium between 65 and 67, and higher premiums if you arent completely vested in SS. Once at 67 no premiums. -Enrollment permitted 3 months before and after person becomes eligible. There are penalties if you dont do this. -If you dont sign up then, you can sign up during general enrollment period (between jan 1 and march 31 each year) -If you want to switch from a and b to c you can do it from oct 15 thru dec 7 (called annual election period (AEP) -If you want to switch back to a and b can do during special disenrollment from jan 1 to feb 17. -Prices set by CMS -Part A: Covers hospital care -Part B: Covers Medical care and physician fees (provides supplemental coverage to part A) -Part C: Basically a PPO version of Parts A and B -Part D: Prescription drug coverage Group Insurance - Correct Ans—Sponsor is issued a master policy -Certificates of insurance and outlines of coverage issued to individuals in the plans -Can be self-insured or go through an insurer -Can be contributory (individuals responsible for part of premium( or non-contributory -Must have a minimum size, generally at least 10 people (if not can still get coverage through "small group market" -Contributory plans must have at least 75% covered, and non-con must have 100% covered -Can have medicaire carve out plans where they fill gap between service covered by medicaire and covered by full group plan -Includes conversion priviledge where they can convert from group to individual -ERISA says a group plan must have a fiduciary, SPD, and claims procedures and appeals -Older workers can not be denied coverage or charged higher premiums because of ADEA Life Insurance Life Insurance COBRA: Says people have the right to continue group coverage for up to 18 months, for spouse and stuff coverage could extend up to 36 months, person must cover cost though and only applies to employers with more than 20 people HIPAA: Says people have a period of time to buy gataunteed coverage after COBRA is exhasuted and they were on a group plan for at least 18 months SHOP: Small Business Health Options Place or some shit is basically the HIX for small business group plans, and can get tax credits for them sometimes - FMLA: Provides coverage for those who go on leave for the military or pregnancy or something like that Health Insurance Underwriting - Correct Ans--No discriminating based on race sex and creed and stuff -Preferred risk applicants (those underwritten as lower risk) get lower premiums -Impairment riders restricts coverage for something like an old disability or something -Morbidity charge offset by interest credit comprises net premium, load added is gross premium -If someone pays a year long premium then cancels after six months, six months worth of premium could be due back Disability Insurance Underwriting - Correct Ans--Can be for own occupation or any occupation -Blue collar jobs typically for any, white collar for own Underwriting Group Health Insurance - Correct Ans--Experience rating focuses on underwriting the experience of the particular group (like electricians) -Community rating is just the geographical region Federal Taxation of Health Insurance - Correct Ans-Disability Insurance: Premiums not deductible, benefits tax free Medical Expense Insurance: Premiums deductible, benefits tax free, nonreimbursed expenses greater than 10% of AGI deductible LTC: Premiums deductible up to limit, benefits deductible up to limit Ad&d benefits: Benefits not taxed Federal Taxation of Group Insurance Plans - Correct Ans--Premiums are deductible to business owner -Employees not taxed on premiums paid by business -Emplyees can deduct contributions if they exceed 10% of AGI, if over 65 only 7.5% -Benefits not taxed -For DI, percentage of contribution from employer taxed to employee Federal Taxation of Business Health Insurance - Correct Ans--Self employed people can deduct the cost of their personal health insurance -Self employed may deduct all LTC premiums -Disability buy out premiums not tax deductible -BOE insurance premiums are deductible Life Insurance Life Insurance Standards for Health Insurance Practices WA State - Correct Ans--A policy in force for two years can not be voided for any reason other than fraud -Grace period for premiums is 7 days for weekly, 10 days for monthly, and 31 days for yearly -Reinstated policies must cover losses from accidental injury immediatly and from sickness in 10 days -Claimant must submit proof of claim to insurer within 1 year -If someone wants to sue, they can do it between 60 days and 3 years after making a claim WA State funded Health Insurance - Correct Ans--Health Insurance Coverage Access Act allows people not eligible for individual or group coverage to get coverage through the wa state pool -Can not get coverage if they have taken more than $2 mil in bennies or terminated service within past 12 months for not paying premiums or other voluntary reason, unless person had continuous coverage during this time Accident and Health (Disability) Insurance Basics WA State - Correct Ans--Outline of policy must be delivered NLT delivering of policy -Buyers guide must be given NLT when application is taken -Health insurance policy must have probationary period of less than 30 days -Accident insurance must have no waiting period -Free look period for health is 10 days -Policy can not require a recurrent condition be separated by more than 6 motn -DI must provide income for 6 months, except for preg or miscairrage which only need 1 mon -For medicaire supp. policy must get garanteed nlt 63 days after coverage ends -Lots of restrictions for medicaire policies including free look period of 30 days -Insurers must keep records of grievances for 3 years (ie complaintes from members) Responsibilities of Producer and Insured under WA state law - Correct Ans--Health insurance policies must be delivered after a reasonable time once they are issued -Producer must physically deliver policy to insured, and shares responsiblity w/insurer -If someone files a false claim, they can get up to 5 years in prison, a fine of 10k, or both LTC under WA State Law - Correct Ans--No limiting coverage for Alzheimers, senile dementia, or organic brain disorder -Can only discriminate on pre existing conditions from 6 months or less ago -Benefits payable if cognitive impairment or cant do 3 activites of daily living -Producers must complete initial 8 hours of LTC traiing plus 4 hours of additional CE every 24 months Managed Care Organizations under WA State law - Correct Ans--After group coverage ends, person can get individual coverage up to 30 days after policy ends without providing evidence of insurability Life Insurance Life Insurance -HMO's must cover newborn children for 60 days without extra premium Types of Private Insurance Providers - Correct Ans--Commercial Insurance Companies -Health and Managed Care Service Providers Commercial Insurers - Correct Ans--Reimburse Individuals for Health Care Costs -Also called Indemnity policies -Individuals with these plans are called insureds -"Fee-for-service" plans -Pay claims with either benefit schedule (ie will pay a certain amount for a certain procedure) or through "usual, customary, and reasonable" (UCR)--which creates payments for typical costs associated with certain procedures in a certain area - Managed Care Providers - Correct Ans--Provide individuals with direct services through a network of hospitals/providers -Include Health Maintenence Organizations (HMO's) and Preferred Provider Organizations (PPO's) -Individuals with these plans are called members -"Prepaid" basis, may have to make copayment but shouldnt get any bills Group Insurance Coverage - Correct Ans--Available for Employer Groups, Franchises and Associations, Governmental Units, Municipalities -Contract issued to the employer (sponsor) -Each participating member gets a certificate of insurance (specifies terms of coverage) -Must cover dependents too, including children up through age 26 -Must offer coverage to 95% of employees to avoid penalty Government Insurance Providers - Correct Ans--Includes Medicaire: Provides hospital and insurance coverage to people 65 and older -Medicaid: Provides coverage for poor of any age -Social Security: Provides disability to those under 65 who become completely disabled -State Workers Comp: Provides disability benefits for workers who become sick or injured on the job Patient Protection and Affordable Care Act (PPACA) aka ACA - Correct Ans--Passed 2010 -Everyone needs to have insurance, penalized if you dont -Everyone can be garanteed health insurance even with pre existing conditions -Establishes minimum standards for policies -Creates health insurance exchanges in every state where people can compare policies (HIX) -ONLY applies to Medical Expense Insurance -Grandfathered plans before March 23, 2010 are not subject to limits for EHB's and can exclude pre existing conditions and dont need to cover preventative services Life Insurance Life Insurance -Medical Loss Ratio (MLR): Individaul plans must pay 80% of revenue to medical costs and group plans must pay 85% -Employers who have more than 50 employees face fines of 2000 every time one of their employees recieve a gvt subsidy to buy individual coverage if they dont offer group insurance, and 3000 fine if they do offer group insurance Health Insurance Exchange (HIX) - Correct Ans--People can compare policies -Open enroll period between November 1 and February 15 -Can enroll during special enroll period (SEP) if you get married, have a kid, lose insurance, become a us citizen, or get out of prison, or move -Poor families can get tax credits to subsidize insurance thorugh the HIX Essential Health Benefits for PPACA Plans - Correct Ans--ambulatory patient services -emergency services -hospitalization -maternity and newborn care -mental health and substance abuse disorder services -prescription drugs -rehabilitation services and devices -laboratory services -preventive and wellness services -chronic disease management -pediatric services NO LIfetime limits on any of these and no yearly limitts on any of these Metal Levels - Correct Ans-Insurance Pays / Individual Pays Bronze: 60/40 Silver: 70/30 Gold: 80/20 Platinum: 90/10 Catastrophic Plans - Correct Ans-For people under 30 -has 60/40 actuarial split -Limit 3 doctor visits per year Reimbursement vs Value Basis - Correct Ans-Reimbursement: Pays percentage of cost accrued ie 80 percent Valued Contracts: Pay a flat rate or value. Agents Report - Correct Ans--Must include how producer met applicant and purpose of coverage -Producer must do field underwriting, ie make sure person is qualified and is responsible for scheduling appointments and stuff Life Insurance Life Insurance Types of Reciepts - Correct Ans--Binding Receipt: Immediately gives the insured coverage while underwriting process is occurring, all claims come up under this are covered until underwriter denies application if they do. -Conditional Receipt: Claims are only valid if applicant is found to be insurable. Mandatory Disclosure Forms - Correct Ans--Notice of Information Practices: Discusses sharing of insureds information to third parties and such -Buyers guide: Explains applicants rights and responsibilities with specific type insurance -Policy Summary: Outlines coverage and benefits of specific policy Specified vs Comprehensive Coverage - Correct Ans--Specified would be something specific like dental insurance or something -Comprehensive would be like a medical expense plan Indemnity Policies - Correct Ans--Basic Hospital: Provides a certain dollar amount of coverage at a hospital for a certain number of days. -Basic surgical: Usually use UCR or could be on a fee schedule -Basic Physician: Covers shit like regular checkup and stuff up to a certain limit -Major Medical Insurance: Used to cover shit that surpases the dollar amounts for these basic policies--typically have high deductable and supplement the basic policies. Sometimes subject to coinsurance (copay usually 80/20 or 70/30) Healthcare Management Organization (HMO) - Correct Ans--Organization where hospitals and care are basically combined with the HMO, through contractual payment arrangements called capitation -Generally dont provide service outside of their networks. If so, called "Closed Panel," if they do with point of service called "open panel" -Big emphasis on preventative care -Generally must see primary care physician before going to a specialist or anything -Must get pre approval for procedures and hospital visists from HMO, in case of emergencies must let them know within certain time period -Generally no deductibles but do have premiums and copays Preffered Provider Organization (PPO) - Correct Ans--Has network of providers with contracts called "preffered providers" -Can go outside but subject to deductibles -Don't need to go through primary care physician -Subject to copays even in network -Exclusive provider organizations (EPO), similar, but can ONLY get coverage in network Blue Cross/Blue Shield Plans - Correct Ans-Blue Cross: Provides Coverage for Hospital Care Blue Shield: Provides coverage for medical and surgical care -Use community rating--basing coverage on a pool of community members -Facilitated by a network of organizations under the BC/BS national organization Life Insurance Life Insurance MSA's, HSA's, and FSA's and HRA's - Correct Ans-MSA: Allows people to save money tax advantegly and apply it to high deductible insurance plans, no longer available since 2007, BUT still available for seniors with medicaire HSA: Replaced MSA's. Contributions grow on tax deferred basis, and when withdrawn to pay for healthcare come out tax free. Must have high deductible plan with deductible between $1300-$6550 for individual coverage and $2600-$13100 for family coverage. Can't be on medicaire. Maximum contribution $3400 for single and $6750 for family, 1k catch up contributoin allowed if over 55. Cant take money out to pay for non healthcare before 65 without getting taxed plus 20% fee. FSA: Health care and dependent care. "Use it or lose it" but have until March 15th of the following year to use it. Can be used for shit like healthcare costs, prescriptions, etc.... HRA: Funded solely by employer, used to pay premiums and healthcare costs. Doesnt expire and can be transferred to other jobs. Limited Risk Plans - Correct Ans--Cover specific risks like accidental death and dismemburment, credit risks if someone becomes sick, deadly disease, etc.... Medicaire Part A - Correct Ans--Covers hospital care for 90 days with a 60 day break -Must pay $1136 deductible -Day 1-60 after deductible covered -61-90 must pay coinsurance -Additional 60 day lifetime reserve with coinsurance, once used must pay more costs -Can also get 20 days in skilled nursing facility, between 21-100 days in skilled nursing facility with coinsurance. Must go there after a minimum 3 day hospital stay and w/in 30 days of discharge -Also covers home health services -ALso covers hospice care for terminally ill pateints Part B Medicaire - Correct Ans--Has premiums -Has annual deductible -Covers supplemental medical costs Part C Medicaire - Correct Ans--Basically an HMO or PPO for medicaire Part D Medicaire - Correct Ans--Covers prescription drugs -Only available for those covered under part A and B -Generally requires copays based on the tier of drugs which is based on drugs that treat certain conditons Medicaire Improvements for Patients and Providers Act of 2008 (MIPPA) - Correct Ans- Just changed some shit, like no predatory calls and stuff Medicaire Supplemental Policies - Correct Ans--No one can be denied coverage as long as they are over 65 and apply w/in three months of getting on medicaire -Plan A-N Life Insurance Life Insurance -Must offer A, and either C or F -Basically fill in gaps that medicaire has, like extended hospital plans, pints of blood, etc... -Also has medicaire select, which is the HMO version of these supplemental policies Medicaid - Correct Ans--Basically for low income people -Jointly funded by state and feds -Those who are blind or disabled and 65 or older eligible for medicaid, but medicaire will pay first Long Term Care - Correct Ans--For shit like nursing homes and stuff, and for people who dont want to spend down to get on medicaid -Benefits triggered generally when person can not perform two or more activites of daily living -Must wait past elimination period (to make sure shit is actually needed) -Also typically has dollar limits and time limits (typically 2-5 years)--money comes from the "pool of money" or all the money in a plan -Has several riders you can get on it. -All issued as garanteed renewable -For Qualified LTC plans (must meet hippa req), premiums are tax deductible up to a certain limit -For non-qualified, they are not. -Benefits not taxed, but for indemnity contracts maximum $360 per day can be paid without tax Standard Life Insurance Policy Provisions - Correct Ans--Insuring clause states company's promise to pay policy's face amount to the named beneficiary if the insured dies while the policy is in force -Entire contract provision states that the insurance policy and signed contract make up the entire contract -A policy may be assigned only if the benificiary designation is revocable -Consideration: The signed application and premium policyowner pays as insurance application -10 day free look period for most people, 30 day for seniors Standard Exclusions - Correct Ans--War -Aviation -Committing a felony -Suicide (for first 2 years) -Hazardous occupations or hobbies Beneficiaries - Correct Ans--Irrevocable benfeciary has a vested interest in the policy, owner can not get them off without their consent -If a minor is a beneficiary, they must create a trust for the minor -Common disaster says that if primary beneficiary does not survive for more than 5 days, proceeds will go to contingent beneficiary Life Insurance Life Insurance Policy Non-Forfeiture Options - Correct Ans--Surrendered Policies Can not be reinstated -Reduced Paid Up: Takes remaining cash value of a lapsed policy and buys a paid up policy -Extended Term Option: Takes remaining cash value and buys a paid up term policy for the same amount of benefit for however long the term will last -Cash Surrender Option: Person takes the cash Riders Covering Additional Insureds - Correct Ans--Can get term riders for your spouse, for your children, or for your family Accelerated Benefits Riders - Correct Ans--Lets payout of part of death benefit for someone still alive with a terminal disease -Can also get an LTC rider, which is exactly what it sounds like Policy Riders for Disability Protection - Correct Ans--To qualify for waiver of premium, must be totally disabled -Payor Benefit: Waves premium if premium payer dies, or becomes disabled while insured is still a minor Life Insurance Settlement Options - Correct Ans--Fixed Period Settlement Option: Death benefit paid in equal installments over a fixed period of time selected by beneficiary -Fixed Amount Settlement Option: Recieve a fixed amount until the money runs dry -Life income Settlement Option: Provides income payments that the payee cannot outlive -Straight life provides largest payout in general -Under J&S monthly payments occur until second payee dies Policy Loan and Withdrawal Provisions - Correct Ans--If loan amount plus accrued interest ever exceeds cash value, policy is cancelled (cash value is used as collateral) -Automatic Premium Loan Provision: allows someone to take an automatic loan out of their policy to pay a premium, cant be paid consecutivley or for more than 12 months -A universal life policy would not have loans, just withdrawals--which would reduce cash value and death benefit, if all money out of a universal life policy it is cancelled. Taxation of Individual Life Insurance - Correct Ans--Benefits are generally not taxable -Interest from benefits is taxable -Modified Endowment Contracts: A Policy that is overfunded (more than 7 years worth of premiums are paid in less than 7 years) loses the ability to take loans out of the policy or tax-free cash withdrawals -COLI: Corporate Life Insurance; Insured must sign statement saying they are insured Taxation of Group Life Insurance - Correct Ans--Anything less than 50000 in employer paid group life insurance benefits is not taxable, anything over is Life Insurance Life Insurance -After tax contributions are subtracted from an employees income dollar for dollar -Employer can deduct premiums it pays on a group life insurance plan 1035 Exchanges - Correct Ans--Almost everything can be exchanged tax free EXCEPT an annuity can not be exchanged tax free for a life insurance policy Washington Life Insurance Laws - Correct Ans--Conservation: An attempt by a producer to dissaude a policy owner from replacing their policy -Basic Illustrations must be kept for 3 years -If insurer has not refunded premium within 30 days after insured has requested it back during free look, they must pay a penalty of 10% of the refund amount -Insurere can defer a policy loan for up to 6 months, unless the loan is to pay the premium -A group life insurer must pay the death benefit no more than 30 days after receiving proof of the insured's death. A group life insurance that fails to pay the death benefit within 30 days of receiving proof of death must also pay interest on the proceeds at the rate of at least 8 percent until payment is made. If a group life insurer has still not paid a death benefit within 90 days of receiving proof of the insured's death, the insurer will be charged additional interest at the rate of 3 percent. A group policyholder is entitled to a grace period of 31 days for payment of any premium after the first. Except for nonpayment of the premium, a group insurer cannot contest the validity of a policy after the policy has been in force for two years after the date it was issued. Types of Life Insurance Policies (If Time) - Correct Ans- Free Look Period WA - Correct Ans--If the Policy is a replacement free look is 20 days. -If it is just a policy free look is 10 Annuities (If Time) - Correct Ans- Life Insurance

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Disability and Life Washington
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Disability and Life Washington

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Subido en
17 de mayo de 2025
Número de páginas
14
Escrito en
2024/2025
Tipo
Examen
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Life Insurance



Disability and Life Washington Test 2025
Insurance Commissioner - Correct Ans-Head of Office of Insurance Commissioner, is in
charge of company supervision, consumer protection, and rates and forms.

-Elected on a 4 year term
-Pays 25k bond
-Must examine records at least every 5 years
Has Power to:
-Issue rules to carryout or enforce the state insurance code
-Hold investigations,
-Hold examinations to see if anyone has broken the code.

If commish has reason to believe someone has broken the code, they can:
-Issue a cease and desist order
-sue to stop the person from continuing the action
-Do both

If Someone found guilty commish can:
-Suspend, revoke, or refuse to issue a license: Must give 15 day warning and hearing
can be asked for. If hearing happens, must give 10 day warning.
-Impose a civil penalty

If someone doesnt have a license they can pay up to a 25k fine per infraction

Filing Rates and Forms - Correct Ans--Must be filed at least 30 days before use
-If not rejected automatically approved after 30 days
-Commish can extend approval period by 15 days
-Premiums have to be approved too

Penalties for breaking insurance code - Correct Ans--It is a misdemeanor
-Fine of $10-$1000 must be paid 15 to 30 days after given
-Imprisonment for up to 364 days
-both
-Any other appropriate penalty

An Insurer is: - Correct Ans—
Insurance Company
-Fraternal Benefit Society
-Certified Health Plan
-Health Maintanence Org.
-Health Care Service contractor

Not Insurance - Correct Ans--Travel or auto services (like AAA)
Life Insurance

, Life Insurance


-Private air ambulance
-Travel emergency service

"Insurance License" is called - Correct Ans--Certificate of Authority

Insurance Gauranty Association - Correct Ans—
Protects insureds for 500k for: Life, medical, disability, annuity
-100k to gvt retirement benefit plan
-Can not be advertised
-Happens if insurer is not solvent

Temporary License - Correct Ans—
Can be granted for 180 days
-To surviving spouse or court appointed beneficiary for purpose of sale of business
-To member of business if owner dies
-To person who will take over business while employee is on active duty for military
-To serve the public interest

Nonresident Producer License - Correct Ans--Currently Licensed as a producer in their
home state
-Fulfilled application requirements and paid fees
-The applicants home state will also grant nonresident licenses on the same basis

Exceptions to those who need licenses: - Correct Ans--Officer, director, etc... of an
insurance company who doesn't get commission
-Someone who just enrolls individuals with plans without getting commission

Persons Exempt from Taking Exam: - Correct Ans--Persons who seek a license only to
transact limited lines (surety, limited line credit, and travel insurance)
-Persons who seek a license only to transact -Specialty lines (communications
equipment or services, rental car, or self-service storage)
-Persons applying for an adjuster's license who, for at least one year before the
application, have been fully employed by an insurer to adjust, investigate, or report
insurance claims
-Persons applying for a nonresident adjuster's license who are licensed in another state
and qualified for a similar license in Washington

Appointing a producer - Correct Ans--Insurance company lets commish know w/in 15
days
-Commish will get back in 15 days
-Commish does have 30 days to determine if the applicant is not able to be approved, if
so, they will let the company know in 10 days.
-If company gets rid of producer, must let commish know in 30 days, and producer in 15

Refusal, Non-renewal, and revocation of license - Correct Ans--Must deliver order to
licensee 15 days before it takes effect and give them the right to a hearing
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