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Ohio Insurance Exam
Insurance Exam
| Question | Answer |
|---|---|
| Defamation occurs when an agent makes a false statement intended to malign another insurer restrict fair trade misrepresent the provisions of an insurance policy replace an existing insurance policy with another | malign another insurer |
| Carole is a licensed agent who lives in Michigan and transacts insurance in Ohio. In Ohio, Carole is considered to be a(n) nonresident agent reciprocal agent foreign agent alien agent | nonresident agent |
| The free look period in Ohio for individual health insurance policies is ___ days. 10 5 30 15 | 10 |
| Insurance companies that are organized in countries outside the United States are referred to as reciprocal nonadmitted alien foreign | alien |
| What is the MINIMUM benefit period that must be offered by a Long-Term Care policy? 18 months 6 months 12 months 24 months | 12 months |
| The superintendent determines an examination of an insurer's books and records is necessary. After receiving the notification, the insurer | must not impede the examination |
| When a health policy is reinstated, insured losses are covered immediately if the losses result from accidental injuries surgery is required claim forms are submitted with proof of loss the losses result from sickness | the losses result from accidental injuries |
| Offering to return a portion of the premium to an insurance applicant as an inducement to purchase insurance is an illegal act known as rebating unfair discrimination defamation intimidation | rebating |
| When screening an applicant for HIV, the insurer inquire about the applicant's sexual history inquire about the applicant's sexual orientation ask an applicant's relatives confirming the applicant's sexual orientation require a blood test for HIV | may require a blood test for HIV |
| Within ___ days after policy delivery, both Medicare Supplement and Long-Term Care policies can be returned for a 100% premium refund. 30 20 15 25 | 30 |
| Sharon the agent intentionally submitted a false statement in support of a claim. This is considered a form of inducement discrimination twisting fraud | fraud |
| Advertisements for accident and health policies that ONLY cover a stated illness MUST display a statement that the policy covers any illness or accident policy's premiums remain level policy is guaranteed issued policy is limited | policy is limited |
| An employee has ___ days after the date of marriage to add a new spouse to a small group health plan. 30 120 90 60 | 30 |
| An employer with under 20 employees must allow a terminated employee to continue accident and health coverage for a MINIMUM of ___ months. 6 12 18 3 | 12 |
| An insurance company advertises an accident and health insurance product in a local Ohio newspaper and refers to dollar amount benefits. This insurer must also disclose which of the following in the advertisement? | Any applicable benefit reduction |
| A life policy loan in Ohio cannot charge a fixed rate of interest higher than 6% 7% 9% 8% | 8% |
| An insurer may refuse to renew an employer's small group health plan due to excessive filing of claims nonpayment of premium employer's bankruptcy status decrease in the number of employees | nonpayment of premium |
| Which of the following actions by an agent would NOT result in a license suspension or revocation? | Producing an insufficient amount of new premium |
| Coverage for newborns under an accident and health plan MUST include coverage for birth abnormalities disability of the mother delivery costs lost wages of the mother | birth abnormalities |
| Long-Term Care policies or certificates issued in Ohio are required to have a disability rider conditional renewal provision permanent level premiums a nonforfeiture value | a nonforfeiture value |
| Advertising regulations exist in order to demonstrate full and truthful disclosures to the public check the backgrounds of company spokespersons protect the rights of insurers generate revenues for the state | demonstrate full and truthful disclosures to the public |
| Unmarried children who are incapable of self support and have proof of incapacity are included under their parent's health coverage until age 21 age 18 policy renewal policy termination | policy termination |
| Which of the following is NOT a circumstance to which a temporary agent license can be issued? | Prospective agent who is waiting to take the state licensing examination |
| Which isn't fraud Depositing premiums into a personal bank account Collecting an insurance charge that is less than required Willfully misappropriating premiums collected Intentionally collecting a higher premium payment | Collecting an insurance charge that is less than what is required |
| Which isn't an Unfair Claims Settlement practice Compelling an insured to initiate a lawsuit by offering less on a claim Providing claim payments to insureds according to guidelines Failing to acknowledge and act promptly with respect to a claim nopay | Providing claim payments to insureds according to the guidelines of the policy's coverage |
| An insurance company has just received a request for verification from a viatical settlement provider. The insurer is required to respond within ___ calendar days to this request. 30 90 60 120 | 30 |
| _________ is "the act of replacing an existing insurance policy with another". | Replacement |
| How long after its effective date will an individual life insurance policy become incontestable? 4 years 1 year 3 years 2 years | 2 years |
| Kiara filled out a life insurance application and was given a policy illustration that showed future premiums being paid out of nonguaranteed values. This illustration MUST disclose that | she may need to resume premium payments, depending on actual results |
| A domestic insurance company in Ohio must honor the charter of the National Association of Insurance Commissioners (NAIC) writes insurance on risks located only in Ohio must own real estate in Ohio is formed under the laws of Ohio | is formed under the laws of Ohio |
| Life insurance replacement can be defined as converting existing term coverage to a permanent policy exchanging an existing life policy for a new policy accepting a reduced paid-up policy reducing the face value of an existing policy | exchanging an existing life policy for a new policy |
| A client told an intentional lie to an insurer in order to receive a favorable premium. This is an example of rebating fraud boycotting misrepresentation | fraud |
| If health insurance benefits are not paid on a timely basis, the benefits paid shall bear simple interest from a date ___ month(s) after satisfactory proof of loss was received by the insurer. 2 3 4 1 | 2 |
| In Ohio, a Long-Term Care policy must be _______ renewable. Optionally Conditionally Contingently Guaranteed | Guaranteed |
| All of the following may be an unfair claims practice EXCEPT | Denying an insured's fraudulent claim |
| All of the following actions are considered rebating EXCEPT | sharing commissions with other agents |
| All of these are responsibilities of the superintendent EXCEPT Approving policy forms Administering oaths Endorsing insurers Subpoena a witness | Endorsing insurers |
| The standard grace period for a life insurance policy sold in Ohio is ___ month(s). 2 4 3 1 | 1 |
| An agent must report to the superintendent any administrative action or criminal charges taken against the agent within __ days of the final disposition of the matter. 20 30 10 5 | 30 |
| Which of the following is NOT information found in a life insurance buyer's guide? | How to take legal action against an insurance company |
| Mary's Medicare Supplement policy had been in effect for 12 months. She recently replaced the policy with a new one that provides better coverage. The replacing policy may only impose a ___ month time exclusion for pre-existing conditions. | 0 |
| Which of these is NOT considered a form of life insurance advertisement? Buyer's Guide Sales presentation materials Brochures handed out at a promotional event Billboard announcing a new insurance product | Buyer's Guide |
| Proof of loss on a health insurance claim must be submitted to an insurer within ___ days after the insured's date of loss. 30 60 120 90 | 90 |
| An agent's appointment has been terminated by the insurer. The insurer must then notify the superintendent within ___ days of the termination. 10 40 20 30 | 30 |
| An individual who has a contract with an insurance company to represent it is called a(n) agent director representative administrator | agent |
| What are the levels of coverage as defined by the Affordable Care Act? Substandard, Standard, Preferred, and Premium PPO, HMO, POS, and MET Bronze, Silver, Gold, and Platinum 1st, 2nd, 3rd, and 4th | Bronze, Silver, Gold, and Platinum |
| All Health Benefit Plans issued after January 1, 2014 must provide long-term care adult vision care preventative health services dental care | preventative health services |
| An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called stop loss coinsurance a managed plan a deductible | coinsurance |
| With a scheduled dental policy, how are covered expenses paid? | Benefits are limited to a specific maximum dollar amount per procedure |
| A form of medical health insurance covering the treatment and care of gum disease is called Medicaid Major Medical Dental expense insurance Franchise health policy | Dental expense insurance |
| An agent is legally permitted to share his/her commissions with a proposed beneficiary with an insurance applicant with an unlicensed agent with another licensed agent | with another licensed agent |
| Barry the agent offers Chris his mountain cabin for the weekend to secure his order for his insurance business. This is an example of rebating bartering twisting subrogation | rebating |
| An agent's license may only be suspended or revoked if the agent filed for bankruptcy did not meet a sales quota has been afforded a right to a hearing has engaged in replacement of an existing policy | has been afforded a right to a hearing |
| Every admitted insurance company in Ohio MUST have their financial affairs examined by the superintendent at LEAST every __ years. 5 2 3 4 | 3 |
| Insurance agent Kelly offers a prospect a $1,000 shopping card if an insurance policy is purchased through her. What illegal activity is this an example of? Defamation Coercion Rebating Twisting | Rebating |
| To be classified as a small employer in Ohio, an employer must employ 1-25 employees 2-100 employees 1-10 employees 2-50 employees | 2-50 employees |
| To be eligible for small employer group coverage, an employee must work a MINIMUM of ___ hours in a typical week. 40 30 25 20 | 25 |
| Janice forgot to make her insurance premium payment by the due date. The period after the due date where she can make payment and avoid discontinuance of coverage is called incontestable period reinstatement period grace period courtesy period | grace period |
| Written notice of a claim must be given within __ days after a covered loss starts or as soon as reasonably possible. 20 40 30 25 | 20 |
| XYZ Corp was issued a group health policy for its employees. Under this plan a | policy must be issued to XYZ, and a certificate must be issued to each employee |
| Ohio requires a licensee to complete ___ hours of continuing education hours each licensing period. 48 12 24 36 | 24 |
| One role of the superintendent is to establish new insurance laws arbitrate claims enforce state insurance laws set sales quotas | enforce state insurance laws |
| A life insurance applicant in Ohio may backdate the application for up to ___ month(s). 2 3 1 4 | 3 |
| A life insurance policy sold in Ohio can be cancelled for nonfraudulent misstatements for up to 2 years 4 years 3 years 1 year | 2 years |
| The Fair Credit Reporting Act protects consumers by recommending insurers with good AM Best ratings from insolvent insurers by providing consumer credit counseling with guidelines regarding credit reporting and distribution | with guidelines regarding credit reporting and distribution |
| A life insurance policy's advertising material MUST contain all of the following information EXCEPT Company's name Agent's commission If the spokesperson was paid Statement that dividends are not guaranteed | Agent's commission |
| An insurer can exclude coverage for a preexisting condition on a Medicare Supplement policy for up to 12 months 6 months 18 months 9 months | 6 months |
| What does the Ohio Life and Health Insurance Guaranty Association provide? | Protection to insureds from financially insolvent insurers |
| A policyowner who anticipates death or develops a life-threatening condition may obtain proceeds from a life insurance contract . These proceeds are known as expedited benefits accelerated benefits cash surrender benefits proceed benefit options | accelerated benefits |
| Which of the following constitutes an Unfair Claims Settlement Practice? | Failing to effectuate prompt, fair, and equitable settlements of claims |
| The first payment for newborn accident and health coverage is due ___ days after the birth. 45 31 14 30 | 31 |
| Which of the following is a requirement to obtaining an Ohio insurance agent license? U.S. citizen At least 18 years old Live in this state at least 5 years Graduate from high school | At least 18 years old |
| A life insurance policyowner is allowed ___ days upon policy delivery to return the policy for a full premium refund. 30 14 10 7 | 10 |
| An agent who sells an individual life insurance policy in Ohio MUST deliver to the policyowner a(n) AM Best rating Policy Summary and Buyer's Guide financial report from the previous year letter showing NAIC compliance | Policy Summary and Buyer's Guide |
| An example of replacement is converting term life coverage to a whole life policy canceling a term life policy to buy a whole life policy | canceling a term life policy to buy a whole life policy |
| A company that is authorized by the superintendent to transact insurance business in Ohio is called a(n) reciprocal insurer accepted insurer authorized insurer legal insurer | authorized insurer |
| XYZ Life Insurance company's home office is located in Michigan and is incorporated in Michigan. In Ohio, they are considered to be Reciprocal Foreign Non-Admitted Alien | Foreign |
| A Medicare Supplement policy's outline of coverage MUST include a(n) signature of the superintendent explanation of all riders and exclusions list of local providers description of policy benefits | description of policy benefits |
| An insurer is REQUIRED to offer which of the following to each long-term care applicant at the time of purchase? Deflation protection Lifetime level premiums Conditional renewability Inflation protection | Inflation protection |
| An insurer may deny health insurance claims based on misstatements in the application for how long from the policy's date of issue? 1 year 180 days 2 years 60 days | 2 years |
| An insurer may non-renew an individual health benefit plan for all the following reasons EXCEPT | the individual is eligible for health care benefits from the Veterans Administration |
| If an insurer refuses to pay a claim, how many days must the insured wait to take legal action against a health insurer after submitting written proof of loss? 40 50 30 60 | 60 |
| A non-admitted insurer only applies to foreign insurers may sell insurance policies in this state is not afforded protection by the guaranty fund may only sell insurance policies through non-admitted agents | is not afforded protection by the guaranty fund |
| Prior to conducting an HIV-related test, the insurer must obtain a(n) | written authorization from the proposed insured |
| All Ohio licensed agents MUST complete which of the following continuing education requirements? 12 hours annually 12 hours every 2 years 24 hours every 2 years 24 hours every 3 years | 24 hours every 2 years |
| In Ohio, accident and health policies that are paid less-frequent than monthly must provide a grace period of at least 10 days 20 days 31 days 7 days | 31 days |
| An agent license is NOT required when negotiating insurance selling insurance soliciting insurance referring insurance | referring insurance |
| Terminally-ill life insurance policyowners may sell their policy at a discount to a third party. This type of agreement is called a(n) viatical settlement accelerated benefit nonforfeiture value annuitized settlement | viatical settlement |
| An agent may begin to solicit insurance ONLY when appointed by an insurer registered for the state insurance examination licensed by the state none of these | appointed by an insurer |
| In Ohio, legal action can be taken for up to ___ year(s) against an insurer for failure to pay health insurance claims after proof of loss was submitted. 2 4 1 3 | 3 |
| An agent must notify the superintendent within ___ days of a felony conviction. 60 30 90 45 | 30 |
| In Ohio, semiannual-premium health insurance policies must provide a grace period of at least 10 days 20 days 7 days 31 days | 31 days |
| Open enrollment for Medicare Supplement coverage starts 3 months before your 65th birthday 3 months after your 65th birthday 6 months after your 65th birthday 6 months before your 65th birthday | 3 months before your 65th birthday |
| The _______ of Coverage describes policy features, benefits, exclusions, and riders in a Long-Term Care policy. Outline Description Summary Proof | Outline |
| An insurance agent agrees to pay the first monthly premium for an insurance applicant. This is called a(n) offer gift rebate incentive | rebate (this is illegal) |
| How are health plans classified according to the Affordable Care Act? 1st Tier, 2nd Tier, 3rd Tier, 4th Tier Standard, Above Average, Good, Superior Plan A, Plan B, Plan C, Plan D Bronze, Silver, Gold, Platinum | Bronze, Silver, Gold, Platinum |
| As of January 1, 2014, an employer with up to 25 full time equivalent (FTE's) with average annual wages of less than $50,000 may be eligible for a tax credit of ___ of the premiums paid by the employer. 30% 60% 40% 50% | 50% |
| A common exclusion or limitation on a dental policy is Fluoride treatments Tooth extractions X-rays Endodontics | Endodontics |
| An example of endodontic treatment is a filling root canal bridge crown | root canal |
| The branch of dentistry which deals with the replacement of missing parts is called Endodontics Periodontics Prosthodontics Orthodontics | Prosthodontics |
| An unauthorized insurer may place insurance business in Ohio through a(n) surplus lines agent unauthorized agent limited lines agent nonresident agent | surplus lines agent |
| An agent's renewal date for his/her license is on or before December 31 every year the first day of the licensee's birth month January 1 every 2 years the last day of the licensee's birth month | the last day of the licensee's birth month |
| Commissions may be shared by a licensed agent and family member licensed and appointed agents a licensed agent and prospective prospect an agent and non-licensed employee | licensed and appointed agents |
| How often must the superintendent examine each domestic insurance company? Every 3 years Every 5 years Every 2 years Every year | 3 years |
| In Ohio, an agent may have his/her license revoked for which of the following acts? | Failing to appear for an interview before the superintendent |
| If an agent is believed to be causing considerable harm, the superintendent may take away the agent's appointment may incarcerate the agent may suspend the agent's license without a hearing may issue a cease and desist order against the agent | may issue a cease and desist order against the agent |
| The free look period in Ohio for individual health insurance policies is ___ days. 30 10 5 15 | 10 |
| Pete the agent recently had his license suspended because he was found to be in violation of a state insurance law. Due to this suspension, Pete | may be assessed the administrative costs sustained by the Department |
| ______ life is designed to pay the balance of a loan if the insured dies before repayment of the loan. Credit Whole Universal Debtor | Credit |
| Which of the following is considered to be an act of misrepresentation? | Falsifying the terms, benefits, advantages, or conditions of an insurance policy |
| A Buyer's Guide MUST | have it's content approved by the superintendent |
| Which of the following is required for an insurer to conduct business in this state? | Certificate of authority |
| The entire contract provision includes all of the following EXCEPT the Policy Changes made by the agent Application Riders | Changes made by the agent |
| Tim the insurance agent collects the initial premium during an insurance transaction then deposits the check into his personal checking account. In this situation, the crime of ______ has been committed. coercion fraud twisting sliding | Fraud |
| Violations of US Code Title 18 section 1033, may result in Loss of company appointments Cease and Desist Order Suspension of Agent's license Fine and/or imprisonment | Fine and/or imprisonment |
| Long-term care insurance applications MUST contain plain and unambiguous health questions. The exception to this rule would be applications for inflation riders guaranteed issue secondary issue nonguaranteed issue | guaranteed issue |
| A viatical settlement broker may NOT recommend a settlement provider to a viator make any transactions before being approved for a license charge fees advertise their services | make any transactions before being approved for a license |
| All of the following are typically included in a life insurance policy illustration EXCEPT Premium of the policy Names of the beneficiaries Cash surrender value in 20 years Interest charged for policy loans | Names of the beneficiaries |
| A minor may receive a life insurance policy's death benefit ONLY if the minor is at least 12 years old if the minor has an appointed guardian when the minor has been approved by the superintendent if the minor is a blood relative | if the minor has an appointed guardian |
| Which of the following is required for the renewal of an agent's insurance license? College credits Prelicensing education Passing an examination Continuing education | Continuing education |
| An Ohio insurance agent solicits a life insurance policy. In the event of a controversy between the insured and the company, the agent is considered to represent the insured beneficiary policyholder company | company |
| Jim recently sold his whole life insurance policy under a viatical settlement contract. The proceeds of this contract could be subject to the claims of beneficiaries creditors the insurer debtors | creditors |
| A foreign insurance company doing business in Ohio | is a company domiciled under the laws of another state |
| A license applicant who provides misleading, incorrect, or materially incomplete information can be found guilty of subrogation coercion misrepresentation twisting | misrepresentation |
| A licensed agent MUST be _________ by an insurer to be eligible for soliciting insurance contracts. authorized admitted approved appointed | appointed |
| Maria the agent would like to advertise an annuity product on a highway billboard. Which of the following must be included in the advertisement? Her home address The annuity's guaranteed interest rate Her name Superintendent's name | Her name |
| All of these are considered forms of advertising EXCEPT An oral presentation given by an agent A radio message promoting an insurer's client satisfaction An insurer's AM Best rating Billboard announcing a new insurance product | An insurer's AM Best rating |
| An advertisement for an insurance product may contain the insurer's name exaggerated benefit amounts the Guaranty Fund's endorsement for this product deceptive information | the insurer's name |
| When an agent is replacing an existing ordinary life insurance policy, the agent must take all of the following actions EXCEPT | Obtain the beneficiary's signature |
| An example of an Unfair Claims Settlement practice is | Misrepresenting insurance policy provisions affecting a loss |
| An insurance agent who convinces a prospective insured to purchase a policy by exaggerating the benefits of the policy may be found guilty of misrepresentation twisting coercion illegal placement | misrepresentation |
| According to the Affordable Care Act, any plan in existence prior to which date is considered a grandfathered plan? 23-Mar-12 23-Mar-10 23-Mar-11 23-Mar-13 | 23-Mar-10 |
| In most dental plans, a deductible typically is NOT applied to restorative dentistry orthodontics oral surgery preventative and diagnostic services | preventative and diagnostic services |
| An employer may qualify for health care tax credits through SHOP Marketplace if that employer has fewer than how many employees? 25 15 10 20 | 25 |
| Group dental plans will frequently place a limit on annual benefits in order to minimize enrollment adverse selection administrative costs coinsurance | adverse selection |
| Which of the following does restorative dental treatment cover? Crowns X-rays Cleanings Dentures | Crowns |
| An agent's appointment may only be terminated by the Superintendent agent NAIC insurer | Insurer |
| An agent's license has been suspended for non-renewal. The agent may apply for reinstatement | within 12 months of the license renewal date |
| How many days is a temporary agent's license valid? 180 90 60 30 | 180 |
| An order issued by the superintendent that prohibits a specific practice listed in the order is called a(n) | cease and desist order |
| Informing an insured of inaccurate terms of an insurance policy is considered to be a form of coercion defamation misrepresentation inducement | misrepresentation |
| Inducement is BEST defined as | offering to buy, sell, give, or allow a prospective insured employment, stock or special favors in exchange for an insurance transaction |
| Ohio requires that a licensee complete __ hours of continuing education on the subject of ethics every reporting period. 6 2 1 3 | 3 |
| Replacement can be BEST described as | exchanging a new policy for one already in force |
| Which of the following is NOT a specific power given to the superintendent? Issue subpoenas Approve policy forms Administer oaths Enact insurance legislation | Enact insurance legislation |
| Publishing information that is false and maliciously critical to an insurer and intended to cause injury is a prohibited practice known as coercion defamation unfair discrimination boycotting | defamation |
| A life insurance policy must be in effect for ___ years before the policyowner may use the nonforfeiture provision. 4 1 3 2 | 3 |
| Who is required to notify the agent in the event of appointment termination? Governor superintendent Attorney General Insurer | Insurer |
| A life insurance policy sold in Ohio can be contested by the insurer ONLY during the first ____ year(s) of the contract. four one three two | two |
| The Ohio Life and Health Insurance Guaranty Association assists in the underwriting of large insurance policies protects insureds from insurance company insolvency serves as an arbitrator for disputed claims is funded by the state government | protects insureds from insurance company insolvency |
| What is the purpose of the Ohio Life and Health Insurance Guaranty Association? | Ensures that claims filed against insolvent insurance companies will be paid |
| An insurer may refuse to renew an employer's small group health plan due to employer's bankruptcy status nonpayment of premium decrease in the number of employees excessive filing of claims | nonpayment of premium |
| An agent is meeting with a client to determine whether an annuity would be suitable for purchase. Which of the following topics needs to be discussed with the client? | Financial objectives |
| Within how many days must a licensee submit a change in address? 14 30 45 21 | 30 |
| Greg has recently been terminated from his job that covered him for group life insurance. How long does he have to convert his coverage to an individual policy? 45 days 31 days 30 days 60 days | 31 days |
| XYZ insurance company took out billboard advertisements in Ohio indicating that it can transact business in this state. This insurer, however, is NOT approved in Ohio. XYZ may be found guilty of coercion twisting sliding false advertising | false advertising |
| Suitability is | obtaining information from the applicant to determine whether an insurance or annuity product is appropriate |
| Tim's individual life insurance policy has just recently lapsed. His policy may be reinstated at any time within ___ year(s). 2 3 4 1 | 3 |
| An agent has committed an insurance crime that violates US Code 1033 (interstate commerce). Who would be responsible for the prosecution of this crime? US Attorney General Superintendent State Senate Lieutenant Governor | US Attorney General |
| An example of an Unfair Claims Settlement Practice is | Failing to promptly provide reasonable explanations for the denial of claims |
| Under the Affordable Care Act, a large employer that does NOT provide health insurance and owes an employer mandate penalty MUST pay an annual penalty, which is calculated by multiplying $2,000 by | the number of full time employees minus 30 |
| Under the Affordable Care Act, how would a grandfathered health plan lose its grandfathered status? | The insurer significantly raises co-insurance charges, deductibles, or co-payment charges |
| A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance? | Dental treatment is needed to repair an injury |
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