Ch. 20 - Oklahoma Laws & Rules

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

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

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

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

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

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

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

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

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

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

Producers must complete a total of                    Continuing Education hours for each two-year licensing period.

a. 12
b. 24
c. 36
d. 48

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

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

Producers must complete              hours of continuing education biannually.

a. 18
b. 21
c. 24
d. 27

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)

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

A producer's license MUST be renewed every       year(s).

a. 1
b. 2
c. 3
d. 4

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

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

The promise of a discount in premium as an inducement to purchase insurance is known as

a. misappropriation
b. misrepresentation
c. intimidation
d. rebating

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

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

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

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

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

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

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

A temporary producer license issued in Oklahoma is valid for up to            days.

a. 90
b. 120
c. 180
d. 270

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

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

Insurance crimes which affect interstate commerce are prosecuted by the

a. US Attorney General
b. Governor
c. FBI
d. Department of Homeland Security

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

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

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

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

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

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

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

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

Most prepaid dental plans cover

a. mouth cancer
b. oral examinations
c. cosmetic delivery
d. work related injuries

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

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

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

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

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)

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

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

In Oklahoma, a life insurance policy loan may NOT exceed an interest rate of

a. 6%
b. 7%
c. 8%
d. 9%

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

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

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

A licensee MUSt notify the Commissioner of an address change within              days of the change.

a. 10
b. 20
c. 30
d. 40

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

Which of the following is a nonprofit entity operating under a lodge system?

a. Fraternal
b. Paternal
c. Maternal
d. Reciprocal

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