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A study guide or reference material for an insurance licensing exam, specifically focused on california life, accident, and health insurance regulations and policies. It covers a wide range of topics, including health benefits exchanges, insurance policy requirements, long-term care policies, unfair claims settlement practices, insurance agent responsibilities, and various insurance-related programs and regulations. Detailed questions and answers on these topics, making it a potentially valuable resource for individuals preparing for an insurance licensing exam or studying insurance-related subjects. The comprehensive coverage of california-specific insurance laws and regulations, as well as the inclusion of recent updates such as the affordable care act (ppaca), suggest this document could be useful for university students studying insurance, risk management, or related fields, as well as insurance professionals seeking to stay up-to-date on the latest industry developments.
Typology: Exams
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According to PPACA, what is a health benefits exchange? - Answer: An entity to which individuals and small businesses can have access to affordable health coverage Which word implies permissiveness according to the California Insurance Code? - Answer: May Which of the following does the California Insurance Code NOT require an insurance policy to specify? - Answer: Insurer's financial rating How many "activities of daily living" must an insured be UNABLE to perform in order to meet the chronically ill requirement of a Long-Term Care policy? - Answer: Minimum of two activities of daily living
Which of the following is NOT considered to be an unfair claims settlement practice? - Answer: Advising a claimant to hire an attorney A person who asserts a right of recovery under an insurance policy is called - Answer: claimant What is required after a life agent sells an insurance policy to an applicant without being appointed by the insurer? - Answer: Notice of appointment must be submitted to the Commissioner The California Insurance Code defines "policy" as a(n) - Answer: written contract The cost of services charged by the Health Insurance Counseling Advocacy Program (HI Cap) is - Answer: no cost Which of the following is NOT covered by the Family and Medical Leave Act (FMLA)? - Answer: Traveling overseas with a spouse Which of the following acts is NOT a federal offense committed by an insurance agent? - Answer: Misrepresentation on an insurance application Which of the following is NOT a primary objective of insurance regulation? - Answer: Interpret policy provisions
Which type of jurisdiction requires an insurer to have its rates accepted by the Insurance Department prior to using them? - Answer: Prior approval What is the purpose of the Pre-Existing Condition Insurance Plan (PCIP)? - Answer: PCIP was created by the PPACA for people rejected by private health insurers due to pre-existing conditions According to the California Insurance Code, what term is used to describe a fact so important it could affect the policy premium? - Answer: Materiality Which of the following actions is NOT allowed by Health Insurance Counseling and Advocacy Program (HiCAP) counselors? - Answer: Charge a fee According to the PPACA, an adult can be covered by a parent's health care plan until what age? - Answer: Age 26 According to the California Insurance Code, what is "insurance"? - Answer: A contract The free-look period for life insurance policyowners age 60 or older is - Answer: 30 days Which of the following is NOT considered to be an act of insurance solicitation? - Answer: Publishing a magazine where one of the advertisers is an insurer
According to PPACA, how long can an adult be covered as a dependent under their parents' insurance plan? - Answer: Up to age 26 How long must a policy be in force before an insurer is prohibited from denying claims based on misstatements made on the health policy application? - Answer: 2 years Kimberly is an employee on leave under the Family and Medical Leave Act (FMLA). What will happen to her group health coverage? - Answer: She continues to be enrolled during the leave Paul has an existing annuity and is sold a new one, in which the new policy holds no greater financial benefit to him than the existing contract. This is considered a(n) - Answer: unnecessary replacement The California Insurance Code requires that an insurer must have enough assets to cover its liabilities a - Answer: Its paid-in capital When an insurer has met the qualifications necessary to transact business in California, it is said to be - Answer: admitted Jim is applying to become an insurance agent and has a past misdemeanor conviction that was later expunged due to California Penal Code 1203.4. Which of the following statements is correct? - Answer: Jim must still disclose the conviction on his insurance license application
According to the California Insurance Code, what is the maximum penalty per violation for anyone who unwillfully commits an unfair method of competition? - Answer: $5, How long must life agents keep their transaction records? - Answer: 5 years A representation may be altered or withdrawn - Answer: only before the insurance is in effect When intentional concealment is involved, what course of action is the injured party entitled to? - Answer: Rescission of the contract Which of the following does NOT have to be included on life insurance policy illustrations? - Answer: Statement that all values and benefits are guaranteed According to the PPACA, the medical enrollment tier that has 80% actuarial value is called - Answer: gold What does the term "indemnity" mean as it pertains to insurance? - Answer: to make whole The California Insurance Code requires that an insurer must have enough assets to cover its liabilities and for reinsurance of all outstanding risks. To remain solvent, it
must also possess additional assets equal to what amount? - Answer: Its paid-in capital Anyone employed in California to assist an insurance agent in transacting insurance is called an insurance - Answer: solicitor An agent's attempt to stop the replacement of an existing life insurance policy is known as - Answer: conservation Life insurance surplus must be distributed to policyowners at what frequency? - Answer: Annually The California Life and Health Insurance Guarantee Association covers all of these types of policies EXCEPT - Answer: Self-funded plans MRMIP is a - Answer: state program that offers health coverage to California residents who are not able to obtain coverage due to pre-existing conditions Both the Federal and state governments jointly finance which health insurance entitlement program? - Answer: Medi-Cal In what order are people on the MRMIP waiting list allowed to enroll? - Answer: Based on the date an individual's application is received
What type of license is required for an individual who charges a fee to review an insured's existing life insurance policy? - Answer: Life and disability analyst Which of the following is NOT an accurate description of Access for Infants and Mothers Program (AIM)? - Answer: Only women who have private insurance plans with a maternity-only deductible or copayment greater than $1,500 are eligible Which entity has jurisdiction over health care coverage providers? - Answer: Department of insurance Who does a life settlement broker represent? - Answer: Individual wanting to sell their life policy to a third party According to the California Insurance Code, how is the word "may" interpreted? - Answer: Permissive What does the term "illustration" mean when used in the phrase "life insurance policy illustration", according to the California Insurance Code? - Answer: Presentation of policy features that includes non-guaranteed elements An individual who transacts life, disability, or life and accident and health insurance on behalf of an insurer is called a(n) - Answer: Life agent