Minnesota Life and Accident & Health Insurance Producer Cross Reference Study Guide

Transcription

1 Minnesota Life and Accident & Health Insurance Producer Cross Reference Study Guide This cross reference provides you with the exam outline for your state insurance exam and a reference code where the specific topics can be located in the Kaplan study material. The reference code numbers in the right hand column refer to the unit number and the applicable topic, subtopic, and sub-subtopics within that unit.

2 EXAMINATION CONTENT OUTLINES LIFE PRODUCER EXAMINATION Effective February 28, 2015 # of Items Minimum Passing Score Time Allowed 75 70% 120 minutes CONTENT OUTLINE Life General Knowledge Product Knowledge, Terms, and Concepts (50 items) Types of Policies Traditional Whole Life Products Ordinary (straight) Life Limited-Pay and Single-Premium Life , Adjustable Life Interest-Sensitive Life Products Universal Life Variable Whole Life Variable Universal Life Term Life Level, Decreasing, and Increasing Term , , Special Features Renewable Convertible Annuities Single, Level, and Flexible Premium , , Immediate and Deferred Fixed and Variable , 12.8 Equity Index Combination Plans and Variations Joint Life Survivorship Life Policy Riders, Provisions, Options, and Exclusions Policy Riders Waiver of Premium and Waiver of Premium with Disability Income , Guaranteed Insurability Payor Benefit Accidental Death and/or Accidental Death and Dismemberment Term Riders Other Insureds (e.g., spouse, children, nonfamily) Cost of Living Policy Provisions and Options Entire Contract Insuring Clause Consideration Owner's Rights , Beneficiary Designations Primary and Contingent

3 Revocable and Irrevocable Changes Common Disaster Minor Beneficiaries Premium Payment Modes Automatic Premium Loan Level or Flexible , Reinstatement Policy Loans, Withdrawals, Partial Surrenders , Nonforfeiture Options Dividends and Dividend Options , 11.7 Incontestability Assignments Suicide Misstatement of Age and Gender Settlement Options Policy Exclusions Completing the Application, Underwriting, and Delivering the Policy Completing the Application Required Signatures Changes in the Application Consequences of Incomplete Applications Warranties and Representations , Collecting the Initial Premium and Issuing the Receipt Replacement Disclosures at Point of Sale (i.e., HIPAA, HIV consent) , Underwriting Insurable Interest Medical Information and Consumer Reports , Fair Credit Reporting Act Risk Classification Delivering the Policy When Coverage Begins Explaining the Policy and its Provisions, Riders, Exclusions, and Ratings to the Client Taxes, Retirement, and other Insurance Concepts Third-Party Ownership Group Life Insurance Conversion Privilege Contributory vs. Noncontributory Retirement Plans Tax-Qualified Plans Nonqualified Plans Business Insurance Social Security Benefits and Taxes Tax Treatment of Insurance Premiums, Proceeds, Dividends , , Individual Life , Group Life Modified Endowment Contracts (MECs) Accelerated Death Benefits Living Benefits , Endowments Twisting (replacement to the detriment of the insured) Life & Health - Minnesota Specific State Laws, Rules, and Regulations (25 items) Ref: 45; 60A through 79A refer to MN statutes; 2700 through 2795 refer to MN rules Minnesota Laws, Rules, and Regulations Common to Life, Health, Property, and Casualty Insurance 20 items

4 Powers and Duties of the Commissioner... See State Supplement Ref: 45; 60A ; 60K; 72A ; 62A.02; 61A.02; 79;2795; 72C Broad Powers Examination of Records Notice and Hearing Forms and Rate Review Definitions Domestic and Foreign Ref: 60A.02 Stock and Mutual Ref: Standard Insurance Definition Certificate of Authority Ref: 60A.07; 72A.41 Fraternals Ref: 64B.01; 64B.05; 64B.19 Licensing and Appointments Ref: 60K; ; 60A.198; Educational Requirements Prelicensing Continuing Education Long-Term Care (LTC) Annuities Ref: 72A.2033 Types of Licenses Producer Temporary Nonresident Termination of License Expiration Revocation or Suspension Appointment Ref: 60K Termination of Appointment Ref: 60K.51 Maintenance and Duration of License Trade Practices Ref: 60K; 72A; 2790; Prohibited Practices Unfair Claims Settlement Methods and Practices Rebating Misrepresentation Defamation Discrimination Penalties Misappropriation or Conversion of Funds Forgery Suitability Twisting Compensation of Licensees Commissions Fees for Service Advertising Ref: 60A; 72A.20; 2790; 61B.28 subd. 4 Agent Conduct and Insurance Marketing Standards Ref: 2700; 2790; 2795; 72A, 72C Required Disclosures Ref: 60K.46; 60A.08 Guaranty Association Ref: 61B; 60C Notice of Policyholder Rights Minnesota Laws, Rules, and Regulations Pertinent to Life Insurance Only 5 items

5 Ref: 61A; 62B; 72A Beneficiaries Ref: 61A.04; 61A.12 Protection from Creditors Policyowner Rights Right to Cancel Ref: 72A Insured Insurance Company Policy Provisions Grace Period Ref: 61A.03 subd. 1(b) Back Dating Ref: 61A.07(3); 72A.52 Credit Insurance (Life and A&H) Ref: 62B Group Life Ref: 61A.092; 62B.03 Continuation of Coverage Ref: 61A.092 Conversion of Coverage Ref: 61A.092 Insurable Interest Act Ref: 60A Replacement Insurance Ref: 61A

6 EXAMINATION CONTENT OUTLINES ACCIDENT & HEALTH PRODUCER EXAMINATION Effective February 28, 2015 # of Items Minimum Passing Score Time Allowed 80 70% 120 minutes CONTENT OUTLINE Accident & Health - General Knowledge Product Knowledge, Terms, and Concepts (50 items) Types of Policies 14 items Disability Income Individual Disability Income Policy Business Overhead Expense Policy Business Disability Buyout Policy Group Disability Income Policy Key Employee/Partner Policies Accidental Death and Dismemberment Medical Expense Insurance Basic Hospital, Indemnity, Medical, and Surgical Policies , , Major Medical Policies Comprehensive Major Medical Policies Health Maintenance Organizations (HMOs) Preferred Provider Organizations (PPOs) Non-profit Health Service Plan (Blue Plans) Point of Service (POS) Plans Medical Savings Accounts (MSAs) Flexible Spending Accounts (FSAs) Health Reimbursement Accounts (HRAs) High Deductible Health Plans (HDHPs) and Related Health Savings Accounts (HSAs) , Health Savings Accounts (HSAs) Medicare Supplement Policies Group Insurance Group Conversion Differences between Individual and Group Contracts , 22.3 General Concepts COBRA HIPAA Long-Term Care (LTC) Individual LTC Contracts , Group/Voluntary LTC Contracts Elimination Period Cancer (for specified diseases) Plans , Critical Illness Plans Worksite (employer-sponsored) Plans Policy Provisions, Clauses, and Riders 20 items Mandatory Provisions Entire Contract Time Limit on Certain Defenses (incontestable)

7 Reinstatement Notice of Claim Claim Forms Proof of Loss Time of Payment of Claims Payment of Claims Physical Examination and Autopsy Legal Actions Change of Beneficiary Optional Provisions Change of Occupation Misstatement of Age Illegal Occupation Other Provisions and Clauses Insuring Clause Consideration Clause Probationary Period Elimination Period Waiver of Premium Exclusions Pre-existing Conditions Recurrent Disability Coinsurance Deductibles Eligible Expenses Copayments Pre-Authorizations and Prior Approval Requirements , Usual, Reasonable, and Customary (URC) Charges Lifetime, Annual, or per Cause Maximum Benefit Limits Riders Impairment Rider (Disability) Guaranteed Insurability Rider Multiple Indemnity Rider (double, triple) Long-Term Care Rider , Rights of Renewability Noncancelable Cancelable Guaranteed Renewable Conditionally Renewable Optionally Renewable Period of Time for Renewal Social Insurance 3 items Medicare Primary, Secondary Payor Medicare Parts A, B, C, D , , 23.6, 23.7 Medical Assistance Social Security Benefits Other Insurance Concepts 4 items Total, Partial, and Residual Disability , Owner's Rights Dependent Children Benefits Primary and Contingent Beneficiaries Nonduplication and Coordination of Benefits (e.g., primary vs. excess) Occupational vs. Nonoccupational Tax Treatment of Premiums and Proceeds of Insurance Contracts (e.g., disability income and medical expenses, etc.) Contracts (e.g., disability income and medical expenses, etc.) Managed Care , 16.6, 16.7 Workers' Compensation Exclusion Subrogation Twisting (replacement to the detriment of the insured)

8 Field Underwriting Procedures 9 items Completing Application and Obtaining Necessary Signatures , Explaining Sources of Insurability Information (e.g., MIB Report, Fair Credit Reporting Act, etc.) Initial Premium Payment, Receipt, and Consequences of the Receipts (e.g., medical examination, etc.) Submitting Application (and initial premium if collected) to Company for Underwriting Assuring Delivery of Policy to Client and Related Documents Explaining Policy and its Provisions, Riders, Exclusions, and Ratings to Clients , 7.5 Replacement Contract Law Requirements of Forming a Contract Insurable Interest Warranties and Representations Unique Aspects of the Health Contract Conditional Unilateral Adhesion Life & Health Minnesota Specific State Laws, Rules, and Regulations (30 items) Ref: 45; 60A through 79A refer to MN statutes; 2700 through 2795 refer to MN rules Minnesota Laws, Rules, and Regulations Common to Life, Health, Property, and Casualty Insurance 20 items Powers and Duties of the Commissioner... See State Supplement Ref: 45; 60A ; 60K; 72A ; 62A.02; 61A.02; 79; 2795; 72C Broad Powers Examination of Records Notice and Hearing Forms and Rate Review Definitions Domestic and Foreign Ref: 60A.02 Stock and Mutual Ref: Standard Insurance Definition Certificate of Authority Ref: 60A.07; 72A.41 Fraternals Ref: 64B.01; 64B.05; 64B.19 Licensing and Appointments Ref: 60K; ; 60A.198; Educational Requirements Prelicensing Continuing Education Long-Term Care (LTC) Annuities Ref: 72A.2033 Types of Licenses Producer Temporary Nonresident Termination of License Expiration Revocation or Suspension Appointment Ref: 60K Termination of Appointment Ref: 60K.51 Maintenance and Duration of License Trade Practices

9 Ref: 60K; 72A; 2790; Prohibited Practices Unfair Claims Settlement Methods and Practices Rebating Misrepresentation Defamation Discrimination Penalties Misappropriation or Conversion of Funds Forgery Suitability Twisting Compensation of Licensees Commissions Fees for Service Advertising Ref: 60A; 72A.20; 2790; 61B.28 subd. 4 Agent Conduct and Insurance Marketing Standards Ref: 2700; 2790; 2795; 72A; 72C Required Disclosures Ref: 60K.46; 60A.08 Guaranty Association Ref: 61B; 60C Notice of Policyholder Rights Minnesota Laws, Rules, and Regulations Pertinent to Health Insurance Only 10 items Policy Clauses and Provisions/Mandates Coverage of Emotionally Disabled Children Ref: 62A.151 Coverage of Physically Disabled Children Ref: 62A.14 Coverage of Newborns and Adopted Children Ref: 62A.27; 62A.042 Continuation/Conversion of Benefits Ref: 62A.17; 62A.21; 62A.65; 62D.101; 62A A.148 Disabled Employees Survivors Termination of Employment Divorce Maternity Benefits Ref: 62A.041 Right to Cancel Ref: 72A Insured Insurance Company Benefits for Treatment of Mental Health and Chemical Dependency Ref: 62Q.47 Standard Provisions Ref: 62A.04 Comprehensive Health Insurance Act (CHIA) Ref: 62E Medicare Supplement Plans Ref: 62A Basic and Extended Basic High Deductible F, K, L, M, N Long-Term Care (LTC) Ref: 60K.365; 62A ; 62S Health Maintenance Organizations (HMOs) Ref: 62D Nonprofit Health Service Plan Corporations Ref: 62C

10 Small Employer Insurance Reform Ref: 62L Grace Period Ref: 62A.04 subd. 2(3)