Laws and Rules Pertinent to Insurance Practice Test

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• What may an insurer require under South Carolina law to determine the cause of an accidental death?
• Long-term care policies must pay for "at-home" care at the same amount as which type of care?
• Which of the following is often used to protect against substantial losses in medical expenses?
• What does general liability insurance cover?
• Which of the following dental procedures is commonly excluded from coverage under a dental policy?
• What is a "statement of benefits" in health insurance?
• A producer giving a $50 handbag for the purchase of an insurance policy is considered to have committed which prohibited sales practice?
• In the context of insurance, what does 'underwriting' primarily refer to?
• What does "excess insurance" provide?
• Which process involves determining the pricing of insurance policies?
• What kind of coverage must group health plans offer under the Affordable Care Act?
• What does the "co-insurance" clause mean?
• A PPO plan is best defined as:
• The Director MUST examine domestic insurers AT LEAST once every:
• Why might an insurer choose to exclude coverage for a preexisting condition?
• What does the term "coverage limit" indicate?
• What is typically a requirement for obtaining a life insurance policy?
• The responsibility for regulating the insurance continuing education requirements belongs to the?
• What is the term for an indemnity plan limitation where the insured pays a portion of dental bills?
• What is the "insurable interest" requirement?
• What does the Flexible Savings Account limit pertain to?
• According to South Carolina insurance Code, what must a producer do when replacing a Life Insurance policy?
• According to the Affordable Care Act, what is the maximum contribution limit to a Flexible Savings Account for an individual?
• What is an "undisclosed risk" in insurance?
• What does "co-payment" mean in health insurance?
• Under what condition can the Director enforce provisions of the insurance code?
• The branch of dentistry which deals with the replacement of missing parts is called?
• In insurance terminology, who is referred to as the "insurer"?
• To operate as a domestic insurer, what must an insurance company obtain?
• Which act primarily governs the use of credit information in the insurance industry?
• What is the primary purpose of the proof of loss requirement in health insurance?
• Which of the following is NOT considered an Unfair Claims Settlement Practice?
• What does the "reciprocity principle" in insurance refer to?
• What is the role of an actuary in the insurance industry?
• What does "auto liability insurance" cover?
• How does “deductible” function in an insurance policy?
• According to the Affordable Care Act, what metal tier is required to have an actuarial value of 70%?
• What regulates the maximum amount that can be charged for a specific insurance coverage?
• What does a fixed co-payment typically apply to?
• In which circumstance can a temporary producer license NOT be issued?
• What does market conduct refer to in insurance regulation?
• What is NOT considered an illegal inducement in insurance practices?
• Which licensee is required to be appointed in order to conduct insurance business?
• Which of the following best describes an insurance contract?
• What must a licensed individual in South Carolina do when changing their legal name?
• What are the levels of coverage specified by the Affordable Care Act?
• What is "subrogation" in insurance?
• Which of the following is a requirement for small group health plans under certain circumstances?
• Which entity typically regulates insurance within a state?
• In which instance could an insurer not exclude coverage for a preexisting condition?
• In health insurance, what does the term "network" refer to?
• What is typically covered by general liability insurance?
• If an insurance agent receives a fee for providing advice, how long must they retain a signed memo of the transaction?
• What is the definition of an "endorsement" in an insurance policy?
• What authority does the Director have concerning state laws related to insurance?
• An employer can qualify for health care tax credits through the SHOP Marketplace if they have fewer than how many employees?
• What is an effect of insurance fraud on the industry?
• What does the term "deductible" refer to?
• Under the Time Limit on Certain Defenses Provision, how long must a disability policy be in force to be deemed incontestable?
• What is "life insurance" intended to provide?
• What is the term for an insurance application where the applicant fails to disclose known material facts?
• What is the significance of an insurance pool for insurers?
• What is typically a key factor when determining insurance premiums for long-term care policies?
• Which of the following describes an insurance premium?
• Under the Time Limit on Certain Defenses Provision, a health insurance policy is incontestable after it has been in force for how long?
• What is an "umbrella policy" in insurance?
• Someone who sells, solicits, or negotiates insurance contracts for compensation on behalf of an insurer is called:
• Which statement regarding an examination of an insurer's books and records by the Director is TRUE?
• How does a broker differ from an agent in the insurance industry?
• What is "risk pooling" in the context of insurance?
• What role does the National Association of Insurance Commissioners (NAIC) serve?
• What does "claims handling" involve?
• What does a "life settlement" involve?
• What does "claims adjustment" encompass?
• What is an example of an alien insurer?
• When selling an insurance policy, what is not required of the agent?
• Which of the following represents an important characteristic of surplus lines insurance?
• What does PIP insurance stand for in the context of auto insurance?
• What does "cancellation" of an insurance policy entail?
• According to the Affordable Care Act, a plan must exist prior to which date to be considered grandfathered?
• How are covered expenses typically paid under a scheduled dental policy?
• What does "adverse selection" mean in insurance?
• Why do group dental plans frequently limit annual benefits?
• What is the difference between "whole life" and "term life" insurance?
• An employer with fewer than 25 full-time equivalent employees may qualify for a tax credit of what percentage of premiums paid, as of January 1, 2014?
• In South Carolina, how long after an insurance agent’s license is revoked must they wait to reapply?
• If the Director determines an individual has violated state insurance laws, what action can they take?
• How does the Affordable Care Act classify health plans?
• According to the Fair Credit Reporting Act, which of the following does an insurer NOT need to do?
• What is commonly included in an insurance policy’s aggregate limit?
• What is a common reason for insurance claims to be denied?
• When can a policy no longer be cancelled for nonfraudulent misstatements after its date of issue?
• An insured must submit proof of loss on a health insurance claim within how many days after the date of loss?
• A false statement made by a producer to replace an existing policy that harms the insured is called what?
• What is a self-insured retention (SIR) in insurance?
• What must all health benefit plans issued after January 1, 2014 provide?
• What is one reason an insurer may choose not to renew a small group health benefit plan?
• What is the primary function of an insurance policy?
• Define "no-fault insurance."
• In insurance terminology, what does "excess insurance" specifically address?
• What is the purpose of a liability waiver?
• What is defined as "insurance fraud"?
• Under which condition can a producer legally share commission with another producer?
• Which organization oversees the regulatory compliance of insurers in South Carolina?
• Who typically needs flood insurance?
• In insurance, what does the term "waiver" refer to?
• What is the primary role of an insurance adjuster?
• In South Carolina, how many days does the free-look provision allow the insured to return an individual insurance policy for a full premium refund?
• What is the purpose of the Fair Credit Reporting Act (FCRA) in insurance?
• In South Carolina, what is the MAXIMUM length of time an insurer can defer payment of a cash surrender value of an annuity?
• What does the term "exclusions" mean in an insurance policy?
• What is the role of the Director in disciplinary hearings?
• What is a key function of the "insurer's duty to defend"?
• What does "insurance density" refer to?
• What is meant by a "pre-existing condition" in health insurance?
• What is one of the Director's responsibilities regarding rate setting?
• What is indicated by a "non-renewal" notice from an insurer?
• How long is the incontestability period for health insurance policies?
• What can cause a grandfathered health plan to lose its status under the Affordable Care Act?
• Which of the following is NOT an example of inducement to purchase insurance?
• What is an "insurance intermediary"?
• Which of the following is considered illegal discrimination in insurance applications?
• What does "premium financing" allow insured individuals to do?
• Which of the following constitutes an unfair claim settlement practice?
• In which case might an insurer deny a claim based on applicant history under the Fair Credit and Reporting Act?
• What role do underwriters play in the insurance process?
• What is the primary function of the Director in relation to policy forms?
• All of the following are subject to false advertising regulations EXCEPT?
• Which activity does not fall under the Director's enforcement capability?
• What does "modified duty" refer to in relation to workers' compensation?
• An insurer may refuse to issue a policy to a particular insurance applicant for a reason based solely on:
• As per the Affordable Care Act, what is the actuarial level of coverage provided by a Silver Plan?
• What is the main purpose of an insurance policy?
• Which of the following is an example of an Unfair Claim Settlement Practice?
• What is the role of an insurance commissioner?
• What is the primary purpose of the insurance free-look provision?
• In South Carolina, the Director may issue a temporary producer license for a maximum period of how long?
• Define "premium" in insurance.
• A deliberate lie by an insured to the insurer for a lower premium is categorized as what?
• What is the role of an insurance adjuster?
• Which of the following statements is correct regarding a policy summary in life insurance transactions?
• An insurance producer has fiduciary responsibilities to all of the following EXCEPT?
• A hospital or medical expense policy typically covers dental treatment expenses when?
• A form of medical health insurance covering the treatment and care of gum disease is called:
• Under the Affordable Care Act, which plan is intended to provide coverage that is actuarially equivalent to 80% of the full value?
• How is an "insurance pool" defined?
• In insurance, what does the term "aggregate limit" refer to?
• What does "statutory surplus" in insurance regulation refer to?
• What is the primary purpose of surplus lines insurance?
• A carrier may discontinue small group health benefit coverage if the employer fails to do what?
• What is "premium" in insurance terminology?
• What is the purpose of an insurance binder?
• A Pre-existing Condition Provision applies if previous creditable coverage was continuous for how many days prior to the new coverage's enrollment date?
• What is the importance of the underwriting process in insurance?
• When replacing a life insurance policy, which document does NOT need to be provided to the purchaser at the time of delivery?
• What does the term "underwriting" refer to in insurance?
• How many years is a producer REQUIRED to maintain transaction records of a policy?
• What is the maximum exclusion period for a late enrollee under a group health policy?
• What is the primary purpose of property insurance?
• Which feature MUST an insurer offer to each policyowner at the time of purchasing long-term care insurance?
• What is the primary purpose of the Fair Credit and Reporting Act?
• What is a "policy declaration"?
• What is South Carolina's REQUIRED grace period for a life insurance policy?
• Mary is issued an initial producer's license on April 29, 2012. Her birthdate is March 14, 1980. When does her license renew?
• A policy illustration given at time of sale does NOT typically include the:
• What is the primary purpose of insurance regulation?
• Making a statement that is false or maliciously critical of an insurer's financial condition is known as?
• What does the term "deductible" mean in insurance?
• For how long can an insurer exclude coverage for a preexisting condition on a Medicare Supplement Policy?
• How is an insurance premium typically calculated?
• Who must be notified when an insurance licensee in South Carolina changes their address?
• What is required for an insurance policy to be enforceable?
• What is necessary for an insurer to exclude a preexisting condition after the allowable period?
• Which of the following is NOT typically covered under long-term care insurance in South Carolina?
• What is an insurance policy?
• Which of the following is NOT a requirement for an enforceable insurance policy?
• Which of the following is NOT an eligible dependent on an Accident and Health policy?
• Which of the following must meet South Carolina's continuing education requirements?
• An insurance producer CANNOT act as an agent of an insurer until the insurance producer becomes:
• What aspect of insurance does "rate making" assess?
• Which provision helps to ensure that an insured's pre-existing conditions are covered after a specific period?
• Which type of policy provides coverage for both the policyholder's life as well as for potentially long-term care?
• How many days' minimum notice must the Director provide before a disciplinary hearing?
• Which of the following dental treatments is covered under restorative dental treatment?
• Which of the following describes a policy where the insured pays a set amount per procedure for dental care?
• What is the significance of the "waiting period" in health insurance?
• Which of the following is not a duty performed by the insurance Director?