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Free Nebraska Producer's Examination for Life, Accident and Health or Sickness Insurance Series 13-03 Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the Nebraska Producer's Examination for Life, Accident and Health or Sickness Insurance Series 13-03 practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1Does Nebraska require an insurance company itself to hold an insurance producer license?

    1. A. Yes, for every line it writes
    2. B. Yes, if it appoints more than one producer
    3. C. No
    4. D. No, but only during its first year

    Answer: C

    Explanation: Section 44-4051(1) says nothing in the act shall be construed to require "an insurer to obtain an insurance producer license."

    Reference: Nebraska Legislature — Neb. Rev. Stat. § 44-4051(1)

  2. 2A Nebraska employer applies for individual life insurance on an adult employee who is neither a spouse nor child. Absent another statutory exception, whose application or written consent is required?

    1. A. The adult employee who will be insured
    2. B. The employer purchasing the policy
    3. C. The person named as beneficiary
    4. D. The adult employee's spouse

    Answer: A

    Explanation: "no policy of insurance shall be issued upon the person of any individual except upon the application of the individual insured or with the written consent of the individual insured" The adult insured must apply or provide written consent; consent from purchaser, beneficiary, or spouse is not a substitute under this individual-policy rule.

    Reference: Nebraska Legislature — Neb. Rev. Stat. §44-704

  3. 3A renewable level term life policy reaches the end of its term after the insured develops a serious condition. What can the policyholder generally do under the renewal feature?

    1. A. Renew at the original premium without any change
    2. B. Renew even with changed health, usually at a higher premium
    3. C. Renew only after passing a new medical examination
    4. D. Renew only by converting to a permanent policy

    Answer: B

    Explanation: "coverage can be continued (“renewed”) at the end of the term, even if your health has changed." The guide states that renewable term coverage can continue at the term's end despite changed health, with higher new premiums; conversion is a different feature.

    Reference: National Association of Insurance Commissioners — NAIC Life Insurance Buyer's Guide, renewable term

  4. 4A retiree has a lump sum and needs annuity income to start within the coming year. Which annuity timing category fits?

    1. A. A deferred annuity with a later payout date
    2. B. An immediate annuity beginning payments soon
    3. C. A flexible-premium deferred annuity
    4. D. An accumulation-only deferred annuity

    Answer: B

    Explanation: "provide income payments to the annuitant within one year of purchasing the contract." An immediate annuity begins income within one year; deferred annuities accumulate before a later payout.

    Reference: National Association of Insurance Commissioners — NAIC Annuities overview, immediate annuities

  5. 5Which Nebraska program provides objective local counseling to Medicare-eligible people, their families, and caregivers?

    1. A. Nebraska SHIP
    2. B. Nebraska Department of Roads
    3. C. Nebraska Workers' Compensation Court
    4. D. Nebraska Real Estate Commission

    Answer: A

    Explanation: The Nebraska Department of Insurance says Nebraska SHIP "empowers, educates, and assists Medicare-eligible individuals, their families, and caregivers" through objective counseling and outreach.

    Reference: Nebraska SHIP & SMP | Nebraska Department of Insurance — Nebraska SHIP & SMP — program description

  6. 6An insurer wants to obtain an applicant's medical information from an MIB consumer report for underwriting. When must the insurer obtain the consumer's consent?

    1. A. After the insurer issues an adverse-action notice
    2. B. Before obtaining the medical information
    3. C. At policy delivery after underwriting ends
    4. D. Only at the next policy renewal

    Answer: B

    Explanation: "get the consumer’s consent — orally, electronically or in writing — before getting medical information." FCRA consent precedes access to medical information, including the MIB report; an adverse-action notice may arise later.

    Reference: Federal Trade Commission — FTC Consumer Reports: What Insurers Need to Know, medical information

  7. 7A Social Security disability claimant's condition is not expected to result in death. What is the minimum expected period that the disability must affect ability to work?

    1. A. At least three months
    2. B. At least six months
    3. C. At least one year
    4. D. At least two years

    Answer: C

    Explanation: "You must have a disability that affects your ability to work for a year or more, or will result in death." Because death is not expected, the minimum duration branch is a year or more; a two-year condition would also qualify but is not the minimum.

    Reference: Social Security Administration — SSA Disability eligibility, Work and disability requirements

  8. 8For Nebraska small-employer health rules, how many employees generally place an employer in the small-employer category?

    1. A. One to twenty-five
    2. B. Two to fifty
    3. C. Ten to one hundred
    4. D. Fifty-one to five hundred

    Answer: B

    Explanation: Section 44-5260 defines the relevant small-employer range as "at least two but not more than fifty employees."

    Reference: Nebraska Legislature — Neb. Rev. Stat. § 44-5260, definition of small employer

  9. 9Does Nebraska's statutory definition of health insurance in section 44-4209 include dental insurance?

    1. A. Yes, always
    2. B. Yes, if employer-paid
    3. C. No, dental insurance is expressly excluded
    4. D. Only if paired with disability income

    Answer: C

    Explanation: Section 44-4209 states that health insurance "does not include ... dental" insurance.

    Reference: Nebraska Legislature — Neb. Rev. Stat. § 44-4209(1)

  10. 10What federal tax feature does the Nebraska Department of Insurance identify for Health Savings Account contributions used for qualified medical expenses?

    1. A. Money may be set aside on a pre-tax basis
    2. B. Every contribution is taxed twice
    3. C. Contributions are allowed only after age sixty-five
    4. D. Qualified withdrawals trigger a mandatory twenty-percent penalty

    Answer: A

    Explanation: The department explains that an HSA "allows you to set aside money on a pre-tax basis to pay for qualified medical expenses."

    Reference: Doi Health Savings Account — What is a Health Savings Account?, opening paragraph

Topics in this practice bank

These topics describe the available practice for Nebraska Producer's Examination for Life, Accident and Health or Sickness Insurance Series 13-03. Review the examination outline and its sources for scope and allocation details.

  • 1.0 Insurance Regulation
    • 1.1 General
    • State specific licensing requirements
    • License issuance (44-4052, 44-4053)
    • License issuance (44-4052, 44-4053) > Application
    • License maintenance
    • License maintenance > Change of name/phone number/address/email address (44-4054(8))
    • License maintenance > Assumed business name (44-4057)
    • License maintenance > Reporting of actions (44-4065)
    • License maintenance > Continuing education including exemptions (44-3901 to 44-3908)
    • License maintenance > Penalties
    • License maintenance > Appointment and termination process
    • License duration
    • License duration > Renewal/nonrenewal (44-4054)
    • License duration > Reinstatement
    • License duration > Continuation
    • License duration > Termination (44-4062)
    • License duration > Surrender
    • License duration > Lapse
    • License duration > Inactivity due to military service
    • License duration > Inactivity due to extenuating circumstances
    • Disciplinary actions related to the license
    • Disciplinary actions related to the license > Denial
    • Disciplinary actions related to the license > Suspension (44-2633, 44-4059)
    • Disciplinary actions related to the license > Surrender
    • Disciplinary actions related to the license > Revocation or refusal to issue or renew (44-2633, 44-4059)
    • Penalties
    • Penalties > Civil
    • Penalties > Criminal (28-631)
    • Penalties > Hearings (44-4059(2))
    • Penalties > Fines (44-2634, 44-4059(4))
    • Penalties > Cease and desist order (44-1529, 44-1542)
    • 1.2 Licensing Types, Purposes, and Processes
    • License types (44-4054)
    • License types (44-4054) > Producer (44-4049, 44-4054)
    • License types (44-4054) > Consultant (44-2606 to 44-2635)
    • License types (44-4054) > Agency
    • License types (44-4054) > Resident (44-2625, 44-4055, 44-4063)
    • License types (44-4054) > Nonresident (44-2625, 44-4055, 44-4063)
    • License types (44-4054) > Temporary (44-4058)
    • Licensing requirements
    • Licensing requirements > Eligibility and qualification
    • Licensing requirements > Licensing exemptions (44-4051)
    • 1.3 State Regulation
    • Acts constituting insurance transaction
    • Acts constituting insurance transaction > Negotiate
    • Acts constituting insurance transaction > Sell
    • Acts constituting insurance transaction > Solicit
    • Director's general duties and powers (44-101.01, 44-2635)
    • Producer regulatory requirements
    • Producer regulatory requirements > Policy signatures
    • Producer regulatory requirements > Application signatures
    • Producer regulatory requirements > Premium payment
    • Producer regulatory requirements > Producer representation
    • Producer regulatory requirements > Commissions/compensation and fees (44-4060)
    • Producer regulatory requirements > Controlled business (44-361.01, 44-361.02)
    • Producer regulatory requirements > Appointment (44-4061)
    • Producer regulatory requirements > Fiduciary responsibility
    • Producer regulatory requirements > Impersonation
    • Producer regulatory requirements > Records maintenance (44-5905)
    • Producer regulatory requirements > Claims reporting
    • Company regulatory requirements
    • Company regulatory requirements > Solvency
    • Company regulatory requirements > Financial requirements
    • Company regulatory requirements > Certificate of authority (44-303)
    • Company regulatory requirements > State of domicile
    • Company regulatory requirements > Records maintenance
    • Company regulatory requirements > Policy forms/rates/exceptions
    • Company regulatory requirements > Appointment/termination
    • Company regulatory requirements > Capital and surplus requirements (44-214, 44-305)
    • Company regulatory requirements > Unfair trade practices complaint register (44-1525(9))
    • Difference between admitted, non-admitted, foreign, and domestic insurers
    • Unfair trade practices
    • Unfair trade practices > Unfair discrimination (44-1525(7))
    • Unfair trade practices > Misrepresentation (44-1525(1))
    • Unfair trade practices > False or deceptive advertising (44-1525(2))
    • Unfair trade practices > Claims settlement
    • Unfair trade practices > Boycott (44-1525(4))
    • Unfair trade practices > Coercion (44-1525(4))
    • Unfair trade practices > Intimidation (44-1525(4))
    • Unfair trade practices > Defamation (44-1525(3))
    • Unfair trade practices > False financial statements
    • Unfair trade practices > Fraud
    • Unfair trade practices > Illegal inducements including rebating and twisting (44-361, 44-1525(8))
    • Unfair trade practices > Misappropriation of funds
    • Unfair trade practices > Testimonials
    • Unfair trade practices > Comparisons
    • Unfair trade practices > Nondisclosure of fees or charges (44-354)
    • Other prohibited practices
    • Other prohibited practices > Commingling of funds
    • Other prohibited practices > Non-transparency
    • Other prohibited practices > STOLI/IOLI
    • Other prohibited practices > Prohibited fees/premiums/extra charges
    • Other prohibited practices > Larceny
    • Other prohibited practices > Acting without a license
    • Unfair claims settlement practices (44-1539, 44-1540)
    • Nonpublic personal information and privacy protection
    • Policy replacement (210 Nebraska Administrative Code Ch. 19)
    • Solicitation and sales (210 Nebraska Administrative Code Ch. 33)
    • Solicitation and sales (210 Nebraska Administrative Code Ch. 33) > Advertising (210 Nebraska Administrative Code Ch. 50)
    • Solicitation and sales (210 Nebraska Administrative Code Ch. 33) > Provisions/rules
    • Solicitation and sales (210 Nebraska Administrative Code Ch. 33) > Policy summary
    • Solicitation and sales (210 Nebraska Administrative Code Ch. 33) > Buyer's Guide (210 Nebraska Administrative Code Ch. 33 § 005, NAIC Current Model Buyer's Guide)
    • Solicitation and sales (210 Nebraska Administrative Code Ch. 33) > Illustrations (210 Nebraska Administrative Code Ch. 72)
    • Solicitation and sales (210 Nebraska Administrative Code Ch. 33) > Suitability (44-8101 to 44-8109)
    • Solicitation and sales (210 Nebraska Administrative Code Ch. 33) > Backdating
    • Selection criteria and unfair discrimination (44-1525(7)(a))
    • Insurance Fraud Act (44-6601 to 44-6608)
    • Privacy of Insurance Consumer Information Act (44-901 to 44-925) Neb. Rev. Stat. §44-902(1)(a)
    • 1.4 Federal Regulation
    • Federal Law (18 U.S. Code § 1033)
    • Fair Credit Reporting Act (15 USC 1681–1681d)
    • Fraud and false statements including 1033 and 1034 waiver
    • "Prohibited Persons" Waiver (Consent to Work) (18 U.S. Code § 1033-1034)
    • Other federal regulations
    • Other federal regulations > Do Not Call List (Telephone Consumer Protection Act)
    • Other federal regulations > Can-Spam Act
    • Other federal regulations > Sarbanes-Oxley Act
    • Other federal regulations > Consumer Data Privacy and Security Act
    • Other federal regulations > Gramm-Leach-Bliley Act
  • 2.0 General Insurance
    • 2.1 Risk management key terms
    • Risk
    • Exposure
    • Hazard
    • Peril
    • Loss
    • Insurance
    • 2.2 Methods of handling risk
    • Avoidance
    • Retention
    • Sharing
    • Reduction
    • Transfer
    • 2.3 Other risk concepts
    • Elements of insurable risks
    • Adverse selection
    • Law of large numbers
    • Reinsurance
    • 2.4 Types of insurers
    • Stock
    • Mutual
    • Fraternal benefit society
    • 2.5 Financial rating services
    • A.M. Best
    • Standard and Poor's
    • Moody's
    • 2.6 Distribution systems
    • Independent
    • Direct
    • Exclusive/captive agent
    • Exchanges
    • 2.7 Law of agency
    • Insurer as principal
    • Producer/agent/broker-insurer relationships
    • 2.8 Authority and powers of producers/agents/brokers
    • Express
    • Implied
    • Apparent
    • 2.9 Elements of a legal contract
    • Offer and acceptance
    • Consideration
    • Competent parties
    • Legal purpose
    • 2.10 Legal interpretations affecting contracts
    • Reasonable expectations
    • Indemnity
    • Utmost good faith
    • Concealment
    • Representations
    • Misrepresentations
    • Warranties
    • Fraud
  • 3.0 Life Insurance Basics
    • 3.1 Producer Authority and Powers
    • Insurable interest (44-704)
    • Personal uses of life insurance
    • Personal uses of life insurance > Survivor protection
    • Personal uses of life insurance > Estate creation/conservation
    • Personal uses of life insurance > Cash accumulation
    • Personal uses of life insurance > Security
    • Personal uses of life insurance > Exemption from creditor claims/probate
    • Needs approach to determining amount of personal life insurance
    • Needs approach to determining amount of personal life insurance > Types of information gathered
    • Needs approach to determining amount of personal life insurance > Determining lump-sum needs
    • Needs approach to determining amount of personal life insurance > Planning for income needs
    • Business uses of life insurance
    • Business uses of life insurance > Key person
    • Business uses of life insurance > Buy-sell
    • Factors in premium determination
    • Factors in premium determination > Mortality
    • Factors in premium determination > Interest
    • Factors in premium determination > Expense
    • Field underwriting
    • Field underwriting > Application procedures
    • Field underwriting > Required signatures
    • Field underwriting > Notice of information practices and premium collection
    • Field underwriting > Conditional receipt
    • Policy delivery
    • Policy delivery > Policy review
    • Policy delivery > Effective date of coverage
    • Policy delivery > Premium collection
    • Policy delivery > Statement of Good Health
    • Policy delivery > Delivery/electronic delivery requirements
    • Information sources and regulation
    • Information sources and regulation > Application
    • Information sources and regulation > Producer report
    • Information sources and regulation > Attending physician statement
    • Information sources and regulation > Investigative consumer report
    • Information sources and regulation > Medical Information Bureau (MIB)
    • Information sources and regulation > Medical examination and lab tests including HIV (RL 71-531)
    • Information sources and regulation > Financial information
    • Risk classifications
    • Risk classifications > Preferred
    • Risk classifications > Standard
    • Risk classifications > Substandard/rated
    • Risk classifications > Declined
  • 4.0 Life Insurance Policies
    • 4.1 Characteristics of Level Term
    • Renewability
    • Level premium
    • Convertibility
    • Term-to-65
    • 4.2 Decreasing Term
    • Credit/mortgage protection
    • 4.3 Whole Life
    • Ordinary
    • Limited pay
    • Single premium
    • 4.4 Characteristics of Whole Life
    • Cash value
    • Maturity
    • Guarantees
    • 4.5 Universal and Indexed Life
    • 4.6 Variable products
    • Regulation of variable products (44-2212, 44-2216; 210 Nebraska Administrative Code Ch. 15 § 006, § 011)
    • Qualifications of producers for the sale of variable products
    • General account versus separate account
    • 4.7 Specialized policies
    • Joint life/first-to-die
    • Survivorship life/second-to-die
    • 4.8 Characteristics of Group Life
    • Individual certificates
    • Eligibility
    • Plan sponsors
    • Underwriting requirements
    • Conversion (44- 1607(8–10), 44-1613, 44-1614)
    • Standard provisions
  • 5.0 Life Insurance Policy Provisions, Options and Riders
    • 5.1 Required Provisions (44-502)
    • Ownership
    • Assignment
    • Entire contract (44-502(3))
    • Right to examine (free look) (44- 502.05)
    • Payment of premiums (44-502(1))
    • Grace period (44-502(2))
    • Reinstatement (44-502(11))
    • Incontestability (44-502(5))
    • Misstatement of age or sex (44-502(6))
    • Exclusions (44-502(5))
    • Suicide
    • Consideration
    • Insuring clause
    • 5.2 Beneficiaries
    • Designation options
    • Designation options > Individuals
    • Designation options > Classes
    • Designation options > Estates
    • Designation options > Minors
    • Designation options > Trusts
    • Succession
    • Succession > Primary
    • Succession > Contingent
    • Revocable versus irrevocable
    • Common Disaster Clause
    • 5.3 Settlement Options
    • Types of settlement options
    • Types of settlement options > Cash payment
    • Types of settlement options > Interest only
    • Types of settlement options > Fixed-period installments
    • Types of settlement options > Fixed-amount installments
    • Types of settlement options > Life income
    • Types of settlement options > Single life
    • Types of settlement options > Joint and survivor
    • Retained asset account
    • Spendthrift clause
    • 5.4 Nonforfeiture Options
    • Types of nonforfeiture options
    • Types of nonforfeiture options > Cash surrender value
    • Types of nonforfeiture options > Extended term
    • Types of nonforfeiture options > Reduced paid-up insurance
    • 5.5 Policy Loan and Withdrawal Options
    • Types of loans and withdrawals
    • Types of loans and withdrawals > Policy loans
    • Types of loans and withdrawals > Automatic premium loans
    • Types of loans and withdrawals > Withdrawals or partial surrenders
    • 5.6 Dividend Options
    • Dividend options
    • Dividend options > Cash
    • Dividend options > Reduction of premium/loan
    • Dividend options > Accumulation at interest
    • Dividend options > One-year term
    • Dividend options > Paid-up additions
    • Dividend options > Paid-up insurance
    • 5.7 Policy Riders
    • Disability riders
    • Disability riders > Waiver of premium
    • Disability riders > Waiver of cost of insurance (Universal Life)
    • Disability riders > Disability income benefit
    • Disability riders > Guaranteed insurability
    • Accelerated (living) and long-term care benefits/riders
    • Accelerated (living) and long-term care benefits/riders > Conditions for payment
    • Accelerated (living) and long-term care benefits/riders > Effect on death benefit
    • Accelerated (living) and long-term care benefits/riders > Qualifying events
    • Accelerated (living) and long-term care benefits/riders > Disclosure
    • Accelerated (living) and long-term care benefits/riders > Exclusions and restrictions
    • Additional insureds
    • Additional insureds > Spouse/other-insured term
    • Additional insureds > Children's term
    • Additional insureds > Family term
    • Riders affecting death benefit
    • Riders affecting death benefit > Accidental death and dismemberment
    • Riders affecting death benefit > Cost of living
    • Riders affecting death benefit > Return of premium
  • 6.0 Annuities
    • 6.1 Annuity Basics
    • Annuity concepts and uses
    • Annuity concepts and uses > Accumulation/annuity periods
    • Annuity concepts and uses > Owner
    • Annuity concepts and uses > Annuitant
    • Annuity concepts and uses > Beneficiary
    • Annuity concepts and uses > Death of owner
    • Types of annuities
    • Types of annuities > Single premium
    • Types of annuities > Fixed premium
    • Types of annuities > Flexible premium
    • Types of annuities > Immediate
    • Types of annuities > Deferred
    • Features/aspects of annuities
    • Features/aspects of annuities > Nonforfeiture
    • Features/aspects of annuities > Surrender charges
    • Fixed versus variable annuities
    • Fixed versus variable annuities > Interest rate guarantees
    • Fixed versus variable annuities > Separate account
    • Fixed versus variable annuities > General account
    • 6.2 Payout Options
    • Life contingency benefit options
    • Life contingency benefit options > Pure life
    • Life contingency benefit options > Life with guaranteed minimum
    • Life contingency benefit options > Single life
    • Life contingency benefit options > Multiple life
    • Annuity certain payment options
    • Annuity certain payment options > Installments for a fixed period/amount
  • 7.0 Federal Taxation of Life Insurance and Annuities
    • 7.1 General
    • Taxation of amounts available to policyowner
    • Taxation of amounts available to policyowner > Cash value increases
    • Taxation of amounts available to policyowner > Dividends
    • Taxation of amounts available to policyowner > Loans
    • Taxation of amounts available to policyowner > Surrenders
    • Taxation of amounts available to policyowner > Accelerated benefits
    • Taxation of amounts available to policyowner > Death benefit
    • Taxation of amounts received by the beneficiary
    • Taxation of amounts received by the beneficiary > General rules and exceptions
    • Taxation of amounts received by the beneficiary > Settlement options
    • Taxation of amounts received by the beneficiary > Tax implications of estate as beneficiary
    • Section 1035 exchanges
    • Qualified versus nonqualified annuities
    • Qualified versus nonqualified annuities > General requirements
    • Qualified versus nonqualified annuities > Taxation of distributions/withdrawals/contributions
    • Qualified versus nonqualified annuities > Premature distributions
    • Qualified versus nonqualified annuities > During accumulation phase
    • Qualified versus nonqualified annuities > Annuity phase, exclusion ratio
    • Modified endowment contracts (MECs)
    • Modified endowment contracts (MECs) > Modified endowment versus life insurance
    • Modified endowment contracts (MECs) > Seven-pay test
    • Modified endowment contracts (MECs) > Distributions
  • 8.0 Customer Relations and Privacy
    • 8.1 Networking and Client Support
    • Product suitability
    • 8.2 Recording, Reporting, and Securing Client Information
    • HIPAA privacy and security (EDI) rules
    • Records maintenance and security
    • Required disclosures
    • Required disclosures > Buyer's/shopper's guide
    • Required disclosures > HIV consent
  • 9.0 Sickness and Accident Risk and Underwriting
    • 9.1 Risk Management
    • Risk management key terms
    • Risk management key terms > Risk
    • Risk management key terms > Exposure
    • Risk management key terms > Hazard
    • Risk management key terms > Peril
    • Risk management key terms > Loss
    • Methods of handling risk
    • Methods of handling risk > Avoidance
    • Methods of handling risk > Retention
    • Methods of handling risk > Sharing
    • Methods of handling risk > Reduction
    • Methods of handling risk > Transfer
    • Other concepts affecting risk
    • Other concepts affecting risk > Elements of insurable risks
    • Other concepts affecting risk > Adverse selection
    • Other concepts affecting risk > Law of large numbers
    • Other concepts affecting risk > Reinsurance
    • Other concepts affecting risk > Indemnity
    • Elements of insurable risk
    • Elements of insurable risk > Due to chance
    • Elements of insurable risk > Definite and measurable
    • Elements of insurable risk > Statistically predictable
    • Elements of insurable risk > Not catastrophic
    • Elements of insurable risk > Randomly selected
    • 9.2 Underwriting
    • Risk classifications
    • Risk classifications > Preferred
    • Risk classifications > Standard
    • Risk classifications > Substandard
    • Allowable sources of underwriting information
    • Allowable sources of underwriting information > Application
    • Allowable sources of underwriting information > Producer report
    • Allowable sources of underwriting information > Attending physicians’ statement
    • Allowable sources of underwriting information > Investigative consumer report
    • Allowable sources of underwriting information > Medical information bureau (MIB)
    • Allowable sources of underwriting information > Medical examinations and lab tests including HIV consent (RL 71-531)
    • Purpose and process of underwriting
    • Unfair discrimination (44-749)
    • Unfair discrimination (44-749) > Blindness
    • Unfair discrimination (44-749) > Genetic characteristics
    • Field underwriting
    • Field underwriting > Application process
    • Common errors or omissions related to underwriting
    • Common errors or omissions related to underwriting > Failing to give required disclosures
    • Common errors or omissions related to underwriting > Misrepresenting client information
    • 9.3 Replacement
    • Limitations and exclusions
    • Limitations and exclusions > Pre-existing conditions
    • Limitations and exclusions > Waiting periods
    • Replacement requirements
    • Replacement requirements > Notifications
    • Replacement requirements > Proof/certificate of creditable coverage
    • Replacement requirements > Suitability
    • 9.4 Policy Delivery Requirements
    • Statement of good health
    • Policy review
  • 10.0 Individual Accident and Sickness Insurance Policy General Provisions and Clauses
    • 10.1 Risk Management
    • Individual optional provisions (44-710.04)
    • Individual optional provisions (44-710.04) > Change of occupation (44-710.04(1))
    • Individual optional provisions (44-710.04) > Age/gender misstatement (44-710.04(2))
    • Individual optional provisions (44-710.04) > Insurance with other insurers (44-710.04(4))
    • Individual optional provisions (44-710.04) > Other insurance in this insurer (44-710.04(3))
    • Individual optional provisions (44-710.04) > Unpaid premiums (44-710.04(7))
    • Individual optional provisions (44-710.04) > Cancellation (44-710.04(8))
    • Individual optional provisions (44-710.04) > Conformity with state statutes (44-710.04(9))
    • Individual optional provisions (44-710.04) > Illegal occupation (44-710.04(10))
    • Individual optional provisions (44-710.04) > Intoxicants and narcotics (44-710.04(11))
    • Individual policy mandatory provisions (44-710.03)
    • Individual policy mandatory provisions (44-710.03) > Time limit on certain defenses (44-710.03(2))
    • Individual policy mandatory provisions (44-710.03) > Physical exam and autopsy (44-710.03(10))
    • Individual policy mandatory provisions (44-710.03) > Legal actions (44-710.03(11))
    • Individual policy mandatory provisions (44-710.03) > Change of beneficiary (44-710.03(12))
    • Individual policy mandatory provisions (44-710.03) > Entire contract (44-710.03(1), 44-710.12)
    • Individual policy mandatory provisions (44-710.03) > Grace period (44-710.03(3))
    • Individual policy mandatory provisions (44-710.03) > Reinstatement (44-710.03(4))
    • Individual policy mandatory provisions (44-710.03) > Claims forms (44-710.03(5–9))
    • Individual policy mandatory provisions (44-710.03) > Notice of claims (44-710.03(5–9))
    • Individual policy mandatory provisions (44-710.03) > Proof of loss
    • Individual policy mandatory provisions (44-710.03) > Time of payment of claims (44-710.03(5–9))
    • Individual policy mandatory provisions (44-710.03) > Payment of claims (44-710.03(5–9))
    • Other provisions
    • Other provisions > Free look period (44-710.18)
    • Other provisions > Insuring clause
    • Other provisions > Consideration clause
    • Other provisions > Coordination of benefits
    • Other provisions > Renewability clause
    • Renewability clauses (44-787)
    • Renewability clauses (44-787) > Noncancelable
    • Renewability clauses (44-787) > Guaranteed renewable
    • Renewability clauses (44-787) > Conditionally renewable at option of insurer
    • Renewability clauses (44-787) > Nonrenewable including cancelable and short-term health
    • Policy exclusions
    • Policy exclusions > Intentionally inflicted
    • Policy exclusions > War
    • Policy exclusions > Elective procedures
    • Policy exclusions > Workers' compensation
  • 11.0 Disability
    • 11.1 General
    • Total disability plans
    • Total disability plans > Indemnity policy versus loss of income
    • Social Security disability programs
    • Social Security disability programs > Coordination of benefits
    • Eligibility requirements
    • Characteristics of disability income insurance
    • Characteristics of disability income insurance > Occupational versus non occupational
    • Characteristics of disability income insurance > Definition of disability
    • Elimination period, waiting period, probationary period, and benefit period
    • 11.2 Types and Classes
    • Short-term versus long-term group disability income insurance
    • Business disability insurance
    • Business disability insurance > Key person
    • Business disability insurance > Buy-sell policy
    • Individual versus group policies
    • Total, partial, presumptive, and residual disability
    • Qualification for individual disability income insurance benefits
    • Qualification for individual disability income insurance benefits > Own occupation and any occupation
    • Effect of preexisting conditions on disability eligibility
  • 12.0 Medical Plans
    • 12.1 General
    • Difference between insureds and subscribers/participants
    • Methods by which insurers control health care costs
    • Methods by which insurers control health care costs > Coinsurance
    • Methods by which insurers control health care costs > Copayments
    • Methods by which insurers control health care costs > Deductibles
    • Characteristics of HMOs, PPOs, EPOs, and POS
    • Characteristics of HMOs, PPOs, EPOs, and POS > Provider network
    • Characteristics of HMOs, PPOs, EPOs, and POS > Out of network
    • Characteristics of HMOs, PPOs, EPOs, and POS > Primary care
    • Characteristics of HMOs, PPOs, EPOs, and POS > Specialist
    • Characteristics of HMOs, PPOs, EPOs, and POS > Utilization review
    • Characteristics of HMOs, PPOs, EPOs, and POS > Prepaid
    • Characteristics of HMOs, PPOs, EPOs, and POS > Fee for service
    • Characteristics of HMOs, PPOs, EPOs, and POS > Expense based
    • Methods of cost containment
    • Methods of cost containment > Utilization review (44-5416 to 44-5431)
    • Methods of cost containment > Preventive care
    • Methods of cost containment > Second opinion
    • Methods of cost containment > Hospital outpatient benefits
    • Methods of cost containment > Urgent care centers
    • Characteristics of major medical plans
    • Characteristics of excepted benefit plans
    • Marketplace to customize suitable insurance plans for businesses and individuals
    • Types of excepted (limited) benefit plans
    • Types of excepted (limited) benefit plans > Accident only
    • Types of excepted (limited) benefit plans > Accidental death and dismemberment
    • Types of excepted (limited) benefit plans > Critical illness
    • Types of excepted (limited) benefit plans > Hospital indemnity
    • Types of excepted (limited) benefit plans > Vision and hearing
    • Characteristics of Flexible savings accounts (FSAs), Health savings accounts (HSAs),
    • Health reimbursement accounts (HRAs), High Deductible Health Plans (HDHPs)
    • 12.2 Affordable Care Act (ACA)
    • Eligibility requirements
    • Patient protections
    • Patient protections > No lifetime limits/annual limits
    • Patient protections > Guaranteed issue
    • Patient protections > Pre-existing conditions
    • Patient protections > Preventive care without cost sharing
    • Patient protections > Dependent age
    • Patient protections > Appeal rights
    • Patient protections > Maternity coverage
    • Patient protections > Newborn coverage
    • Patient protections > No rescission
    • Patient protections > Emergency care
    • Enrollment periods
    • Definition of qualified health plan
    • Ten Essential Benefits
    • Ten Essential Benefits > 1. Ambulatory patient services
    • Ten Essential Benefits > 2. Emergency Services
    • Ten Essential Benefits > 3. Hospitalization
    • Ten Essential Benefits > 4. Pregnancy, maternity, and newborn care (both before and after birth)
    • Ten Essential Benefits > 5. Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
    • Ten Essential Benefits > 6. Prescription drugs
    • Ten Essential Benefits > 7. Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
    • Ten Essential Benefits > 8. Lab results
    • Ten Essential Benefits > 9. Preventive and wellness services and chronic disease management
    • Ten Essential Benefits > 10. Pediatric services, including oral and vision care
    • Rate setting factors
    • Rate setting factors > Geographic rating area
    • Rate setting factors > Family composition
    • Rate setting factors > Age
    • Rate setting factors > Tobacco use
    • Non-discrimination
    • Types of ACA plans
    • Types of ACA plans > Metal levels
    • Types of ACA plans > Catastrophic
    • Premium tax credits and subsidies
    • Federal versus state exchange/marketplace
    • Requirements for continuation of individual coverage, special enrollment period, and loss of minimum essential coverage
    • Events that lead to termination of coverage
    • 12.3 Mental Health Parity and Addiction Equity Act (MHPAEA)
    • Purpose of Mental Health Parity and Addiction Equity Act
  • 13.0 Group Plans
    • 13.1 General
    • Blanket policy
    • No loss/no gain statutes
    • Group underwriting (44-760)
    • General characteristics of group plans
    • General characteristics of group plans > Group contract, certificate of coverage
    • General characteristics of group plans > Experience versus community rating
    • General characteristics of group plans > Conversion (44-1613; 44-32, 44-130)
    • General characteristics of group plans > Contributory versus non-contributory
    • Types of eligible groups
    • Types of eligible groups > Individual employer groups
    • Types of eligible groups > Multiple-Employer Trusts/Welfare Arrangements
    • Types of eligible groups > Associations
    • Coverage eligibility
    • Coverage eligibility > Open enrollment
    • Coverage eligibility > Waiting periods
    • Coverage eligibility > Part-time employees
    • Coverage eligibility > Dependent/spousal coverage
    • Coverage eligibility > Disabled children
    • Small group and large group eligibility and renewability (44-5259, 44-5253)
    • Types of funding and administration
    • Types of funding and administration > Self-funded versus insured
    • Federal regulations of employer group insurance plans
    • Federal regulations of employer group insurance plans > Applicability
    • Federal regulations of employer group insurance plans > Fiduciary responsibilities
    • Federal regulations of employer group insurance plans > Effects on contributions
    • Federal regulations of employer group insurance plans > Reporting and disclosure requirements
    • Federal regulations of employer group insurance plans > ERISA
    • Eligibility and the benefits of continuation under COBRA (44-1640 to 44-1645)
    • Events that lead to termination of coverage
  • 14.0 Dental Insurance
    • 14.1 General
    • Indemnity plans, PPO/HMO dental plans, prepaid dental plans
    • Stand-alone dental plan (SADPs)
    • Types of dental treatment/service categories
    • Types of dental treatment/service categories > Endodontics
    • Types of dental treatment/service categories > Orthodontics
    • Types of dental treatment/service categories > Periodontics
    • Types of dental treatment/service categories > Prosthodontics
    • Types of dental treatment/service categories > Restorative care
    • Types of dental treatment/service categories > Oral surgery
    • Types of dental treatment/service categories > Diagnostic and preventive
    • Types of dental treatment/service categories > Basic and major
    • The role of the federal health insurance marketplace in dental insurance
    • Cost sharing
    • Cost sharing > Deductibles
    • Cost sharing > Coinsurance
    • Cost sharing > Copay
    • 14.2 Group Plans
    • Characteristics of employer group dental insurance
    • Minimizing adverse selection
    • Integrated deductibles
  • 15.0 Insurance for Senior Citizens and Individuals with Special Needs
    • 15.1 Long-Term Care
    • Continuing Education Requirements - Guidance Document F3
    • Coverage eligibility
    • Coverage eligibility > Underwriting
    • Coverage eligibility > Preexisting conditions
    • Coverage eligibility > Exclusions (210 Nebraska Administrative Code Ch. 46 § 006(006.02))
    • Coverage eligibility > Free look (44-3608; 210 Nebraska Administrative Code Ch. 36 § 017(017.01E))
    • Coverage eligibility > Guaranteed renewability
    • Elimination and benefit periods
    • Policy options
    • Policy options > Inflation protection
    • Policy options > Guarantee of insurability
    • Policy options > Return of premium
    • Policy options > Nonforfeiture options
    • Policy options > Waiver of premium
    • Benefit triggers
    • Benefit triggers > Activities of daily living
    • Benefit triggers > Cognitive impairment
    • Coverages
    • Coverages > Home healthcare (210 Nebraska Administrative Code Ch. 46 § 005(005.10), § 010)
    • Coverages > Hospice
    • Coverages > Assisted living (210 Nebraska Administrative Code Ch. 46 § 005(005.21))
    • Coverages > Adult daycare (210 Nebraska Administrative Code Ch. 46 § 005(005.02))
    • Coverages > Respite care
    • Purpose and levels of care
    • Purpose and levels of care > Skilled
    • Purpose and levels of care > Intermediate
    • Purpose and levels of care > Custodial
    • Cancellations or unintentional lapses
    • Required disclosures
    • Required disclosures > Outline of coverage (44-3607; 210 Nebraska Administrative Code Ch. 36 § 017(017.03))
    • Required disclosures > Shopper’s guide (210 Nebraska Administrative Code Ch. 46 § 027)
    • Trusted contacts (secondary addressee)
    • Potential future rate increases and cost of living adjustments
    • 15.2 Medicaid
    • Medicaid benefits
    • Medicaid eligibility requirements
    • The effects of the expansion of Medicaid benefits on long-term care and prescription drugs
    • 15.3 Medicare
    • Medicare eligibility requirements
    • Role of primary and secondary insurance
    • Effects of employer group health plans on employees with disabilities and employees over 65
    • Effects of employer group health plans on employees with disabilities and employees > Part A: Hospital Insurance eligibility, enrollment, coverage, and exclusions
    • Effects of employer group health plans on employees with disabilities and employees > Part B: Medical Insurance eligibility, enrollment, coverage, and exclusions
    • Effects of employer group health plans on employees with disabilities and employees > Part C: Medicare Advantage Plans eligibility, enrollment, coverage, and exclusions
    • Effects of employer group health plans on employees with disabilities and employees > Part D: Prescription Drug Plans eligibility, enrollment, coverage, and exclusions
    • 15.4 Medicare Supplements
    • Eligibility and enrollment (210 Nebraska Administrative Code Ch. 36 § 011)
    • The purpose of Medicare Supplement Insurance (210 Nebraska Administrative Code Ch. 36 § 001)
    • Standardized Medicare supplement plans and core benefits (210 Nebraska Administrative Code Ch. 36 § 009)
    • Policy requirements
    • Policy requirements > Free-look (44-3608; 210 Nebraska Administrative Code Ch. 36 § 017(017.01E))
    • Policy requirements > Pre-existing conditions (44-4513(2, 3))
    • Medicare Supplement Replacement
    • Medicare Supplement Replacement > Re-entry following Medicare Advantage
    • Medicare Supplement Replacement > Pre-existing conditions
    • Medicare Supplement Replacement > Waiting periods
  • 16.0 Federal Tax Considerations for Sickness and Accident Insurance
    • 16.1 Premiums and Benefits
    • Tax treatment of premiums and benefits for sole proprietors, partners, and limited liability corporations
    • Tax treatment of premiums and benefits for employer group insurance
    • Tax treatment of premiums and benefits for employer group insurance > Medical
    • Tax treatment of premiums and benefits for employer group insurance > Disability income
    • Tax treatment of premiums and benefits for individual coverages
    • Tax treatment of premiums and benefits for individual coverages > LTC
    • Tax treatment of premiums and benefits for individual coverages > Medical expense
    • Tax treatment of premiums and benefits for individual coverages > Health insurance
    • Tax consideration for Flexible spending accounts (FSAs), Health savings accounts (HSAs), and Health reimbursement accounts (HRAs)
    • 16.3 Disability
    • Tax considerations for disability insurance for personally-owned and employer/group health insurance
    • Tax considerations for Social Security Disability and Workers Compensation
    • Tax considerations for business disability insurance
    • Tax considerations for business disability insurance > Key person
    • Tax considerations for business disability insurance > Buy-sell policy

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These are independent study questions, not actual examination items. For examination requirements and official information, view Nebraska Producer's Examination for Life, Accident and Health or Sickness Insurance Series 13-03 details.