OpenExamsFREE PRACTICE — ANY EXAM

SD Accident & Health or Sickness Producer — Information & Free Practice

US-SD · Examination information

184 free questions · Answer explanations · No signup required

Start free practice →

SD Accident & Health or Sickness Producer

Provider
Pearson VUE
Format
Test center or OnVUE online examination
Passing score
70 (scaled score)
Examination outline
  • General knowledge: I. TYPES OF POLICIES
    • A. Disability income
    • A. Disability income / 1. Individual disability income policy
    • A. Disability income / 2. Business overhead expense policy
    • A. Disability income / 3. Business disability buyout policy
    • A. Disability income / 4. Group disability income policy
    • A. Disability income / 5. Key employee policy
    • B. Accidental death and dismemberment
    • C. Medical expense insurance
    • C. Medical expense insurance / 1. Basic hospital, medical, and surgical policies
    • C. Medical expense insurance / 2. Major medical policies
    • C. Medical expense insurance / 3. Health Maintenance Organizations (HMOs)
    • C. Medical expense insurance / 4. Preferred Provider Organizations (PPOs)
    • C. Medical expense insurance / 5. Point of Service (POS) plans
    • C. Medical expense insurance / 6. Flexible Spending Accounts (FSAs)
    • C. Medical expense insurance / 7. High Deductible Health Plans (HDHPs) and related Health Savings Accounts (HSAs)
    • C. Medical expense insurance / 8. Health Reimbursement Accounts (HRAs)
    • D. Medicare supplement policies
    • E. Group insurance
    • E. Group insurance / 1. Differences between individual and group contracts
    • E. Group insurance / 2. General characteristics
    • E. Group insurance / 3. COBRA
    • F. Individual/Group Long Term Care (LTC)
    • F. Individual/Group Long Term Care (LTC) / 1. Eligibility
    • F. Individual/Group Long Term Care (LTC) / 2. Levels of care
    • G. Other policies
    • G. Other policies / 1. Dental
    • G. Other policies / 2. Vision
    • G. Other policies / 3. Cancer
    • G. Other policies / 4. Critical illness or specified disease
    • G. Other policies / 5. Worksite (employer-sponsored)
    • G. Other policies / 6. Hospital indemnity
    • G. Other policies / 7. Short-term medical
    • G. Other policies / 8. Accident
  • General knowledge: II. POLICY PROVISIONS, CLAUSES, AND RIDERS
    • A. Mandatory and optional provisions
    • A. Mandatory and optional provisions / 1. Entire contract
    • A. Mandatory and optional provisions / 2. Time limit on certain defenses (incontestable)
    • A. Mandatory and optional provisions / 3. Grace period
    • A. Mandatory and optional provisions / 4. Reinstatement
    • A. Mandatory and optional provisions / 5. Notice of claim
    • A. Mandatory and optional provisions / 6. Claim forms
    • A. Mandatory and optional provisions / 7. Proof of loss
    • A. Mandatory and optional provisions / 8. Time of payment of claims
    • A. Mandatory and optional provisions / 9. Payment of claims
    • A. Mandatory and optional provisions / 10. Physical examination and autopsy
    • A. Mandatory and optional provisions / 11. Legal actions
    • A. Mandatory and optional provisions / 12. Change of beneficiary
    • A. Mandatory and optional provisions / 13. Misstatement of age or sex
    • A. Mandatory and optional provisions / 14. Change of occupation
    • A. Mandatory and optional provisions / 15. Illegal occupation
    • A. Mandatory and optional provisions / 16. Relation of earnings to insurance
    • B. Other provisions and clauses
    • B. Other provisions and clauses / 1. Insuring clause
    • B. Other provisions and clauses / 2. Free look
    • B. Other provisions and clauses / 3. Consideration clause
    • B. Other provisions and clauses / 4. Probationary period
    • B. Other provisions and clauses / 5. Elimination period
    • B. Other provisions and clauses / 6. Waiver of premium
    • B. Other provisions and clauses / 7. Exclusions and limitations
    • B. Other provisions and clauses / 8. Preexisting conditions
    • B. Other provisions and clauses / 9. Coinsurance
    • B. Other provisions and clauses / 10. Deductibles
    • B. Other provisions and clauses / 11. Eligible expenses
    • B. Other provisions and clauses / 12. Copayments
    • B. Other provisions and clauses / 13. Pre-authorizations and prior approval requirements
    • B. Other provisions and clauses / 14. Usual, reasonable, and customary (URC) charges
    • B. Other provisions and clauses / 15. Lifetime, annual, or per cause maximum benefit limits
    • C. Riders
    • C. Riders / 1. Impairment/exclusions
    • C. Riders / 2. Guaranteed insurability
    • C. Riders / 3. Future increase option
    • D. Rights of renewability
    • D. Rights of renewability / 1. Noncancelable
    • D. Rights of renewability / 2. Cancelable
    • D. Rights of renewability / 3. Guaranteed renewable
  • General knowledge: III. SOCIAL INSURANCE
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • General knowledge: IV. OTHER INSURANCE CONCEPTS
    • A. Total, partial, recurrent and residual disability
    • B. Owner’s rights
    • C. Dependent children benefits
    • D. Primary and contingent beneficiaries
    • E. Modes of premium payments
    • F. Nonduplication and coordination of benefits (e.g., primary vs. excess)
    • G. Occupational vs. non-occupational
    • H. Tax treatment of premiums and proceeds of insurance contracts (e.g., disability income and medical expenses, etc.)
    • I. Managed care
    • J. Workers Compensation
    • J. Workers Compensation / 1. Impact on health insurance benefits
    • K. Subrogation
    • L. Cost containment
  • General knowledge: V. FIELD UNDERWRITING PROCEDURES
    • A. Completing the application
    • B. Explaining sources of insurability and HIPAA privacy information (e.g., MIB Report, Fair Credit Reporting Act, etc.)
    • C. Initial premium payment and receipt and consequences of the receipt (e.g., medical examination, etc.)
    • D. Submitting application (and initial premium if collected) to company for underwriting
    • E. Policy delivery
    • F. Explainingpolicyand its provisions, riders, exclusions, and ratings to clients
    • G. Replacement
    • H. Contract law
    • H. Contract law / 1. Elements of a contract
    • H. Contract law / 2. Insurable interest
    • H. Contract law / 3. Warranties and representations
    • H. Contract law / 4. Unique aspects of the insurance contract
    • H. Contract law / 4. Unique aspects of the insurance contract / a. Conditional
    • H. Contract law / 4. Unique aspects of the insurance contract / b. Unilateral
    • H. Contract law / 4. Unique aspects of the insurance contract / c. Adhesion
    • H. Contract law / 4. Unique aspects of the insurance contract / d. Aleatory
  • South Dakota specific: I. SD STATUTES, RULES, AND REGULATIONS COMMON TO LIFE, ACCIDENT AND HEALTH, PROPERTY, AND CASUALTY INSURANCE
    • A. Director of Insurance
    • A. Director of Insurance / 1. Duties and powers
    • A. Director of Insurance / 2. Examination of records
    • A. Director of Insurance / 3. Hearings/notice of hearings
    • A. Director of Insurance / 4. Penalties (and fines)
    • A. Director of Insurance / 5. Cease and desist orders
    • B. Insurance Definitions
    • B. Insurance Definitions / 1. Acts constituting an insurance transaction
    • B. Insurance Definitions / 2. Domestic, foreign and alien company
    • B. Insurance Definitions / 3. Fraternals
    • B. Insurance Definitions / 4. Authorized and unauthorized companies
    • B. Insurance Definitions / 5. Stock and mutual companies
    • B. Insurance Definitions / 6. Certificate of authority
    • C. Licensing
    • C. Licensing / 1. Types of licenses
    • C. Licensing / 1. Types of licenses / a. Producer
    • C. Licensing / 1. Types of licenses / b. Resident/Nonresident
    • C. Licensing / 1. Types of licenses / c. Temporary license
    • C. Licensing / 1. Types of licenses / d. Business entity
    • C. Licensing / 2. Qualifications for obtaining a license
    • C. Licensing / 2. Qualifications for obtaining a license / a. Exemptions/Exceptions
    • C. Licensing / 2. Qualifications for obtaining a license / b. License denial
    • C. Licensing / 3. Maintaining a license
    • C. Licensing / 3. Maintaining a license / a. Continuing education
    • C. Licensing / 3. Maintaining a license / b. Change of address
    • C. Licensing / 3. Maintaining a license / c. Renewal/Nonrenewal
    • C. Licensing / 3. Maintaining a license / d. Record maintenance
    • C. Licensing / 3. Maintaining a license / e. License suspension/ revocation/refusalto issue or renew
    • C. Licensing / 3. Maintaining a license / f. Reporting of actions
    • C. Licensing / 3. Maintaining a license / g. Assumed business name
    • C. Licensing / 3. Maintaining a license / h. Inactivity due to military service
    • C. Licensing / 3. Maintaining a license / i. Inactivity due to extenuating circumstances
    • C. Licensing / 3. Maintaining a license / j. Reinstatement, continuation, termination
    • C. Licensing / 4. Appointments
    • C. Licensing / 4. Appointments / a. Termination of appointment
    • D. Producer responsibilities
    • D. Producer responsibilities / 1. Fiduciary responsibilities
    • D. Producer responsibilities / 2. Commissions, compensation, fees
    • D. Producer responsibilities / 3. Reporting of felonies and crimes of moral turpitude
    • D. Producer responsibilities / 4. Influence of witnesses
    • D. Producer responsibilities / 5. Response to Division inquiries
    • E. Life and Health Insurance Guaranty Association
    • E. Life and Health Insurance Guaranty Association / 1. Purpose and disclaimer
    • E. Life and Health Insurance Guaranty Association / 2. Advertising
    • F. Marketing practices
    • F. Marketing practices / 13. 1, 14, 15, 24, 25, 26, 32, 35, 36, 37, 56, 76, 77, 78, 125;
    • F. Marketing practices / 1. Unfair practices
    • F. Marketing practices / 1. Unfair practices / a. Boycott, coercion, intimidation
    • F. Marketing practices / 1. Unfair practices / b. Commingling
    • F. Marketing practices / 1. Unfair practices / c. Controlled business
    • F. Marketing practices / 1. Unfair practices / d. Defamation
    • F. Marketing practices / 1. Unfair practices / e. False advertising
    • F. Marketing practices / 1. Unfair practices / f. Illegal inducement
    • F. Marketing practices / 1. Unfair practices / g. Misrepresentation
    • F. Marketing practices / 1. Unfair practices / h. Rebating
    • F. Marketing practices / 1. Unfair practices / i. Twisting
    • F. Marketing practices / 1. Unfair practices / j. Unfair discrimination
    • F. Marketing practices / 1. Unfair practices / k. Acting without a license
    • F. Marketing practices / 1. Unfair practices / l. Larceny
    • F. Marketing practices / 1. Unfair practices / m. Prohibited fees/ premiums/ extra charges
    • F. Marketing practices / 1. Unfair practices / n. Loans
    • F. Marketing practices / 1. Unfair practices / o. Notification of suspected fraud
    • F. Marketing practices / 2. Unfair claims settlement practices
    • G. Policy delivery and receipt
    • H. Insurance Fraud Regulation
  • South Dakota specific: II. SD STATUTES, RULES, AND REGULATIONS PERTINENT TO ACCIDENT AND HEALTH INSURANCE ONLY
    • A. South Dakota requirements (individual and group)
    • A. South Dakota requirements (individual and group) / 1. Eligibility requirements
    • A. South Dakota requirements (individual and group) / 1. Eligibility requirements / a. Family coverage
    • A. South Dakota requirements (individual and group) / 1. Eligibility requirements / b. Intellectual or physical disability coverage
    • A. South Dakota requirements (individual and group) / 1. Eligibility requirements / c. Newborn child coverage
    • A. South Dakota requirements (individual and group) / 1. Eligibility requirements / d. Dependent coverage
    • A. South Dakota requirements (individual and group) / 2. Benefit offers
    • A. South Dakota requirements (individual and group) / 2. Benefit offers / a. Alcoholism treatment coverage and benefit limitations
    • A. South Dakota requirements (individual and group) / 2. Benefit offers / b. Chiropractor
    • A. South Dakota requirements (individual and group) / 2. Benefit offers / c. Diabetes
    • A. South Dakota requirements (individual and group) / 3. Advertising
    • B. Employer group Health insurance
    • B. Employer group Health insurance / 1. Continuation of coverage under COBRA and South Dakota Specific Rules
    • B. Employer group Health insurance / 2. Conversion including, divorce, cancellation, or nonrenewal
    • C. Medicare Supplement Insurance
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / a. Delivery of buyer’s guide
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / b. Delivery of Outline of Coverage
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / c. Replacement requirements
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / d. Refund
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / e. Pre-existing conditions
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / f. Right to examine (Free Look)
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / g. Overinsurance prohibited
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / h. Suitability
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / i. Misrepresentation
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / j. Failure to provide forms
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / k. Prohibited marketing practices
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / l. Duplication of coverage prohibited
    • C. Medicare Supplement Insurance / 1. South Dakota regulations and required provisions / m. Cancellation or nonrenewal
    • C. Medicare Supplement Insurance / 2. Medicare SELECT
    • D. Long-term Care Policies
    • D. Long-term Care Policies / 1. LTC Partnerships, definitions & Deficit Reduction Act of 2005
    • D. Long-term Care Policies / 2. Exclusions
    • D. Long-term Care Policies / 3. Advertising
    • D. Long-term Care Policies / 4. Marketing Standards
    • D. Long-term Care Policies / 5. Right to Return (free look)
    • D. Long-term Care Policies / 6. Cost-of-Living Adjustments
    • D. Long-term Care Policies / 7. Pre-existing conditions
    • D. Long-term Care Policies / 8. Outline of Coverage
    • D. Long-term Care Policies / 9. Activities of daily living (ADLs)
    • D. Long-term Care Policies / 10. Appropriate of recommended purchase or replacement
    • D. Long-term Care Policies / 11. Shopper’s guide
    • D. Long-term Care Policies / 12. Suitability
    • D. Long-term Care Policies / 13. Rate stabilization
    • E. Small employer medical plans
    • E. Small employer medical plans / 1. Definition of small employer
    • E. Small employer medical plans / 2. Benefit plans offered
    • E. Small employer medical plans / 3. Availability of coverage
    • E. Small employer medical plans / 4. Prohibited Activities
    • F. ACA (Affordable Care Act)
    • F. ACA (Affordable Care Act) / 1. On-exchange versus off exchange
    • F. ACA (Affordable Care Act) / 2. Subsidized versus non subsidized
    • F. ACA (Affordable Care Act) / 3. Eligibility
    • F. ACA (Affordable Care Act) / 3. Eligibility / a. Medicare/Medicaid
    • F. ACA (Affordable Care Act) / 3. Eligibility / b. Advance premium tax credits
    • F. ACA (Affordable Care Act) / 3. Eligibility / c. Cost sharing reductions
    • F. ACA (Affordable Care Act) / 4. Essential Health Benefits (EHBs)
    • F. ACA (Affordable Care Act) / 4. Essential Health Benefits (EHBs) / a. No lifetime/annual limits
    • F. ACA (Affordable Care Act) / 4. Essential Health Benefits (EHBs) / b. Benchmark plan
    • F. ACA (Affordable Care Act) / 4. Essential Health Benefits (EHBs) / c. Mental health and substance abuse
    • F. ACA (Affordable Care Act) / 5. Qualified Health Plan
    • F. ACA (Affordable Care Act) / 6. Actuarial value
    • F. ACA (Affordable Care Act) / 7. Levels of coverage (metal tiers)
    • F. ACA (Affordable Care Act) / 8. Special enrollment periods
    • F. ACA (Affordable Care Act) / 9. Minimum essential coverage
    • F. ACA (Affordable Care Act) / 9. Minimum essential coverage / a. Tax penalties
    • F. ACA (Affordable Care Act) / 9. Minimum essential coverage / b. Hardship exemption
    • F. ACA (Affordable Care Act) / 9. Minimum essential coverage / c. Catastrophic plan
    • F. ACA (Affordable Care Act) / 10. Rating structures
    • F. ACA (Affordable Care Act) / 11. External review
    • F. ACA (Affordable Care Act) / 12. Qualifying events
    • F. ACA (Affordable Care Act) / 13. Guaranteed Issue
    • F. ACA (Affordable Care Act) / 13. Guaranteed Issue / a. No health underwriting
    • F. ACA (Affordable Care Act) / 13. Guaranteed Issue / b. No pre-existing conditions
    • F. ACA (Affordable Care Act) / 13. Guaranteed Issue / c. No waiting periods
    • F. ACA (Affordable Care Act) / 13. Guaranteed Issue / d. Guaranteed renewability/re-enrollment
    • F. ACA (Affordable Care Act) / 14. Dependents
    • F. ACA (Affordable Care Act) / 14. Dependents / a. Age limits
    • F. ACA (Affordable Care Act) / 14. Dependents / b. Dependent continuation
    • F. ACA (Affordable Care Act) / 15. Emergency care
    • F. ACA (Affordable Care Act) / 16. Preventative benefits
    • F. ACA (Affordable Care Act) / 17. Pediatric dental and vision
    • F. ACA (Affordable Care Act) / 18. Requirements for termination
    • F. ACA (Affordable Care Act) / 18. Requirements for termination / a. Rescission
    • F. ACA (Affordable Care Act) / 19. Network
    • F. ACA (Affordable Care Act) / 19. Network / a. Adequacy
    • F. ACA (Affordable Care Act) / 19. Network / b. Design
    • F. ACA (Affordable Care Act) / 19. Network / c. Narrow
    • F. ACA (Affordable Care Act) / 19. Network / d. Provider directory
    • F. ACA (Affordable Care Act) / 20. Formulary
    • F. ACA (Affordable Care Act) / 21. Marketing
    • F. ACA (Affordable Care Act) / 21. Marketing / a. Summary of benefits and coverage
    • F. ACA (Affordable Care Act) / 21. Marketing / b. Plan brochures
    • F. ACA (Affordable Care Act) / 21. Marketing / c. Federal marketplace
    • F. ACA (Affordable Care Act) / 22. Navigators
Examination sources