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Oregon Producer's Examination for Health Insurance — Information & Free Practice

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Oregon Producer's Examination for Health Insurance

Provider
PSI Services LLC
Format
Computer examination at a test center or by remote proctor
Exam questions
100 scored questions; five to ten additional experimental questions may be administered and are not scored
Time limit
Two hours
Passing score
70 percent correct
Exam fee
$45
Examination outline
  • Insurance Regulation (10%)
    • Licensing
    • Licensing > Purpose
    • Licensing > Process (ORS 744.058, .059, .062)
    • Licensing > Types of licensees
    • Licensing > Types of licensees > Producers (ORS 744.052, .053, 731.104)
    • Licensing > Types of licensees > Consultants (ORS 744.605, .609, .626; OAR 836-071-0150)
    • Licensing > Types of licensees > Adjusters (ORS 744.531)
    • Licensing > Types of licensees > Nonresidents (ORS 744.063)
    • Licensing > Types of licensees > Temporary (ORS 744.073)
    • Licensing > Maintenance and duration
    • Licensing > Maintenance and duration > Renewal and nonrenewal (ORS 744.072, .074) OAR 836-071-0146)
    • Licensing > Maintenance and duration > Continuing education requirements (ORS 744.072(4); OAR 836-071-0215 to 0250)
    • Licensing > Maintenance and duration > Reinstatement (ORS 744.018, .072(6))
    • Licensing > Maintenance and duration > Assumed business name (ORS 744.028(2),.068)
    • Licensing > Maintenance and duration > Change of address or telephone number (ORS 744.068)
    • Licensing > Maintenance and duration > Reporting of actions (ORS 744.089(1), (2))
    • Licensing > Maintenance and duration > Suitability (OAR 836-080-0090; OAR 836-080-0170 to 0190)
    • Licensing > Maintenance and duration > Replacement (OAR 836-080-0001 to 0043)
    • Licensing > Disciplinary actions
    • Licensing > Disciplinary actions > Cease and desist orders (ORS 731.252)
    • Licensing > Disciplinary actions > License probation, suspension, revocation or refusal to issue or renew (ORS 744.074)
    • Licensing > Disciplinary actions > Civil penalty (ORS 731.988)
    • Licensing > Disciplinary actions > Criminal penalty (ORS 731.992)
    • State regulation
    • State regulation > Director's enforcement authority (ORS 731.256)
    • State regulation > Director's enforcement authority (ORS 731.256) > Director's inquiries (ORS 731.296)
    • State regulation > Company regulation
    • State regulation > Company regulation > Producer appointment (ORS 744.078)
    • State regulation > Company regulation > Termination of appointment (ORS 744.079,.081)
    • State regulation > Company regulation > Unfair claim settlement practices (ORS 746.230; OAR 836-080-0205 to 0250)
    • State regulation > Producer regulation
    • State regulation > Producer regulation > Fiduciary and trust account responsibilities (ORS 744.083; OAR 836-074-0020 to 0050)
    • State regulation > Producer regulation > Place of business/records maintenance(ORS 744.068)
    • State regulation > Producer regulation > Controlled business (ORS 746.065, .160)
    • State regulation > Producer regulation > Commissions (ORS 744.076, .077;OAR 836-071-0269–0277)
    • State regulation > Producer regulation > Fees (ORS 744.076, .077; OAR 836-071-0260 to 0277)
    • State regulation > Unfair trade practices
    • State regulation > Unfair trade practices > Misrepresentation (ORS 746.075, .100)
    • State regulation > Unfair trade practices > False advertising (ORS 746.110; OAR 836-080-0155)
    • State regulation > Unfair trade practices > Rebating (ORS 746.045)
    • State regulation > Unfair trade practices > Unfair discrimination (ORS 746.015; OAR 836-081-0005, 0010, 0020, 0030)
    • State regulation > Unfair trade practices > Illegal inducement (ORS 746.035)
    • State regulation > Examination of records (ORS 744.068(2, 3))
    • State regulation > Privacy of Consumer Information (ORS 746.600, .620, .630, .665; OAR 836-080-0501 to 836-080-0551)
  • Federal Laws and Regulations (4%)
    • Fair Credit Reporting Act - Purpose
    • Prohibited Persons in Insurance (18 United States Code (USC) Sections 1033 and 1034) waiver
    • Privacy [Gramm Leach Bliley]
    • Affordable Care Act (ACA)
    • National Do Not Call List
    • CAN-SPAM Act
  • General Insurance Concepts (10%)
    • Risk
    • Risk > Definitions (risk, hazard, peril, loss)
    • Risk > Methods of handling risk (e.g., avoidance, retention, sharing, reduction, transfer)
    • Risk > Elements of insurable risks
    • Authority and powers of producer
    • Authority and powers of producer > Express
    • Authority and powers of producer > Implied
    • Authority and powers of producer > Apparent
    • Authority and powers of producer > The Law of Agency
    • Elements of a contract
    • Elements of a contract > Offer
    • Elements of a contract > Acceptance
    • Elements of a contract > Consideration
    • Elements of a contract > Competent parties
    • Elements of a contract > Legal purpose
    • Legal interpretations affecting contracts
    • Legal interpretations affecting contracts > Reasonable expectations
    • Legal interpretations affecting contracts > Indemnity
    • Legal interpretations affecting contracts > Good faith
    • Legal interpretations affecting contracts > Warranties, representations, misrepresentations, and concealment
    • Legal interpretations affecting contracts > Fraud
  • Accident and Health Insurance (15%)
    • Types of products and benefits
    • Types of products and benefits > Medical and surgical (ORS 743B.005)
    • Types of products and benefits > Dental (ORS 731.162, 743B.005)
    • Types of products and benefits > Long-term care (ORS 743B.005, 743.650, OAR 836-052-0516)
    • Types of products and benefits > Short-term care (ORS 743.652(5))
    • Types of products and benefits > Medicare supplements (ORS 743.680, OAR 836-052-0103)
    • Types of products and benefits > Accident (ORS 743B.005)
    • Types of products and benefits > Disability
    • Types of products and benefits > Student health (ORS 743.550)
    • Types of products and benefits > Blanket (ORS 743.536)
    • Types of products and benefits > Vision
    • Types of health insurance policies
    • Types of health insurance policies > TRICARE (ORS 743B.005)
    • Marketing requirements
    • Marketing requirements > Advertising (OAR 836-020-0200–0305)
    • Marketing requirements > Oregon Life and Health Insurance Guaranty Association (ORS 734.750–.890)
    • Marketing requirements > Outline of coverage (OAR 836-020-0305)
    • Field underwriting
    • Field underwriting > Disclosures and privacy
    • Field underwriting > Application procedures
    • Policy delivery
    • Policy delivery > Effective date of coverage
    • Policy delivery > Policy review
    • Policy delivery > Premium collection methods (e.g., electronic, physical, EFT, ACH)
    • Policy delivery > Statement of good health
    • Definitions of perils
    • Definitions of perils > Accidental injury
    • Definitions of perils > Sickness
    • Types of losses and benefits
    • Types of losses and benefits > Loss of income from disability (short-term/long-term disability)
    • Types of losses and benefits > Medical expense
    • Types of losses and benefits > Long-term care expense
    • Classification of risks
    • Classification of risks > Preferred
    • Classification of risks > Standard
    • Classification of risks > Substandard
    • Underwriting requirements (varies by insurer)
    • Sources of underwriting
    • Sources of underwriting > Application
    • Sources of underwriting > Producer's report
    • Sources of underwriting > Medical information bureau (MIB)
    • Sources of underwriting > Inspection report
    • Sources of underwriting > Medical examination
    • Sources of underwriting > Attending physician's report
  • Individual Accident and Health Insurance Policy Provisions (14%)
    • Uniform required provisions
    • Uniform required provisions > Incontestability (ORS 743.414, .472)
    • Uniform required provisions > Grace period (ORS 743.417)
    • Uniform required provisions > Reinstatement (ORS 743.420)
    • Uniform required provisions > Time limit on certain defenses
    • Uniform required provisions > Claim forms
    • Uniform required provisions > Proof of loss
    • Uniform required provisions > Time of payment of claims
    • Uniform required provisions > Physical examinations and autopsy
    • Uniform required provisions > Legal actions
    • Uniform required provisions > Entire contract
    • Uniform required provisions > Payment of claims
    • Uniform required provisions > Change of beneficiary
    • Uniform required provisions > Notice of claim
    • Uniform optional provisions
    • Uniform optional provisions > Change of occupation (ORS 743.450)
    • Uniform optional provisions > Misstatement of age/sex (ORS 743.453, .489)
    • Uniform optional provisions > Illegal occupation
    • Uniform optional provisions > Intoxicants, narcotics, or other controlled substances
    • Other general provisions
    • Other general provisions > Right to examine /free look (ORS 743.492)
    • Other general provisions > Consideration clause
    • Other general provisions > Renewability clause (ORS 743.495, .498, 743B.125(5))
    • Other general provisions > Renewability clause (ORS 743.495, .498, 743B.125(5)) > Noncancelable
    • Other general provisions > Renewability clause (ORS 743.495, .498, 743B.125(5)) > Guaranteed renewable
    • Other general provisions > Renewability clause (ORS 743.495, .498, 743B.125(5)) > Conditionally renewable
    • Other general provisions > Renewability clause (ORS 743.495, .498, 743B.125(5)) > Renewable at option of insurer
    • Other general provisions > Renewability clause (ORS 743.495, .498, 743B.125(5)) > Nonrenewable (cancelable, term)
    • Other general provisions > Cancellation (ORS 743.472, 743B.125(6))
    • Other general provisions > Insuring clause
    • Other general provisions > Coinsurance
    • Other general provisions > Probationary period
    • Other general provisions > Elimination period
    • Other general provisions > Exclusions
  • Disability Income and Related Insurance (10%)
    • Benefits determination for disability
    • Benefits determination for disability > Indemnity
    • Benefits determination for disability > Loss of income
    • Qualifications of disability
    • Qualifications of disability > Total (own occupation, any occupation)
    • Qualifications of disability > Partial
    • Qualifications of disability > Permanent
    • Qualifications of disability > Presumptive
    • Qualifications of disability > Recurrent
    • Qualifications of disability > Residual
    • Qualifications of disability > Inability to perform duties
    • Qualifications of disability > Occupational versus non-occupational
    • Individual disability income insurance
    • Individual disability income insurance > Basic Total Disability Plan
    • Individual disability income insurance > Cost of Living Rider
    • Individual disability income insurance > Future Increase Option Rider
    • Individual disability income insurance > Change of Occupation
    • Individual disability income insurance > Other Cash Benefits - (Accidental Death and Dismemberment (AD&D), Rehabilitation Benefit, Medical Reimbursement Benefit)
    • Individual disability income insurance > Refund Provisions
    • Individual disability income insurance > Exclusions
    • Individual disability income insurance > Waiver of Premium
    • Individual disability income insurance > Probationary Period
    • Individual disability income insurance > Elimination Period
    • Individual disability income insurance > Benefit Limits
    • Unique aspects of individual disability underwriting
    • Unique aspects of individual disability underwriting > Occupational considerations
    • Unique aspects of individual disability underwriting > Benefit limits
    • Unique aspects of individual disability underwriting > Policy issuance alternatives
    • Group disability income insurance
    • Group disability income insurance > Short-term disability
    • Group disability income insurance > Long-term disability
    • Group disability income insurance > Coordination of Benefits (Workers' Compensation Benefits and Social Insurance)
    • Group disability income insurance > At-work benefits
    • Business disability insurance
    • Business disability insurance > Key employee disability income
    • Business disability insurance > Disability buy-sell policy
    • Business disability insurance > Business overhead expense
    • Social Security disability income
    • Social Security disability income > Qualification for disability benefits
    • Social Security disability income > Definition of disability
    • Social Security disability income > Waiting period
  • Medical Plans (18%)
    • Medical plan concepts
    • Medical plan concepts > Fee-for-service
    • Medical plan concepts > Prepaid
    • Medical plan concepts > Specified disease/dread disease insurance
    • Medical plan concepts > Comprehensive coverage
    • Medical plan concepts > Dependent coverage
    • Provisions and clauses
    • Provisions and clauses > Deductibles
    • Provisions and clauses > Stop-loss provision
    • Provisions and clauses > Impairment rider
    • Types of medical plans
    • Types of medical plans > Major medical insurance
    • Types of medical plans > Health maintenance organizations (HMOs)
    • Types of medical plans > Preferred provider organizations (PPOs)
    • Types of medical plans > Point-of-service (POS) plans
    • Oregon requirements (individual and group)
    • Oregon requirements (individual and group) > Eligibility requirements
    • Oregon requirements (individual and group) > Eligibility requirements > Newborn child coverage (ORS 743A.090)
    • Oregon requirements (individual and group) > Eligibility requirements > Dependent child age limit (ORS 743A.090)
    • Oregon requirements (individual and group) > Eligibility requirements > Coverage for adopted children (ORS 743A.090)
    • Cost containment in health care delivery
    • Cost containment in health care delivery > Managed care
    • Cost containment in health care delivery > Preventive care
    • Cost containment in health care delivery > Outpatient benefits
    • Cost containment in health care delivery > Utilization management
    • Cost containment in health care delivery > Preauthorization
    • Cost containment in health care delivery > Primary care physician
    • Limited health insurance policies
    • Limited health insurance policies > Accidental death and dismemberment
    • Limited health insurance policies > Hospital indemnity
    • Limited health insurance policies > Critical illness/dread disease
    • Limited health insurance policies > Vision care
    • Limited health insurance policies > Hearing
    • Limited health insurance policies > Dental
    • Affordable Care Act (ACA)
    • Affordable Care Act (ACA) > Eligibility
    • Affordable Care Act (ACA) > Dependent coverage
    • Affordable Care Act (ACA) > Essential Health Benefits
    • Affordable Care Act (ACA) > Levels of Coverage (Metallic plans)
    • Affordable Care Act (ACA) > Oregon's Health Insurance Exchange/Marketplace
    • Affordable Care Act (ACA) > Oregon's Health Insurance Exchange/Marketplace > Definition
    • Affordable Care Act (ACA) > Oregon's Health Insurance Exchange/Marketplace > Medicaid
    • Affordable Care Act (ACA) > Oregon's Health Insurance Exchange/Marketplace > Medicaid > Eligibility
    • Affordable Care Act (ACA) > Oregon's Health Insurance Exchange/Marketplace > Medicaid > Benefits
    • Affordable Care Act (ACA) > Oregon's Health Insurance Exchange/Marketplace > Subsidies/Tax Credits
    • Health Insurance Portability and Accountability Act (HIPAA)
    • Health Insurance Portability and Accountability Act (HIPAA) > Eligibility requirements
    • Health Insurance Portability and Accountability Act (HIPAA) > Terms
    • Health Insurance Portability and Accountability Act (HIPAA) > Privacy
    • Health Insurance Portability and Accountability Act (HIPAA) > Portability
  • Group Health Insurance (6%)
    • Characteristics of group health insurance
    • Characteristics of group health insurance > Group contract
    • Characteristics of group health insurance > Certificate of coverage
    • Characteristics of group health insurance > Eligible groups
    • Characteristics of group health insurance > Contributory versus non-contributory
    • Purpose of group insurance (ORS 743B.003(1) -(8))
    • Purpose of group insurance (ORS 743B.003(1) -(8)) > Issuance of group contract (ORS 743B.010)
    • Purpose of group insurance (ORS 743B.003(1) -(8)) > Provisions of coverage (ORS 743B.011)
    • Types of eligible groups
    • Types of eligible groups > Employment-related groups (ORS 743B.010)
    • Types of eligible groups > Employment-related groups (ORS 743B.010) > Multiple-Employer Trusts (METs) or Welfare Arrangements (MEWAs) (ORS 750.301)
    • Employer group health insurance
    • Employer group health insurance > Insurer underwriting criteria
    • Employer group health insurance > Eligibility for insurance (ORS 743B.105(4), (5))
    • Employer group health insurance > Coordination of benefits (OAR 836-020-0770–0806)
    • Employer group health insurance > Coordination of benefits (OAR 836-020-0770–0806) > Continuation of coverage under COBRA and Oregon rules (ORS 743B.347; OAR 836-052-0860)
    • Employer group health insurance > Coordination of benefits (OAR 836-020-0770–0806) > Conversion of coverage (ORS 743B.343 - .345)
    • Employer group health insurance > Open enrollment
    • Employer group health insurance > Probation/waiting period
    • COBRA
    • COBRA > Eligibility
    • COBRA > Duration of coverage
    • COBRA > Premium
    • Small employer medical plans
    • Small employer medical plans > Definition of small employer (ORS 743B.005 )
    • Small employer medical plans > Definition of small employer (ORS 743B.005 ) > Requirements of small employer (ORS 742.360)
    • Small employer medical plans > Basic coverage (ORS 743B.005, 743B.012)
    • Small employer medical plans > Availability of coverage (ORS 743B.104)
    • Small employer medical plans > Renewability of coverage (ORS 743B.013 (5))
    • Small employer medical plans > Participation requirements (ORS 743B.013(7))
    • Small employer medical plans > Purchase policy through exchange/marketplace (ORS 743B.010)
  • Specialized Health Insurance for Qualified Individuals (9%)
    • Medicare
    • Medicare > Eligibility
    • Medicare > Part A
    • Medicare > Part B
    • Medicare > Part C
    • Medicare > Part D
    • Medicare supplements insurance
    • Medicare supplements insurance > Purpose (OAR 836-052-0103)
    • Medicare supplements insurance > Enrollment Periods (OAR 836-052-0138)
    • Medicare supplements insurance > Standardized Plan Benefits
    • Medicare supplements insurance > Standardized Plan Benefits > Core benefits (OAR 836-052-0133)
    • Medicare supplements insurance > Standardized Plan Benefits > Additional benefits
    • Medicare supplements insurance > Oregon regulations and required provisions
    • Medicare supplements insurance > Oregon regulations and required provisions > Standards for marketing (OAR 836-052-0175)
    • Medicare supplements insurance > Oregon regulations and required provisions > Advertising (ORS 743.687; OAR 836-052-0170)
    • Medicare supplements insurance > Oregon regulations and required provisions > Appropriateness of recommended purchase and excessive insurance (OAR 836-052-0180)
    • Medicare supplements insurance > Oregon regulations and required provisions > Right to return (free look) (ORS 743.686)
    • Medicare supplements insurance > Oregon regulations and required provisions > Replacement (ORS 743B.300); OAR 836-052-0165, 0190)
    • Medicare supplements insurance > Oregon regulations and required provisions > Pre-existing conditions (OAR 836-052-0190)
    • Medicare supplements insurance > Oregon regulations and required provisions > Required disclosure provisions (ORS 743.685;OAR 836-052-0160)
    • Medicare supplements insurance > Oregon regulations and required provisions > Outline of coverage (ORS 743.685(2);OAR 836-052-0160, 0190)
    • Medicare supplements insurance > Oregon regulations and required provisions > Buyer's guide (ORS 743.685(6))
    • Medicare supplements insurance > Oregon regulations and required provisions > Permitted compensation (OAR 836-052-0156)
    • Medicare supplements insurance > Medicare SELECT (OAR 836-052-0139)
    • Medicare supplements insurance > Medicaid
    • Medicare supplements insurance > Medicaid > Eligibility
    • Long-Term Care policies
    • Long-Term Care policies > Definitions (ORS 743.650 to .665)
    • Long-Term Care policies > Benefit triggers (ORS 743.652(2))
    • Long-Term Care policies > Eligibility for benefits (activities of daily living) (OAR 836-052-0516(1))
    • Long-Term Care policies > Covered services (OAR 836-052-0596)
    • Long-Term Care policies > Benefit/elimination periods (ORS 743.655(5))
    • Long-Term Care policies > Levels of care (skilled, intermediate, custodial)
    • Long-Term Care policies > Benefit amounts (OAR 836-052-0586)
    • Long-Term Care policies > Optional benefits
    • Long-Term Care policies > Optional benefits > Guarantee of insurability
    • Long-Term Care policies > Optional benefits > Return of premium (ORS 743.652(7)(b)(E))
    • Long-Term Care policies > Qualified LTC plans (OAR 836-052-0531)
    • Long-Term Care policies > Exclusions
    • Long-Term Care policies > Oregon regulations and required provisions
    • Long-Term Care policies > Oregon regulations and required provisions > Training for insurance producers (OAR 836-052-0639)
    • Long-Term Care policies > Oregon regulations and required provisions > Standards for marketing (OAR 836-052-0706)
    • Long-Term Care policies > Oregon regulations and required provisions > Advertising (OAR 836-052-0696)
    • Long-Term Care policies > Oregon regulations and required provisions > Shopper's guide (OAR 836-052-0786)
    • Long-Term Care policies > Oregon regulations and required provisions > Outline of coverage (ORS 743.655(7); OAR 836-052-0776)
    • Long-Term Care policies > Oregon regulations and required provisions > Appropriateness of recommended purchase
    • Long-Term Care policies > Oregon regulations and required provisions > Right to return (free look) (ORS 743.655(6))
    • Long-Term Care policies > Oregon regulations and required provisions > Replacement (OAR 836-052-0626, 0736)
    • Long-Term Care policies > Oregon regulations and required provisions > Renewal provisions
    • Long-Term Care policies > Oregon regulations and required provisions > Continuation or conversion
    • Long-Term Care policies > Oregon regulations and required provisions > Required disclosure provisions (OAR 836-052-0716)
    • Long-Term Care policies > Oregon regulations and required provisions > Inflation protection (OAR 836-052-0616)
    • Long-Term Care policies > Oregon regulations and required provisions > Pre-existing conditions (ORS 743.655(3); 743(b).005(21))
    • Long-Term Care policies > Oregon regulations and required provisions > Protection against unintentional lapse (OAR 836-052-0536(a)(b); 836-052-0740(7))
    • Long-Term Care policies > Oregon regulations and required provisions > Partnership provisions (OAR 836-052-0531)
    • Long-Term Care policies > Oregon regulations and required provisions > Prohibited provisions
  • Federal Tax Considerations for Health Insurance (4%)
    • Health insurance premiums and benefits
    • Health insurance premiums and benefits > Individual
    • Health insurance premiums and benefits > Group
    • Health insurance premiums and benefits > Disability income (individual and group)
    • Health insurance premiums and benefits > Business disability insurance
    • Consumer-driven health plans
    • Consumer-driven health plans > Health savings accounts (HSAs)
    • Consumer-driven health plans > Health savings accounts (HSAs) > High deductible health plans (HDHPs)
    • Consumer-driven health plans > Health reimbursement accounts (HRAs)
    • Consumer-driven health plans > Flexible spending accounts (FSAs)
Examination sources