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Free DE Accident and Health Producer Practice Questions

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Sample Practice Questions

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  1. 1A self-employed consultant wants monthly benefits to replace her own earnings if an illness prevents her from working. Which disability coverage addresses that loss?

    1. A. Business overhead expense coverage
    2. B. Individual disability income coverage
    3. C. Key employee disability coverage
    4. D. Business disability buyout coverage

    Answer: B

    Explanation: "Disability Income - a policy designed to compensate insured individuals for a portion of the income they lose because of a disabling injury or illness." Individual disability income replaces part of her lost earnings. Overhead coverage pays operating expenses, key employee coverage protects the firm, and buyout coverage finances an ownership transfer.

    Reference: NAIC Glossary of Insurance Terms — Disability Income

  2. 2Under Delaware's required individual health-policy provisions, what generally constitutes the entire contract?

    1. A. The policy, endorsements, and attached papers, including the application if attached
    2. B. Only the application
    3. C. Only the declarations page
    4. D. Any later oral statement by the producer

    Answer: A

    Explanation: Section 3305 requires an Entire Contract provision identifying the policy, endorsements, and attached papers as the entire contract. Direct text: “This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance”.

    Reference: Delaware Code Title 18 — 18 Del. C. § 3305

  3. 3A client asks which Medicare part generally helps cover physician services and outpatient care. Which part should the producer identify?

    1. A. Medicare Part A
    2. B. Medicare Part B
    3. C. Medicare Part C
    4. D. Medicare Part D

    Answer: B

    Explanation: "Services from doctors and other health care providers" appears under Medicare Part B, together with outpatient care. Part A addresses inpatient hospital benefits, Part C offers a Medicare plan route, and Part D addresses prescription drugs.

    Reference: Medicare.gov Parts of Medicare — Part B (Medical Insurance)

  4. 4An insured paid the premiums on an accident or health policy personally with after-tax funds. How are benefits received under that policy generally treated for federal income tax?

    1. A. Included in income as employer-paid sick pay
    2. B. Excluded from taxable income under the insured-paid rule
    3. C. Treated as taxable interest from the insurer
    4. D. Treated as wages for the premium payment year

    Answer: B

    Explanation: "if you paid the premiums on an accident or health insurance policy, the benefits you receive under the policy aren’t taxable." IRS distinguishes insured-paid benefits from employer-paid sick pay. The benefit is generally not taxable under the stated facts; it is not interest or wages.

    Reference: IRS Publication 525 (2025) — Publication 525, Sick pay

  5. 5With the applicant's authorization, an individual health insurer wants a reporting source that collects medical conditions and hazardous avocations for underwriting. Which source matches?

    1. A. Medical Information Bureau (MIB) report
    2. B. Consumer credit-score disclosure report
    3. C. Employer group enrollment certificate
    4. D. Medicare eligibility determination record

    Answer: A

    Explanation: "Collects information about medical conditions and hazardous avocations." CFPB identifies MIB as collecting those facts and reporting them with authorization for individual insurance underwriting. The other documents serve different information purposes.

    Reference: CFPB, MIB Inc. — MIB, Inc.

  6. 6In Delaware, who must hold the appropriate line-of-authority license before transacting insurance?

    1. A. Only an insurer's directors
    2. B. A person acting as a producer, adjuster, or appraiser
    3. C. Only persons receiving commissions
    4. D. Only resident business entities

    Answer: B

    Explanation: 18 Del. C. § 1703 says a person may not transact insurance unless licensed as a producer, adjuster, or appraiser for that line. Direct text: “A person shall not transact insurance in this State”.

    Reference: Delaware Code Title 18 — 18 Del. C. § 1703

  7. 7Delaware's consumer credit insurance chapter generally applies to credit insurance connected with which transactions?

    1. A. Personal, family, or household credit transactions
    2. B. Only first-mortgage loans
    3. C. Only business acquisitions
    4. D. Only securities margin accounts

    Answer: A

    Explanation: Section 3702(a) applies the chapter to consumer credit insurance tied to loans or credit transactions for personal, family, or household purposes. Direct text: “All consumer credit insurance issued or sold in connection with loans or other credit transactions for personal, family or household purposes”.

    Reference: Delaware Code Title 18 — 18 Del. C. § 3702(a)

  8. 8A Delaware individual health policy reserves the right to refuse renewal. How far before the premium due date must nonrenewal notice be delivered or mailed?

    1. A. 5 days
    2. B. 10 days
    3. C. 15 days
    4. D. 31 days

    Answer: A

    Explanation: Section 3307 adds an advance-notice clause for such policies. Direct text: “Unless not less than five days prior to the premium due date”.

    Reference: Delaware Code Title 18 — 18 Del. C. § 3307

  9. 9What must a Delaware long-term-care insurer develop and use when evaluating a purchase or replacement?

    1. A. A fixed income cutoff imposed by statute
    2. B. Suitability standards addressing the applicant's needs
    3. C. A Medicare underwriting score
    4. D. A property-insurance replacement-cost table

    Answer: B

    Explanation: Regulation 1404 § 25.2.1 requires suitability standards to determine whether a purchase or replacement is appropriate for the applicant's needs. Direct text: “Develop and use suitability standards to determine whether the purchase or replacement of long-term care insurance is appropriate”.

    Reference: De Reg (1404) — 18 DE Admin. Code 1404 § 25.2.1

  10. 10The owner of a two-person practice becomes disabled. The practice needs help paying rent, utilities, and staff payroll while the owner recovers. Which coverage fits that need?

    1. A. Individual disability income policy
    2. B. Business overhead expense rider
    3. C. Key employee disability policy
    4. D. Business disability buyout policy

    Answer: B

    Explanation: "This type of provision covers standard business expenses such as payroll, utilities," The overhead rider addresses operating costs during the owner's disability; personal income, key person loss, and ownership buyout answer different financial needs.

    Reference: NAIC Small Business Insurance — Disability Insurance, business overhead paragraph

Topics in this practice bank

These topics describe the available practice for DE Accident and Health Producer. Review the examination outline and its sources for scope and allocation details.

  • General knowledge: 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
  • General knowledge: 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
  • General knowledge: III. SOCIAL INSURANCE
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • General knowledge: 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
    • J. Workers Compensation / 1. Impact on health insurance benefits
    • K. Subrogation
    • L. Cost containment
  • General knowledge: 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. 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
  • State specific: I. DELAWARE STATUTES, REGULATIONS, AND BULLETINS PERTINENT TO LIFE, ACCIDENT AND HEALTH, PROPERTY AND CASUALTY INSURANCE
    • A. LICENSE REGULATIONS
    • A. LICENSE REGULATIONS / 1. Persons required to be licensed and responsibilities
    • A. LICENSE REGULATIONS / 1. Persons required to be licensed and responsibilities / a. Producer/Agent
    • A. LICENSE REGULATIONS / 1. Persons required to be licensed and responsibilities / b. Producer/Consultant
    • A. LICENSE REGULATIONS / 2. License requirements
    • A. LICENSE REGULATIONS / 2. License requirements / a. Fees and application
    • A. LICENSE REGULATIONS / 2. License requirements / b. Prerequisites
    • A. LICENSE REGULATIONS / 2. License requirements / c. Written examinations and exemptions
    • A. LICENSE REGULATIONS / 2. License requirements / d. Exemptions from licensing
    • A. LICENSE REGULATIONS / 2. License requirements / e. Insurer’s appointment
    • A. LICENSE REGULATIONS / 3. Authority
    • A. LICENSE REGULATIONS / 3. Authority / a. Definitions
    • A. LICENSE REGULATIONS / 3. Authority / b. License requirements
    • A. LICENSE REGULATIONS / 3. Authority / c. Lines of authority
    • A. LICENSE REGULATIONS / 3. Authority / d. Termination of appointment
    • A. LICENSE REGULATIONS / 4. Notice of address change
    • A. LICENSE REGULATIONS / 5. Continuing education
    • B. Marketing Practices
    • B. Marketing Practices / 1. Duties of licensed personnel
    • B. Marketing Practices / 2. Record keeping
    • B. Marketing Practices / 3. Compensation of licensees
    • B. Marketing Practices / 4. Termination, suspension, fines
    • C. Insurance Commissioner
    • C. Insurance Commissioner / 1. Election and term
    • C. Insurance Commissioner / 2. General powers and duties
    • C. Insurance Commissioner / 3. Examination of insurers and producers
    • C. Insurance Commissioner / 4. Hearings
    • C. Insurance Commissioner / 5. Cease and desist orders and penalties
    • C. Insurance Commissioner / 6. General penalties
  • State specific: II. DELAWARE STATUTES, RULES, REGULATIONS, AND BULLETINS COMMON TO BOTH LIFE AND HEALTH INSURANCE
    • A. Credit Life and Health
    • B. Life and Health Guaranty Association Act
  • State specific: III. DELAWARE STATUTES, RULES, REGULATIONS, AND BULLETINS PERTINENT TO HEALTH INSURANCE ONLY
    • A. Individual Health insurance required provisions
    • B. Individual Health insurance optional provisions
    • C. Individual accident and health minimum standards
    • D. Group and blanket health insurance
    • D. Group and blanket health insurance / 1. Definitions
    • D. Group and blanket health insurance / 2. Required provisions
    • D. Group and blanket health insurance / 3. Small employer health insurance
    • D. Group and blanket health insurance / 4. Medicare Secondary Payor
    • E. Long Term Care
    • F. Medicare Supplement
    • G. AIDS related testing
  • State specific: IV. INSURANCE ETHICS
    • A. Definitions
    • A. Definitions / 1. Market Conduct
    • A. Definitions / 2. Authority
    • A. Definitions / 2. Authority / a. Express
    • A. Definitions / 2. Authority / b. Implied
    • A. Definitions / 2. Authority / c. Apparent
    • A. Definitions / 3. Agency versus individual licensee
    • A. Definitions / 4. Suitability
    • A. Definitions / 5. Ethical behavior and good moral standards
    • B. Market Conduct examination
    • C. Binding coverage
    • D. Disclosure letters and forms
    • E. Errors and Omissions insurance
    • F. Unfair practices
    • F. Unfair practices / 1. Twisting
    • F. Unfair practices / 2. Churning
    • F. Unfair practices / 3. Commingling
    • F. Unfair practices / 4. Misrepresentation
    • F. Unfair practices / 5. Defamation
    • F. Unfair practices / 6. Coercion and intimidation
    • F. Unfair practices / 7. Unfair discrimination
    • F. Unfair practices / 8. Rebating
    • F. Unfair practices / 9. Unfair claims settlement practices
    • F. Unfair practices / 10. Coercion of debtors
    • F. Unfair practices / 11. Publicized Founded Complaints
    • G. Insurance fraud and Fraud Prevention Bureau
    • H. Advertisement procedures
    • I. Privacy
    • J. Conflict of issues and producer’s responsibilities

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