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Free New York Accident and Health Insurance Agent/Broker Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the New York Accident and Health Insurance Agent/Broker practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1What is the minimum age for an individual applying for a New York insurance agent license under Insurance Law §2103?

    1. A. 16
    2. B. 18
    3. C. 19
    4. D. 21

    Answer: B

    Explanation: Section 2103(d) requires the individual applicant or proposed sublicensee to be at least 18 when the license is issued. The controlling official text states, "eighteen years of age or over".

    Reference: Isc (2103) — §2103(d)

  2. 2A client seeks protection against accidental bodily injury and also buys shares of a new company. Which risk classification fits these two exposures?

    1. A. The injury exposure is pure risk; the share purchase is speculative risk.
    2. B. The injury exposure is speculative risk; the share purchase is pure risk.
    3. C. Both the injury exposure and the share purchase are pure risks.
    4. D. Both the injury exposure and the share purchase are speculative risks.

    Answer: A

    Explanation: "Pure risk involves no chance of economic gain" "Speculative risk involves the chance of gain or loss" Accidental bodily injury offers no economic gain, while shares can gain or lose value. Thus the first is pure risk and the second speculative.

    Reference: NAIC, A Regulator's Introduction to the Insurance Industry — Chapter 2, Risk and Uncertainty / Pooling

  3. 3Which advertisement best complies with New York Regulation 34?

    1. A. One that truthfully and adequately discloses material information
    2. B. One that hides important benefit limits
    3. C. One that implies an unlicensed product is approved
    4. D. One that uses a misleading comparison

    Answer: A

    Explanation: Regulation 34 requires truthful, adequate disclosure in accident and health advertising. The controlling official text states, "The purpose of this Part is to assure truthful and adequate disclosure of all material and relevant information in the advertising of accident and health insurance".

    Reference: Dfs Opinion 080419 — 11 NYCRR §215.1

  4. 4Who may change a New York individual accident and health policy after issue under §3216's entire-contract provision?

    1. A. Agent through an oral representation
    2. B. Executive officer through an attached endorsement
    3. C. Broker through an electronic message
    4. D. Claimant through a written request

    Answer: B

    Explanation: The provision says no agent may change or waive policy terms; a change requires an executive officer and endorsement or attachment. The controlling official text states, "No agent or broker has authority to change this policy or to waive any of its provisions".

    Reference: Isc (3216) — §3216(d)(1)(A)

  5. 5To which benefit does New York's relation-of-earnings provision apply?

    1. A. Hospital room reimbursement
    2. B. Loss-of-time disability benefits
    3. C. Dental cleaning benefits
    4. D. Accidental death principal sum

    Answer: B

    Explanation: Section 3216(d)(2)(F) applies the earnings relationship to loss-of-time coverage rather than medical-expense benefits. The controlling official text states, "RELATION OF EARNINGS TO INSURANCE".

    Reference: Isc (3216) — §3216(d)(2)(F)

  6. 6An applicant for ACA-compliant individual health coverage has a diagnosed condition before enrollment. Which response by the insurer is consistent with the preexisting-condition protection?

    1. A. Cover treatment for that condition without a surcharge based solely on the condition.
    2. B. Cover treatment for that condition only after charging a condition-specific surcharge.
    3. C. Exclude treatment for that condition while covering newly diagnosed conditions.
    4. D. Decline the application solely because treatment for the condition may be costly.

    Answer: A

    Explanation: "Insurance companies can't refuse to cover treatment for your pre-existing condition or charge you more." For covered ACA health insurance, a preexisting condition alone cannot justify denial of its treatment or an extra charge.

    Reference: HealthCare.gov Pre-existing Condition Glossary — Pre-existing condition

  7. 7At the time an applicant buys New York long-term-care insurance, what option must the insurer offer under Regulation 62?

    1. A. An inflation-protection feature
    2. B. An unlimited cash surrender value
    3. C. A Medicare Part D rider
    4. D. A workers' compensation endorsement

    Answer: A

    Explanation: DFS's LTC product outline states that §52.25(c)(3) requires an inflation-protection option at purchase. The controlling official text states, "option to purchase the policy with an inflation protection feature".

    Reference: Dfs Ltc Product Outline — 11 NYCRR §52.25(c)(3)

  8. 8Which arrangement is central to an employer group eligible under New York §4235?

    1. A. A policy issued to an employer covering eligible employees
    2. B. Separate policies chosen by unrelated strangers
    3. C. A group formed only to buy insurance yesterday
    4. D. A policy issued to an exam vendor

    Answer: A

    Explanation: Section 4235 recognizes employer-based groups in which the policyholder employer covers eligible employees under the group contract. The controlling official text states, "eligible employees".

    Reference: Isc (4235) — §4235(c)(1)(A)

  9. 9What type of event is New York Disability Benefits Law designed primarily to cover?

    1. A. A work-related injury covered by workers' compensation
    2. B. A non-work-related injury or illness causing disability
    3. C. Property damage to an employer
    4. D. Routine preventive care

    Answer: B

    Explanation: The Workers' Compensation Board describes Disability Benefits as temporary cash benefits for an eligible wage earner disabled by an off-the-job injury or illness. The controlling official text states, "off-the-job injury or illness".

    Reference: Introduction to the Disability Benefits Law — Workers’ Compensation Law §§201–205

  10. 10When must a New York Medigap insurer accept an eligible Medicare enrollee's application?

    1. A. Only during one six-month window
    2. B. Only each October
    3. C. At any time throughout the year
    4. D. Only after a medical examination

    Answer: C

    Explanation: DFS states that New York Medigap applications must be accepted throughout the year and cannot be denied because of health status. The controlling official text states, "at any time throughout the year".

    Reference: Medicare Insurance Coverage Information for Consumers | Department of Financial Services — 11 NYCRR Part 58; Open Enrollment

Topics in this practice bank

These topics describe the available practice for New York Accident and Health Insurance Agent/Broker. Review the examination outline and its sources for scope and allocation details.

  • Insurance Regulation
    • Licensing
    • Licensing > Process (2103(d–i))
    • Licensing > Definitions
    • Licensing > Definitions > Producer definition (2101(k))
    • Licensing > Definitions > Who should be licensed (2101(k)(1))
    • Licensing > Definitions > Home state (2101(l))
    • Licensing > Definitions > Negotiate (2101(m))
    • Licensing > Definitions > Sell (2101(n))
    • Licensing > Definitions > Solicit (2101(o))
    • Licensing > Types of licensees
    • Licensing > Types of licensees > Agents (2101(a, k); 2103; Reg 6, Part 22.2; Reg 7, Part 23.2)
    • Licensing > Types of licensees > Brokers (2101(c, h, k); 2104)
    • Licensing > Types of licensees > Consultants (2107)
    • Licensing > Types of licensees > Adjusters (2101(g), 2108)
    • Licensing > Types of licensees > Nonresident (2101(d, e); 2103(g)(5, 11); 2136)
    • Licensing > Types of licensees > Business entities (2101(p), 2103(j)(2))
    • Licensing > Types of licensees > Temporary (2109; Regs 9, 18, 29, Part 20.1)
    • Licensing > Maintenance and duration
    • Licensing > Maintenance and duration > Renewal (2103(j); Reg 5, Part 21.2)
    • Licensing > Maintenance and duration > Continuing education (2132)
    • Licensing > Maintenance and duration > Assumed names (2102(f))
    • Licensing > Maintenance and duration > Change of address (all addresses, including email) (2134; Reg 5, Part 21.4; Reg 6, Part 22.3; Reg 7, Part 23.4)
    • Licensing > Maintenance and duration > Reporting of actions (2110(i))
    • Licensing > Disciplinary actions
    • Licensing > Disciplinary actions > Hearings - Notice and Process (2405, 2406, Financial Services 305)
    • Licensing > Disciplinary actions > Suspension, revocation, and nonrenewal (2110)
    • Licensing > Disciplinary actions > Penalties (2127, 109)
    • State Regulation
    • State Regulation > Superintendent's general duties and powers (2404, Financial Services 201, 202, 301)
    • State Regulation > Company regulation
    • State Regulation > Company regulation > Certificate of authority (1102(a-b))
    • State Regulation > Company regulation > Solvency (307)
    • State Regulation > Company regulation > Unfair claim settlement practices (2601; Reg 64, Parts 216.3 to .6)
    • State Regulation > Company regulation > Appointment of agent (2112(a–c))
    • State Regulation > Company regulation > Termination of agent appointment (2112(d); Regs 9, 18, 29, Part 20.2)
    • State Regulation > Unfair and prohibited practices
    • State Regulation > Unfair and prohibited practices > Misrepresentation (2123; Reg 64, Part 216.3)
    • State Regulation > Unfair and prohibited practices > False advertising (2603)
    • State Regulation > Unfair and prohibited practices > Defamation of insurer (2604)
    • State Regulation > Unfair and prohibited practices > Unfair discrimination (2606–2608, 2612)
    • State Regulation > Unfair and prohibited practices > Rebating (2324)
    • State Regulation > Licensee regulation
    • State Regulation > Licensee regulation > Controlled business (2103(i))
    • State Regulation > Licensee regulation > Sharing commissions (2121, 2128)
    • State Regulation > Licensee regulation > Fiduciary responsibility (2120; Regs 9, 18, 29, Parts 20.3, 20.4)
    • State Regulation > Licensee regulation > License display (Reg 125, Part 34.5)
    • State Regulation > Licensee regulation > Commissions and compensation (2102(e), 2114–2116, 2119; Regs 9, 18, 29, Part 20.6; 194 Part 30)
    • State Regulation > Licensee regulation > Termination responsibilities of producer (2112)
    • State Regulation > Examination of books and records (2404; Reg 152, Parts 243.0 to .3)
    • State Regulation > Insurance Frauds Prevention Act (401– 405, Financial Services 403-405)
    • State Regulation > Aiding Unauthorized Insurer (2117)
    • State Regulation > Prohibitions (403)
    • State Regulation > Reporting (405)
    • State Regulation > Consumer privacy regulation (Reg 169, Part 420.0 to .4)
    • State Regulation > Producer Compensation Transparency (Reg 194, Parts 30.1 to 30.5)
    • State Regulation > Cyber Security Requirements for Financial Services Companies (Reg 23)
    • Federal Regulation
    • Federal Regulation > Fair Credit Reporting Act (15 USC 1681– 1681d)
    • Federal Regulation > Fraud and false statements including 1033 waiver (18 USC 1033, 1034)
  • General Insurance
    • Concepts
    • Concepts > Risk management key terms
    • Concepts > Risk management key terms > Risk (pure and speculative)
    • Concepts > Risk management key terms > Exposure
    • Concepts > Risk management key terms > Hazard (physical, moral, morale)
    • Concepts > Risk management key terms > Peril
    • Concepts > Risk management key terms > Loss
    • Concepts > Methods of handling risk
    • Concepts > Methods of handling risk > Avoidance
    • Concepts > Methods of handling risk > Retention
    • Concepts > Methods of handling risk > Sharing
    • Concepts > Methods of handling risk > Reduction
    • Concepts > Methods of handling risk > Transfer (by contractual liability or insurance contract)
    • Concepts > Methods of handling risk > Elements of insurable risks
    • Concepts > Methods of handling risk > Adverse selection
    • Concepts > Methods of handling risk > Law of large numbers
    • Concepts > Methods of handling risk > Reinsurance
    • Insurers
    • Insurers > Types of insurers
    • Insurers > Types of insurers > Stock companies
    • Insurers > Types of insurers > Mutual companies
    • Insurers > Types of insurers > Fraternal benefit societies
    • Insurers > Private versus government insurers
    • Insurers > Admitted versus nonadmitted insurers
    • Insurers > Domestic, foreign, and alien insurers
    • Insurers > Financial status (independent rating services)
    • Insurers > Marketing (distribution) systems
    • Agents and general rules of agency
    • Agents and general rules of agency > Insurer as principal
    • Agents and general rules of agency > Agent/insurer relationship
    • Agents and general rules of agency > Authority and powers of agents
    • Agents and general rules of agency > Authority and powers of agents > Express
    • Agents and general rules of agency > Authority and powers of agents > Implied
    • Agents and general rules of agency > Authority and powers of agents > Apparent
    • Agents and general rules of agency > Responsibilities to the applicant/insured
    • Contracts
    • Contracts > Elements of a legal contract
    • Contracts > Elements of a legal contract > Offer and acceptance
    • Contracts > Elements of a legal contract > Consideration
    • Contracts > Elements of a legal contract > Competent parties
    • Contracts > Elements of a legal contract > Legal purpose
    • Contracts > Characteristics of insurance contracts
    • Contracts > Characteristics of insurance contracts > Contract of adhesion
    • Contracts > Characteristics of insurance contracts > Aleatory contract
    • Contracts > Characteristics of insurance contracts > Personal contract
    • Contracts > Characteristics of insurance contracts > Unilateral contract
    • Contracts > Characteristics of insurance contracts > Conditional contract
    • Contracts > Legal concepts and interpretations affecting contracts
    • Contracts > Legal concepts and interpretations affecting contracts > Indemnity
    • Contracts > Legal concepts and interpretations affecting contracts > Utmost good faith
    • Contracts > Legal concepts and interpretations affecting contracts > Representations/misrepresentations (3105)
    • Contracts > Legal concepts and interpretations affecting contracts > Warranties (3106)
    • Contracts > Legal concepts and interpretations affecting contracts > Rescission
    • Contracts > Legal concepts and interpretations affecting contracts > Concealment
    • Contracts > Legal concepts and interpretations affecting contracts > Fraud
    • Contracts > Legal concepts and interpretations affecting contracts > Waiver and estoppel
  • Accident and Health Insurance Basics
    • Definitions of perils
    • Definitions of perils > Accidental injury
    • Definitions of perils > Sickness
    • Principal types of losses and benefits
    • Principal types of losses and benefits > Loss of income from disability
    • Principal types of losses and benefits > Hospital and medical expense
    • Principal types of losses and benefits > Long-term care expense
    • Classes of accident and health insurance coverage
    • Classes of accident and health insurance coverage > Individual and group
    • Classes of accident and health insurance coverage > Private versus government
    • Classes of accident and health insurance coverage > Limited versus comprehensive
    • Types of Limited Policies
    • Types of Limited Policies > Limited benefits and amounts
    • Types of Limited Policies > Required notice to insured
    • Types of Limited Policies > Types of limited policies
    • Types of Limited Policies > Types of limited policies > Accident-only
    • Types of Limited Policies > Types of limited policies > Specified (dread) disease
    • Types of Limited Policies > Types of limited policies > Hospital indemnity (income)
    • Types of Limited Policies > Types of limited policies > Dental insurance
    • Types of Limited Policies > Types of limited policies > Vision care
    • Common exclusions from coverage
    • Common exclusions from coverage > Workers' Compensation
    • Common exclusions from coverage > Cosmetic
    • Common exclusions from coverage > Experimental/investigation
    • Common exclusions from coverage > Medical Necessity
    • Licensee responsibilities in individual accident and health insurance
    • Licensee responsibilities in individual accident and health insurance > Marketing requirements
    • Licensee responsibilities in individual accident and health insurance > Marketing requirements > Advertising (Reg 34, Parts 215.1 to .18)
    • Licensee responsibilities in individual accident and health insurance > Marketing requirements > Sales presentations
    • Licensee responsibilities in individual accident and health insurance > Marketing requirements > Outline of coverage
    • Licensee responsibilities in individual accident and health insurance > Marketing requirements > Application procedures
    • Licensee responsibilities in individual accident and health insurance > Marketing requirements > Requirements at delivery of policy
    • Considerations in replacing accident and health insurance
    • Considerations in replacing accident and health insurance > Benefits, limitations, and exclusions
    • Considerations in replacing accident and health insurance > Licensee liability for errors and omissions
    • Community rating of policies (4317; Reg 145, Part 360)
    • Community rating of policies (4317; Reg 145, Part 360) > Definition of small group
  • Individual Health Insurance Policy General Provisions
    • Required provisions
    • Required provisions > Entire contract; changes (3216(d)(1)(A))
    • Required provisions > Time limit on certain defenses (3216(d)(1)(B))
    • Required provisions > Grace period (3216(d)(1)C)
    • Required provisions > Reinstatement (3216(d)(1)(D))
    • Other provisions
    • Other provisions > Coordination of benefits
    • Other provisions > Other benefits (3216(d)(2)(E))
    • Other provisions > Unpaid premium (3216(d)(2)(G))
    • Other provisions > Cancellation (3216(d)(2)(H))
    • Other provisions > Conformity with state statutes (3216(d)(2)(I))
    • Other provisions > Illegal occupation (3216(d)(2)(J))
    • Other provisions > Intoxicants and narcotics (3216(d)(2)(K))
    • Other general provisions
    • Other general provisions > Right to examine (free look)
    • Other general provisions > Insuring clause
    • Other general provisions > Consideration clause
    • Other general provisions > Renewability clause (3216(g))
    • Other general provisions > Renewability clause (3216(g)) > Noncancelable
    • Other general provisions > Renewability clause (3216(g)) > Guaranteed renewable
  • Disability Income and Related Insurance
    • Qualifying for disability benefits
    • Qualifying for disability benefits > Inability to perform duties
    • Qualifying for disability benefits > Inability to perform duties > Own occupation
    • Qualifying for disability benefits > Inability to perform duties > Any occupation
    • Qualifying for disability benefits > Inability to perform duties > Presumptive disability
    • Qualifying for disability benefits > Inability to perform duties > Proof of Loss
    • Individual disability income insurance
    • Individual disability income insurance > Basic total disability plan
    • Individual disability income insurance > Basic total disability plan > Income benefits
    • Individual disability income insurance > Basic total disability plan > Elimination and benefit periods
    • Individual disability income insurance > Basic total disability plan > Waiver of premium feature
    • Individual disability income insurance > Coordination of benefits
    • Individual disability income insurance > Individual premium consideration
    • Individual disability income insurance > Individual premium consideration > Additional Monthly Benefit (AMB)
    • Individual disability income insurance > Individual premium consideration > Social Insurance Supplement (SIS)
    • Individual disability income insurance > Individual premium consideration > Occupational versus nonoccupational coverage
    • Individual disability income insurance > Individual premium consideration > Noncancelable (3216(d)(2)(H))
    • Individual disability income insurance > Individual premium consideration > Guaranteed renewability
    • Individual disability income insurance > Other provisions affecting income benefits
    • Individual disability income insurance > Other provisions affecting income benefits > Cost of Living Adjustment (COLA) rider
    • Individual disability income insurance > Other provisions affecting income benefits > Future Increase Option (FIO) rider
    • Individual disability income insurance > Other provisions affecting income benefits > Relation of earnings to insurance (3216(d)(2)(F))
    • Individual disability income insurance > Benefits
    • Individual disability income insurance > Benefits > Accidental death and dismemberment
    • Individual disability income insurance > Benefits > Rehabilitation benefit
    • Individual disability income insurance > Benefits > Medical reimbursement benefit (nondisabling injury)
    • Individual disability income insurance > Benefits > Partial disability benefit
    • Individual disability income insurance > Benefits > Residual disability benefit
    • Individual disability income insurance > Benefits > Total disability benefit
    • Individual disability income insurance > Benefits > 24-hour coverage versus limited/at- work coverage
    • Individual disability income insurance > Exclusions
    • Group disability income insurance
    • Group disability income insurance > Group versus individual plans
    • Group disability income insurance > Short-Term Disability (STD)
    • Group disability income insurance > Long-Term Disability (LTD)
    • Business disability insurance
    • Business disability insurance > Key person disability income
    • Business disability insurance > Disability buy-sell policy
    • Business disability insurance > Business overhead expense policy
  • Medical Plans
    • Medical plan concepts
    • Medical plan concepts > Fee-for-service basis versus prepaid basis
    • Medical plan concepts > Specified coverages versus comprehensive care
    • Medical plan concepts > Benefit schedule versus usual/reasonable/customary charges
    • Medical plan concepts > Any provider versus limited choice of providers
    • Medical plan concepts > Insureds versus subscribers/participants
    • Types of plans
    • Types of plans > Major medical insurance (indemnity plans)
    • Types of plans > Major medical insurance (indemnity plans) > Characteristics
    • Types of plans > Major medical insurance (indemnity plans) > Common limitations
    • Types of plans > Major medical insurance (indemnity plans) > Exclusions from coverage
    • Types of plans > Major medical insurance (indemnity plans) > Provisions affecting cost to insured
    • Types of plans > Health Maintenance Organizations (HMOs)
    • Types of plans > Health Maintenance Organizations (HMOs) > General characteristics
    • Types of plans > Health Maintenance Organizations (HMOs) > Preventive care services (4303(j))
    • Types of plans > Health Maintenance Organizations (HMOs) > Primary Care Physician (PCP)
    • Types of plans > Health Maintenance Organizations (HMOs) > Referral (specialty) physician
    • Types of plans > Health Maintenance Organizations (HMOs) > Emergency care
    • Types of plans > Health Maintenance Organizations (HMOs) > Hospital services
    • Types of plans > Health Maintenance Organizations (HMOs) > Other basic services
    • Types of plans > Health Maintenance Organizations (HMOs) > Preferred Provider Organizations (PPOs), Point-of-Service (POS) plans and Exclusive Provider Organizations (EPOs)
    • Types of plans > Health Maintenance Organizations (HMOs) > General characteristics
    • Types of plans > Health Maintenance Organizations (HMOs) > In-network and out-of-network provider access
    • Types of plans > Health Maintenance Organizations (HMOs) > Primary Care Physician (PCP) referral
    • Types of plans > Health Maintenance Organizations (HMOs) > Indemnity plan features
    • Types of plans > Health Maintenance Organizations (HMOs) > Catastrophic
    • Cost containment in health care delivery
    • Cost containment in health care delivery > Utilization review (Art. 49)
    • Cost containment in health care delivery > Utilization review (Art. 49) > Prospective review
    • Cost containment in health care delivery > Utilization review (Art. 49) > Concurrent review
    • Cost containment in health care delivery > Utilization review (Art. 49) > Retrospective review
    • New York mandated benefits and offers (individual and/or group)
    • New York mandated benefits and offers (individual and/or group) > Dependent child age limit (3216(a)(4);4235(f)(1)(2))
    • New York mandated benefits and offers (individual and/or group) > Policy extension for handicapped children (3216(c)(4)(A))
    • New York mandated benefits and offers (individual and/or group) > Newborn child coverage (3216(c)(4)(c)
    • New York required benefits (individual and/or group)
    • New York mandated offers (individual and/or group)
    • HIPAA (Health Insurance Portability and Accountability Act) requirements
    • HIPAA (Health Insurance Portability and Accountability Act) requirements > Eligibility
    • HIPAA (Health Insurance Portability and Accountability Act) requirements > Guaranteed issue
    • HIPAA (Health Insurance Portability and Accountability Act) requirements > Renewability
    • HIPAA (Health Insurance Portability and Accountability Act) requirements > Privacy protections
  • Federal Patient Protection and Affordable Care Act
    • Affordable Care Act
    • Affordable Care Act > Preexisting conditions
    • Affordable Care Act > Insurance exchanges
    • Affordable Care Act > Insurance exchanges > Eligibility (individual and small employer)
    • Affordable Care Act > Insurance exchanges > APTC (advance premium tax credit)
    • Affordable Care Act > Insurance exchanges > Cost share reeducation
    • Affordable Care Act > Insurance exchanges > Benchmark plan
    • Affordable Care Act > Insurance exchanges > State vs. Federal
    • Affordable Care Act > Insurance exchanges > Metal levels
    • Affordable Care Act > Catastrophic
    • Affordable Care Act > Medical loss ratio
    • Affordable Care Act > Actuarial value
    • Affordable Care Act > Enrollment period
    • Affordable Care Act > Individual mandate
    • Affordable Care Act > Employer shared responsibility
    • Affordable Care Act > Annual lifetime dollar limits
    • Affordable Care Act > 10 Essential benefits
  • Long-Term Care (LTC) Insurance
    • Benefits
    • Benefits > LTC, Medicare and Medicaid compared
    • Benefits > Eligibility for benefits
    • Benefits > Levels of care
    • Benefits > Levels of care > Skilled care
    • Benefits > Levels of care > Intermediate care
    • Benefits > Levels of care > Custodial care
    • Benefits > Types of care
    • Benefits > Types of care > Home health care
    • Benefits > Types of care > Adult day care
    • Benefits > Types of care > Respite care
    • Benefits > Types of care > Nursing home facility care
    • Benefits > Types of care > Assisted living
    • Benefits > Types of care > Benefit periods
    • Benefits > Types of care > Benefit amounts
    • Benefits > Types of care > Activities of Daily Living (ADLs)
    • Benefits > Optional benefits
    • Benefits > Optional benefits > Reimbursement versus indemnity/cash
    • Benefits > Optional benefits > Inflation protection (COLA) (Reg 62, Part 52.25(c)(3))
    • Benefits > Optional benefits > Nonforfeiture benefits (Reg 62, Part 52.25(c)(7))
    • Benefits > Optional benefits > Guarantee of insurability
    • Benefits > Optional benefits > Return of premium
    • Benefits > Optional benefits > Shared care
    • Benefits > Optional benefits > Individual, group, and association plans
    • Benefits > Optional benefits > Hybrid plans
    • Benefits > Optional benefits > Exclusions (Reg 62, Part 52.25(b)(2))
    • Benefits > Optional benefits > Underwriting considerations
    • Benefits > Optional benefits > Suitability
    • New York regulations and required provisions
    • New York regulations and required provisions > Renewability (Reg 62, Part 52.25(b)(1))
    • New York regulations and required provisions > Required disclosure provisions (Reg 62, Part 52.65)
    • New York regulations and required provisions > Prohibited practices
    • New York regulations and required provisions > Replacement (Reg 62, Part 52.29)
    • New York regulations and required provisions > New York State Partnership for Long Term Care (Reg 144, Part 39)
    • New York regulations and required provisions > Dollar for dollar or time element
    • New York regulations and required provisions > Medicaid Estate Recovery Act (OBRA '93)
    • New York regulations and required provisions > New York Tax credit
  • Group Health and Blanket Insurance
    • Characteristics of group insurance
    • Characteristics of group insurance > Group contract
    • Characteristics of group insurance > Certificate of coverage
    • Characteristics of group insurance > Experience rating versus community rating
    • Characteristics of group insurance > Definition of eligible group (4235(b)(c))
    • Types of eligible groups (4235)
    • Types of eligible groups (4235) > Employment-related groups
    • Types of eligible groups (4235) > Employment-related groups > Individual employer groups
    • Types of eligible groups (4235) > Employment-related groups > Professional employer organizations
    • Types of eligible groups (4235) > Employment-related groups > Associations (alumni, professional, and other)
    • Types of eligible groups (4235) > Employment-related groups > Customer groups (depositors, creditor-debtor, and others)
    • Types of eligible groups (4235) > Employment-related groups > Blanket customer groups (teams, passengers, and others)
    • Regulation of employer group insurance plans
    • Regulation of employer group insurance plans > Employee Retirement Income Security Act (ERISA)
    • Regulation of employer group insurance plans > Employee Retirement Income Security Act (ERISA) > Applicability
    • Regulation of employer group insurance plans > Employee Retirement Income Security Act (ERISA) > Fiduciary responsibilities
    • Regulation of employer group insurance plans > Employee Retirement Income Security Act (ERISA) > Reporting and disclosure
    • Regulation of employer group insurance plans > Employee Retirement Income Security Act (ERISA) > Family Medical Leave Act (FMLA)
    • Regulation of employer group insurance plans > Relationship with Medicare
    • Regulation of employer group insurance plans > Relationship with Medicare > Medicare secondary rules
    • Regulation of employer group insurance plans > Relationship with Medicare > Medicare carve-outs and supplements
    • Regulation of employer group insurance plans > Relationship with Medicare > Nondiscrimination rules (highly- compensated)
    • Types of funding and administration
    • Types of funding and administration > Conventional fully-insured plans
    • Types of funding and administration > Partially self-insured plans
    • Types of funding and administration > Partially self-insured plans > Stop-loss coverage
    • Types of funding and administration > Partially self-insured plans > Administrative Services Only (ASO) arrangements
    • Marketing considerations
    • Marketing considerations > Advertising
    • Marketing considerations > Regulatory jurisdiction/place of delivery
    • Employer group health insurance
    • Employer group health insurance > Insurer underwriting criteria
    • Employer group health insurance > Insurer underwriting criteria > Characteristics of group
    • Employer group health insurance > Insurer underwriting criteria > Plan design factors
    • Employer group health insurance > Insurer underwriting criteria > Persistency factors
    • Employer group health insurance > Insurer underwriting criteria > Administrative capability
    • Employer group health insurance > Eligibility for coverage
    • Employer group health insurance > Eligibility for coverage > Annual open enrollment
    • Employer group health insurance > Eligibility for coverage > Employee eligibility
    • Employer group health insurance > Eligibility for coverage > Probationary period
    • Employer group health insurance > Eligibility for coverage > Dependent eligibility
    • Employer group health insurance > Coordination of benefits provision (Reg 62, Part 52.23)
    • Employer group health insurance > Change of insurance companies or loss of coverage
    • Employer group health insurance > Change of insurance companies or loss of coverage > Events that terminate coverage
    • Employer group health insurance > Change of insurance companies or loss of coverage > Extension of benefits
    • Employer group health insurance > Change of insurance companies or loss of coverage > Continuation of coverage under COBRA and New York continuations
    • Employer group health insurance > Change of insurance companies or loss of coverage > Conversion privilege (3221(e))
    • Small employer medical plans
    • Small employer medical plans > Definition of small employer (Reg 145, Part 360.2(f))
    • Small employer medical plans > Benefit plans offered
    • Small employer medical plans > Availability of coverage (Reg 145, Part 360.2(e), .3)
    • Small employer medical plans > Renewability (Reg 145, Part 360.2(e))
    • Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs)
    • Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) > Definition
    • Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) > Eligibility
    • Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) > Contribution
  • Government Insurance Plans
    • Workers' Compensation
    • Workers' Compensation > Eligibility
    • Workers' Compensation > Benefits
    • Social Security Disability
    • Social Security Disability > Qualifications for disability benefits
    • Social Security Disability > Definition of disability
    • Social Security Disability > Waiting period
    • Social Security Disability > Disability income benefits
    • New York State Disability Benefits Law
    • New York State Disability Benefits Law > Purpose
    • New York State Disability Benefits Law > Definitions
    • New York State Disability Benefits Law > Employment covered
    • New York State Disability Benefits Law > Benefits
    • Medicaid
    • Medicaid > Eligibility and benefits
    • Medicaid > Child Health Plus
    • Medicaid > Child Health Plus > Eligibility and benefits
    • Medicare
    • Medicare > Nature, financing, and administration
    • Medicare > Part A - Hospital Insurance
    • Medicare > Part A - Hospital Insurance > Individual eligibility requirements
    • Medicare > Part A - Hospital Insurance > Enrollment
    • Medicare > Part A - Hospital Insurance > Coverages and cost-sharing amounts
    • Medicare > Part B - Medical Insurance
    • Medicare > Part B - Medical Insurance > Individual eligibility requirements
    • Medicare > Part B - Medical Insurance > Enrollment
    • Medicare > Part B - Medical Insurance > Coverages and cost-sharing amounts
    • Medicare > Part B - Medical Insurance > Exclusions
    • Medicare > Part C - Medicare Advantage
    • Medicare > Part D - Prescription Drug Insurance
    • Healthy New York (4326)
  • Private Insurance for Senior Citizens and Special Needs Individuals
    • Medicare supplements
    • Medicare supplements > Purpose
    • Medicare supplements > Open enrollment (Reg 193, Part 58))
    • Medicare supplements > Standardized Medicare supplement plans
    • Medicare supplements > Standardized Medicare supplement plans > Core benefits
    • Medicare supplements > Standardized Medicare supplement plans > Additional benefits
    • Medicare supplements > New York regulations and required provisions
    • Medicare supplements > New York regulations and required provisions > Standards for marketing (Reg 193, Part 58)
    • Medicare supplements > New York regulations and required provisions > Permitted compensation arrangements (Reg 193, Part 58)
    • Medicare supplements > New York regulations and required provisions > Appropriateness of recommended purchase or replacement (Reg 193, Part 58)
    • Medicare supplements > New York regulations and required provisions > Replacement (Reg 193, Part 58)
    • Medicare supplements > New York regulations and required provisions > Disclosure statement (Reg 193, Part 58)
    • Medicare supplements > New York regulations and required provisions > Renewability (Reg 193, Part 58)
    • Medicare supplements > New York regulations and required provisions > Med Advantage
    • Other Medicare options for individuals
    • Other Medicare options for individuals > Disabled individuals
    • Other Medicare options for individuals > Individuals with kidney failure
    • Other Medicare options for individuals > Employer group health plans
    • Other Medicare options for individuals > Employer group health plans > Employees age 65 or older

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