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LA Health and Accident or Sickness Series 102 — Information & Free Practice

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LA Health and Accident or Sickness Series 102

Provider
PSI
Format
Onsite (Test Center)
Exam questions
100
Time limit
120 Minutes
Passing score
70% Correct
Examination outline
  • Louisiana Insurance Regulation (10%)
    • Requirements (22:1543)
    • Types of licenses (22:1547, 1962(F))
    • Types of licenses (22:1547, 1962(F)) > Individual producer (22:1542(6), 1546(A))
    • Types of licenses (22:1547, 1962(F)) > Business entity 1546(B))
    • Types of licenses (22:1547, 1962(F)) > Resident versus nonresident (22:1546, 1548, 1560)
    • Types of licenses (22:1547, 1962(F)) > Temporary (22:1553)
    • Maintenance and duration
    • Maintenance and duration > Expiration (22:1547(B))
    • Maintenance and duration > Renewal (22:1547(C))
    • Maintenance and duration > Change of name, address, telephone number (22:1547(G))
    • Maintenance and duration > Assumed names (22:1552)
    • Maintenance and duration > Reporting of actions (22:1563)
    • Maintenance and duration > Continuing education requirements including exemptions and penalties (37:XI:10.703, .705 & Rule 10.711)
    • Maintenance and duration > Inactivity due to extenuating circumstances
    • Maintenance and duration > Inactivity due to military service
    • Disciplinary actions
    • Disciplinary actions > Hearings (22:1968, 2191, 2193-2195, 2197, 2198, 2204-2208)
    • Disciplinary actions > Cease and desist order (22:1969)
    • Disciplinary actions > Fines, License probation, suspension, revocation, or refusal to issue or renew (22:1554)
    • Disciplinary actions > Penalties with or without suspension of license (22:1969, 1970)
    • State regulation
    • State regulation > Commissioner's general duties and powers (22:2, 1967)
    • State regulation > Company regulation
    • State regulation > Company regulation > Certificate of authority (22:65, 66, 331, 332)
    • State regulation > Company regulation > Unfair claims settlement practices (22:1964(14))
    • State regulation > Company regulation > Appointment (22:1558)
    • State regulation > Company regulation > Termination of appointment (22:1559)
    • State regulation > Company regulation > Policy Forms (22:864)
    • State regulation > Company regulation > Annual Reports (22:571)
    • State regulation > Company regulation > State of domicile
    • State regulation > Producer regulation
    • State regulation > Producer regulation > Controlled business (22:1544(C))
    • State regulation > Producer regulation > Shared commissions (22:1557)
    • State regulation > Producer regulation > Payment to unlicensed entities (22:1562)
    • State regulation > Producer regulation > Commissions, compensations, fees ((22:1542 (3); 22:1557)
    • State regulation > Producer regulation > Appointments (22:1547)
    • State regulation > Unfair trade practices (22:1964)
    • State regulation > Unfair trade practices (22:1964) > Misrepresentation (22:1964(1, 18))
    • State regulation > Unfair trade practices (22:1964) > False advertising (22:1964(2))
    • State regulation > Unfair trade practices (22:1964) > Defamation (22:1964(3))
    • State regulation > Unfair trade practices (22:1964) > Boycott, coercion and intimidation (22:1964(4))
    • State regulation > Unfair trade practices (22:1964) > False financial statements (22:1964(5))
    • State regulation > Unfair trade practices (22:1964) > Unfair discrimination (22:1964(7); 22:34)
    • State regulation > Unfair trade practices (22:1964) > Rebating (22:1964(8)
    • State regulation > Unfair trade practices (22:1964) > Refusing to insure (22:1964(7)(f))
    • State regulation > Unfair trade practices (22:1964) > Misrepresentation for replacement of limited benefit policies (22:1964(27))
    • State regulation > Examination of books and records (22:1967, 1981-1995)
    • State regulation > Insurance fraud and reporting requirements (22:1964(13, 27), 1921–1929)
    • State regulation > Privacy of Consumer Financial Information (37:XIII.9903– .9953)
  • Licensing and Regulation (2%)
    • Federal Regulation
    • Federal Regulation > Fair Credit Reporting Act
    • Federal Regulation > Felony Convictions and Written Consent (18 USC Sections 1033 and 1034)
    • Federal Regulation > Privacy (Gramm Leach Bliley)
    • Federal Regulation > National Do Not Call List
    • Federal Regulation > Affordable Care Act
  • General Insurance Concepts (11%)
    • Risk
    • Risk > Methods of Handling Risk (e.g., Avoidance, Retention, Sharing, Reduction, Transfer)
    • Risk > Elements of Insurable Risks
    • Risk > Definitions (e.g., Risk, Hazard, Peril, Loss)
    • Classifications of Insurers
    • Classifications of Insurers > Mutual, Stock
    • Classifications of Insurers > Admitted, Non-Admitted
    • Classifications of Insurers > Foreign, Domestic, Alien
    • Elements of a Contract
    • Elements of a Contract > Consideration
    • Elements of a Contract > Competent Parties
    • Elements of a Contract > Legal Purpose
    • Elements of a Contract > Offer
    • Elements of a Contract > Acceptance
    • Authority and Powers of Producers
    • Authority and Powers of Producers > Express
    • Authority and Powers of Producers > Implied
    • Authority and Powers of Producers > Apparent
    • Authority and Powers of Producers > The Law of Agency
    • Legal Interpretations Affecting Contracts
    • Legal Interpretations Affecting Contracts > Reasonable Expectations
    • Legal Interpretations Affecting Contracts > Indemnity
    • Legal Interpretations Affecting Contracts > Good Faith
    • Legal Interpretations Affecting Contracts > Fraud
    • Legal Interpretations Affecting Contracts > Warranties, Representations, Misrepresentations, and Concealment
  • Health and Accident Insurance Basics (10%)
    • Field Underwriting
    • Field Underwriting > Application Procedures
    • Field Underwriting > Warranties and Representations
    • Policy Delivery
    • Policy Delivery > Effective Date of Coverage
    • Policy Delivery > Policy Review
    • Policy Delivery > Premium Collection
    • Policy Delivery > Statement of Good Health
    • Definitions of Perils
    • Definitions of Perils > Accidental Injury
    • Definitions of Perils > Sickness
    • Types of Losses and Benefits
    • Types of Losses and Benefits > Loss of Income from Disability (Short-Term/Long-Term Disability)
    • Types of Losses and Benefits > Medical Expense
    • Types of Losses and Benefits > Long-Term Care Expense
    • Types of Losses and Benefits > Prescriptions
    • Limited Health Insurance Policies
    • Limited Health Insurance Policies > Accidental Death and Dismemberment
    • Limited Health Insurance Policies > Hospital Indemnity
    • Limited Health Insurance Policies > Critical Illness/Dread Disease
    • Limited Health Insurance Policies > Vision Care
    • Limited Health Insurance Policies > Hearing
    • Limited Health Insurance Policies > Dental
    • Limited Health Insurance Policies > Credit Disability
    • Classification of Risks
    • Classification of Risks > Preferred
    • Classification of Risks > Standard
    • Classification of Risks > Substandard
  • Individual Accident and Health Insurance Policy Provisions (14%)
    • Uniform Required Provisions
    • Uniform Required Provisions > Time Limit on Certain Defenses
    • Uniform Required Provisions > Grace Period
    • Uniform Required Provisions > Reinstatement
    • Uniform Required Provisions > Claim Forms
    • Uniform Required Provisions > Proof of Loss
    • Uniform Required Provisions > Time of Payment of Claims
    • Uniform Required Provisions > Physical Examinations and Autopsy
    • Uniform Required Provisions > Legal Actions
    • Uniform Required Provisions > Entire Contract
    • Uniform Required Provisions > Payment of Claims
    • Uniform Required Provisions > Change of Beneficiary
    • Uniform Required Provisions > Notice of Claim
    • Uniform Optional Provisions
    • Uniform Optional Provisions > Change of Occupation
    • Uniform Optional Provisions > Misstatement of Age/Sex
    • Uniform Optional Provisions > Illegal Occupation
    • Uniform Optional Provisions > Intoxicants, Narcotics, or Other Controlled Substances
    • Other General Provisions
    • Other General Provisions > Right to Examine/Free Look
    • Other General Provisions > Insuring Clause
    • Other General Provisions > Consideration Clause
    • Other General Provisions > Renewability Clause
    • Other General Provisions > Coinsurance
    • Other General Provisions > Probationary Period
    • Other General Provisions > Elimination Period
    • Other General Provisions > Exclusions
  • Disability Income and Related Insurance (15%)
    • Benefits Determination for Disability
    • Benefits Determination for Disability > Pure Loss of Income
    • Benefits Determination for Disability > Indemnity
    • Qualifications of Disability
    • Qualifications of Disability > Total (Own Occupation, Any Occupation)
    • Qualifications of Disability > Partial
    • Qualifications of Disability > Permanent
    • Qualifications of Disability > Presumptive
    • Qualifications of Disability > Recurrent
    • Qualifications of Disability > Residual
    • Qualifications of Disability > Inability to Perform Duties
    • Qualifications of Disability > Occupational versus Non-Occupational
    • Individual Disability Income Insurance
    • Individual Disability Income Insurance > Basic Total Disability Plan
    • Individual Disability Income Insurance > Cost of Living Rider
    • Individual Disability Income Insurance > Future Increase Option Rider
    • Individual Disability Income Insurance > Change of Occupation
    • Individual Disability Income Insurance > Other Cash Benefits
    • Individual Disability Income Insurance > Refund Provisions
    • Individual Disability Income Insurance > Exclusions
    • Individual Disability Income Insurance > Waiver of Premium
    • Individual Disability Income Insurance > Probationary Period
    • Individual Disability Income Insurance > Elimination Period
    • Individual Disability Income Insurance > Benefit Limits
    • Unique Aspects of Individual Disability Underwriting
    • Unique Aspects of Individual Disability Underwriting > Occupational Considerations
    • Unique Aspects of Individual Disability Underwriting > Benefit Limits
    • Unique Aspects of Individual Disability Underwriting > Policy Issuance Alternatives
    • Group Disability Income Insurance
    • Group Disability Income Insurance > Short-Term Disability
    • Group Disability Income Insurance > Long-Term Disability
    • Group Disability Income Insurance > Coordination of Benefits (Workers' Compensation Benefits and Social Insurance)
    • Group Disability Income Insurance > At-Work Benefits
    • Business Disability Insurance
    • Business Disability Insurance > Key Employee Disability Income
    • Business Disability Insurance > Disability Buy-Sell Policy
    • Business Disability Insurance > Business Overhead Expense
    • Social Security Disability
    • Social Security Disability > Qualification for Disability Benefits
    • Social Security Disability > Definition of Disability
    • Social Security Disability > Waiting Period
  • Medical Plans (10%)
    • Medical Plan Concepts
    • Medical Plan Concepts > Fee-for-Service
    • Medical Plan Concepts > Prepaid
    • Medical Plan Concepts > Specified Coverage
    • Medical Plan Concepts > Comprehensive Coverage
    • Medical Plan Concepts > Dependent Coverage
    • Provisions and Clauses
    • Provisions and Clauses > Deductibles
    • Provisions and Clauses > Stop-Loss Provision
    • Provisions and Clauses > Impairment Rider
    • Types of Medical Plans
    • Types of Medical Plans > Basic Plans
    • Types of Medical Plans > Major Medical Insurance
    • Types of Medical Plans > Health Maintenance Organizations (HMOs)
    • Types of Medical Plans > Preferred Provider Organizations (PPOs)
    • Types of Medical Plans > Point-of-Service (POS) Plans
    • Cost Containment in Health Care Delivery
    • Cost Containment in Health Care Delivery > Managed Care
    • Cost Containment in Health Care Delivery > Preventive Care
    • Cost Containment in Health Care Delivery > Outpatient Benefits
    • Cost Containment in Health Care Delivery > Utilization Management
    • Cost Containment in Health Care Delivery > Preauthorization
    • Cost Containment in Health Care Delivery > Gatekeeper
    • Health Insurance Portability and Accountability Act (HIPAA)
    • Health Insurance Portability and Accountability Act (HIPAA) > Eligibility Requirements
    • Health Insurance Portability and Accountability Act (HIPAA) > Terms
    • Health Insurance Portability and Accountability Act (HIPAA) > Privacy
    • Health Insurance Portability and Accountability Act (HIPAA) > Portability
  • Group Health Insurance (9%)
    • Characteristics of Group Health Insurance
    • Characteristics of Group Health Insurance > Group Contract
    • Characteristics of Group Health Insurance > Certificate of Coverage
    • Characteristics of Group Health Insurance > Eligible Groups
    • Characteristics of Group Health Insurance > Contributory versus Non-Contributory
    • Employer Group Health Insurance
    • Employer Group Health Insurance > Underwriting Criteria
    • Employer Group Health Insurance > Eligibility for Insurance
    • Employer Group Health Insurance > Conversion of Coverage
    • Employer Group Health Insurance > Open Enrollment
    • Employer Group Health Insurance > Probation Period
    • Employer Group Health Insurance > Coordination of Benefits
    • COBRA
    • COBRA > Eligibility
    • COBRA > Duration of Coverage
    • COBRA > Premium
  • Health Insurance for Senior Citizens and Special Needs Individuals (14%)
    • Medicare
    • Medicare > Administration
    • Medicare > Eligibility
    • Medicare > Part A
    • Medicare > Part B
    • Medicare > Part C
    • Medicare > Part D
    • Medicare > Medicare Select
    • Medicare Supplement Insurance
    • Medicare Supplement Insurance > Open Enrollment
    • Medicare Supplement Insurance > Types of Plans
    • Medicare Supplement Insurance > Standardized Plan Benefits
    • Other options for individuals with Medicare
    • Other options for individuals with Medicare > Employer Group Health Plans
    • Other options for individuals with Medicare > Medicaid
    • Long-Term Care Policies
    • Long-Term Care Policies > Eligibility for Benefits
    • Long-Term Care Policies > Benefit Periods and Amounts
    • Long-Term Care Policies > Exclusions
    • Long-Term Care Policies > Guaranteed Insurability Rider
    • Long-Term Care Policies > Cost of Living Rider
    • Levels of Long-Term Care
    • Levels of Long-Term Care > Skilled
    • Levels of Long-Term Care > Intermediate
    • Levels of Long-Term Care > Custodial
    • Types of Long-Term Care
    • Types of Long-Term Care > Home Health
    • Types of Long-Term Care > Adult Daycare
    • Types of Long-Term Care > Respite Care
  • Federal Tax Considerations for Health Insurance (5%)
    • Health Insurance Premiums and Benefits
    • Health Insurance Premiums and Benefits > Individual
    • Health Insurance Premiums and Benefits > Group
    • Health Insurance Premiums and Benefits > Disability Income
    • Health Insurance Premiums and Benefits > Business Disability Insurance
    • Health Insurance Premiums and Benefits > Medical Expense
    • Health Insurance Premiums and Benefits > Long-Term Care
    • Consumer-Driven Health Plans
    • Consumer-Driven Health Plans > Health Savings Accounts (HSAs)
    • Consumer-Driven Health Plans > Health Reimbursement Accounts (HRAs)
    • Consumer-Driven Health Plans > Flexible Spending Accounts (FSAs)
Examination sources