Questions and Answers
What is the minimum benefit period that must be offered by a long-term care policy?
12 months
Under Texas insurance law, what does the term 'transacting business' include?
collecting premiums
Which Unfair Trade Practice involves an agent telling a prospective client that a policy's dividends are guaranteed?
Which of the following groups may not be insured by a group life insurance policy?
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An insurance agent has a fiduciary responsibility to all the following EXCEPT:
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How long does an insurance company appointment remain in force?
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An insured may assign up to ______ of policy ownership under an individual life insurance policy.
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How long must an HMO hold an open enrollment period every 12 months after the initial enrollment period?
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Which of the following is a valid reason for an enrollee to be cancelled by a Health Maintenance Organization (HMO) plan?
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Which of the following is NOT a required provision in group life policies?
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A certificate of _______ permits an insurance company to transact business in Texas.
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What action will a life insurance company most likely take if an insured dies and it is discovered that the insured's age was misstated on the application?
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Which of the following statements about health coverage for newborns is NOT true?
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When advertising, what must an insurance company use?
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What is an insurance company organized under New York laws and licensed to do business in Texas considered?
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An example of false advertising would be:
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Who may purchase a plan through the marketplace?
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Which of these is NOT an example of doing insurance business?
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What is a domestic insurance company in Texas considered?
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How long can a cash surrender value payment be deferred by the insurance company under the nonforfeiture law?
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With whom may an agent split commissions?
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What is a requirement for obtaining a Texas insurance agent's license?
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Which of the following is NOT included in a life insurance illustration?
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How often must insurance agent licenses normally be renewed?
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In Texas, how long is a grace period required for an individual life insurance policy?
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An example of rebating would be:
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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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What is ABC Insurance company committing if it is actively engaging in boycott, coercion, and intimidation that results in the unreasonable restraint of trade?
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A foreign insurance company conducting insurance business in Texas:
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For what reason may a Medicare Supplement policy be cancelled?
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If an insured's age has been misstated on a life insurance policy, what does the Misstatement of Age provision require?
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Who owns a stock insurance company?
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An insurer is NOT required to provide information on fraudulent claims if requested by:
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Which of the following benefits is NOT required under a group health plan for drug and alcohol treatment?
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In Texas, which of these statements regarding the Suicide clause is TRUE?
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Why would the Insurance Commissioner examine the records of an insurance company?
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When must an applicant receive an Outline of Coverage?
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All of these statements about the Commissioner of Insurance are true EXCEPT:
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An Evidence of Coverage form may be issued by a Health Maintenance Organization (HMO) after being approved by the:
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What is an organization that solicits insurance only to its members?
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Study Notes
Minimum Benefit Period
- Long-term care policy must offer a minimum benefit period of 12 months.
Transacting Business
- "Transacting business" under Texas insurance law includes collecting premiums.
Unfair Trade Practice
- Misrepresentation is when an agent claims a policy's dividends are guaranteed.
Group Life Insurance Policy Restrictions
- Group life insurance policies cannot insure individuals solely related by blood.
Fiduciary Responsibility
- An insurance agent has a fiduciary duty to applicants, insureds, and insurers but not to other agents.
Insurance Company Appointments
- Appointments for insurance companies remain in force until terminated.
Policy Ownership Assignment
- An individual can assign up to 100% of policy ownership under a life insurance policy.
Open Enrollment Period
- Health Maintenance Organizations (HMOs) must hold a 31-day open enrollment period every 12 months after initial enrollment.
Cancellation of HMO Plans
- A valid reason for an enrollee's cancellation by an HMO is nonpayment of premium.
Required Provisions in Group Policies
- "Right to Loan" is not a required provision in group life insurance policies; required provisions include free look, incontestable clauses, and conversion rights.
Certificate of Authority
- A certificate of authority allows an insurance company to transact business in Texas.
Misstated Age on Insurance Application
- If an insured's age is misstated, the life insurance company will pay an amount based on what the premiums would have purchased at the actual age.
Coverage for Newborns
- Coverage for newborns begins at birth and continues beyond 31 days upon premium payment; it does not only cover congenital defects.
Advertising Requirements
- Insurance companies must use their legal corporate name in advertising.
Foreign Insurance Companies
- An insurance company incorporated in New York but licensed in Texas is classified as a foreign company.
False Advertising Example
- An example of false advertising is an insurer exaggerating its dividends in promotional materials.
Marketplace Plan Eligibility
- Any legal resident except those imprisoned can purchase a plan through the marketplace.
Insurance Business Definition
- Selling shares of stock is not considered part of doing insurance business.
Domestic Insurance Company
- A domestic insurance company in Texas is incorporated there.
Deferred Cash Surrender Value
- Under nonforfeiture laws, cash surrender value payments can be deferred by the insurer for up to 6 months.
Commission Splitting
- Agents are permitted to split commissions with other agents who share the same line of insurance.
Agent's License Requirements
- Honesty, trustworthiness, and reliability are essential qualities for obtaining a Texas insurance agent's license.
Life Insurance Illustration Components
- A life insurance illustration does not include the company's mortality table.
License Renewal Frequency
- Insurance agent licenses in Texas must typically be renewed every 2 years.
Grace Period for Individual Policies
- Individual life insurance policies in Texas are required to have a grace period of 31 days.
Rebating Practices
- Returning a portion of a premium as an inducement to purchase insurance is categorized as rebating.
Temporary Agent's License Validity
- A temporary agent's license issued by the commissioner is valid for up to 90 days.
Unfair Methods of Competition
- Engaging in boycott, coercion, and intimidation constitutes a prohibited act under Texas insurance laws.
Foreign Insurance Company Compliance
- A foreign insurance company conducting business in Texas was formed under the laws of another state.
Medicare Supplement Policy Cancellation
- A Medicare Supplement policy can be canceled due to nonpayment of premium.
Misstatement of Age Provision
- If age is misstated, the death benefit will be adjusted to the amount that premiums would have purchased at the correct age.
Ownership of Stock Insurance Companies
- Stock insurance companies are owned by stockholders.
Fraudulent Claims Information Policy
- Insurers are not obligated to provide information on fraudulent claims if requested by an insured.
Group Health Plan Requirements
- Transportation to and from treatment facilities is not required under a group health plan for drug and alcohol treatment.
Suicide Clause Regulation
- After the second year, an insurer cannot use suicide as a defense against payment.
Insurance Company Examination
- Insurance records are examined by the Insurance Commissioner to assess the company's solvency.
Outline of Coverage Requirement
- Applicants must receive an Outline of Coverage when applying for Medicare Supplement policies.
Commissioner of Insurance
- The Insurance Commissioner is appointed by the governor, not elected, and oversees the insurance business in Texas.
Evidence of Coverage Form
- An Evidence of Coverage form from an HMO must be approved by the commissioner.
Fraternal Benefit Society Definition
- A fraternal benefit society is an organization that solicits insurance only to its members.
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Description
Test your knowledge on Texas laws and rules relevant to insurance with this set of flashcards. Learn key definitions and concepts such as minimum benefit periods and unfair trade practices. Perfect for students preparing for insurance licensing exams.
