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Accident & Health — Information & Free Practice

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Accident & Health

Provider
Pearson VUE
Format
Multiple choice; general knowledge and Iowa-specific portions within one licensing examination
Exam questions
80 scored questions (50 general knowledge, 30 Iowa specific) plus 10 pretest questions (5 in each portion)
Time limit
2 hours
Exam fee
$44
Examination outline
  • General knowledge — I. TYPES OF POLICIES (16 scoreable questions)
    • A. Disability income
    • A.1. Individual disability income policy
    • A.2. Business overhead expense policy
    • A.3. Business disability buyout policy
    • A.4. Group disability income policy
    • A.5. Key employee policy
    • B. Accidental death and dismemberment
    • C. Medical expense insurance
    • C.1. Basic hospital, medical, and surgical policies
    • C.2. Major medical policies
    • C.3. Health Maintenance Organizations (HMOs)
    • C.4. Preferred Provider Organizations (PPOs)
    • C.5. Point of Service (POS) plans
    • C.6. Flexible Spending Accounts (FSAs)
    • C.7. High Deductible Health Plans (HDHPs) and related Health Savings Accounts (HSAs)
    • C.8. Health Reimbursement Accounts (HRAs)
    • D. Medicare supplement policies
    • E. Group insurance
    • E.1. Differences between individual and group contracts
    • E.2. General characteristics
    • E.3. COBRA
    • F. Individual/Group Long Term Care (LTC)
    • F.1. Eligibility
    • F.2. Levels of care
    • G. Other policies
    • G.1. Dental
    • G.2. Vision
    • G.3. Cancer
    • G.4. Critical illness or specified disease
    • G.5. Worksite (employer-sponsored)
    • G.6. Hospital indemnity
    • G.7. Short-term medical
    • G.8. Accident
  • General knowledge — II. POLICY PROVISIONS, CLAUSES, AND RIDERS (15 scoreable questions)
    • A. Mandatory and Optional provisions
    • A.1. Entire contract
    • A.2. Time limit on certain defenses (incontestable)
    • A.3. Grace period
    • A.4. Reinstatement
    • A.5. Notice of claim
    • A.6. Claim forms
    • A.7. Proof of loss
    • A.8. Time of payment of claims
    • A.9. Payment of claims
    • A.10. Physical examination and autopsy
    • A.11. Legal actions
    • A.12. Change of beneficiary
    • A.13. Misstatement of age or gender
    • A.14. Change of occupation
    • A.15. Illegal occupation
    • A.16. Relation of earning to insurance
    • B. Other provisions and clauses
    • B.1. Insuring clause
    • B.2. Free look
    • B.3. Consideration clause
    • B.4. Probationary period
    • B.5. Elimination period
    • B.6. Waiver of premium
    • B.7. Exclusions and limitations
    • B.8. Preexisting conditions
    • B.9. Coinsurance
    • B.10. Deductibles
    • B.11. Eligible expenses
    • B.12. Copayments
    • B.13. Pre-authorizations and prior approval requirements
    • B.14. Usual, reasonable, and customary (URC) charges
    • B.15. Lifetime, annual, or per cause maximum benefit limits
    • C. Riders
    • C.1. Impairment/exclusions
    • C.2. Guaranteed insurability
    • C.3. Future increase option
    • D. Rights of renewability
    • D.1. Noncancelable
    • D.2. Cancelable
    • D.3. Guaranteed renewable
  • General knowledge — III. SOCIAL INSURANCE (6 scoreable questions)
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • General knowledge — IV. OTHER INSURANCE CONCEPTS (5 scoreable 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
    • K. Subrogation
  • General knowledge — V. FIELD UNDERWRITING PROCEDURES (8 scoreable 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.1. Elements of a contract
    • H.2. Insurable interest
    • H.3. Warranties and representations
    • H.4. Unique aspects of the insurance contract
    • H.4.a. Conditional
    • H.4.b. Unilateral
    • H.4.c. Adhesion
    • H.4.d. Aleatory
  • Iowa specific — I. IOWA LAWS, RULES, AND REGULATIONS COMMON TO ALL LINES (15 scoreable questions)
    • A. Insurance Commissioner/Division
    • A.1. Broad powers and duties
    • A.2. Examination of records
    • A.3. Hearings
    • A.4. Penalties
    • A.5. Cease and desist
    • B. Licensing
    • B.1. Applications
    • B.2. Change of address
    • B.3. Licensing examinations
    • B.4. Resident/nonresident
    • B.5. Temporary license
    • B.6. Exemptions
    • B.7. Denial, renewal, termination of licenses
    • B.8. Commissions and referral fees
    • B.9. Company appointments
    • B.10. Continuing education
    • C. Unfair and Deceptive Practices
    • C.1. Unfair discrimination
    • C.2. Misrepresentation
    • C.3. Rebating
    • C.4. False information and advertising
    • C.5. Claims settlement
    • C.6. Defamation
    • C.7. Boycott, coercion and intimidation
    • D. Iowa Insurance Fraud Act
    • E. Producer Responsibilities
    • E.1. Prohibited Acts
    • E.2. Use of credit information — published marker ** applies to Property/Casualty associated exams only
    • F. Guaranty Association
    • G. Definitions
    • G.1. Domestic, foreign, alien
    • G.2. Fraternal benefit society — published marker * applies to Life/Health only
    • G.3. Certificate of Authority
    • H. Surplus — published marker ** applies to Property/Casualty associated exams only
    • I. Insurance Notices and Documents - Electronic Delivery
  • Iowa specific — II. IOWA LAWS, RULES, AND REGULATIONS PERTINENT TO ACCIDENT AND HEALTH INSURANCE ONLY (15 scoreable questions)
    • A. Individual Health insurance
    • A.1. Eligibility
    • A.2. Required provisions
    • A.3. Renewability
    • A.4. Mandatory coverages
    • A.4.1. Diabetes
    • A.4.2. Mammography
    • A.4.3. Coverage for newborns
    • A.4.4. Adopted children
    • A.4.5. Complications of pregnancy
    • A.5. Preexisting conditions
    • A.6. Claims
    • A.7. Credit disability
    • B. Group Health insurance
    • B.1. Eligibility
    • B.2. Required provisions
    • B.3. Claims
    • B.4. Mandatory coverages
    • B.4.1. Diabetes
    • B.4.2. Mammography
    • B.4.3. Coverage for newborns
    • B.4.4. Adopted children
    • B.4.5. Complications of pregnancy
    • C. Medicare supplement insurance
    • C.1. Purpose
    • C.2. Required provisions
    • C.3. Preexisting conditions
    • C.4. Exclusions
    • C.5. Replacement
    • C.6. Cancellation
    • D. Long Term Care insurance
    • D.1. Marketing and training
    • D.2. Policy provisions
    • D.3. Types of care
    • D.3.1. Home Health Care
    • D.3.2. Nursing Home
    • D.3.3. Assisted living
    • D.4. Iowa Long-Term Care partnership program
    • E. Special Programs
    • E.1. Healthy and Well Kids in Iowa Program (HAWK-I)
    • E.2. HIPIOWA
    • F. Affordable Care Act
    • F.1. Exchanges/Marketplace (ACA Section 1321)
    • F.2. Taxes, penalties, and subsidies (ACA Section 1401, 1402)
    • F.3. Essential health benefits (ACA Section 1302)
    • F.3.a. Mental health parity
    • F.3.b. Pediatric services
    • F.3.c. Preventive services
    • F.4. Employer notification responsibilities (ACA Section 1511-1515)
    • G. No Surprises Act — Title I of Division BB of the CAA, 2021, Title XXVII of PHS Act Part E
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