Colorado Life & Health Insurance State Law Supplement Practice Exam Latest Version Graded A

Colorado Life & Health Insurance State Law Supplement Practice Exam Latest Version Graded A What is the maximum amount the commissioner can fine an insurer for each violation of a cease-and-desist order? $10,000 When appropriate the commissioner reports a violation of insurance law to The district attorney A company that has not been authorized to operate in Colorado is known as A nonadmitted insurer An insurer that terminates the producers appointment must inform the commissioner within how many days? 30 All of the following are duties of the commissioner except: a. keeping records of the insurers that he has examined b. adopting rules and regulations c. writing insurance laws d. submitting an annual report to the General assembly See. Writing insurance laws When an insurer terminates a producer's appointment, the insurer must notify The commissioner and producer An insurance producer who solicits insurance on behalf of an insurer represents the Insurer The commissioner may... Conduct investigations and subpoena witnesses whenever he deems it necessary The commissioner gives approval to an insurer to do business in Colorado in a certificate of Authority In Colorado all of the following are considered unfair trade practices except: a. Misrepresentation b. Rebating c.. Replacement D. Coercion C. Replacement All of the following are violations of Colorado insurance law except: a. Charging individuals of the same class different premium rates b. Offering tickets to a football game as an incentive to purchase a policy c. In forming a new policy holder that his new policy, if lapsed for nonpayment of premium, could be reinstated upon reapplication d. Having an arrangement to sell stock to a person contingent upon the purchase of an annuity C. In forming a new policy holder that his new policy, if lapsed for nonpayment of premium, could be reinstated upon reapplication All of the following insurance practices are illegal in Colorado except: A. Soliciting or procuring insurance without a license B. Paying a fee for services as an insurance producer to anyone who is not properly licensed C. Inquiring about an applicant sexual orientation in connection with an application D. Replacing one life insurance policy with another D. Replacing one life insurance policy with another How many hours of continuing education must be in courses associated with the lines of insurance for which the producer is licensed? 18 All of the following are examples of unfair claims settlement practices except: A. Paying the claim without conducting an investigation B. Denying a claim promptly but without explaining the coverage or laws on which the denial is based C. Paying a claim promptly but without explaining the coverage or laws on which the payment is based D. Denying the claim without making an investigation A. Paying a claim without conducting an investigation A producer has how many days to file a written appeal to the commissioner after he has been terminated by his appointing insurer? 30 A fraternal benefit society representative need not be licensed as a producer if he sells life insurance with the face amount equal to or less than: 50,000 To be licensed to sell life, accident and health insurance in Colorado, and applicant must complete: 100 hours of pre-licensing education A fiduciary responsibility is defined as: A relationship of special trust and confidence when a person is entrusted with another's funds A producer who has to write a majority of his insurance business on the employees and officers of a restaurant owned by his wife is transacting: Controlled business Circulation of a maliciously critical statement about an insurer's financial condition to damage the insurer's reputation or business is called: Defamation In general, people who represent fraternal benefit society's to solicit insurance are: Considered insurance producers and must meet all licensing requirements How must insurance producers account for each insurance policy and the premiums they receive on it? As a separate account of the insured Suppose a producer helps a client set up an estate plan, which is not part of the producers usual service. The producer can charge a fee for this service if all of the following circumstances are in place except: A. When it is clear from the beginning that no sale of an insurance product is related to the service B. When the client signs the disclosure statement which stipulates that he is not obligated to buy insurance from the producer in exchange for the service C. When the producer always planned to sell insurance to the client D. When the financial service is beyond the producers normal duties C. When the producer always planned to sell insurance to the client Which of the following policy holders may request that the commissioner examine an insurer because they fear the insurer is unsound or insolvent? At least five policyholders that have at least $100,000 insurance in force and to have specified their concerns in writing To be valid, a group life insurance policy: May not be issued to a group formed solely for the purpose of obtaining insurance. The usual free look period For life insurance policy that is not delivered as a replacement policy is how many days? 15 A group life policy is incontestable (except for nonpayment of premium) once it has been in effect for: 2 Years A group life insurance policy holder must be given a grace period for premium payment of how many days? 31 Which of the following statements regarding the notice regarding replacement of life insurance is correct: C. A copy of the notice must be signed by the applicant and submitted with the application. Which of the following potential insurance sales would be subject to replacement regulations? B. A new policy that causes an existing life insurance policy to be surrendered. If the producer office to refund part of a prospects premium in exchange for the purchase of a life insurance policy, the producer is committing the illegal act of: Rebating Which of the following is not a problem when existing life insurance is replaced with new coverage? B. Comprehensive coverage may increase under the new policy. When an employee's coverage terminates under a group health policy, the employee must be offered continuation coverage for: 18 months Accident and health policies that provide coverage on an expense incurred basis for a family member of the insured: Must cover a newborn child from the moment of birth An individual accident and health policy whose premiums are paid on a quarterly basis, without any subsidy assistance, must contain a grace period of at least how many days? 31 Which of the following coverage exclusions or limitations is permitted under a long-term care policy issued in Colorado? A. Pre-existing conditions B. Alzheimer's disease C. Senile dementia D. Parkinson's disease Pre-existing conditions All accident and health policies issued in Colorado they provide a major medical services must offer policyholders the opportunity to purchase: a. Disability coverage B. Double indemnity coverage C. Home health care coverage D. Supplemental coverage C. Home health care coverage Which of the following is not considered an essential health benefit? A. Emergency services B. Long term care services C. Maternity and newborn care D. Prescription drugs B. Long-term care services An insurer providing group health coverage may not be required to issue a converted policy to: Anyone covered by Medicare Which of the following statements about a Medicare supplement policy is correct: a. The insurer may cancel it on the grounds of the insured's health status alone. B. The insurer may cancel it because the insured has not paid the premiums C. It can indemnify against losses resulting from sickness on a different bases from claims resulting from accidents D. The insurer may cancel it on the grounds of the insured's geographic location B. The insurer may cancel it because the insured has not paid the premiums An insurance policy that increases benefits to keep up with anticipated cost increases for long-term care services is said to have: Inflation protection How often must an individual accident and health insurance policy pay for the mammograms of a 56-year-old Colorado woman? Once every year Suppose that an insurance producer urges an elderly applicant to buy a second Medicare supplement policy just to be sure our potential medical expenses are covered. This sale is: Prohibited because the sale of a supplement which will provide a person with more than one Medicare supplement is illegal Long-term care policies can limit or exclude coverage for all of the following circumstances except: A. Pre-existing conditions or diseases B. Family history of heart condition before the effective date of coverage C. Treatment provided in a government facility which is not required by law D. Services provided by a member of the insured's family Family history of heart condition before the effective date of coverage What accident and health insurance renewability clause means the insurer cannot unilaterally change any provision what the policy is in force that can change premium rate my class? Guaranteed renewable The primary difference between the Colorado partnership LTC policy and other LTC policy is is: Medicaid asset protection If an individual collected $100,000 in benefits from her Colorado partnership LTC policy, how much asset protection will she receive? $100,000 or 100% How many days is the free look period For a purchaser of the long-term care insurance policy? 30 An insurer can deny a claim under a long-term care insurance policy for any material misrepresentation made by the insured if it has been in effect for: Fewer than six months Which of the following is a set a formal techniques that evaluates the clinical necessity, appropriateness, or efficiency of Healthcare Services and procedures? Utilization review