Insurance Regulations Quiz

Laws and Regulations in Insurance

• New York agents may face license revocation for not paying state income tax.

• Employers with up to 25 full-time equivalents earning less than $50,000 annually can receive a tax credit covering 50% of paid premiums.

• Insurers are mandated to offer inflation protection to long-term care applicants at the time of purchase.

• Continuing education is a requirement for resident agents in the insurance field.

• Violations of US Code Title 18, Section 1033 can lead to fines or imprisonment.

• Misrepresentation includes providing incorrect or misleading information in a license application.

• The superintendent of insurance has various responsibilities but does not endorse insurers.

Insurance Coverage and Policies

• Terminated employees like Greg have 31 days to convert group life insurance to an individual policy without needing to prove insurability.

• Superintendent serves a 4-year term, while health insurance claims must be reported to the insurer within 20 days post-loss.

• The Fair Credit Reporting Act allows insured individuals not to discuss credit report inconsistencies with applicants.

• Rebating is illegal; an example is offering a shopping card for purchasing a policy.

• Life settlement brokers negotiate life settlement contracts and must provide a disclosure notice before signing an application.

• Long-term care policies in New York cannot exclude coverage for senile dementia.

Compliance and Claim Handling

• A 30-day right to examine period exists for long-term care policies sold in New York.

• An insurer must provide a reasonable explanation for claim denial; failing this is deemed an unfair claim settlement practice.

• Discrimination based on marital status in coverage decisions is unfair.

• A life insurance policy's lapsed reinstatement requires a waiting period of 10 days for illness coverage.

Regulations Governing Agents

• New York agents renew licenses every two years and must report administrative actions within 30 days.

• Flexible Savings Accounts are capped at a $2,500 contribution under the Affordable Care Act.

• Agents must disclose the insurer's identity in all health insurance advertisements.

• Sharing commissions is permitted only with other licensed agents in the same line of business.

Health Plan Classifications and Policies

• Under the Affordable Care Act, health plans are classified as Bronze, Silver, Gold, and Platinum based on actuarial value.

• A Silver Plan provides 70% coverage, while a Gold Plan covers 80% of full actuarial value.

• Medicare supplement policies may exclude pre-existing conditions for six months.

Miscellaneous

• The federal fraud and false statements regulation requires written consent from state agencies for individuals with felony convictions to engage in insurance transactions.

• In the event of misrepresentation during policy sales, clients and agents must sign notices regarding replacements or changes.

• Twisting refers to misleading policy replacements and is considered insurance fraud.

• An example of a long-term care policy's minimum benefit requirement is 12 months.

• Proof of loss for health insurance claims needs to be submitted within 90 days of the insured's date of loss.

Test your knowledge on key laws and regulations in the insurance industry. This quiz covers topics such as license requirements, employer tax credits, and responsibilities of the superintendent of insurance. Enhance your understanding of insurance coverage and policies with specific scenarios and legal guidelines.