Ch. 20 - Oklahoma Laws & Rules

  1. Jerry has an indemnity lan which covers dental expenses. Typically, these types of plans

    a. has a limited network of dentists to chose from
    b. cover preventative care once every six months
    c. never require a deductible for major services
    d. cover oral surgery as a result from an injury
    cover preventative care once every six months
  2. Which of the following is NOT a duty of the Insurance Commissioner?

    a. examine any insurance company operating in the State
    b. enact insurance legislation
    c. issue subpoenas and administer oaths
    d. make annual reports to the Governor of Oklahoma
    enact insurance legislation
  3. Which of these is a valid reason for an insurer's cancellation of a Medicare Supplement policy?

    a. unemployment of the insured
    b. non-payment of premium
    c. claims exceeded a threshold for the previous year
    d. deterioration of health
    non-payment of premium
  4. Before emailing a client an insurance document during a transaction, what must the client provide before the producer can send the document?

    a. a fee for electronic delivery
    b. their email address
    c. a promise to sign
    d. consent to receive the email
    consent to receive the email
  5. Which of these statements is FALSE regarding immunization benefits for dependent children?

    a. must not be subject to a coinsurance
    b. must not be subject to a schedule
    c. must not be subject to a deductible
    d. must not be subject to a copayment
    must not be subject to a schedule
  6. The Insurance Information and Privacy Protection Act is designed to limit or direct the information collection activities of all of the following, EXCEPT:

    a. producers and limited representatives
    b. COBRA representatives
    c. insurance support organizations
    d. insurance companies
    COBRA representatives
  7. All of these may be an Unfair Claims Practice EXCEPT

    a. refusing to pay claims without a reasonable investigation
    b. refusing to pay persons bringing false or fraudulent claims
    c. failing to promptly provide a reasonable explanation of any claim denial
    d. offering low amounts to force insureds to institute litigation
    refusing to pay persons bringing false or fraudulent claims
  8. An individual whose producer's license had been suspended continues to perform insurance transactions illegally. This individual could be charged with a felony and fined up to

    a. $2,000
    b. $3,000
    c. $4,000
    d. $5,000
    $5,000
  9. Annual mammography screenings for women         and older MUST be covered under group and individual health insurance plans in Oklahoma.

    a. 30
    b. 35
    c. 40
    d. 45
    40
  10. Which of the following actions by a producer would NOT result in a license suspension or revocation?

    a. producing an inadequate amount of new premium
    b. producer demonstrates incompetency to transact business as an insurance producer
    c. producer misrepresents the terms of an existing insurance contract
    d. producer misappropriates an insured's premium payment
    producing an inadequate amount of new premium
  11. Producers must complete a total of                    Continuing Education hours for each two-year licensing period.

    a. 12
    b. 24
    c. 36
    d. 48
    24
  12. Charging different rates between individuals of the same class and equal expectation of life is best described as:

    a. normal business practice
    b. punishable by incarceration 
    c. always permitted
    d. unfair discrimination
    unfair discrimination
  13. An insured previously covered under a private health insurance plan must notify the insurer within         days  of deactivation from the military in order to reinstate the coverage.

    a. 15
    b. 30
    c. 45
    d. 60
    30
  14. Producers must complete              hours of continuing education biannually.

    a. 18
    b. 21
    c. 24
    d. 27
    24
  15. Which of the following types of policies does the Oklahoma Life and Health Insurance Guaranty NOT provide financial policyholder protection for? 

    a. term life insurance
    b. disability insurance
    c. annuities
    d. Health Maintenance Organizations (HMOs)
    Health Maintenance Organizations (HMOs)
  16. Which of the following actions by a producer would NOT result in a license suspension or revocation?

    a. found guilty of misrepresentation in obtaining the license
    b. misdemeanor conviction
    c. misappropriating an insured's premium payment
    d. violated any state insurance law
    misdemeanor conviction
  17. A producer's license MUST be renewed every       year(s).

    a. 1
    b. 2
    c. 3
    d. 4
    2
  18. A prepaid dental plan has an agreement in place with a network of dentists which

    a. allows the dentists to determine the deductible and coinsurance amounts
    b. accepts an established amount as payment in full for the dental services rendered
    c. requires all the dentists to be located within the same state
    d. must cover 100% of all orthodontic treatments
    accepts an established amount as payment in full for the dental services rendered
  19. How long must a life insurance policy be in effect before the policyowner may use the nonforfeiture provision?

    a. 1 year
    b. 2 years
    c. 3 years
    d. 4 years
    3 years
  20. The promise of a discount in premium as an inducement to purchase insurance is known as

    a. misappropriation
    b. misrepresentation
    c. intimidation
    d. rebating
    rebating
  21. How often must be Commissioner examine each domestic insurance company?

    a. Every year
    b. Every 2 years
    c. Every 3 years
    d. Every 5 years
    Every 5 years
  22. All of these are considered to be a violation of the Federal Fraud and False Statements Act EXCEPT

    a. overvaluing land
    b. abstracting funds
    c. false entries on reports
    d. claims reimbursement
    claims reimbursement
  23. A medical expense health plan claim may be denied due to material misrepresentation within          year(s) of issue.

    a. one
    b. two
    c. three
    d. four
    two
  24. Prepaid dental plans differ from most other types of dental plans in what way?

    a. x-rays and teeth cleanings are fully covered
    b. possible exclusion of pre-existing conditions
    c. closed panel of dentists can only be used
    d. deductibles may have to be met
    closed panel of dentists can only be used
  25. Oklahoma requires that a licensee completes      hours of continuing education on the subject of ethics every reporting period.

    a. 1
    b. 2
    c. 3
    d. 6
    3
  26. Which of the following is NOT a qualification to be licensed as a producer?

    a. passed the state exam
    b. completed pre-licensing education
    c. high school diploma
    d. be 18 years of age
    high school diploma
  27. All of the following are typically covered under dental insurance EXCEPT

    a. treatment which began before the eligibility date
    b. fluoride treatment
    c. teeth cleanings
    d. x-rays
    treatment which began before the eligibility date
  28. A temporary producer license issued in Oklahoma is valid for up to            days.

    a. 90
    b. 120
    c. 180
    d. 270
    180
  29. Treatment for diabetes (when prescribed by a physician) MUST be included under all

    a. individual or group health contracts
    b. disability programs
    c. limited benefit plans
    d. wellness programs
    individual or group health contracts
  30. If a new policy is replacing an existing one, the insured is given the right to return for a full refund of at least            days after policy delivery.

    a. 10
    b. 15
    c. 20
    d. 25
    20
  31. Insurance crimes which affect interstate commerce are prosecuted by the

    a. US Attorney General
    b. Governor
    c. FBI
    d. Department of Homeland Security
    US Attorney General
  32. According to federal fraud and false statements regulation, what is required for a prohibited person to transact insurance business in this state?

    a. completing twenty-four hours of ethics education
    b. completing three years of community service
    c. written consent from the U.S. Attorney General
    d. written consent from the state insurance regulatory agency
    written consent from the state insurance regulatory agency
  33. A producer may be disciplined by the Commissioner for which of the following actions?

    a. being accused of a felony
    b. misappropriation of premium funds
    c. sharing commissions with other licensed producers
    d. failing to meet insurer production requirements
    misappropriation of premium funds
  34. In the state of Oklahoma, a licensed producer

    a. represents the insurer
    b. may modify insurance contracts
    c. approves insurance contracts
    d. represents the insured
    represents the insurer
  35. An applicant for health insurance deliberately lies in order to obtain a lower premium rate. This is an example of

    a. embezzlement
    b. misrepresentation
    c. fraud
    d. unfair settlement practice
    fraud
  36. Which of these is NOT an Unfair Claims Settlement Practice?

    a. refusing to pay claims without conducting a reasonable investigation
    b. compelling insureds to initiate a lawsuit by offering less on insurance claims
    c. failing to acknowledge and act promptly with respect to insurance claims
    d. providing claim payments to insureds under the guidelines of the insurance contract
    providing claim payments to insureds under the guidelines of the insurance contract
  37. If a producer is found to have violated an Oklahoma insurance statute, a fine can be given up to             for each violation.

    a. $500
    b. $1,000
    c. $1,500
    d. $2,000
    $1,000
  38. In Oklahoma, how many hours of inpatient care must be provided for an insured mother and her newborn following delivery?

    a. 12 hours for vaginal birth; 24 hours for caesarean section
    b. 24 hours for vaginal birth; 36 hours for caesarean section
    c. 36 hours for vaginal birth; 48 hours for caesarean section
    d. 48 hours for vaginal birth; 96 hours for caesarean section
    48 hours for vaginal birth; 96 hours for caesarean section
  39. Which of these is NOT considered a Federal punishment for unfair and deceptive insurance practices?

    a. prison sentence
    b. revocation of license
    c. monetary fine
    d. community service
    community service
  40. Most prepaid dental plans cover

    a. mouth cancer
    b. oral examinations
    c. cosmetic delivery
    d. work related injuries
    oral examinations
  41. A life insurance policy becomes incontestable after it has been in force for 

    a. 30 days
    b. 6 months
    c. 2 years
    d. 3 years
    2 years
  42. A false written or oral statement made by a producer for the purpose of replacing an existing policy to the detriment of the insured is

    a. twisting
    b. illegal inducement
    c. discrimination
    d. defamation
    twisting
  43. What type of life insurance is designed to pay the balance of a loan if the insured dies before the loan has been repaid?

    a. accelerated
    b. universal
    c. settlement
    d. credit
    credit
  44. Under HIPAA (Health Insurance Portability and Accountability) requires guarantee issue of insurance as long as there has not been more than a             day gap in coverage.

    a. 21
    b. 30
    c. 46
    d. 63
    63
  45. Security laws passed by Congress are enforced by which Federal agency?

    a. Securities Enforcement Agency (SEA)
    b. Department of Homeland Security
    c. Security and Exchange Commission
    d. National Association of Insurance Commissioners (NAIC)
    Security and Exchange Commission
  46. In the event of employment termination, a person covered by a group life policy also has the right to convert such coverage to an individual policy within             days without proving insurability.

    a. 10
    b. 15
    c. 30
    d. 31
    31
  47. If a Texas company proposes, and/or makes an insurance contract by mail for an Oklahoma resident, this is considered:

    a. the only method for a Texas company
    b. illegal
    c. business in the state of Oklahoma
    d. mail fraud
    business in the state of Oklahoma
  48. In Oklahoma, a life insurance policy loan may NOT exceed an interest rate of

    a. 6%
    b. 7%
    c. 8%
    d. 9%
    8%
  49. All of these are common limiting factors with dental insurance EXCEPT for

    a. limit placed on number of teeth that may be treated annually
    b. limit on cosmetic-related procedures
    c. limit on number of X-rays per year
    d. limit on number of annual teeth cleanings
    limit placed on number of teeth that may be treated annually
  50. Upon receiving a producer complaint, the Commissioner may may immediately

    a. issue a cease and desist order
    b. revoke the license
    c. impose a fine
    d. issue a warrant for arrest
    issue a cease and desist order
  51. A(n)               insurance company is one that was formed under the laws of another country outside of the U.S.

    a. alien
    b. foreign
    c. international
    d. reciprocal
    alien
  52. A licensee MUSt notify the Commissioner of an address change within              days of the change.

    a. 10
    b. 20
    c. 30
    d. 40
    30
  53. An example of an Unfair Claims Settlement Practice is

    a. making it mandatory that proof of loss be provided for each claim
    b. requiring a time limit for submitting a claim
    c. misrepresenting policy provisions affecting a loss
    d. paying a claim in a timely matter
    misrepresenting policy provisions affecting a loss
  54. Which of the following is a nonprofit entity operating under a lodge system?

    a. Fraternal
    b. Paternal
    c. Maternal
    d. Reciprocal
    Fraternal
  55. How can a group dental insurer discourage adverse selection?

    a. allow pre-existing conditions
    b. eliminate deductible and coinsurance
    c. extend open enrollment period
    d. limit the duration of coverage
    limit the duration of coverage
Author
jdavis123
ID
353397
Card Set
Ch. 20 - Oklahoma Laws & Rules
Description
Ch. 20 - Oklahoma Laws & Rules
Updated