Free Illinois Accident & Health practice questions

Answer: D. A written designation of another notice recipient, or a signed waiver

To guard against unintentional lapse, Illinois bars issuance of an individual long-term care policy until the insurer holds either the applicant's written designation of at least one other person to receive notice of lapse or termination for nonpayment, or a dated, signed waiver declining to name anyone. Naming a person creates no liability on that person for services provided to the insured, so a third party agreeing to pay for care is not what the rule asks for. The rule calls for neither an automatic payment arrangement nor notice to a physician.

Answer: D. Incorrect, because a listed act committed knowingly qualifies on its own

Section 154.5 makes a Section 154.6 act an improper claims practice in either of two situations: when it is committed knowingly in violation of the Act or its rules, or when it occurs often enough to show a persistent tendency. The two are alternatives, so a single knowing violation is enough and no pattern is required. It follows that a listed act is not automatically an improper claims practice, because one done unknowingly and only once satisfies neither branch. Section 154.5 contains no requirement that a lawsuit follow.

Answer: B. No, because no officer, director or department head permitted or knew of it in advance

Section 152(3) provides that a company is not guilty of violating Section 151 because of an act of an agent, general agent, representative, broker or employee who is not an officer, director or department head, unless an officer, director or department head of the company knowingly permitted the act or had prior knowledge of it. General agents are named expressly, the section does not impose strict liability on the company, and it sets no condition about ending the agent's appointment.

Answer: B. He may not receive one, because an individual may hold only one in a lifetime

An individual applicant is limited to one applicant temporary producer license during his or her lifetime. The limit attaches to the individual, so a request from a different insurer does not reset it, and because it runs for his lifetime, the passage of time does not reopen it. A second course and a waiting year are not an exception the Code provides.

Answer: A. Evidence of the date of termination, disenrollment, or Part D enrollment

Under 50 Ill. Adm. Code 2008.75(a)(1), eligible persons are those described in the rule's categories who seek to enroll during the specified period and who submit, with the application, evidence of the date of termination, disenrollment, or Medicare Part D enrollment. A physician's statement, a minimum period of prior coverage, and a preexisting condition waiver are not among the conditions that subsection sets.

Answer: D. An accident and health license plus the one-time training course

Illinois requires an individual who sells, solicits or negotiates long-term care insurance to be licensed as a producer for accident and health and to have finished a one-time training course first. A life-only license does not meet the licensing half, so the course alone is not enough. Training is a precondition to soliciting rather than something that may wait for the first renewal, and the ongoing training the rule requires is in addition to the one-time course, not a substitute for it.

Answer: A. The Director may make reasonable rules and regulations needed to make the insurance laws effective

Section 401 charges the Director with enforcing and executing the State's insurance laws, and paragraph (a) grants the power to make reasonable rules and regulations as may be necessary to make those laws effective. The power is tied to the insurance laws, so a rule unconnected to them falls outside it, and its stated purpose is to give those laws effect rather than to set a Code section aside. Nothing in paragraph (a) confines the power to internal staffing or office procedures.

Answer: C. Yes, because the authority extends to an applicant for a producer license as well as a holder

Section 500-110(a) lets the Director examine any applicant for, or holder of, an insurance producer license, a limited line producer license or a temporary producer license, as well as any business entity. Because applicants are named, Dana can be examined before any license issues. Waiting for issuance reads the word applicant out of the subsection, a temporary license is one of the listed categories rather than a precondition, and the subsection does not make a complaint the trigger for an examination.

Answer: A. A 1990 Standardized Medicare Supplement Benefit Plan

Under 50 Ill. Adm. Code 2008.40, a 1990 Plan is a policy issued on or after February 11, 1992 with a coverage effective date before June 1, 2010, and the term includes such policies renewed later that the issuer has not replaced at the insured's request. A 2010 Plan needs a coverage effective date on or after June 1, 2010, and a Pre-Standardized Plan needs issue before February 11, 1992, so neither fits a 2005 policy. The definitions section defines no 1992 Standardized Plan.

Answer: D. The 12-month period immediately following the issuance of the license

Illinois will not grant or extend a producer license if the Director has reasonable cause to believe that, in the 12 months immediately after issuance or extension, the applicant's aggregate premiums on controlled business would exceed the aggregate premiums on all her other business. Coverage on her own business and her spouse's property is controlled business. The forward-looking window is 12 months, not 6 or 24, and it runs from issuance rather than from the next calendar year.