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IN Health Laws & Regulations

Provider
Pearson VUE
Format
Computer-delivered multiple choice
Exam questions
35 total questions (30 scored, 5 pretest)
Time limit
60 minutes
Passing score
70%
Examination outline
  • I. INDIANA LAWS AND DEPARTMENT RULES COMMON TO ALL LINES OF INSURANCE (20 questions)
    • A. Department of Insurance
    • A. Department of Insurance / 1. Insurance Commissioner
    • A. Department of Insurance / 1. Insurance Commissioner / a. Appointment by Governor
    • A. Department of Insurance / 1. Insurance Commissioner / b. Member of National Association of Insurance Commissioners (NAIC)
    • A. Department of Insurance / 1. Insurance Commissioner / c. Powers
    • A. Department of Insurance / 1. Insurance Commissioner / d. Duties
    • A. Department of Insurance / 2. Admission of Insurance Companies
    • A. Department of Insurance / 2. Admission of Insurance Companies / a. Certificate of Authority
    • A. Department of Insurance / 2. Admission of Insurance Companies / b. Admitted versus non-admitted companies
    • A. Department of Insurance / 2. Admission of Insurance Companies / c. Domestic, foreign, and alien companies
    • A. Department of Insurance / 3. Examination of Admitted Insurance Companies
    • A. Department of Insurance / 3. Examination of Admitted Insurance Companies / a. Fiscal examinations
    • A. Department of Insurance / 3. Examination of Admitted Insurance Companies / b. Waiving examinations of foreign and alien companies
    • A. Department of Insurance / 4. Insurance Guaranty Associations
    • A. Department of Insurance / 4. Insurance Guaranty Associations / a. Purpose
    • A. Department of Insurance / 4. Insurance Guaranty Associations / b. Policy benefits that are guaranteed
    • B. Producer Licensing Laws
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / a. Resident producer
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / b. Nonresident producer
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / c. Temporary producer
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / d. Consultant
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / e. Business entity
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / f. Limited Lines
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / f. Limited Lines / i. Travel
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / f. Limited Lines / ii. Title
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / f. Limited Lines / iii. Credit
    • B. Producer Licensing Laws / 1. Types of Insurance Licenses, Eligibility Requirements & Powers and Duties / f. Limited Lines / iv. Prearranged funeral insurance
    • B. Producer Licensing Laws / 2. Who must be licensed
    • B. Producer Licensing Laws / 2. Who must be licensed / a. Solicit, negotiate or sell contracts of insurance
    • B. Producer Licensing Laws / 3. Producer qualifications and the licensing process
    • B. Producer Licensing Laws / 3. Producer qualifications and the licensing process / a. Pre-licensing education, state exam, license application
    • B. Producer Licensing Laws / 3. Producer qualifications and the licensing process / b. Denial of license application
    • B. Producer Licensing Laws / 3. Producer qualifications and the licensing process / b. Denial of license application / i. Appeals process/Notice of hearing
    • B. Producer Licensing Laws / 4. Insurance Company: Producer appointments and termination
    • B. Producer Licensing Laws / 5. Limitations of a Producer
    • B. Producer Licensing Laws / 5. Limitations of a Producer / a. Controlled business
    • B. Producer Licensing Laws / 5. Limitations of a Producer / b. Acting as a Consultant
    • B. Producer Licensing Laws / 5. Limitations of a Producer / c. Fees and commissions
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance / a. Producer notification requirements
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance / a. Producer notification requirements / i. Change of legal or assumed name
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance / a. Producer notification requirements / ii. Change of contact information; business, email and/or residential address
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance / a. Producer notification requirements / iii. Criminal or administrative action
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance / b. License renewal/reinstatement process
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance / c. Continuing Education (CE) requirements
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance / d. Sircon license & CE tracking system
    • B. Producer Licensing Laws / 6. Producer’s License Maintenance / d. Sircon license & CE tracking system / i. Producer Responsibilities
    • C. Producer/Company Compliance
    • C. Producer/Company Compliance / 1. Producer Licensing Law & Violations
    • C. Producer/Company Compliance / 2. Unfair Competition Law & Violations
    • C. Producer/Company Compliance / 3. Definitions
    • C. Producer/Company Compliance / 3. Definitions / a. Twisting
    • C. Producer/Company Compliance / 3. Definitions / b. Rebating
    • C. Producer/Company Compliance / 3. Definitions / c. Sharing commissions with an unlicensed person
    • C. Producer/Company Compliance / 3. Definitions / d. Defamation
    • C. Producer/Company Compliance / 3. Definitions / e. False advertising
    • C. Producer/Company Compliance / 3. Definitions / f. Misrepresentation
    • C. Producer/Company Compliance / 3. Definitions / g. Boycott, coercion, and intimidation
    • C. Producer/Company Compliance / 3. Definitions / h. Unfair discrimination
    • C. Producer/Company Compliance / 4. Penalties/Disciplinary Actions
    • C. Producer/Company Compliance / 4. Penalties/Disciplinary Actions / a. Penalty for violating Licensing law
    • C. Producer/Company Compliance / 4. Penalties/Disciplinary Actions / b. Penalty for violating Unfair Competition Law
    • C. Producer/Company Compliance / 4. Penalties/Disciplinary Actions / c. Penalty for violating Cease and Desist Orders
    • C. Producer/Company Compliance / 4. Penalties/Disciplinary Actions / d. Criminal violations
    • D. Unfair Claims Settlement Practices
  • II. HEALTH REGULATIONS (10 questions)
    • A. Health Insurance Contracts
    • A. Health Insurance Contracts / 1. Standard Provisions in Medical Expense and Disability Income Policies
    • A. Health Insurance Contracts / 1. Standard Provisions in Medical Expense and Disability Income Policies / a. Individual Provisions
    • A. Health Insurance Contracts / 1. Standard Provisions in Medical Expense and Disability Income Policies / b. Group Provisions
    • A. Health Insurance Contracts / 2. Required Coverages
    • A. Health Insurance Contracts / 2. Required Coverages / a. Mammogram coverage
    • A. Health Insurance Contracts / 3. Underwriting Restrictions
    • A. Health Insurance Contracts / 3. Underwriting Restrictions / a. AIDS/HIV
    • A. Health Insurance Contracts / 3. Underwriting Restrictions / b. Genetic Testing
    • A. Health Insurance Contracts / 4. Rights of Dependent Children
    • A. Health Insurance Contracts / 4. Rights of Dependent Children / a. Newborns and adopted children
    • A. Health Insurance Contracts / 4. Rights of Dependent Children / b. Limiting age
    • A. Health Insurance Contracts / 4. Rights of Dependent Children / c. Handicapped children
    • A. Health Insurance Contracts / 5. Advertising
    • B. Specialized Coverage
    • B. Specialized Coverage / 1. Indiana Small Group Health
    • B. Specialized Coverage / 2. Group Coordination of Benefits
    • B. Specialized Coverage / 3. Children’s Health Insurance Program (CHIP)
    • C. Long Term Care
    • C. Long Term Care / 1. Provisions
    • C. Long Term Care / 1. Provisions / a. Free Look
    • C. Long Term Care / 1. Provisions / b. Length of coverage
    • C. Long Term Care / 1. Provisions / c. Pre-existing conditions, etc.
    • C. Long Term Care / 2. Standards for Marketing
    • C. Long Term Care / 3. Replacement
    • C. Long Term Care / 4. Producer’s Duties
    • C. Long Term Care / 5. Long Term Care Partnership Program (LTCP)
    • D. Medicare Supplement Policies
    • D. Medicare Supplement Policies / 1. Provisions
    • D. Medicare Supplement Policies / 1. Provisions / a. Free Look
    • D. Medicare Supplement Policies / 1. Provisions / b. Pre-existing conditions, etc.
    • D. Medicare Supplement Policies / 2. Standards for Marketing
    • D. Medicare Supplement Policies / 3. Replacement
    • D. Medicare Supplement Policies / 4. Producer’s Duties
    • E. Affordable Care Act (ACA)
    • E. Affordable Care Act (ACA) / 1. Marketplace (ACA Section 1101, 1321)
    • E. Affordable Care Act (ACA) / 1. Marketplace (ACA Section 1101, 1321) / a. Agent/broker training/Registration requirements
    • E. Affordable Care Act (ACA) / 1. Marketplace (ACA Section 1101, 1321) / b. Metal levels and catastrophic plans ACA Section (1302)
    • E. Affordable Care Act (ACA) / 2. Enrollment periods (ACA Section 1311)
    • E. Affordable Care Act (ACA) / 3. Essential health benefits (ACA Section 1302)
    • E. Affordable Care Act (ACA) / 3. Essential health benefits (ACA Section 1302) / a. Mental health and substance use disorder parity
    • E. Affordable Care Act (ACA) / 3. Essential health benefits (ACA Section 1302) / b. Pediatric services
    • E. Affordable Care Act (ACA) / 3. Essential health benefits (ACA Section 1302) / c. Preventive services
Examination sources