OpenExamsFREE PRACTICE — ANY EXAM

Accident & Health and Sickness — Information & Free Practice

US-HI · Examination information

165 free questions · Answer explanations · No signup required

Start free practice →

Accident & Health and Sickness

Provider
Pearson VUE
Format
Computer-based written examination; test center or online proctoring
Exam questions
85 scored questions and 10 pretest questions: general 50 + 5; Hawaii 35 + 5
Time limit
General 75 minutes; Hawaii 45 minutes
Passing score
Scaled score 70
Exam fee
$75
Examination outline
  • I. TYPES OF POLICIES
    • A. Disability income
    • A. Disability income / 1. Individual disability income policy
    • A. Disability income / 2. Business overhead expense policy
    • A. Disability income / 3. Business disability buyout policy
    • A. Disability income / 4. Group disability income policy
    • A. Disability income / 5. Key employee policy
    • B. Accidental death and dismemberment
    • C. Medical expense insurance
    • C. Medical expense insurance / 1. Basic hospital, medical, and surgical policies
    • C. Medical expense insurance / 2. Major medical policies
    • C. Medical expense insurance / 3. Health Maintenance Organizations (HMOs)
    • C. Medical expense insurance / 4. Preferred Provider Organizations (PPOs)
    • C. Medical expense insurance / 5. Point of Service (POS) plans
    • C. Medical expense insurance / 6. Flexible Spending Accounts (FSAs)
    • C. Medical expense insurance / 7. High Deductible Health Plans (HDHPs) and related Health Savings Accounts (HSAs)
    • C. Medical expense insurance / 8. Health Reimbursement Accounts (HRAs)
    • D. Medicare supplement policies
    • E. Group insurance
    • E. Group insurance / 1. Differences between individual and group contracts
    • E. Group insurance / 2. General characteristics
    • E. Group insurance / 3. COBRA
    • F. Individual/Group Long Term Care (LTC)
    • F. Individual/Group Long Term Care (LTC) / 1. Eligibility
    • F. Individual/Group Long Term Care (LTC) / 2. Levels of care
    • G. Other policies
    • G. Other policies / 1. Dental
    • G. Other policies / 2. Vision
    • G. Other policies / 3. Cancer
    • G. Other policies / 4. Critical illness or specified disease
    • G. Other policies / 5. Worksite (employer-sponsored)
    • G. Other policies / 6. Hospital indemnity
    • G. Other policies / 7. Short-term medical
    • G. Other policies / 8. Accident
  • II. POLICY PROVISIONS, CLAUSES, AND RIDERS
    • A. Mandatory and optional provisions
    • A. Mandatory and optional provisions / 1. Entire contract
    • A. Mandatory and optional provisions / 2. Time limit on certain defenses (incontestable)
    • A. Mandatory and optional provisions / 3. Grace period
    • A. Mandatory and optional provisions / 4. Reinstatement
    • A. Mandatory and optional provisions / 5. Notice of claim
    • A. Mandatory and optional provisions / 6. Claim forms
    • A. Mandatory and optional provisions / 7. Proof of loss
    • A. Mandatory and optional provisions / 8. Time of payment of claims
    • A. Mandatory and optional provisions / 9. Payment of claims
    • A. Mandatory and optional provisions / 10. Physical examination and autopsy
    • A. Mandatory and optional provisions / 11. Legal actions
    • A. Mandatory and optional provisions / 12. Change of beneficiary
    • A. Mandatory and optional provisions / 13. Misstatement of age or gender
    • A. Mandatory and optional provisions / 14. Change of occupation
    • A. Mandatory and optional provisions / 15. Illegal occupation
    • A. Mandatory and optional provisions / 16. Relation of earning to insurance
    • B. Other provisions and clauses
    • B. Other provisions and clauses / 1. Insuring clause
    • B. Other provisions and clauses / 2. Free look
    • B. Other provisions and clauses / 3. Consideration clause
    • B. Other provisions and clauses / 4. Probationary period
    • B. Other provisions and clauses / 5. Elimination period
    • B. Other provisions and clauses / 6. Waiver of premium
    • B. Other provisions and clauses / 7. Exclusions and limitations
    • B. Other provisions and clauses / 8. Preexisting conditions
    • B. Other provisions and clauses / 9. Coinsurance
    • B. Other provisions and clauses / 10. Deductibles
    • B. Other provisions and clauses / 11. Eligible expenses
    • B. Other provisions and clauses / 12. Copayments
    • B. Other provisions and clauses / 13. Pre-authorizations and prior approval requirements
    • B. Other provisions and clauses / 14. Usual, reasonable, and customary (URC) charges
    • B. Other provisions and clauses / 15. Lifetime, annual, or per cause maximum benefit limits
    • C. Riders
    • C. Riders / 1. Impairment/exclusions
    • C. Riders / 2. Guaranteed insurability
    • C. Riders / 3. Future increase option
    • D. Rights of renewability
    • D. Rights of renewability / 1. Noncancelable
    • D. Rights of renewability / 2. Cancelable
    • D. Rights of renewability / 3. Guaranteed renewable
  • III. SOCIAL INSURANCE
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • IV. OTHER INSURANCE CONCEPTS
    • A. Total, partial, recurrent and residual disability
    • B. Owner’s rights
    • C. Dependent children benefits
    • D. Primary and contingent beneficiaries
    • E. Modes of premium payments
    • F. Nonduplication and coordination of benefits (e.g., primary vs. excess)
    • G. Occupational vs. non-occupational
    • H. Tax treatment of premiums and proceeds of insurance contracts (e.g., disability income and medical expenses, etc.)
    • I. Managed care
    • J. Workers Compensation
    • K. Subrogation
  • V. FIELD UNDERWRITING PROCEDURES
    • A. Completing the application
    • B. Explaining sources of insurability and HIPAA privacy information (e.g., MIB Report, Fair Credit Reporting Act, etc.)
    • C. Initial premium payment and receipt and consequences of the receipt (e.g., medical examination, etc.)
    • D. Submitting application (and initial premium if collected) to company for underwriting
    • E. Policy delivery
    • F. Explaining policy and its provisions, riders, exclusions, and ratings to clients
    • G. Replacement
    • H. Contract law
    • H. Contract law / 1. Elements of a contract
    • H. Contract law / 2. Insurable interest
    • H. Contract law / 3. Warranties and representations
    • H. Contract law / 4. Unique aspects of the insurance contract
    • H. Contract law / 4. Unique aspects of the insurance contract / a. Conditional
    • H. Contract law / 4. Unique aspects of the insurance contract / b. Unilateral
    • H. Contract law / 4. Unique aspects of the insurance contract / c. Adhesion
    • H. Contract law / 4. Unique aspects of the insurance contract / d. Aleatory
  • I. HAWAII LAWS AND RULES COMMON TO LIFE, ACCIDENT AND HEALTH, PROPERTY, CASUALTY AND PERSONAL LINES INSURANCE
    • A. Insurance Commissioner
    • A. Insurance Commissioner / 1. General powers and duties
    • A. Insurance Commissioner / 2. Examination of records
    • A. Insurance Commissioner / 3. Notice of hearings
    • A. Insurance Commissioner / 4. Penalties
    • B. Definitions
    • B. Definitions / 1. Authorized and unauthorized
    • B. Definitions / 2. Domestic, foreign, and alien
    • B. Definitions / 3. Stock, reciprocal and mutual
    • B. Definitions / 4. Certificate of authority
    • B. Definitions / 5. Insurance
    • C. Licensing
    • C. Licensing / 1. General qualifications for licensing
    • C. Licensing / 2. Persons required to be licensed
    • C. Licensing / 2. Persons required to be licensed / a. Producer
    • C. Licensing / 2. Persons required to be licensed / b. Temporary license
    • C. Licensing / 2. Persons required to be licensed / c. Nonresident
    • C. Licensing / 2. Persons required to be licensed / d. Exemptions
    • C. Licensing / 3. Denial, suspension, revocation of licenses
    • C. Licensing / 4. Renewal of license and continuing education
    • D. Marketing practices
    • D. Marketing practices / 1. Unfair and deceptive practices
    • D. Marketing practices / 2. Reporting and accounting for premiums
    • D. Marketing practices / 3. Sharing commissions
    • D. Marketing practices / 4. Required records and record retention
    • D. Marketing practices / 5. Controlled business
    • D. Marketing practices / 6. Premiums
    • E. Guaranty Associations
  • II. HAWAII LAWS AND RULES PERTINENT TO ACCIDENT AND HEALTH INSURANCE ONLY
    • A. Marketing methods and practices
    • A. Marketing methods and practices / 1. Prepaid health care
    • A. Marketing methods and practices / 2. Temporary Disability Insurance (TDI)
    • B. Policy clauses and provisions
    • B. Policy clauses and provisions / 1. Mandated benefits
    • B. Policy clauses and provisions / 2. Cancellation
    • C. Long Term Care
    • C. Long Term Care / 1. Basic standards
    • C. Long Term Care / 2. Outline of coverage
    • C. Long Term Care / 3. Policy definitions
    • C. Long Term Care / 4. Suitability
Examination sources

Related license preparation

This examination may be required or accepted as an alternative, depending on the license and application pathway.