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Insurance Licensing NY-Life-Accident-and-Health Exam Syllabus Topics:

SectionObjectives
Insurance Fundamentals- Principles of insurance and risk management
  • 1. Risk classification and pooling of risk
    • 2. Insurable interest and indemnity concepts
      - Insurance contract law basics
      • 1. Policy provisions and clauses
        • 2. Elements of a valid contract
          Accident and Health Insurance- Health insurance products
          • 1. Hospital and medical expense coverage
            • 2. Disability income insurance
              - Policy features and provisions
              • 1. Elimination periods and benefit limits
                • 2. Coordination of benefits
                  State Regulations (New York)- Licensing requirements
                  • 1. Application and background checks
                    • 2. Pre-licensing education requirements
                      - Ethics and compliance
                      • 1. Producer responsibilities and conduct
                        • 2. Unfair trade practices

                          Insurance Licensing New York Life, Accident and Health Insurance Agent/Broker Examination Series 17-55 Sample Questions:

                          1. When a provider does NOT have an agreement with the insurer for payment, they will be reimbursed

                          A) a usual, customary, and reasonable fee.
                          B) a relative fee.
                          C) an absolute fee.
                          D) a non-scheduled plan customary fee.


                          2. Multiple policies that are rated for different communities and have substantially similar benefits as determined by the superintendent will be required to:

                          A) refile rates
                          B) change benefits
                          C) pool experience
                          D) merge plans


                          3. What information must be included in the statement accompanying an insurance claim payment made by an insurer?

                          A) A list of all claimants involved
                          B) The agent ' s name and address
                          C) The reinsurance carrier involved
                          D) The coverage under which the payment is being made


                          4. How long can an insurer exclude coverage for a preexisting condition on a Medicare Supplement Policy?

                          A) 12 months.
                          B) 6 months.
                          C) 24 months.
                          D) 18 months.


                          5. Insurance is defined as what type of risk?

                          A) Speculative
                          B) Legal
                          C) Physical
                          D) Pure


                          Solutions:

                          Question # 1
                          Answer: A
                          Question # 2
                          Answer: C
                          Question # 3
                          Answer: D
                          Question # 4
                          Answer: B
                          Question # 5
                          Answer: D

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