Accident and Health Agent — Information & Free Practice

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Accident and Health Agent

Provider: Pearson VUE
Format: Multiple-choice; general product knowledge and Tennessee law within one examination; test-center or OnVUE delivery
Exam questions: 68 scored questions (50 general knowledge and 18 Tennessee-specific) plus 9 pretest questions (5 general knowledge and 4 Tennessee-specific)
Time limit: 1 hour and 45 minutes
Passing score: 70 scaled score on the reporting scale of 0 to 100
Exam fee: $55 for Accident & Health taken alone

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 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
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.a. Conditional
- H. Contract law — 4.b. Unilateral
- H. Contract law — 4.c. Adhesion
- H. Contract law — 4.d. Aleatory
VI. Tennessee Laws, and Departmental Rules Common to Life, Accident and Health, Property and Casualty Insurance
- A. Powers of Commissioner
- A. Powers of Commissioner — 1. Hearings and judicial review
- A. Powers of Commissioner — 2. Investigations
- A. Powers of Commissioner — 3. Regulatory authority
- A. Powers of Commissioner — 4. Penalties
- B. Definitions
- B. Definitions — 1. Insurance Producer
- B. Definitions — 2. Business Entity
- B. Definitions — 3. Limited Lines Producer
- B. Definitions — 4. Unauthorized insurer
- B. Definitions — 5. Compensation and referrals
- B. Definitions — 6. Fiduciary
- B. Definitions — 7. Domestic and Foreign Insurance Companies
- C. License Requirements
- C. License Requirements — 1. Insurance Producer
- C. License Requirements — 2. Agency Appointments/Termination
- C. License Requirements — 3. Resident/nonresident
- C. License Requirements — 4. Exceptions
- C. License Requirements — 4.a. Licenses
- C. License Requirements — 4.b. Examination
- C. License Requirements — 5. Temporary license
- C. License Requirements — 6. License renewal
- C. License Requirements — 7. General requirements
- C. License Requirements — 8. Continuing Education
- D. License Suspension/Revocation
- D. License Suspension/Revocation — 1. General provisions
- D. License Suspension/Revocation — 2. Notice
- E. Unfair Practices
- E. Unfair Practices — 1. False advertising
- E. Unfair Practices — 2. Defamation
- E. Unfair Practices — 3. Boycotting, coercion, and intimidation
- E. Unfair Practices — 4. Unfair Discrimination
- E. Unfair Practices — 5. Rebating
- E. Unfair Practices — 6. Unfair claims settlement practices
- E. Unfair Practices — 7. Other topics
- F. Life and Health Guaranty Association
VII. Tennessee Laws, and Departmental Rules Pertinent to Accident and Health Insurance Only
- A. Required provisions
- B. Policy cancellation, renewal
- C. Group policies
- D. Blanket or franchise school insurance
- E. School accident coverage
- F. Medicare supplement insurance
- F. Medicare supplement insurance — 1. Policy Terms/Definitions
- F. Medicare supplement insurance — 2. Prohibited Policy provisions
- F. Medicare supplement insurance — 3. Minimum standards
- F. Medicare supplement insurance — 4. Eligibility
- G. Long-term Care
- H. Mandated Coverages (Offerings and Benefits)
- I. External Review
- J. Affordable Care Act
- J. Affordable Care Act — 1. Exchanges/Marketplace (ACA Section 1321)
- J. Affordable Care Act — 2. Taxes, penalties, and subsidies (ACA Section 1401, 1402)
- J. Affordable Care Act — 3. Essential health benefits (ACA Section 1302)
- J. Affordable Care Act — 3.a. Mental health and substance use disorder parity
- J. Affordable Care Act — 3.b. Pediatric services
- J. Affordable Care Act — 3.c. Preventive services
- J. Affordable Care Act — 4. Employer notification responsibilities (ACA Section 1511-1515)
- J. Affordable Care Act — 5. Fees for individual major medical policy when commission is not paid (56-6-125(b))

Examination sources

Tennessee Insurance Content Outlines
Cover, effective date
Tennessee Insurance Content Outlines
Health general knowledge content outline, p. S3
Tennessee Insurance Content Outlines
Accident and Health Tennessee specific content outline, p. S4
Tennessee Insurance Licensing Candidate Handbook
Exam Structure and Content, p. 15, complete blueprints
Tennessee Insurance Licensing Candidate Handbook
Exam Structure and Content, p. 15, scoring
Tennessee Insurance Licensing Candidate Handbook
Equating and Scaling, p. 13, passing score
Tennessee Insurance Licensing Candidate Handbook
Exam Fees and Combinations, p. 7, Accident & Health row
Tennessee Insurance Licensing Candidate Handbook
Exam Fees and Combinations, p. 7, individual session
Tennessee Insurance Licensing Candidate Handbook
Exam Structure and Content, p. 15, general and Tennessee content

Related license preparation

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

Business Entity Insurance Producer License — Accident and Health; Limited Lines Producer License; Temporary License under Military Families Licensing Recognition Act; Insurance Producer License — Accident and Health or Sickness; temporary insurance producer license