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Life insurance tennessee, Study notes of Business

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Tennessee Life, Accident and Health Insurance Producer
Examination Content Outlines
Cross Reference to
ClassNotes (Taxonomy #)
Effective September 16, 2024
Please note: It is very important that you refer to the Updates/Errata icon
on your course dashboard located under Study Tools. Any updated study
material for your state insurance exam is located in the Updates/Errata
icon
LIFE— GENERAL KNOWLEDGE CONTENT OUTLINE
Product Knowledge, Terms, and Concepts
(50 scoreable questions plus 5 pretest questions)
I. TYPES OF POLICIES 15
A. Traditional whole life products 4.5.2
1. Ordinary whole life 4.5.2.1
2. Limited-pay and single-premium life 4.5.2.2, 4.5.2.3
B. Interest/market-sensitive/adjustable life products 4.6, 4.6.2.1
1. Universal life 4.6.2.2
2. Variable whole life 4.7.2.1
3. Variable universal life 4.7.2.2
4. Interest-sensitive whole life 4.5.2.7
5. Indexed life 4.6.2.3
C. Term life 4.4
1. Types 4.4.2
a. Level 4.4.2.1
b. Decreasing 4.4.2.2
c. Return of premium 4.4.2.4
d. Annually renewable 4.4.2.5
2. Special features 4.8
a. Renewable 4.4.2.5
b. Convertible 4.4.2.6
D. Annuities 9.1
1. Single and flexible premium 9.4.1, 9.4.2
2. Immediate and deferred 9.4.1, 9.4.2, 9.4.2.1
3. Fixed and variable 9.6.1, 9.6.2
4. Indexed 9.6.3
5. Accumulation and Annuity Periods 9.3.1.1, 9.3.1.2
6. Payout options 9.5
E. Combination plans and variations 4.8
1. Joint life (first to die) 4.8.1
2. Survivorship life (second to die) 4.8.2
II. POLICY RIDERS, PROVISIONS, OPTIONS, AND EXCLUSIONS 15
A. Policy riders 5.3
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Tennessee Life, Accident and Health Insurance Producer

Examination Content Outlines

Cross Reference to

ClassNotes (Taxonomy #)

Effective September 16, 2024

Please note: It is very important that you refer to the Updates/Errata icon on your course dashboard located under Study Tools. Any updated study material for your state insurance exam is located in the Updates/Errata icon

LIFE— GENERAL KNOWLEDGE CONTENT OUTLINE Product Knowledge, Terms, and Concepts (50 scoreable questions plus 5 pretest questions)

I. TYPES OF POLICIES 15 A. Traditional whole life products 4.5.

  1. Ordinary whole life 4.5.2.
  2. Limited-pay and single-premium life 4.5.2.2, 4.5.2. B. Interest/market-sensitive/adjustable life products 4.6, 4.6.2.
  3. Universal life 4.6.2.
  4. Variable whole life 4.7.2.
  5. Variable universal life 4.7.2.
  6. Interest-sensitive whole life 4.5.2.
  7. Indexed life 4.6.2. C. Term life 4.
  8. Types 4.4. a. Level 4.4.2. b. Decreasing 4.4.2. c. Return of premium 4.4.2. d. Annually renewable 4.4.2.
  9. Special features 4. a. Renewable 4.4.2. b. Convertible 4.4.2. D. Annuities 9.
  10. Single and flexible premium 9.4.1, 9.4.
  11. Immediate and deferred 9.4.1, 9.4.2, 9.4.2.
  12. Fixed and variable 9.6.1, 9.6.
  13. Indexed 9.6.
  14. Accumulation and Annuity Periods 9.3.1.1, 9.3.1.
  15. Payout options 9. E. Combination plans and variations 4.
  16. Joint life (first to die) 4.8.
  17. Survivorship life (second to die) 4.8.

II. POLICY PROVISIONS, CLAUSES, AND RIDERS

A. Policy riders 5.

III. COMPLETING THE APPLICATION, UNDERWRITING, AND DELIVERING

  1. Group life 10.3.
  2. Modified Endowment Contracts (MECs) 10.3.

LIFE-TENNESSEE SPECIFIC CONTENT OUTLINE

State Laws, Rules and Regulations (18 scoreable questions plus 4 pretest questions)

V. TENNESSEE LAWS, AND DEPARTMENTAL RULES COMMON TO LIFE, ACCIDENT AND HEALTH, PROPERTY AND CASUALTY INSURANCE 14 Ref: 56-6-101 through 56-6- A. Powers of Commissioner 2

  1. Hearings and judicial review State Supplement Ref: 56-6-
  2. Investigations State Supplement Ref: 56-6-
  3. Regulatory authority State Supplement Ref: 56-6-107 through 112
  4. Penalties State Supplement Ref: 56-6-112(e), 56-2- B. Definitions 3
  5. Insurance Producer State Supplement Ref: 56-6-
  6. Business Entity State Supplement Ref: 56-6-
  7. Limited Lines Producer State Supplement Ref: 56-6-102, 56-6-
  8. Unauthorized insurer State Supplement Ref: 56-6-
  9. Compensation and referrals State Supplement Ref: 56-6-113, 56-6-
  10. Fiduciary State Supplement Ref: 56-6-
  11. Domestic and Foreign Insurance Companies State Supplement Ref: 56-1- C. License Requirements 3- Ref: 56-6-103; 56-6-104; 56-6-
  12. Insurance Producer State Supplement Ref: Dept. Rule 0780-1-56; 56-6-106; 56-6-112; 56-6-
  13. Agency Contracts/Termination State Supplement Ref: 56-6-115; 56-6-
  14. Resident/nonresident State Supplement Ref: 56-6-106; 56-6-
  15. Exceptions State Supplement Ref: 56-6-104; 56-6-105; 56-6- a. Licenses State Supplement

b. Examination State Supplement

  1. Temporary license State Supplement Ref: 56-6-
  2. License renewal State Supplement Ref: 56-6-
  3. General requirements State Supplement Ref: 56-6-103, 56-6-104; Dept. Rule 0780-01-
  4. Continuing Education State Supplement Ref: Dept. Rule 0780-1-56; 56-6-107; Dept. Rule 0780-01- D. License Suspension/Revocation 1
  5. General provisions State Supplement Ref: 56-6-112, 56-1-109, 36-5-
  6. Notice State Supplement Ref: 56-6- E. Unfair Practices 4 Ref: 56-6-125, 56-8-104-
  7. False advertising State Supplement Ref: 56-8-
  8. Defamation State Supplement Ref: 56-8-
  9. Boycotting, coercion, and intimidation Updates/errata Ref: 56-8-
  10. Unfair Discrimination State Supplement Ref: 56-8-
  11. Rebating State Supplement Ref: 56-8-
  12. Unfair claims settlement practices (^) State Supplement Ref: 56-8-105; Dept. Rule 0780-01-
  13. Other topics State Supplement Ref: 56-8- F. Life and Health Guaranty Association 0- Ref: 56-12-201 through 220

VI. TENNESSEE LAWS AND DEPARTMENTAL RULES PERTINENT TO LIFE INSURANCE ONLY 4 A. Required Provisions State Supplement Ref: 56-7-2305, 2307, 2308 B. Definitions State Supplement Ref: Dept. Rule 0780-1-40-.03. 0780-1-40-. C. Disclosure requirements State Supplement Ref: Dept. Rule 0780-1-40-. D. General rules State Supplement Ref: Dept. Rule 0780-1-40-. E. Replacement State Supplement Ref: Dept. Rule 0780-1-24-.

  1. Exemptions State Supplement

8. Accident 12.7.

  1. Time limit on certain defenses (incontestable) 14.3.

  2. Misstatement of age or gender 14.4.

  3. Change of occupation 14.4.

  4. Free look 14.5.

  5. Exclusions and limitations

8. Preexisting conditions 13.3.3.7, 18.9.

  1. Deductibles 16.4.2.
  2. Eligible expenses 16.4.2.
  3. Pre-authorizations and prior approval requirements 17.7.1.2, 17.7.
  4. Lifetime, annual, or per cause maximum benefit limits 13.3.3.4, 15.7.

C. Riders

3. Future increase option 15.4.5.

    1. Waiver of premium and waiver of monthly deduction 5.4.
    1. Guaranteed insurability 5.7.
    1. Payor benefit 5.4.
    1. Accidental death and/or accidental death and dismemberment 5.7.3, 5.7.3.
    1. Term riders 5.7.
    1. Other insureds 5.6.
    1. Long term care 5.
    1. Return of premium 5.7.
    1. Disability 5.
    1. Cost of Living 5.7.
  • B. Policy provisions and options 7.3, 7.
    1. Entire contract 7.4.
    1. Insuring clause 7.4.
    1. Free look 7.4.
    1. Consideration 7.4.
    1. Owner’s rights 7.4.
    1. Beneficiary designations 7.
  • a. Primary and contingent 7.5.
  • b. Revocable and irrevocable 7.5.
  • c. Common disaster 7.5.
  • d. Minor beneficiaries 7.5.1.
    1. Premium Payment 7.4.
  • a. Modes 7.4.
  • b. Grace period 7.4.
  • c. Automatic premium loan 6.5.
  • d. Level or flexible 7.4.
    1. Reinstatement 7.4.
    1. Policy loans, withdrawals, partial surrenders 6.5.1, 6.5.
    1. Non-forfeiture options 6.
    1. Dividends and dividend options (eg. participating, non-participating) 6.6, 6.6.1, 6.6.
    1. Incontestability 7.4.
    1. Assignments 7.4.
    1. Suicide 7.4.
    1. Misstatement of age and gender 7.4.
    1. Settlement options 6.
    1. Accelerated death benefits 5.5, 10.3.1.
  • C. Policy exclusions 7.
    1. War 7.6.
    1. Aviation 7.6.
    1. Dangerous Occupation 7.6.
  • THE POLICIES
  • A. Completing the application 2.
    1. Required signatures 2.4.
    1. Changes in the application 2.4.2.
    1. Consequences of incomplete applications 2.4.
    1. Warranties and representations 1.10.2.8, 2.6.
    1. Collecting the initial premium and issuing the receipt 2.4.7, 2.4.
    1. Disclosures at point of sale (e.g., HIPAA, HIV consent) 2.4.6. 6. Replacement State Supplement
    1. USA PATRIOT Act/anti-money laundering 2.
  • B. Underwriting 2. 9. Gramm-Leach-Bliley Act (GLBA) Privacy Updates/errata
    1. Insurable interest 3.
    1. Medical information and consumer reports 2.5.1.2, 2.5.1.3, 2.5.1.4, 2.5.1.
    1. Fair Credit Reporting Act 2.7.
    1. Risk classification 2.5.
    1. Stranger/Investor-owned life insurance (STOLI/IOLI) 2.
  • C. Delivering the policy 2.6.
    1. When coverage begins 2.6.
  • client 2.6. 2. Explaining the policy and its provisions, riders, exclusions, and ratings to the
  • D. Contract law 1.
    1. Elements of a contract 1.10.
  • a. Consideration 1.10.1.
  • b. Offer and Acceptance 1.10.1.
  • c. Competent parties 1.10.1.
  • d. Legal purpose 1.10.1.
    1. Unique aspects of the insurance contract 1.10.
  • a. Conditional 1.10.2.
  • b. Unilateral 1.10.2.
  • c. Adhesion 1.10.2.
  • d. Aleatory 1.10.2.
  • IV. RETIREMENT AND OTHER INSURANCE CONCEPTS
  • A. Third-party ownership 3.
  • D. Group life insurance 8. C. Life Settlements State Supplement
    1. Conversion privilege 8.
    1. Contributory vs. noncontributory 8.
  • E. Retirement plans 11.
    1. Qualified plans 11.
    1. Nonqualified plans 11.
  • F. Life insurance needs analysis/suitability 1.9.2, 3.
    1. Personal insurance needs 3.
    1. Business insurance needs 3.5.
  • a. Key person 3.5.3.
  • b. Buy sell 3.5.3.
  • G. Social Security benefits 3.5.2.
  • H. Tax treatment of insurance premiums, proceeds, and dividends 10.
    1. Individual life 10.3.
  • Ref: Dept. Rule 0780-1-24-.
  • Ref: Dept. Rule 0780-1-24-.
  • Ref: Dept. Rule 0780-01- F. Annuities State Supplement
  • I. TYPES OF POLICIES (50 scoreable questions plus 5 pretest questions)
  • A. Disability income 15.
    1. Individual disability income policy 15.
    1. Business overhead expense policy 15.6.
    1. Business disability buyout policy 15.6.
    1. Group disability income policy 15.
    1. Key employee policy 15.6.
  • B. Accidental death and dismemberment 15.4.6.
  • C. Medical expense insurance 16.
    1. Basic hospital, medical, and surgical policies 16.4.
    1. Major medical policies 16.4.
    1. Health Maintenance Organizations (HMOs) 17.
    1. Preferred Provider Organizations (PPOs) 17.
    1. Point of Service (POS) plans 17.
    1. Flexible Spending Accounts (FSAs) 22.
  • (HSAs) 22. 7. High Deductible Health Plans (HDHPs) and related Health Savings Accounts
    1. Health Reimbursement Accounts (HRAs) 22.
  • D. Medicare supplement policies 20.
  • E. Group insurance 18.
    1. Differences between individual and group contracts 12.5.1, 18.
    1. General characteristics 18.
    1. COBRA 18.7.
  • F. Individual/Group Long Term Care (LTC) 21.
    1. Eligibility 21.
    1. Levels of care 21.
  • G. Other policies 12.
    1. Dental 12.
    1. Vision 12.7.
    1. Cancer 12.7.
    1. Critical illness or specified disease 12.7.
    1. Worksite (employer-sponsored) 12.8.
    1. Hospital indemnity 12.7.
    1. Short-term medical 12.7.
    1. Accident 12.7.
  • II. POLICY PROVISIONS, CLAUSES, AND RIDERS
    1. Entire contract 14.3. A. Mandatory and optional provisions
    1. Time limit on certain defenses (incontestable) 14.3.
    1. Grace period 14.3.
    1. Reinstatement 14.3.
    1. Notice of claim 14.3.
    1. Claim forms 14.3.
    1. Proof of loss 14.3.
    1. Time of payment of claims 14.3.
    1. Payment of claims 14.3.
    1. Physical examination and autopsy 14.3.
    1. Legal actions 14.3.
    1. Change of beneficiary 14.3.
    1. Misstatement of age or gender 14.4.
    1. Change of occupation 14.4.
    1. Illegal occupation 14.4.
    1. Relation of earnings to insurance 14.4.
    1. Insuring clause 14.5. B. Other provisions and clauses
    1. Free look 14.5.
    1. Consideration clause 14.5.
    1. Probationary period 18.5.2.
    1. Elimination period 15.4.1.2, 21.6.
    1. Waiver of premium 15.4.1.
  • 20.3.2.6, 20.3.5, 21. 12.8, 15.4.8, 16.4.2.7, 19.3.2.6,
    1. Preexisting conditions 13.3.3.7, 18.9.
    1. Coinsurance 16.4.2.
    1. Deductibles 16.4.2.
    1. Eligible expenses 16.4.2.
    1. Copayments 17.3.1.
    1. Pre-authorizations and prior approval requirements 17.7.1.2, 17.7.
    1. Usual, reasonable, and customary (URC) charges 16.3.
    1. Lifetime, annual, or per cause maximum benefit limits 13.3.3.4, 15.7.
  • 15.4.5.2, 15.4.6.1, 15.4.7. 15.4.2.1, 15.4.2.2, 15.4.5.1,
    1. Impairment/exclusions 15.4.9.
    1. Guaranteed insurability 21.6.
    1. Future increase option 15.4.5.
  • D. Rights of renewability 14.5.
    1. Noncancelable 14.5.
    1. Cancelable 14.5.
    1. Guaranteed renewable 14.5.

III. SOCIAL INSURANCE 3

A. Medicare (Parts A, B, C, D) 20. B. Medicaid 20. C. Social Security benefits 15.7.

IV. OTHER INSURANCE CONCEPTS 5 A. Total, partial, recurrent and residual disability 15.4.3.1, 15.4.3.2, 15.4. B. Owner’s rights 7.4. C. Dependent children benefits 13.3.3.8, 15.7.2, 18.5.2. D. Primary and contingent beneficiaries 18.7.5. E. Modes of premium payments 14.3. F. Nonduplication and coordination of benefits (e.g., primary vs. excess) 18.5. G. Occupational vs. non-occupational 15.4.2. H. Tax treatment of premiums and proceeds of insurance contracts (e.g., disability income and medical expenses, etc.) 22. I. Managed care 17. J. Workers Compensation 15. K. Subrogation State Supplement

V. FIELD UNDERWRITING PROCEDURES 8 A. Completing the application 2.

B. Explaining sources of insurability and HIPAA privacy information (e.g., MIB Report, Fair Credit Reporting Act, etc.)

C. Initial premium payment and receipt and consequences of the receipt (e.g., medical examination, etc.) 2.4. D. Submitting application (and initial premium if collected) to company for underwriting 1.10.1. E. Policy delivery 2. F. Explaining policy and its provisions, riders, exclusions, and ratings to clients 2.6. G. Replacement 20.4. H. Contract law 1.

  1. Elements of a contract 1.10.
  2. Insurable interest 3.
  3. Warranties and representations 1.10.2.
  4. Unique aspects of the insurance contract 1.10. a. Conditional 1.10.2. b. Unilateral 1.10.2. c. Adhesion 1.10.2.

d. Aleatory 1.10.2.

ACCIDENT AND HEALTH TENNESSEE SPECIFIC CONTENT OUTLINE

State Laws, Rules and Regulations (18 scoreable questions plus 4 pretest questions)

Ref: Dept. Rule 0780-1-56; 56-6- D. License Suspension/Revocation 1

  1. General provisions State Supplement Ref: 56-6-112, 56-1-109, 36-5-
  2. Notice State Supplement Ref: 56-6- E. Unfair Practices 4 Ref: 56-6-125, 56-8-104-
  3. False advertising State Supplement Ref: 56-8-
  4. Defamation State Supplement Ref: 56-8-
  5. Boycotting, coercion, and intimidation Updates/errata Ref: 56-8-
  6. Unfair Discrimination State Supplement Ref: 56-8-
  7. Rebating State Supplement Ref: 56-8-
  8. Unfair claims settlement practices State Supplement Ref: 56-8-105; Dept. Rule 0780-01-
  9. Other topics State Supplement Ref: 56-8- F. Life and Health Guaranty Association 0- Ref: 56-12-201 through 220

VII. TENNESSEE LAWS, AND DEPARTMENTAL RULES PERTINENT TO ACCIDENT AND HEALTH INSURANCE ONLY 4 A. Required provisions State Supplement Ref: 56-26-108, 56-26- B. Policy cancellation, renewal State Supplement Ref: 56-26-125, 126, 56-26- C. Group policies State Supplement Ref: 56-26-127, 202, 56-7-2301, 56-7-2360, 56-7- D. Blanket or franchise school insurance State Supplement Ref: 56-7-2323, 2324 E. School accident coverage State Supplement Ref: 56-7-2324, 2325 F. Medicare supplement insurance State Supplement Ref: 56-26-132; Dept. Rule 0780-1-58-.

  1. Policy Terms/Definitions State Supplement Ref: Dept. Rule 0780-1-58-.05, 0780-1-58-.
  2. Prohibited Policy provisions State Supplement Ref: Dept. Rule 0780-1-58-.
  3. Minimum standards State Supplement Ref: Dept. Rule 0780-1-58-.08, 0780-58-.
  4. Eligibility State Supplement

Ref: 56-7-1453; Dept. Rule 0780-01-58.13- G. Long-Term Care State Supplement Ref: 56-42-101-105, 107-11; Rule 0780-1- H. Mandated Coverages (Offerings and Benefits) State Supplement Ref: 56-7-1002, 56-7-1003, 2301-2368, 2601- I. External Review State Supplement Ref: 56-61-113, 116 J. Affordable Care Act 13.

  1. Exchanges/Marketplace (ACA Section 1321) 13.3.
  2. Taxes, penalties, and subsidies (ACA Section 1401, 1402) 13.3.5.
  3. Essential health benefits (ACA Section 1302) 13.3.3. a. Mental health and substance use disorder parity 13.3.3. b. Pediatric services 13.3. c. Preventive services 13.3.3.
  4. Employer notification responsibilities (ACA Section 1511-1515) 13.3.5.
  5. Fees for individual major medical policy when commission is not paid State Supplement Ref: 56-6-125(b)