WV Accident and Health or Sickness Producer — Information & Free Practice

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WV Accident and Health or Sickness Producer

Provider: Pearson VUE
Format: Computer-based written examination; general knowledge and West Virginia law parts
Exam questions: 50 scored general-knowledge questions plus 5 pretest; 30 scored state-law questions plus 6 pretest
Time limit: 2 hours
Passing score: Scaled score of 70
Exam fee: $84

Examination outline

General Knowledge — I. TYPES OF POLICIES (16 scoreable 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
General Knowledge — II. POLICY PROVISIONS, CLAUSES, AND RIDERS (15 scoreable questions)
- 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 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
- J. Workers Compensation — 1. Impact on health insurance benefits
- K. Subrogation
- L. Cost containment
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. 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
West Virginia Specific — I. WEST VIRGINIA LAWS AND RULES COMMON TO LIFE AND ACCIDENT AND SICKNESS INSURANCE (21 scoreable questions)
- A. Insurance Commissioner (2 questions)
- A. Insurance Commissioner (2 questions) — 1. Broad powers
- A. Insurance Commissioner (2 questions) — 2. Examination of records
- A. Insurance Commissioner (2 questions) — 3. Notice and conduct of hearing
- A. Insurance Commissioner (2 questions) — 4. Penalties
- A. Insurance Commissioner (2 questions) — 5. Filing and approval of forms
- B. Definitions (4 questions)
- B. Definitions (4 questions) — 1. Domestic, foreign, and alien companies
- B. Definitions (4 questions) — 2. Stock and mutual
- B. Definitions (4 questions) — 3. Transacting insurance
- B. Definitions (4 questions) — 4. Producer
- C. Licensing (7 questions)
- C. Licensing (7 questions) — 1. Purpose/Requirements
- C. Licensing (7 questions) — 2. Qualifications
- C. Licensing (7 questions) — 2. Qualifications — a. Producer
- C. Licensing (7 questions) — 2. Qualifications — b. Direct response
- C. Licensing (7 questions) — 2. Qualifications — c. Nonresident Life/A&H producer
- C. Licensing (7 questions) — 2. Qualifications — d. Fingerprinting
- C. Licensing (7 questions) — 3. Termination of license
- C. Licensing (7 questions) — 3. Termination of license — a. Expiration and cancellation
- C. Licensing (7 questions) — 3. Termination of license — b. Revocation and suspension
- C. Licensing (7 questions) — 3. Termination of license — c. Nonrenewal
- C. Licensing (7 questions) — 4. Limitation of license
- C. Licensing (7 questions) — 5. Appointment
- C. Licensing (7 questions) — 6. Education requirements
- C. Licensing (7 questions) — 6. Education requirements — a. Continuing education
- C. Licensing (7 questions) — 7. Mandatory reporting requirements
- C. Licensing (7 questions) — 7. Mandatory reporting requirements — a. Criminal prosecution and administrative action
- C. Licensing (7 questions) — 7. Mandatory reporting requirements — b. Fraud
- D. Unfair Trade Practices (6 questions)
- D. Unfair Trade Practices (6 questions) — 1. Unfair claims methods and practices
- D. Unfair Trade Practices (6 questions) — 2. Excessive charges
- D. Unfair Trade Practices (6 questions) — 3. Rebating
- D. Unfair Trade Practices (6 questions) — 4. Coercion
- D. Unfair Trade Practices (6 questions) — 5. Misrepresentation
- D. Unfair Trade Practices (6 questions) — 6. Defamation
- D. Unfair Trade Practices (6 questions) — 7. Advertising
- D. Unfair Trade Practices (6 questions) — 8. Penalties
- E. Mass Marketed Life & Sickness Insurance (1 question)
- F. West Virginia Life and Health Guaranty Association (1 question)
- G. Unauthorized Insurers
West Virginia Specific — II. WEST VIRGINIA LAWS AND RULES PERTINENT TO ACCIDENT AND HEALTH OR SICKNESS INSURANCE ONLY (9 scoreable questions)
- A. Required Disclosure Provisions; Individual Minimum A&S Standards (1 question)
- B. Requirements for Replacement; Individual Minimum A&S Standards (1 question)
- C. Medicare Supplement Insurance (2 questions)
- D. Health Maintenance Organization Act (1 question)
- D. Health Maintenance Organization Act (1 question) — 1. Definitions
- D. Health Maintenance Organization Act (1 question) — 2. Deceptive practice
- E. Corporations (1 question)
- E. Corporations (1 question) — 1. Hospital service corporations
- E. Corporations (1 question) — 2. Medical service corporations
- E. Corporations (1 question) — 3. Dental service corporations
- E. Corporations (1 question) — 4. Health service corporations
- F. Coverage for Newborn Children (1 question)
- G. Long-Term Care (1–2 questions)
- H. Small Employer Group (0–1 question)

Examination sources

West Virginia Insurance Supplement — Examination Content Outlines
S3, general knowledge title
West Virginia Insurance Supplement — Examination Content Outlines
S3, general knowledge allocation
West Virginia Insurance Supplement — Examination Content Outlines
S4, health state content title
West Virginia Insurance Supplement — Examination Content Outlines
S4, state-specific allocation
West Virginia Insurance Candidate Handbook
p.14, Content Outlines
West Virginia Insurance Supplement — Examination Content Outlines
S3 footer, outline effective date
West Virginia Insurance Candidate Handbook
p.12, Score Explanation — equating
West Virginia Insurance Candidate Handbook
p.12, Scaled Score
West Virginia Code, Chapter 33, Article 12
§33-12-5(a)
Pearson VUE West Virginia Insurance Public Exam List
Public exams, InsWV-AcSi02
West Virginia Insurance Candidate Handbook
p.12, Waivers — both parts of licensing exam

Related license preparation

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

West Virginia Agency Insurance Producer License; Car Rental Limited License; Limited Line Credit Insurance Producer; limited lines travel insurance producer business entity license; limited lines travel insurance producer license; Insurance Producer — Accident and Health or Sickness; Provisional License; service representative permit; Solicitor's License; temporary insurance producer license