Podcast
Questions and Answers
Which requirement must be included in all group health insurance policies under Florida law?
Which requirement must be included in all group health insurance policies under Florida law?
What does 'guaranteed renewable' mean in health insurance policies?
What does 'guaranteed renewable' mean in health insurance policies?
What is the defining feature of a 'Medicare Advantage Plan'?
What is the defining feature of a 'Medicare Advantage Plan'?
In the event a health insurer in Florida goes bankrupt, what does the Florida Guaranty Fund cover?
In the event a health insurer in Florida goes bankrupt, what does the Florida Guaranty Fund cover?
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What happens after two years if an insured is not truthful about their health condition?
What happens after two years if an insured is not truthful about their health condition?
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What must be provided to a policyholder upon receiving a life insurance policy in Florida?
What must be provided to a policyholder upon receiving a life insurance policy in Florida?
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If a 60-year-old with a pre-existing condition applies for health insurance in Florida, which statement is true?
If a 60-year-old with a pre-existing condition applies for health insurance in Florida, which statement is true?
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What is the term for a provision in a life insurance policy that allows borrowing against the cash value?
What is the term for a provision in a life insurance policy that allows borrowing against the cash value?
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What is the likely action of an insurer upon receiving a claim for a pre-existing condition that was not disclosed within the first two years?
What is the likely action of an insurer upon receiving a claim for a pre-existing condition that was not disclosed within the first two years?
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What does the Florida Guaranty Fund cover for an individual's medical expenses when an insurer goes bankrupt?
What does the Florida Guaranty Fund cover for an individual's medical expenses when an insurer goes bankrupt?
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What amount will the Florida Guaranty Fund provide for a claim payment if a Florida insurer goes bankrupt?
What amount will the Florida Guaranty Fund provide for a claim payment if a Florida insurer goes bankrupt?
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When a group health policy is terminated for financial reasons in Florida, what must an insurer offer?
When a group health policy is terminated for financial reasons in Florida, what must an insurer offer?
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What is required for an insurance agent in Florida to comply with continuing education requirements?
What is required for an insurance agent in Florida to comply with continuing education requirements?
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What is the required continuing education for licensed insurance agents every two years?
What is the required continuing education for licensed insurance agents every two years?
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What happens to a life insurance policy if a significant misrepresentation is found after two years?
What happens to a life insurance policy if a significant misrepresentation is found after two years?
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Which insurance policy guarantees renewal as long as premiums are paid?
Which insurance policy guarantees renewal as long as premiums are paid?
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What is the primary purpose of HIPAA in Florida?
What is the primary purpose of HIPAA in Florida?
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What is the minimum number of employees required for a small employer to apply for group health insurance in Florida?
What is the minimum number of employees required for a small employer to apply for group health insurance in Florida?
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What must be included in a Medicare Supplement policy in Florida?
What must be included in a Medicare Supplement policy in Florida?
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When a small employer applies for group health insurance, which statement is TRUE?
When a small employer applies for group health insurance, which statement is TRUE?
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Under Florida law, what must an insurer provide when they cancel or refuse to renew a health insurance policy?
Under Florida law, what must an insurer provide when they cancel or refuse to renew a health insurance policy?
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Which provision is essential in long-term care insurance policies?
Which provision is essential in long-term care insurance policies?
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Which health plan allows for seeking care from a non-network provider at a higher cost?
Which health plan allows for seeking care from a non-network provider at a higher cost?
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What is true about a
What is true about a
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What is the maximum coverage limit for health insurance claims under the Florida Life and Health Insurance Guaranty Association?
What is the maximum coverage limit for health insurance claims under the Florida Life and Health Insurance Guaranty Association?
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When must a group health insurer provide an Outline of Coverage to potential policyholders?
When must a group health insurer provide an Outline of Coverage to potential policyholders?
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What is the maximum time frame for excluding pre-existing conditions in a group health insurance policy?
What is the maximum time frame for excluding pre-existing conditions in a group health insurance policy?
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What is the primary distinction between an HMO and a PPO health plan?
What is the primary distinction between an HMO and a PPO health plan?
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Which feature does a life insurance policy with a 'waiver of premium' rider have?
Which feature does a life insurance policy with a 'waiver of premium' rider have?
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Which provision is allowed in health insurance policies in Florida?
Which provision is allowed in health insurance policies in Florida?
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Study Notes
Florida Insurance Laws - Study Notes
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Free Look Period (Life Insurance): A required provision in Florida life insurance policies, allowing the policyholder a specific timeframe to review the policy and return it if dissatisfied.
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Pre-existing Conditions (Health Insurance): Florida law prohibits insurers from denying coverage outright due to pre-existing conditions. Insurers may impose a waiting period, but cannot deny coverage.
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Loan Option (Life Insurance): A life insurance policy provision that permits borrowing against the policy's cash value.
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Claims for Pre-existing Conditions (First Two Years): If a pre-existing condition is undisclosed, insurers can deny claims within the first two policy years based on misrepresentation.
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Florida Guaranty Fund (Health Insurance): The fund covers up to $250,000 in medical benefits for policyholders when a Florida insurer declares bankruptcy.
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Florida Guaranty Fund (Life Insurance): The fund provides up to $300,000 in coverage for medical claims to policyholders if the insurer goes bankrupt.
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Group Health Policy Termination: If a group health policy terminates due to financial reasons, Florida law mandates that insurers provide coverage continuation at group rates.
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Insurance Agent Continuing Education: Florida insurance agents need 30 hours of continuing education every two years.
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Misrepresentation After Two Years (Life Insurance): Insurers cannot cancel policies based on misrepresentations discovered after two years, though they can deny claims arising from the misrepresentation.
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Guaranteed Renewable (Insurance Policies): Policies with the "guaranteed renewable" feature permit the insurer to adjust policy terms but cannot cancel coverage as long as premiums are paid.
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Policy Cancellation After Two Years (Misrepresentation): Policies cannot be canceled after the first two years for a misrepresentation that is not considered fraudulent.
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HIPAA (Health Insurance): Florida law reinforces HIPAA's purpose: maintaining the privacy and confidentiality of health records and medical information.
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Small Employer Group Health Insurance: Florida law mandates that insurance be provided for the entire group, pre-existing conditions included, when a small employer purchases group health insurance. Minimum employees for group coverage is 2.
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Medicare Supplement Policies: They are in Florida, and must contain minimum benefit standards.
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Individual Health Policy Cancellation: Insurers must provide a written notice 45 days before canceling or refusing to renew an individual policy.
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Long-Term Care Insurance: A primary function of long-term care insurance: covers custodial care, not elective surgery or temporary disabilities.
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PPO Health Plans: PPO plans, compared to HMOs, permit patients to see out-of-network providers, but at a higher cost.
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POS (Point of Service) Health Plans: A health plans that blend aspects of HMOs and PPOs, offering flexibility in selecting providers and potentially lower costs compared to HMOs but higher costs compared to PPOs.
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Prepaid Service Organization (Health Plan): Prepaid service organizations (PSOs) predetermine payment of medical services before they're needed.
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Florida Health Insurance Guaranty Association: covers up to $300,000 in health insurance claims for bankrupt insurers.
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Outline of Coverage (Health Insurance): Insurers must provide an "Outline of Coverage" to prospective policyholders at the time of policy application in Florida.
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Pre-existing Condition Exclusions (Waiting Period): The maximum waiting period for pre-existing conditions, to be excluded from a group health insurance policy, is six months in Florida.
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HMO vs. PPO Plans: HMOs restrict patient choices to in-network providers, PPOs permit patients to utilize any provider, though it may cost more.
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Waiver of Premium (Rider): The waiver of premium rider waives premiums for a life insurance policy if the insured becomes totally disabled.
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Prohibited Provisions (Health Insurance): Florida law forbids gender-based pricing in health insurance policies.
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Group Health Policies (Required Provisions): All group health insurance policies must include coverage for preventive services.
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Guaranteed Renewable Health Policies: These policies aren't permanent. The issuer can change plan terms with notice.
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Medicare Advantage Plans: Medicare Advantage plans in Florida are coordination plans between Medicare and other insurers to provide additional benefits.
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Florida Guaranty Fund (Bankruptcy Coverage): The fund covers a maximum of $250,000 in individual health claims if a Florida health insurer declares bankruptcy.
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Misrepresentation (After Two Years): After two years, insurers cannot deny claims based on the policyholder's prior health representations. They can deny claims if the representation is fraudulent.
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Description
Explore key provisions and regulations in Florida insurance laws with this quiz. Topics include the Free Look Period, handling of pre-existing conditions, and the Florida Guaranty Fund for both life and health insurance. Test your knowledge on essential legal aspects of insurance in Florida.
