Questions and Answers
A plan through the Marketplace may be purchased by?
What must an agent do during a sales presentation for a participating life insurance policy?
Make a prospect understand that dividends are not guaranteed.
How long must an HMO hold an open enrollment period after the initial enrollment period?
31 days
Which of the following is NOT a required provision in group life policies?
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Under what circumstances can a license be denied, suspended, or revoked?
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Which of the following is a valid reason for an enrollee to be cancelled by a Health Maintenance Organization (HMO)?
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How long does an insurance company appointment remain in force?
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What is the monetary penalty for willfully violating a cease-and-desist order?
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What may B, an insurance agent, be found guilty of if he tells clients their rights may be impaired for not completing a release form?
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What action will a life insurance company most likely take if an insured dies and their age was misstated on the application?
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Which of the following is a requirement for obtaining a Texas insurance agent's license?
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What is an example of an unfair claims settlement practice?
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For what reason may a Medicare Supplement policy be cancelled?
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A temporary agent's license issued by the Commissioner of Insurance is valid for up to _____ days.
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An insurer is NOT required to provide information on fraudulent claims if requested by?
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A certificate of _______ permits an insurance company to transact business in Texas.
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ABC Insurance Company is actively engaging in boycott, coercion, and intimidation. What are they committing under Texas insurance laws?
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Which of the following groups may NOT be insured by a group life insurance policy?
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What defines a foreign insurance company conducting business in Texas?
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Which action does the Commissioner of Insurance NOT have the power to conduct?
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An employee is covered under a company group life plan with a $50,000 death benefit. What is the maximum amount a spouse may be insured for under this program?
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Who is liable when an insured suffers a loss on a policy sold by an agent through an insurer not authorized to conduct business in Texas?
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What is required for an agent whose license has been revoked?
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______ of continuing education MUST be completed in the classroom or classroom equivalent.
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What must an applicant receive when an application is taken for a Medicare Supplement policy?
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Who approves an Evidence of Coverage form issued by a Health Maintenance Organization (HMO)?
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With whom may an agent legally share commissions?
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Which statement about health coverage for newborns is NOT true?
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An insured may assign up to ______ of policy ownership under an individual life insurance policy.
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Study Notes
Insurance License and Regulations
- Legal residents, except those imprisoned, may purchase plans through the Marketplace.
- For life insurance sales presentations, agents must clarify that dividends are not guaranteed.
- Every 12 months after the initial enrollment, Health Maintenance Organizations (HMOs) must offer a 31-day open enrollment period.
- Group life policies do not require a right to loan provision.
- A license may be denied, suspended, or revoked if misrepresentation is detected in obtaining it.
- Nonpayment of coverage is a valid reason for an enrollee being canceled by an HMO.
- Insurance company appointments remain in force until terminated.
Compliance and Violations
- A monetary penalty for willfully violating a cease-and-desist order can be as high as $500.
- Coercion can occur if an agent misrepresents rights related to release forms.
- If an insured's age is misstated, companies will pay benefits based on what premiums would have purchased at the correct age.
- Obtaining a Texas insurance agent's license requires honesty, trustworthiness, and reliability.
- Unfair claims settlement practices include denying claims without providing a basis for denial.
Insurance Policies and Coverage
- Medicare Supplement policies can be canceled for non-payment of premiums.
- Temporary licenses issued by the Commissioner of Insurance are valid for a maximum of 90 days.
- Insurers are not required to provide information on fraudulent claims upon request from an insured.
- A certificate of authority is required for insurance companies to operate in Texas.
- Engaging in boycott, coercion, or intimidation constitutes unfair competition under Texas laws.
Group and Life Insurance Specifics
- Individuals related by blood cannot be insured under a group life insurance policy.
- A foreign insurance company in Texas is one formed under another state's laws.
- The Commissioner of Insurance cannot activate a company's financial reserves.
- A spouse can be insured for a maximum of $25,000 under a group life plan that provides a $50,000 death benefit.
- When an agent sells a policy through an unauthorized insurer, the agent alone is liable for losses sustained by the insured.
Agent Requirements and Education
- An agent whose license is revoked must wait at least 5 years before applying for a new one.
- Fifty percent of continuing education must be completed in a classroom setting or its equivalent.
- An Outline of Coverage must be provided when an application for a Medicare Supplement policy is taken.
- Evidence of Coverage forms from HMOs require approval from the commissioner.
- Agents can legally share commissions only with other agents authorized in the same line of insurance.
Coverage Specifics for Newborns and Policy Assignments
- Health coverage for newborns is not limited to congenital defects; it typically covers a wider range of health needs.
- An insured may assign up to 100% of policy ownership under an individual life insurance policy.
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Description
This quiz covers key concepts and regulations from Chapter 8 of Texas Laws and Rules. Use these flashcards to test your understanding of life insurance policies, HMOs, and enrollment procedures. Perfect for exam preparation or quick reviews.