An insured receives a notice from the insurer that the policy has been cancelled in the middle of the term. Which of the following policies did the insured MOST likely have?
Correct Answer: D
Acancelablehealth insurance policy allows the insurer to cancel the policy at any time during the term with proper notice, typically for reasons like non-payment or fraud, as permitted under Oklahoma's regulations (Title 36 O.S. § 4405). Other policy types, like optionally renewable (insurer can refuse renewal at term end), conditionally renewable (renewal subject to conditions), or term (fixed duration), do not typically allow mid- term cancellation. * Option A: Incorrect. Optionally renewable policies can be non-renewed at term end, not cancelled mid- term. * Option B: Incorrect. Term policies (life or health) run for a fixed period and are not typically cancelled mid-term. * Option C: Incorrect. Conditionally renewable policies restrict renewal, not mid-term cancellation. * Option D: Correct. A cancelable policy allows mid-term cancellation by the insurer. : Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: General Knowledge - Accident and Health Insurance). Oklahoma Insurance Department, Title 36 O.S. § 4405 (health insurance provisions). Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.
An endorsement to an insurance policy that modifies clauses and provisions of the policy is referred to as
Correct Answer: C
Arideris an endorsement or amendment to an insurance policy that modifies its clauses, provisions, or coverage. Riders can add, remove, or alter benefits, such as adding coverage for a specific condition or family members in life or health insurance policies. The term is standard in Oklahoma insurance law and practice. * Option A: Incorrect. An attachment is not a specific insurance term for policy modifications. * Option B: Incorrect. A supplement may refer to additional coverage but is not the standard term for policy endorsements. * Option C: Correct. A rider is an endorsement that modifies policy provisions. * Option D: Incorrect. "Add-on" is not a formal insurance term for policy modifications. This question aligns with the Prometric content outline under "Provisions, Options, Exclusions, Riders, Clauses, and Rights," which covers policy endorsements. : Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: General Knowledge - Life and Health Insurance Provisions). Oklahoma Insurance Department, Title 36 O.S. § 4001 et seq. (policy provisions). Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.
In broad terms, the types of support and services generally associated with Long-Term Care policies are provided at which three levels of care?
Correct Answer: D
Long-Term Care (LTC) insurance policies cover services for individuals who need assistance with activities of daily living (ADLs) or have severe cognitive impairments. The three primary levels of care in LTC policies areskilled nursing care(intensive medical care by licensed professionals),intermediate care(less intensive medical care with some nursing support), andcustodial care(non-medical assistance with ADLs, such as bathing or dressing). These levels are standard in Oklahoma's LTC regulations and align with federal guidelines. * Option A: Incorrect. Professional, social, and economic care are not standard LTC levels. * Option B: Incorrect. While home-based and assisted living are settings for LTC, they are not levels of care; medical care is too vague. * Option C: Incorrect. Functional and rehabilitational care are not standard LTC categories; medical care is not specific enough. * Option D: Correct. Skilled nursing, intermediate, and custodial care are the recognized levels of care in LTC policies. This question falls under the Prometric content outline section on "Long-Term Care (LTC) Policies," which includes knowledge of LTC services and coverage. : Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: General Knowledge - Long-Term Care Policies). Oklahoma Insurance Department, Title 36 O.S. § 4426.1 (long-term care insurance regulations). Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.
A condition for which medical advice, diagnosis, care, or treatment was recommended or received during the 6 months immediately preceding the effective date of group health coverage is
Correct Answer: D
Apreexisting conditionis defined in health insurance as a medical condition for which advice, diagnosis, care, or treatment was recommended or received within a specified period (commonly 6 months) before the effective date of coverage. In Oklahoma, group health insurance policies often include provisions limiting or excluding coverage for preexisting conditions for a certain period, as regulated by federal and state laws, including the Health Insurance Portability and Accountability Act (HIPAA). * Option A: Incorrect. An elimination period is the waiting period before benefits begin, typically in disability or long-term care policies, not related to preexisting conditions. * Option B: Incorrect. An affiliation period is a waiting period for late enrollees in HMOs under HIPAA, not tied to medical conditions. * Option C: Incorrect. A diagnosed condition is not a standard insurance term; it does not specifically denote the timeframe of prior treatment like a preexisting condition. * Option D: Correct. A preexisting condition matches the definition provided, as per Oklahoma and federal regulations. This question aligns with the Prometric content outline under "Provisions, Options, Exclusions, Riders, Clauses, and Rights," which covers health insurance exclusions and limitations. : Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: General Knowledge - Accident and Health Insurance). Oklahoma Insurance Department, Title 36 O.S. § 6060.4 (preexisting condition provisions). HIPAA, 45 CFR § 144.103 (definition of preexisting condition).
In regards to advertising, insurers are responsible for which of the following?
Correct Answer: A
Under Oklahoma insurance regulations (Title 36 O.S. § 1204 and O.A.C. 365:10-3-10), insurers are responsible for ensuring that all advertising materials comply with state laws, including maintaining control over thecontent and formto prevent misleading or deceptive practices. This includes ensuring advertisements are truthful, not disparaging, and compliant with regulatory standards. * Option A: Correct. Insurers must control the content and form of advertising to ensure compliance. * Option B: Incorrect. The cost of delivery is not a regulatory responsibility of insurers. * Option C: Incorrect. The cost of production is an internal business matter, not a regulatory requirement. * Option D: Incorrect. Communications between agents are not directly related to advertising content control. This question is part of the Prometric content outline under "State Insurance Statutes, Rules, and Regulations," which covers advertising regulations. : Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: State- Specific Knowledge - Oklahoma Insurance Statutes). Oklahoma Insurance Department, Title 36 O.S. § 1204; O.A.C. 365:10-3-10 (advertising rules). Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.
