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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Health Insurance Basics | - Social insurance - Disability income insurance - Health insurance concepts - Medical expense insurance - Policy provisions and riders | |
| Topic 2: Specialized Health Insurance for Qualified Individuals | - Long-term care insurance - Medicare - HIPAA - Medicaid | |
| Topic 3: Pennsylvania Statutes, Rules and Regulations Common to Life, Accident and Health | 30% | - Agent conduct and trade practices - Pennsylvania Insurance Department - Penalties and offenses - Unfair trade practices - Licensing requirements |
| Topic 4: Insurance Regulation | 8% | - Licensing - Federal regulation - State regulation |
| Topic 5: Life Insurance Basics | 8% | - Differences in life insurance policies - Business uses of life insurance - Determining amount of personal life insurance - Individual underwriting by the insurer - Personal uses of life insurance - Factors in premium determination - Insurable interest - Licensee responsibilities - Premiums |
| Topic 6: Group Health Insurance | - Group health insurance provisions - Group health insurance plans - Group health insurance concepts | |
| Topic 7: Individual Health Insurance Policy General Provisions | - Optional provisions - Other provisions - Uniform required provisions | |
| Topic 8: Life Insurance Policies | 11% | - Specialized policies - Group life insurance - Flexible premium policies - Term life insurance - Whole life insurance |
| Topic 9: General Insurance | 6% | - Agents and general rules of agency - Concepts - Insurers - Contracts |
| Topic 10: Annuities | - Annuity taxation - Annuity products - Annuity principles and concepts |
Question 1
Long-term care policies may NOT exclude
A. treatment payable by workers' compensation.
B. organic cognitive disorders.
C. treatment caused by participation in criminal activities.
D. alcoholism and drug addiction.
Question 2
To prevent an insured from earning a higher income than if he or she were working, disability income policies utilize
A. benefit limits.
B. waiting periods.
C. coinsurance.
D. deductibles
Question 3
A group health insurance Certificate of Coverage is
A. only provided to an employer
B. given to the employee as proof of coverage.
C. issued to the policyowner as proof of coverage.
D. issued in lieu of a policy.
Question 4
What annuity payout option has no additional payouts regardless of when the annuitant dies?
A. Cash refund.
B. Installment refund.
C. Life only.
D. Life certain.
Question 5
An Insurer, in general business practice, fails to promptly provide a reasonable explanation for the denial of a claim. This is considered to be
A. a contractual liability.
B. a violation of the grace period provision.
C. an unfair claim settlement practice.
D. a fraudulent insurance act.
Solutions:
| Question 1 Answer: B | Question 2 Answer: A | Question 3 Answer: B | Question 4 Answer: C | Question 5 Answer: C |
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