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South Carolina Accident and Health Insurance Producer — Information & Free Practice

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South Carolina Accident and Health Insurance Producer

Provider
Pearson VUE
Format
Computer-delivered written licensing examination; general knowledge and South Carolina law portions constitute one examination result.
Exam questions
85 total: 50 scored general knowledge, 25 scored South Carolina specific, and 10 pretest questions.
Time limit
120 minutes
Passing score
Reported passing score 70 on a 0–100 scale; not a percentage correct. A failed portion requires retaking the entire exam; the combination exam has one score.
Exam fee
$59 per examination
Examination outline
  • General knowledge — I. TYPES OF POLICIES (16 scored items)
    • 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
  • General knowledge — II. POLICY PROVISIONS, CLAUSES, AND RIDERS (15 scored items)
    • 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 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
    • 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
  • General knowledge — III. SOCIAL INSURANCE (6 scored items)
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • General knowledge — IV. OTHER INSURANCE CONCEPTS (5 scored items)
    • 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. nonoccupational
    • 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
    • L. Cost containment
  • General knowledge — V. FIELD UNDERWRITING PROCEDURES (8 scored items)
    • A. Completing the application
    • B. Explaining sources of insurability and HIPAA privacy (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
  • South Carolina specific — I. SOUTH CAROLINA LAWS AND REGULATIONS PERTINENT TO ALL LINES (18 scored items)
    • A. Insurance Department and Director
    • A. Insurance Department and Director / 1. Powers and duties Ref: 38-3-60, 110
    • A. Insurance Department and Director / 2. Examination of books and records Ref: 38-13-10–30; 38-43-250
    • A. Insurance Department and Director / 3. Investigations/Notice of hearing Ref: 38-3-170; 38-57-200
    • A. Insurance Department and Director / 4. Penalties and fines Ref: 38-2-10–30, 38-43-130
    • A. Insurance Department and Director / 5. Cease and desist orders Ref: 38-59-20, 270
    • B. General insurance definitions
    • B. General insurance definitions / 1. Domestic, foreign and alien insurers Ref: 38-1-20
    • B. General insurance definitions / 2. Admitted/Nonadmitted insurer Ref: 38-1-20; 38-5-80
    • B. General insurance definitions / 3. Sell, solicit, negotiate Ref: 38-1-20, 38-43-10
    • C. Licensing
    • C. Licensing / 1. Producer Ref: 38-43-10, 20, 30, 60
    • C. Licensing / 2. License fees and application Ref: 38-43-80, 100, 101
    • C. Licensing / 3. License probation, revocation, suspension, or denial of reissuance Ref: 38-43-130, 230
    • C. Licensing / 4. Temporary License Ref 38-43-102
    • C. Licensing / 5. Nonresident License Ref: 38-43-70
    • C. Licensing / 6. Agent appointment/termination of contract Ref: 38-43-40, 50, 55
    • C. Licensing / 7. Continuing education Ref: 38-43-106; Reg. 69-50
    • C. Licensing / 8. Change of Address/name change Ref: 38-43-10(C), 107
    • C. Licensing / 9. Reinstatement/license expiration Ref: 38-43-110(B)
    • D. Unfair and prohibited trade practices
    • D. Unfair and prohibited trade practices / 1. Rebating Ref: 38-57-130
    • D. Unfair and prohibited trade practices / 2. Defamation Ref: 38-57-90
    • D. Unfair and prohibited trade practices / 3. Unfair Discrimination Ref: 38-55-50; 38-57-120
    • D. Unfair and prohibited trade practices / 4. Misrepresentation Ref: 38-57-40
    • D. Unfair and prohibited trade practices / 5. False advertising Ref: 38-57-40, 50
    • D. Unfair and prohibited trade practices / 6. Boycott, coercion, and intimidation Ref: 38-57-100, 110
    • D. Unfair and prohibited trade practices / 7. Unfair claims settlement practices Ref: 38-59-10, 20
    • D. Unfair and prohibited trade practices / 8. Fraud Ref: 38-43-245
    • D. Unfair and prohibited trade practices / 9. False Financial Statements Ref: 38-57-80
    • D. Unfair and prohibited trade practices / 10. Prohibited inducements Ref: 38-57-130, 150,
    • E. Reporting and Disposition of Premiums
    • E. Reporting and Disposition of Premiums / 1. Fiduciary capacity; misappropriation of funds Ref: 38-43-130, 240, 420
    • E. Reporting and Disposition of Premiums / 2. Commissions and compensation/charges for extra services Ref: 38-43-200
    • E. Reporting and Disposition of Premiums / 3. Reporting of Actions Ref: 38-43-247
    • F. Life and Accident Health Insurance Guaranty Association Ref: 38-29-20, 30, 40, 50, 80, 130. 200
    • G. Consumer information privacy regulation Ref: Reg 69-58 Sec 1–16
  • South Carolina specific — II. SOUTH CAROLINA LAWS AND REGULATIONS PERTINENT TO ACCIDENT & HEALTH INSURANCE (7 scored items)
    • A. Individual and Group Accident and Health Insurance Ref: 38-71 et al
    • B. Medicare Supplement Ref: Reg 69-46 Sec 1– 8, 11– 13, 17– 24
    • C. Long Term Care Ref: Reg 69-44 Sec 1, 3 – 9 and 12 – 14
Examination sources