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Questions and Answers
The branch of dentistry which deals with the replacement of missing parts is called?
The branch of dentistry which deals with the replacement of missing parts is called?
Prosthodontics
The Fair Credit Reporting Act protects consumers with guidelines regarding what?
The Fair Credit Reporting Act protects consumers with guidelines regarding what?
credit reporting and distribution
Within how many days must a producer submit a change in address?
Within how many days must a producer submit a change in address?
30
What happens if the insurer discovers that the insured's age was accidentally misstated on an application for an individual life insurance policy?
What happens if the insurer discovers that the insured's age was accidentally misstated on an application for an individual life insurance policy?
Proof of loss on a health insurance claim must be submitted to an insurer within _____ days after the insured's date of loss.
Proof of loss on a health insurance claim must be submitted to an insurer within _____ days after the insured's date of loss.
How long is the free-look period for a life insurance policy sold in Louisiana?
How long is the free-look period for a life insurance policy sold in Louisiana?
Which of the following permits an insurance company to transact business in Louisiana?
Which of the following permits an insurance company to transact business in Louisiana?
When the Commissioner of Insurance requests a producer's business records, they must be produced?
When the Commissioner of Insurance requests a producer's business records, they must be produced?
A licensed producer MUST be __________ by an insurer to be eligible for soliciting insurance contracts.
A licensed producer MUST be __________ by an insurer to be eligible for soliciting insurance contracts.
To be classified as a small employer in Louisiana, an employer must employ?
To be classified as a small employer in Louisiana, an employer must employ?
Must a Louisiana insurance producer be age 21 to obtain a license?
Must a Louisiana insurance producer be age 21 to obtain a license?
After an annuity has been in force for _____ year(s), it becomes incontestable.
After an annuity has been in force for _____ year(s), it becomes incontestable.
All of the following actions are considered rebating EXCEPT?
All of the following actions are considered rebating EXCEPT?
How often must the Commissioner examine each domestic insurance company?
How often must the Commissioner examine each domestic insurance company?
Sharon the producer intentionally submitted a false statement in support of a claim. This is considered a form of?
Sharon the producer intentionally submitted a false statement in support of a claim. This is considered a form of?
An existing life insurance policy is being replaced by a new one. A notice of replacement must be provided by the ________ to be signed by the applicant.
An existing life insurance policy is being replaced by a new one. A notice of replacement must be provided by the ________ to be signed by the applicant.
Maria the producer would like to advertise an annuity product on a highway billboard. Which of the following must be included in the advertisement?
Maria the producer would like to advertise an annuity product on a highway billboard. Which of the following must be included in the advertisement?
Charles is a producer who is licensed in Louisiana but resides in Mississippi. Charles is considered to be a(n)?
Charles is a producer who is licensed in Louisiana but resides in Mississippi. Charles is considered to be a(n)?
A life insurance applicant in Louisiana may backdate the application for up to ______ month(s).
A life insurance applicant in Louisiana may backdate the application for up to ______ month(s).
A Medicare Supplement policy's outline of coverage MUST include a(n)?
A Medicare Supplement policy's outline of coverage MUST include a(n)?
An insurer has _____ days to file a notice of appointment to the Commissioner.
An insurer has _____ days to file a notice of appointment to the Commissioner.
In order for a business entity to be licensed as a producer, a licensed producer must be designated as responsible for compliance with __________.
In order for a business entity to be licensed as a producer, a licensed producer must be designated as responsible for compliance with __________.
How often must an insurance producer's license in Louisiana be renewed?
How often must an insurance producer's license in Louisiana be renewed?
After a disability policy has been in force for ____ year(s), it is considered incontestable.
After a disability policy has been in force for ____ year(s), it is considered incontestable.
An individual who has a contract with an insurance company to represent it is called a(n)?
An individual who has a contract with an insurance company to represent it is called a(n)?
A nonresident producer from a state outside of Louisiana may become licensed in Louisiana IF a(n)?
A nonresident producer from a state outside of Louisiana may become licensed in Louisiana IF a(n)?
What are the levels of coverage as defined by the Affordable Care Act?
What are the levels of coverage as defined by the Affordable Care Act?
Under the Louisiana Health Plan, comprehensive health benefits are provided to?
Under the Louisiana Health Plan, comprehensive health benefits are provided to?
A producer must notify the Commissioner within _____ days of a felony conviction.
A producer must notify the Commissioner within _____ days of a felony conviction.
Which of the following is NOT information found in a life insurance buyer's guide?
Which of the following is NOT information found in a life insurance buyer's guide?
A company that is authorized by the Commissioner to transact insurance business in Louisiana is called a(n)?
A company that is authorized by the Commissioner to transact insurance business in Louisiana is called a(n)?
Which license is REQUIRED in order to solicit Long Term Care insurance in the State of Louisiana?
Which license is REQUIRED in order to solicit Long Term Care insurance in the State of Louisiana?
A domestic insurance company in Louisiana MUST?
A domestic insurance company in Louisiana MUST?
Which of these is NOT considered a form of life insurance advertisement?
Which of these is NOT considered a form of life insurance advertisement?
Jim recently sold his life insurance policy under a viatical settlement contract. The proceeds of this contract could be subject to the claims of?
Jim recently sold his life insurance policy under a viatical settlement contract. The proceeds of this contract could be subject to the claims of?
A pre-existing condition is a condition for which medical advice or treatment was recommended by or received from a provider of health care service within _____ months preceding a healthy policy's effective date.
A pre-existing condition is a condition for which medical advice or treatment was recommended by or received from a provider of health care service within _____ months preceding a healthy policy's effective date.
In Louisiana, a small employer may not consist of more than how many eligible employees?
In Louisiana, a small employer may not consist of more than how many eligible employees?
A cease and desist order?
A cease and desist order?
An example of an Unfair Claims Settlement Practice is?
An example of an Unfair Claims Settlement Practice is?
A business entity wishing to act as an insurance producer MUST?
A business entity wishing to act as an insurance producer MUST?
After ____ years from date of issue, a policy can no longer be cancelled by the insurer for misstatements (except for fraud).
After ____ years from date of issue, a policy can no longer be cancelled by the insurer for misstatements (except for fraud).
Which of these is NOT an Unfair Claims Settlement Practice?
Which of these is NOT an Unfair Claims Settlement Practice?
Individual health policies sold in Louisiana require dependent children coverage up to age?
Individual health policies sold in Louisiana require dependent children coverage up to age?
How many days is a temporary producer's license valid?
How many days is a temporary producer's license valid?
An insurance producer decides to conduct business under an assumed name. The Commissioner MUST be notified of this change?
An insurance producer decides to conduct business under an assumed name. The Commissioner MUST be notified of this change?
Karen the producer pays for her client's initial premium payment as an incentive for purchase. This act is considered a(n)?
Karen the producer pays for her client's initial premium payment as an incentive for purchase. This act is considered a(n)?
Before a producer may sell, solicit, or negotiate insurance for an insurer, the producer must have a(n)?
Before a producer may sell, solicit, or negotiate insurance for an insurer, the producer must have a(n)?
How long after its effective date will an individual life insurance policy become incontestable?
How long after its effective date will an individual life insurance policy become incontestable?
Which entity regulates claim settlement practices?
Which entity regulates claim settlement practices?
What is the purpose of the Louisiana Life and Health Insurance Guaranty Association?
What is the purpose of the Louisiana Life and Health Insurance Guaranty Association?
All of the following are considered to be fraud EXCEPT?
All of the following are considered to be fraud EXCEPT?
Which of the following permits an insurance company to transact business in Louisiana?
Which of the following permits an insurance company to transact business in Louisiana?
When a small employer health insurance plan is offered, it must be available?
When a small employer health insurance plan is offered, it must be available?
An insurer may exclude preexisting conditions on a Medicare Supplement policy for ______ months.
An insurer may exclude preexisting conditions on a Medicare Supplement policy for ______ months.
When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT?
When a producer is replacing an existing ordinary life insurance policy, the producer must take all of the following actions EXCEPT?
All Medicare Supplement policies MUST contain which provision?
All Medicare Supplement policies MUST contain which provision?
An alien insurer?
An alien insurer?
An Arkansas resident producer who would like to solicit insurance in Louisiana MUST obtain a nonresident license in Louisiana. Which of these is NOT a requirement for obtaining a nonresident license?
An Arkansas resident producer who would like to solicit insurance in Louisiana MUST obtain a nonresident license in Louisiana. Which of these is NOT a requirement for obtaining a nonresident license?
Advertising regulations exist in order to?
Advertising regulations exist in order to?
Long-term care policies sold in Louisiana may NOT exclude coverage for?
Long-term care policies sold in Louisiana may NOT exclude coverage for?
A life insurance replacement transaction could result in a(n)?
A life insurance replacement transaction could result in a(n)?
A dependent child may remain on a parent's health insurance plan beyond 26 if the child?
A dependent child may remain on a parent's health insurance plan beyond 26 if the child?
A common exclusion or limitation on a dental policy is?
A common exclusion or limitation on a dental policy is?
In order for a business entity to be licensed as a producer, _______ is required.
In order for a business entity to be licensed as a producer, _______ is required.
A producer license is NOT required when?
A producer license is NOT required when?
An eligible employee can be excluded from group health coverage for up to _____ months if he/she is considered a 'late enrollee'.
An eligible employee can be excluded from group health coverage for up to _____ months if he/she is considered a 'late enrollee'.
A producer who sells most of his/her insurance policies to family members is said to be engaging in?
A producer who sells most of his/her insurance policies to family members is said to be engaging in?
What is the MINIMUM benefit period that must be offered by a Long-Term Care policy?
What is the MINIMUM benefit period that must be offered by a Long-Term Care policy?
Under the Affordable Care Act, which of these plans is designed to provide coverage that is actuarially equivalent to 80% of the full actuarial value of the benefits provided under the plan?
Under the Affordable Care Act, which of these plans is designed to provide coverage that is actuarially equivalent to 80% of the full actuarial value of the benefits provided under the plan?
The required grace period for a life insurance policy sold in Louisiana is ____ days.
The required grace period for a life insurance policy sold in Louisiana is ____ days.
A policyowner has _____ days after policy delivery to return a major medical policy.
A policyowner has _____ days after policy delivery to return a major medical policy.
Kiara filled out a life insurance application and was given a policy illustration that showed future premiums being paid out of nonguaranteed values. This illustration MUST disclose that?
Kiara filled out a life insurance application and was given a policy illustration that showed future premiums being paid out of nonguaranteed values. This illustration MUST disclose that?
An example of unfair discrimination would be?
An example of unfair discrimination would be?
Which of the following unfair trade practices involves a producer who makes malicious public statements regarding an insurer's financial condition?
Which of the following unfair trade practices involves a producer who makes malicious public statements regarding an insurer's financial condition?
A viatical settlement broker may NOT?
A viatical settlement broker may NOT?
Terminally ill life insurance policyowners may sell their policy at a discount to a third party. This type of agreement is called a(n)?
Terminally ill life insurance policyowners may sell their policy at a discount to a third party. This type of agreement is called a(n)?
Coverage for newborns under an accident and health plan MUST include coverage for?
Coverage for newborns under an accident and health plan MUST include coverage for?
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Study Notes
Louisiana Insurance Laws and Regulations
- Prosthodontics: Dentistry branch dealing with replacement of missing parts.
- Fair Credit Reporting Act: Protects consumers by regulating credit reporting and distribution practices.
- Address Change Notification: Producers must submit address changes within 30 days.
- Age Misstatement: If an insured's age is misstated, benefits will reflect the correct age's coverage equivalent.
- Proof of Loss Submission: Required within 90 days for health insurance claims after the date of loss.
- Free-Look Period: Life insurance policies in Louisiana have a 10-day free-look period.
- Certificate of Authority: Necessary for an insurance company to conduct business in Louisiana.
- Business Records Compliance: Producers must present their business records upon the Insurance Commissioner's request.
- Producer Appointment: A licensed producer must be appointed by an insurer to solicit insurance contracts.
- Small Employer Definition: Defined as having 1-50 employees in Louisiana.
Licensing and Compliance
- Producer License Requirements: Age 21 is NOT a requirement for obtaining a Louisiana insurance producer license.
- Incontestability Period: Annuities become incontestable after 2 years.
- Rebating Exceptions: Sharing commissions with other producers is not considered rebating.
- Commissioner Examination Frequency: Domestic insurance companies are examined every 5 years.
- Fraudulent Claims: Intentionally false statements in claims by a producer are classified as fraud.
Policy Regulations and Practices
- Replacement Policies: Producers must provide a notice of replacement for existing life insurance policies.
- Annuity Advertisement Disclosure: Producers advertising annuities must include their name in the advertisements.
- Nonresident Producers: Producers licensed in other states can operate in Louisiana if there’s a reciprocal licensing agreement.
- Application Backdating: Life insurance applicants can backdate applications up to 6 months.
- Medicare Supplement Policy: Must include a description of benefits in its outline of coverage.
Duties and Responsibilities
- Appointment Notification: Insurers have 15 days to file a notice of appointment to the Commissioner.
- Business Entity Licensing: A responsible licensed producer must be designated for compliance with insurance laws.
- License Renewal Cycle: An insurance producer's license must be renewed every two years.
- Incontestability for Disability Policies: These policies are considered incontestable after 3 years.
- Producer Representation: An individual with a contract with an insurance company is termed a 'producer'.
Special Provisions and Consumer Protection
- Health Benefits for Uninsurable Residents: The Louisiana Health Plan offers coverage for those deemed medically uninsurable.
- Felony Conviction Notification: Producers must notify the Commissioner within 30 days of a felony conviction.
- Life Insurance Buyer’s Guide: Must NOT contain legal action instructions against an insurance company.
- Authorized Insurer: An insurer permitted by the Commissioner to conduct business in Louisiana.
- Long-Term Care Insurance License: A Health Insurance Producer License is mandatory for soliciting Long-Term Care insurance.
Claims and Coverage Details
- Grace Period Requirement: Life insurance policies require a 30-day grace period.
- Coverage for Dependent Children: Individual health policies must cover dependent children up to age 26.
- Temporary Producer's License Duration: Valid for 180 days.
- Medicare Supplement Preexisting Conditions: Can be excluded for up to 6 months.
- Unfair Claims Settlement Practices: Includes actions like failing to provide timely explanations for claim denials.
Fraud and Misconduct
- Definition of Fraud: Includes actions like intentionally false statements but does NOT include charging below required premiums.
- Maintaining Confidentiality: Producers who use assumed names are required to notify the Commissioner beforehand.
- Control of Business Practice: Producers selling primarily to family members are engaging in controlled business, which could raise ethical concerns.
Additional Regulations
- Viatical Settlements: Terminally ill policyowners can sell policies at a discount through viatical settlements, needing a license to engage in such transactions.
- Coverage for Newborns: Health plans must cover birth defects or abnormalities for newborns.
- Louisiana Life and Health Insurance Guaranty Association: Ensures that claims against insolvent insurance firms will be honored.
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