Podcast
Questions and Answers
A plan through the Marketplace may be purchased by?
A plan through the Marketplace may be purchased by?
What must an agent do during a sales presentation for a participating life insurance policy?
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?
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?
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?
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)?
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?
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?
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?
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?
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?
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?
What is an example of an unfair claims settlement practice?
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For what reason may a Medicare Supplement policy be cancelled?
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.
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?
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.
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?
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?
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?
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?
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?
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?
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?
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.
______ 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?
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)?
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?
With whom may an agent legally share commissions?
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Which statement about health coverage for newborns is NOT true?
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.
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.
