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| Section | Weight | Objectives |
|---|---|---|
| Accident and Health Insurance | 25-30% | - Major medical coverage - Disability income insurance - Dental and vision insurance basics - Health insurance policy types (individual, group, HMOs) - Long-term care insurance basics - Medical expense coverage |
| General Insurance Principles | 15-20% | - Agent/broker duties and ethics - Fair claims settlement practices - Ethical sales practices - Insurance contract fundamentals - Underwriting principles |
| Life Insurance Fundamentals | 25-30% | - Policy reinstatement - Policy riders and endorsements - Beneficiary designations - Dividends and nonforfeiture options - Policy types and provisions |
| New York State Regulations | 20-25% | - Advertising regulations - Consumer protection regulations - Fiduciary responsibilities - Replacement and churn rules - Licensing requirements and procedures - NYS Insurance Law requirements |
Question 1
Penalties that may be levied by the Department of Insurance for committing insurance fraud do NOT include
A. license suspension.
B. license revocation.
C. fines.
D. probation.
Question 2
Which of the following is a characteristic of level premium term life insurance?
A. It matches the level amount of protection on the insured ' s life expectancy.
B. It provides for lower benefits.
C. The cost of insurance is averaged throughout the life of the contract.
D. It can be used for cash value.
Question 3
With respect to small group health benefit plans, a carrier may discontinue coverage or may refuse to renew such a plan if the employer
A. falls to pay the premium prior to the end of the grace period.
B. employs fewer than 15 full-time employees.
C. has a supplemental plan with a competing carrier.
D. has filed for bankruptcy in the prior year.
Question 4
In health insurance policies, the reinstatement provision is
A. mandatory.
B. optional.
C. not required.
D. elective.
Question 5
An insurer monitors the care an insured is receiving in the hospital to be sure that everything is proceeding according to schedule. This BEST describes
A. claims adjudication.
B. benefit checking.
C. precertification authorization.
D. concurrent review.
Solutions:
| Question 1 Answer: D | Question 2 Answer: C | Question 3 Answer: A | Question 4 Answer: A | Question 5 Answer: D |
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