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US-KY · Examination information

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Health Insurance License Examination

Provider
Kentucky Department of Insurance
Format
Written examination, computerized and graded upon completion
Exam questions
50 questions, as allocated by the published outline
Passing score
70% of questions answered correctly
Exam fee
$50 per examination, including retake
Examination outline
  • Types of Health Insurance Policies (8%)
    • Contract and Policy Terminology
    • General Categories of Health Policies
    • Accident Policies
    • Definition of Accident
    • Accident Benefits
    • Dismemberment
    • Capital and Principal Sums
    • Accidental Death Benefit
    • Multiple Indemnity
    • Accidental Means
    • Accidental Death Time Limits
  • Disability Income Insurance (8%)
    • Function of Disability Income Insurance
    • Individual versus Group Coverage
    • Financial Planning Considerations
    • Alternatives to Disability Income Insurance
    • Basic Disability Income Provisions
    • Defining Total Disability
    • Probationary Period
    • Elimination Period
    • Benefit Periods
    • Benefit Amounts
    • Confining versus Nonconfining Disability
    • Other Disability Concepts
    • Partial Disability
    • Residual Disability
    • Recurrent Disability
    • Delayed Disability
    • Combined Accident and Sickness Disabilities
    • Nondisabling Injuries
    • Optional Short-Term Benefits
    • Rehabilitation Benefit
    • Disability Insurance Refund Provisions
    • Return of Premium
    • Cash Surrender Value
    • Business Uses
    • Key Person Disability
    • Business Overhead Expense
    • Reducing Term Disability
    • Disability Buy-Sell
  • Medical Expense Insurance (8%)
    • Basic Expense Insurance
    • Individual versus Group Coverage
    • Hospital Expense Benefits
    • Room and Board Benefit
    • Miscellaneous Medical Expenses Benefit
    • Surgical Expense Benefits
    • Scheduled Plan
    • Nonscheduled Plan
    • Regular Medical Expense Benefits
    • Other Medical Expense Benefits
    • Maternity Benefits
    • Emergency First-Aid Coverage
    • Mental Infirmity
    • Common Exclusions and Limitations
    • Major Medical Coverage
    • Comprehensive Major Medical Benefits
    • Supplemental Major Medical Benefits
    • Covered Expenses
    • Other Major Medical Concepts
    • Deductible Features
    • Benefit Periods and Inside Limits
    • Restoration of Benefits
  • Health Insurance Providers (8%)
    • Traditional Insurers
    • Stocks and Mutual Companies
    • Fraternals
    • Consumer Cooperatives
    • Participating and Nonparticipating Policies
    • Domestic, Foreign, and Alien Companies
    • Authorized/Admitted and Unauthorized/Nonadmitted Companies
    • Health Maintenance Organizations (HMOs)
    • Preferred Provider Organizations (PPOs)
    • Point-of-Service Plans
  • Common Provisions and Features (8%)
    • Insuring Clause
    • Consideration Clause
    • Benefits Payment Provision
    • Free-Look Provision
    • Assignment
    • Accumulations
    • Policy Continuation
    • Optionally and Conditionally Renewable Policies
    • Cancelable Policies
    • Guaranteed Renewable Policies
    • Noncancelable Policies
    • Term Policies
    • Nonoccupational versus Full Coverage Policies
    • Case Management Provisions
    • Dependents’ Rights in Family Policies
    • Conversion to an Individual Policy
    • Newborn Children
    • Physical and Mental Handicaps
    • Riders and Endorsements
    • Multiple Indemnity Rider
    • Waiver of Premium Rider
    • Hospital Confinement Rider
    • Impairment Rider
    • Guaranteed Insurability Rider
    • Cost of Living Adjustment
    • Social Security Rider
    • Lifetime Extension Rider
  • Required Uniform Policy Provisions (6%)
    • Required Provision 1: Entire Contract; Changes
    • Required Provision 2: Time Limit on Certain Defenses – Incontestability
    • Required Provision 3: Grace Period
    • Required Provision 4: Reinstatement
    • Required Provision 5: Notice of Claim
    • Required Provision 6: Claim Forms
    • Required Provision 7: Proof of Loss
    • Required Provision 8: Time of Payment of Claims
    • Required Provision 9: Payment of Claims
    • Required Provision 10: Physical Examination and Autopsy
    • Required Provision 11: Legal Actions
    • Required Provision 12: Change of Beneficiary
  • Optional Uniform Policy Provisions (6%)
    • Optional Provision 1: Change of Occupation
    • Optional Provision 2: Misstatement of Age
    • Optional Provision 3: Other Insurance in this Insurer
    • Optional Provisions 4 and 5: Insurance with other Insurers
    • Optional Provision 6: Relation of Earnings to Insurance – Average Earnings Clause
    • Optional Provision 7: Unpaid Premium
    • Optional Provision 8: Cancellation
    • Optional Provision 9: Conformity with State Statutes
    • Optional Provision 10: Illegal Occupation
    • Optional Provision 11: Narcotics
  • The Application and Underwriting (8%)
    • Application Defined
    • Relationship of the Application to the Policy
    • Importance of the Application
    • Correcting Applications
    • Representations and Warranties
    • Concealment
    • Executing Agreements
    • Conditional Receipt
    • Agent Responsibilities
    • Policy Replacement
    • Obtaining Additional Underwriting Information
    • Inspection Reports
    • Medical Reports
    • Medical Information Bureau (MIB)
    • Fair Credit Reporting Act
    • Information and Privacy Protection Acts
    • Risk Classification
    • Commonly Used Factors
    • Three Major Risk Types
    • Occupational Hazards
    • AIDS Considerations
    • Substandard Risks
    • Preferred Risks
    • Premium Payments
    • Definition of Premium
    • Earned and Unearned Premium
    • Payment Modes
    • Initial Premium
    • Policy Effective Date
    • Policy Term
    • Policy Fee
    • Factors in Premium Computation
    • Types of Reserves
    • Reinsurance
  • Group Health Insurance (8%)
    • The Nature of Group Coverage
    • Master Policy and Policyowner
    • Group Risk Selection
    • Eligibility and Eligibility Period
    • Adverse Selection
    • Benefit Provisions
    • Establishing a Group Plan
    • Contributory and Noncontributory Plans
    • Certificates of Insurance
    • Group Premium Rating Factors
    • Group Policy Types
    • Group Coverage Provisions
    • Coordination of Benefits Provision
    • Continuation and Conversion Privileges
    • Plan Termination
    • COBRA and Employees’ Dependents
    • Group Insurance Plan Regulations
    • Age Discrimination in Employment Act
    • The Americans with Disabilities Act (ADA)
    • Pregnancy Discrimination
    • The Employee Retirement Income Security Act (ERISA)
    • Portability of Coverage
    • Group Health Insurance Funding Alternatives
    • Self-Insured Funds
    • 501(c)(9) Trusts
    • Third-Party Administrators and Administrative Services Only
    • Other Forms of Group Insurance
    • Blanket Policies
    • Franchise Policies
    • Multiple Employer Trusts (METs)
    • Multiple Employer Welfare Associations (MEWAs)
    • Taft-Hartley Trusts
    • Individual versus Group Insurance
  • Special Types of Health Policies (6%)
    • Dental Care Insurance
    • Basic Coverages
    • Exclusions and Limitations
    • Minimizing Adverse Selection
    • Limited Policies
    • Dread Disease
    • Travel Accident Insurance
    • Hospital Income (Indemnity) Insurance
    • Vision Care Insurance
    • Prescription Drug Policies
    • Credit Insurance
  • Long-Term Care (LTC) Insurance (6%)
    • Common Provisions
    • Benefit Triggers
    • Marketing LTC Coverage
    • Long-Term Care Partnership Program
  • Social Health Insurance (8%)
    • Medicare
    • Eligibility
    • Enrollment
    • Benefits Under Medicare Part A
    • What Part A does not Cover
    • Benefits Under Medicare Part B
    • What Part B does not Cover
    • Claims and Appeals
    • Medicare Supplement Insurance
    • Standard Medicare Supplement Benefits
    • Core Benefits
    • Optional Benefits
    • Standardized Policy Forms
    • Other Standard Provisions
    • Medicare Part C: Medicare Advantage
    • Medicare Part D: Prescription Drug Plan
    • Plans K and L
    • Medicare and Employer Coverage
    • Medicaid
    • Financial Tests
    • Spousal Impoverishment Rule
    • Medicare Cost Assistance
    • Social Security Disability
    • TRICARE
    • Workers' Compensation
    • Types of Benefits
    • Compensable Injuries
    • Occupational Diseases
    • Types of Disability
    • Compulsory and Elective Compensation Laws
    • Extraterritorial Provisions
    • Second Injury Funds
  • Health Insurance and Taxation (4%)
    • Taxation and Government Health Programs
    • Medicare
    • Social Security Disability Benefits
    • Taxation and Nongovernmental Plans
    • Individual Policies
    • Group Policies
    • Sole Proprietorships and Partnerships
    • Business Policies
    • Health Savings Accounts (HSAs)
  • Code & Regulations Kentucky Law (8%)
    • KRS 304.12-110
    • KRS 304.14-150
    • KRS 304.2-120
    • KRS 304.9-295
    • KRS 304.9-425(5)
    • KRS 304.9-440
    • KRS 304.42
    • 806 KAR 17:081 Sec. 3
    • 806 KAR 17:081 Sec.10
Examination sources

Related license preparation

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