Does my insurance company have to issue a Medicare supplement policy?
( An insurance company must make available to each applicant a policy form offering the basic core benefits (Plan A) if it will offer any Medicare Supplement policies. An insurance company does not have to issue all or any of the plans B through N)
When must the Medicare supplement Buyer's Guide be presented?
When must the Medicare Supplement Buyer's Guide be presented? (Issuers of accident and sickness policies which provide hospital or medical expense coverage on the expense incurred or indemnity basis to the person eligible for Medicare by reason of age, must provide to that applicant a Medicare supplements Buyers Guide.
Can a 70-year-old apply for a Medicare supplement policy?
A 70-year-old individual who bought a Part B Medicare policy 2 months ago just began kidney dialysis treatments this week. The individual is now applying for a Medicare supplement policy, Which begins in 8 months.
When does the insurance company have to deliver the Buyers Guide?
Except for direct response issuers, delivery of the buyers guide must be made at the time of the application, and the insurance company must obtain a receipt) When must an insurance company present an outline of coverage to an applicant for Medicare supplement policy?
Which of the following entities must approve all continuing education courses in this state?
Which of the following entities must approve all continuing education courses in this state? All continuing education programs and courses must be approved by the Commissioner.
When must an insurer provide a Medicare Supplement Buyer's Guide and an outline of coverage?
The insurer must provide a Medicare Supplement Buyer's Guide and an Outline of Coverage at the time of application. LTC policies may define a preexisting condition as: a condition for which advice or treatment was recommended or received within 6 months of the effective date of coverage.
How long must an insurer retain an advertisement?
(a) Every insurer providing long-term care coverage in California shall provide a copy of any advertisement intended for use in California to the commissioner for review at least 30 days before dissemination. The advertisement shall comply with all laws in California.
How soon following the occurrence of a covered loss must an insured submit written proof of such lost to the insurance company?
How soon following the occurrence of a covered loss must an insured submit written proof such as loss to the insurance company? Within 90 days or as soon as reasonably possible, but not exceed 1 year. Unless not legally competent to comply with this provision.
When must a producer deliver the outline of coverage to a Medicare supplement applicant?
39.18(1) An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means which prominently direct the attention of the recipient to the document and its purpose.
Which of the following must be included in a Medicare supplement policies outline of coverage quizlet?
All Medicare supplement policies must provide certain core benefits, including coverage for Medicare Part A-eligible hospital expenses not covered by Medicare from the 61st day through the 90th day in any Medicare benefit period, the coinsurance amount of Medicare Part B-eligible expenses, and coverage under Medicare ...
Which of the following must be disclosed in all advertisement and policies of term life insurance for individuals 55 years of age or older?
correct! When a term life insurance monetary value index is adopted by the Commissioner, it must be disclosed in all advertisements and policies of term life insurance for individuals age 55 and older.
Which of the following entities ultimately decides if an advertisement is complete and truthful?
Advertising regulations state that an advertisement shall be “truth- ful and not misleading in fact or by implication.” But who decides if an ad is truthful or misleading? The Commissioner of Insurance decides and it is important to consider that his/ her level of scrutiny can vary depend- ing upon the targeted market.
Which entity is responsible for regulating insurance advertising in New Jersey?
NJDOBI | Division of Insurance. The National Association of Insurance Commissioners (NAIC) is the organization of insurance regulators from the 50 states, the District of Columbia and U.S. territories. More information about New Jersey and the NAIC...
Which of the following entities has the authority to make changes to an insurance policy?
Insurer's executive office *Only an executive officer of the company, not an agent, has authority to make any changes to the policy. The insurer must have the insured's written agreement to the change.
Which of the following entities can legally bind coverage?
can legally bind coverage? Only insurers, not agents, can bind coverage.
What time requirements does the policyholder have to complete the requirements that the insurer has requested?
Cal. Ins. Code § 2695.5(e). An insurer has 40 days to accept or deny a claim in whole or in part.
What is the Florida Health Insurance Coverage Continuation Act?
The Florida Health Insurance Coverage Continuation Act requires insurers that sell health plans to small employers to offer in those plans to elect to continue coverage, without providing evidence of insurability, to employees who lose their coverage and are unable to replace it.
What is a multiple employer trust?
Multiple employer trust is a group of 10 or more employers who form a trust in order to maximize tax implications of providing certain types of benefits for their employees, particularly life insurance)
Where to get a certificate of authority?
A) Obtain a certificate of authority from the insurance department
When an advertisement contains an application form to be completed by the applicant and returned by mail, the application form shall contain answer?
(3) When an advertisement contains an application form to be completed by the applicant and returned by mail, the application form shall contain a question or statement that reflects the preexisting condition provisions of the policy immediately preceding the blank space for the applicant’s signature. For example, such an application form shall contain a question or statement substantially as follows:
What does an advertisement of an individual policy not include?
An advertisement shall not contain phrases describing an enrollment period as “special,” “limited,” or similar words or phrases when the insurer uses such enrollment periods as the usual method of advertising Medicare supplement insurance.
What is an advertisement for insurance?
An advertisement shall not directly or indirectly make unfair or incomplete comparisons of policies or benefits or comparisons of non-comparable policies of other insurers, and shall not disparage competitors, their policies, services or business methods, and shall not disparage or unfairly minimize competing methods of marketing insurance.
How long do testimonials have to be used in an insurance advertisement?
When a testimonial or endorsement is used more than one year after it was originally given, a confirmation must be obtained.
Can an advertisement be seen beyond the limits of the jurisdiction in which the insurer is licensed?
An advertisement that is intended to be seen or heard beyond the limits of the jurisdiction in which the insurer is licensed shall not imply licensing beyond those limits.
When a group disability insurance policy is paid entirely by the employer, benefits paid to disabled employees are: "?
When a group disability insurance policy is paid entirely by the employer, benefits paid to disabled employees are: -deductible income to the employee -deductible business expense to the employer -taxable income to the employer -taxable income to the employee
How often should an insurance company examine a claim?
While a claim is pending, an insurance company may require: -the insured to be examined only once annually -an independent examination only once every 45 days -an independent examination as often as reasonably required -the insured to be examined only within the first 30 days
Who is paid for health insurance?
Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to: -beneficiary of the death benefit -the spouse of the insured -the insured - creditors
What does U1 mean in insurance?
in favor of the insured (insurance policies are contracts of adhesion) U1. Insurance is the transfer of: -hazard -peril -risk -loss. risk (insurance is the transfer of financial responsibility associated with a potential of a loss/risk to an insurance company) U1.