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KS Accident & Health Producer — Information & Free Practice

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KS Accident & Health Producer

Provider
Pearson VUE
Format
Multiple-choice; one score for the whole examination
Exam questions
84 scored questions plus 11 pretest questions
Time limit
90 minutes
Passing score
70%
Exam fee
$57
Examination outline
  • I. TYPES OF POLICIES (16 scored questions)
    • 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 (15 scored questions)
    • A. Mandatory provisions
    • A. Mandatory provisions / 1. Entire contract
    • A. Mandatory provisions / 2. Time limit on certain defenses (incontestable)
    • A. Mandatory provisions / 3. Grace period
    • A. Mandatory provisions / 4. Reinstatement
    • A. Mandatory provisions / 5. Notice of claim
    • A. Mandatory provisions / 6. Claim forms
    • A. Mandatory provisions / 7. Proof of loss
    • A. Mandatory provisions / 8. Time of payment of claims
    • A. Mandatory provisions / 9. Payment of claims
    • A. Mandatory provisions / 10. Physical examination and autopsy
    • A. Mandatory provisions / 11. Legal actions
    • A. Mandatory provisions / 12. Change of beneficiary
    • A. Mandatory provisions / 13. Misstatement of age or gender
    • A. Mandatory provisions / 14. Change of occupation
    • A. Mandatory provisions / 15. Illegal occupation
    • A. Mandatory provisions / 16. Relation of earnings 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
    • B. Riders
    • B. Riders / 1. Impairment/exclusions
    • B. Riders / 2. Guaranteed insurability
    • B. Riders / 3. Future increase option
    • D. Rights of renewability
    • D. Rights of renewability / 1. Noncancellable
    • D. Rights of renewability / 2. Cancelable
    • D. Rights of renewability / 3. Guaranteed renewable
  • III. SOCIAL INSURANCE (6 scored questions)
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • IV. OTHER INSURANCE CONCEPTS (5 scored questions)
    • 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
    • J. Workers Compensation / 1. Impact on health insurance benefits
    • K. Subrogation
    • L. Cost containment
  • V. FIELD UNDERWRITING PROCEDURES (8 scored questions)
    • 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
  • VI. KANSAS STATUTES AND REGULATIONS COMMON TO LIFE, HEALTH, PROPERTY, AND CASUALTY INSURANCE (20 scored questions)
    • A. Commissioner of Insurance
    • A. Commissioner of Insurance / 1. Election [Ref: 40-106]
    • A. Commissioner of Insurance / 2. General duties and powers [Ref: 40-103, 40-104, 40-105]
    • A. Commissioner of Insurance / 3. Examinations [Ref: 40-208, 40- 222, 40-246a]
    • A. Commissioner of Insurance / 4. Hearings/Notice of hearings/Orders [Ref: 40-281, 40-2406, 40-2407; 40-2,125]
    • A. Commissioner of Insurance / 5. Penalties [Ref: 40-246a, 40-246d, 40-2407, 40-4909; 40-2,125]
    • B. Definitions
    • B. Definitions / 1. Domestic company [Ref: 40-2c01]
    • B. Definitions / 2. Foreign company [Ref: 40-2c01; 40-209]
    • B. Definitions / 3. Fraternals [Ref: 40-738]
    • B. Definitions / 4. Certificate of authority [Ref: 40-2702]
    • C. Licensing
    • C. Licensing / 1. Persons required to be licensed
    • C. Licensing / 1. Persons required to be licensed / a. Producer [Ref: 40-239, 40-4902]
    • C. Licensing / 1. Persons required to be licensed / b. Resident/Nonresident [Ref: 40-4902, 40-4906]
    • C. Licensing / 1. Persons required to be licensed / c. Temporary license [Ref: 40-4907]
    • C. Licensing / 2. Producer appointment/certification and termination of appointment [Ref: K.A.R. 40-7-25; K.A.R. 40-7-22; 40-7-11; 40-4912]
    • C. Licensing / 3. Obtaining a license
    • C. Licensing / 3. Obtaining a license / a. Qualifications/Examinations [Ref: 40-241; 40-4905]
    • C. Licensing / 3. Obtaining a license / b. Exemptions/exceptions [Ref: 40-4904, 40-4908]
    • C. Licensing / 4. Maintaining a license
    • C. Licensing / 4. Maintaining a license / a. Continuing education [Ref: 40-4902, 40-4903; K.A.R. 40-7-20a]
    • C. Licensing / 4. Maintaining a license / b. Change of address/ place of business [Ref: K.A.R. 40-7-9]
    • C. Licensing / 4. Maintaining a license / c. License renewal and fees [Ref: 40-4903]
    • C. Licensing / 4. Maintaining a license / d. Suspension or revocation of licenses/felony convictions [Ref: 40-246d, 40-4909]
    • D. Marketing practices [Ref: 40-2404]
    • D. Marketing practices [Ref: 40-2404] / 1. Rebating [Ref: 40- 2404(8); 40-966]
    • D. Marketing practices [Ref: 40-2404] / 2. Misrepresentation [Ref: 40-235; 40-2404(1)]
    • D. Marketing practices [Ref: 40-2404] / 3. False advertising [Ref: 40-2404(2)]
    • D. Marketing practices [Ref: 40-2404] / 4. Defamation [Ref: 40-2404(3)]
    • D. Marketing practices [Ref: 40-2404] / 5. Boycott, coercion, intimidation [Ref: 40-2404(4)]
    • D. Marketing practices [Ref: 40-2404] / 6. Unfair discrimination [Ref: 40-2404(7)]
    • D. Marketing practices [Ref: 40-2404] / 7. Twisting [Ref: 40-2404(1)(f)]
    • E. Life and Health Insurance Guaranty Association Act [Ref: 40-3002 through 40-3018]
  • VII. KANSAS STATUTES, RULES, AND REGULATIONS PERTINENT TO HEALTH INSURANCE ONLY (14 scored questions)
    • A. Individual/Group accident and health policy clauses and provisions [Ref: 40-2203, 40-2209]
    • A. Individual/Group accident and health policy clauses and provisions [Ref: 40-2203, 40-2209] / 1. Required and optional coverages
    • A. Individual/Group accident and health policy clauses and provisions [Ref: 40-2203, 40-2209] / 1. Required and optional coverages / a. Newborns and adopted children [Ref: 40-2,102]
    • A. Individual/Group accident and health policy clauses and provisions [Ref: 40-2203, 40-2209] / 1. Required and optional coverages / b. Substance abuse/mental disorders [Ref: 40-2,105; 40-2,154]
    • A. Individual/Group accident and health policy clauses and provisions [Ref: 40-2203, 40-2209] / 1. Required and optional coverages / c. Maternity benefits [Ref: 40-2,102; 40-2,160]
    • A. Individual/Group accident and health policy clauses and provisions [Ref: 40-2203, 40-2209] / 1. Required and optional coverages / d. Grace Period (Individual Accident and Health) [Ref. 40-2203]
    • B. Group accident and health insurance only [Ref: 40-2209]
    • B. Group accident and health insurance only [Ref: 40-2209] / 1. Coordination of benefits [Ref: K.A.R. 40-4-34]
    • B. Group accident and health insurance only [Ref: 40-2209] / 2. Continuation [Ref: 40-2209 (i)]
    • B. Group accident and health insurance only [Ref: 40-2209] / 3. Small Employer Health Insurance Availability Act [Ref: 40-2209b −2209j, 40-2209m −2209p]
    • C. Blanket insurance [Ref: 40-2210]
    • D. Medicare Supplement insurance [Ref: K.A.R. 40-4-35]
    • E. Long-Term Care (including education requirements) [Ref: 40-2225−2228; K.A.R. 40-4-37a −40-4-37 v]
    • F. Advertising [Ref: K.A.R. 40-9-100, 126]
    • G. Affordable Care Act
    • G. Affordable Care Act / 1. Intent and general information regarding the ACA
    • G. Affordable Care Act / 2. Navigators
    • G. Affordable Care Act / 3. Eligibility, premiums and mandatory benefits
Examination sources