Insurance Licensing Ok-Life-Accident-and-Health-or-Sickness-Producer Oklahoma Life, Accident, and Health or Sickness Producer Exam Exam Practice Test

Disability income insurance policies are designed to replace a portion of the insured’s income if they become disabled and unable to work. These policiesmost often pay benefits in the form of periodic income, typically monthly, to provide ongoing financial support during the disability period, as outlined in Oklahoma’s health insurance regulations (Title 36 O.S. § 4405). Lump sum payments or annuities are less common and usually associated with other types of coverage.

Option A: Incorrect. Annuities provide retirement income, not disability benefits.

Option B: Correct. Disability policies typically pay periodic (e.g., monthly) income.

Option C: Incorrect. Lump sum reimbursements are rare in disability policies; periodic payments are standard.

Option D: Incorrect. Lump sum payments based on projected income are not typical for disability insurance.

Twistingis the unethical practice of using misrepresentation or incomplete information to persuade an insured to replace an existing policy with a new one, often to their detriment. It is prohibited under Oklahoma’s Unfair Trade Practices Act (Title 36 O.S. § 1204) to protect consumers from deceptive sales practices.

Option A: Incorrect. Rebating involves offering a portion of the premium or other inducements to purchase insurance.

Option B: Correct. Twisting involves misrepresenting benefits to induce policy replacement.

Option C: Incorrect. Defamation is making false statements harming someone’s reputation, not policy replacement.

Option D: Incorrect. Forfeiting is not a term related to policy replacement practices.

This question aligns with the Prometric content outline under “State Insurance Statutes, Rules, and Regulations,” which covers unfair trade practices.

Afield underwriter, typically an insurance producer, gathers initial information from applicants to assess their insurability and ensure the application is accurate and complete. A main task is ensuring the accuracy and completeness of an individual’s medical information, as this is critical for the insurer’s underwriting decision. Field underwriters do not approve policies or edit reports to guarantee approval; they facilitate the process by providing reliable data.

Option A: Incorrect. Editing reports to ensure approval is unethical and not a field underwriter’s role.

Option B: Incorrect. Approving policies is the role of the insurer’s underwriting department, not the field underwriter.

Option C: Correct. Ensuring accuracy and completeness of medical information is a key task of a field underwriter.

Option D: Incorrect. Obtaining an MIB report is typically done by the insurer, not the field underwriter.

This question aligns with the Prometric content outline under “Underwriting,” which covers the role of field underwriters.

Ascheduled dental policyprovides coverage based on a predetermined schedule of benefits, which lists specific maximum dollar amounts payable for each dental procedure (e.g., $100 for a filling, $500 for a crown). This contrasts with comprehensive dental plans that may pay a percentage of expenses or cover all costs after a deductible.

Option A: Incorrect. Scheduled dental policies do not pay all expenses after a deductible; they limit payments to scheduled amounts.

Option B: Incorrect. Paying a percentage of expenses is typical of comprehensive dental plans, not scheduled policies.

Option C: Correct. Benefits are limited to a specific maximum dollar amount per procedure, as defined in the schedule.

Option D: Incorrect. Benefits are not paid as a lump sum directly to the insured; they are paid per procedure up to the scheduled limit.

This question aligns with the Prometric content outline under “Health Providers and Products,” which covers dental insurance structures.

Long-Term Care (LTC) policies cover services for individuals who need assistance withActivities of Daily Living (ADLs), which are basic self-care tasks. Oklahoma regulations (O.A.C. 365:10-5-44) and federal standards define ADLs as including dressing, eating, toileting, bathing, transferring, and continence.Talkingis not considered an ADL, as it is not a fundamental self-care activity.

Option A: Incorrect. Dressing is an ADL.

Option B: Correct. Talking is not an ADL.

Option C: Incorrect. Eating is an ADL.

Option D: Incorrect. Toileting is an ADL.

Thecontestable periodfor a life insurance policy in Oklahoma, as mandated by Title 36 O.S. § 4004, is24 months(2 years) from the policy’s issuance. During this period, the insurer can contest the policy’s validity based on material misrepresentations in the application (e.g., health or lifestyle). After 2 years, the policy becomes incontestable except for non-payment of premiums or fraud in some cases.

Option A: Incorrect. 6 months is too short for the contestable period.

Option B: Incorrect. 12 months is insufficient; the standard is 24 months.

Option C: Correct. The contestable period is 24 months.

Option D: Incorrect. 36 months exceeds the standard period.

This question aligns with the Prometric content outline under “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers the incontestability provision.

Thegrace periodin life and health insurance policies, as mandated by Oklahoma law (Title 36 O.S. § 4005 for life, § 4405 for health), is a period (typically 31 days) after a premium due date during which the policy remains in force, protecting the policyowner from an unintentional lapse. If the insured dies during the grace period, the death benefit is payable, minus any overdue premiums.

Option A: Incorrect. The period after premium payment but before policy issuance is the underwriting or application phase, not the grace period.

Option B: Incorrect. This is similar to Option A and does not describe the grace period.

Option C: Incorrect. The time between death and benefit payment is the claim processing period, not the grace period.

Option D: Correct. The grace period protects against unintentional policy lapse due to late premium payment.

This question falls under the Prometric content outline section on “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers grace period provisions.

Awhole life insurance policyprovidespermanent coveragefor the insured’s entire life, as long as premiums are paid, along with a guaranteed death benefit and cash value accumulation. This is a key advantage over term life, which is temporary. Whole life premiums are typically higher than term life, and underwriting guidelines or premium flexibility depend on the insurer, not the product itself.

Option A: Incorrect. Underwriting guidelines vary by insurer, not by policy type.

Option B: Incorrect. Whole life has higher initial premiums compared to term life.

Option C: Incorrect. Whole life typically has fixed premiums, unlike universal life, which offers variable premiums.

Option D: Correct. Permanent coverage is a primary advantage of whole life insurance.

This question falls under the Prometric content outline section on “Life Products,” which covers the benefits of whole life insurance.

A life insurance policyowner has several rights, including assigning or transferring the policy (e.g., through absolute or collateral assignment), borrowing against the cash value (in policies with cash value), and selecting or changing the beneficiary, as outlined in Oklahoma’s Insurance Code (Title 36 O.S. § 4001 et seq.). However, anabsolute assignmenttransfers all ownership rights to the assignee, and the original policyowner cannot unilaterally revoke it without the assignee’s consent, as it is a complete transfer of ownership.

Option A: Incorrect (is a right). The policyowner can assign or transfer the policy to another party.

Option B: Incorrect (is a right). The policyowner can borrow against the cash value in policies like whole life or universal life.

Option C: Incorrect (is a right). The policyowner can select and change the beneficiary unless restricted (e.g., irrevocable beneficiary).

Option D: Correct (is not a right). An absolute assignment cannot be revoked by the original policyowner without the assignee’s agreement.

This question aligns with the Prometric content outline under “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers policyowner rights and assignments.

Anaccelerated death benefit (ADB)provision, regulated in Oklahoma (Title 36 O.S. § 4051), allows an insured with aterminal illness(typically with a life expectancy of 12–24 months) to receive a portion of the life insurance death benefit before death. This provides funds for medical or personal expenses during the insured’s lifetime.

Option A: Incorrect. Disability may trigger other riders (e.g., waiver of premium), not ADB.

Option B: Correct. A terminal illness qualifies for accelerated death benefits.

Option C: Incorrect. Reaching retirement age does not trigger ADB.

Option D: Incorrect. A dependent’s illness is not a qualifying condition for ADB.

This question falls under the Prometric content outline section on “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers accelerated death benefits.

Medicare Advantage (Part C)plans are private health plans approved by Medicare, includingPPOs,HMOs, andPFFSplans, which provide an alternative to Original Medicare.Social Security Disability Income (SSDI)is a federal program providing income support for disabled individuals, not a Medicare Advantage plan.

Option A: Incorrect. PPO plans are a type of Medicare Advantage plan.

Option B: Incorrect. HMO plans are a type of Medicare Advantage plan.

Option C: Incorrect. PFFS plans are a type of Medicare Advantage plan.

Option D: Correct. SSDI is not a Medicare Advantage plan; it is a disability income program.

This question aligns with the Prometric content outline under “Medicare,” which covers Medicare Advantage plans.

Most life insurance policies include asuicide clause, typically lasting 2 years in Oklahoma (Title 36 O.S. § 4004), which limits the insurer’s liability if the insured commits suicide within that period. If suicide occurs within the clause’s timeframe (e.g., 13 months), the insurer is generally not liable to pay the death benefit and instead refunds the premiums paid. However, the question emphasizes the policy’s expressed provision limiting liability, suggesting no payout beyond premiums, making “not liable to make any payouts” the most accurate choice. Insanity is not a standard exception unless specified.

Option A: Incorrect. While premium refunds are common, the question emphasizes no payouts, aligning with the provision’s limit.

Option B: Correct. The insurer is not liable to make any payouts due to the suicide clause.

Option C: Incorrect. The full value is not paid within the suicide clause period.

Option D: Incorrect. Insanity is not a standard exception in suicide clauses unless explicitly stated.

Arideris an endorsement or amendment to an insurance policy that modifies its clauses, provisions, or coverage. Riders can add, remove, or alter benefits, such as adding coverage for a specific condition or family members in life or health insurance policies. The term is standard in Oklahoma insurance law and practice.

Option A: Incorrect. An attachment is not a specific insurance term for policy modifications.

Option B: Incorrect. A supplement may refer to additional coverage but is not the standard term for policy endorsements.

Option C: Correct. A rider is an endorsement that modifies policy provisions.

Option D: Incorrect. “Add-on” is not a formal insurance term for policy modifications.

This question aligns with the Prometric content outline under “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers policy endorsements.

Mortgage redemption or cancellation insuranceis a type ofdecreasing term life insurancedesigned to pay off a mortgage balance if the insured dies. The death benefit decreases over time, matching the declining mortgage balance, while premiums typically remain level, making it cost-effective for this purpose.

Option A: Incorrect. Increasing term insurance has a rising death benefit, unsuitable for mortgage protection.

Option B: Correct. Decreasing term insurance aligns with the declining mortgage balance.

Option C: Incorrect. Whole life provides permanent coverage with cash value, not specific to mortgage payoff.

Option D: Incorrect. Universal life is flexible permanent insurance, not typically used for mortgage redemption.

This question falls under the Prometric content outline section on “Life Products,” which covers types of term life insurance.

Oklahoma regulations (O.A.C. 365:10-3-16) provide afree-look periodfor life insurance or annuity replacement policies, allowing the policyowner to return the policy for afull refund of premiumwithin20 daysfrom receipt. This extended period for replacements (compared to 10 days for non-replacement policies) ensures consumers can review the new policy and compare it to the replaced one.

Option A: Incorrect. 3 days is too short for the free-look period.

Option B: Incorrect. 7 days is not the required timeframe.

Option C: Incorrect. 14 days is shorter than the replacement free-look period.

Option D: Correct. The free-look period for replacement policies is 20 days.

In insurance underwriting, individuals are classified based on their risk profile. Asubstandard riskis an applicant who, due to health issues, hazardous habits (e.g., smoking), or high-risk occupations (e.g., stunt performer), cannot be insured at standard rates. These individuals may be offered coverage at higher premiums or with exclusions, as outlined in standard underwriting practices and Oklahoma’s regulations (Title 36 O.S. § 1204).

Option A: Incorrect. “Rating risk” is not a standard underwriting term.

Option B: Incorrect. A standard risk qualifies for standard rates with average risk.

Option C: Incorrect. A preferred risk qualifies for lower-than-standard rates due to low risk.

Option D: Correct. A substandard risk is not acceptable at standard rates due to higher risk factors.

This question aligns with the Prometric content outline under “Underwriting,” which covers risk classification.

In Oklahoma’s Insurance Code (Title 36 O.S. § 105), aforeign insureris defined as an insurance company formed under the laws of another U.S. state or territory. This distinguishes it from adomestic insurer(formed in Oklahoma) and analien insurer(formed in a foreign country).

Option A: Incorrect. An insurer formed in Oklahoma is a domestic insurer.

Option B: Incorrect. An insurer from a foreign country is an alien insurer.

Option C: Correct. A foreign insurer is formed under the laws of another U.S. state or government.

Option D: Incorrect. Geographic proximity is irrelevant; the definition is based on legal formation.

This question aligns with the Prometric content outline under “State Insurance Statutes, Rules, and Regulations,” which covers insurer classifications.

The primary purpose of life insurance is to provide adeath benefit, which is a financial payout to beneficiaries upon the insured’s death, ensuring financial protection for dependents or obligations (Title 36 O.S. § 4002). While some policies offer cash value or tax advantages, these are secondary to the death benefit.

Option A: Incorrect. Tax deductions are not the primary reason; they may apply to specific scenarios but are secondary.

Option B: Correct. Death benefits are the primary reason for purchasing life insurance.

Option C: Incorrect. Retirement income is a goal of annuities or cash value policies, not the primary purpose.

Option D: Incorrect. Safety of principal relates to investments, not the core purpose of life insurance.

Theownership provisionin a life insurance policy specifies that the policyowner (who may or may not be the insured) holds all rights and privileges during the insured’s lifetime, including changing beneficiaries, borrowing against cash value, or surrendering the policy. This is standard in Oklahoma’s Insurance Code (Title 36 O.S. § 4001 et seq.). Beneficiaries have no rights until the insured’s death, and the insured’s family has no automatic rights unless designated as owners.

Option A: Incorrect. The insured has no ownership rights unless they are also the policyowner.

Option B: Correct. The policyowner holds all rights and privileges.

Option C: Incorrect. The insured’s family has no inherent rights unless they are the policyowner.

Option D: Incorrect. Beneficiaries have rights only after the insured’s death.

Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs) are two common types of managed care plans in health insurance. According to standard insurance study materials for the Oklahoma Life, Accident, and Health or Sickness Producer exam, a key distinction between PPOs and HMOs lies in the flexibility of provider choice. PPOs allow members to choose from a broader network of doctors and medical service providers, both in-network and out-of-network, without requiring a referral from a primary care physician. HMOs, in contrast, typically restrict members to in-network providers and require a designated primary care physician to coordinate care.

Option A: Incorrect. PPO plans often provide coverage for out-of-state medical services, especially within their network or through out-of-network benefits, though at potentially higher costs. This is not a defining characteristic compared to HMOs.

Option B: Correct. PPOs are known for offering more choices of doctors and medical service providers, as they do not mandate a primary care physician or referrals for specialists, unlike HMOs.

Option C: Incorrect. HMOs require members to designate a primary care physician, while PPOs do not.

Option D: Incorrect. While PPOs offer flexibility, the ability to see a physician on a walk-in basis is not a standard feature distinguishing them from HMOs, as both may vary in appointment requirements.

This aligns with the Prometric exam content outline under “Health Providers and Products,” which emphasizes understanding differences between health insurance plans like HMOs and PPOs.

Thewaiver of premium clausein a disability income policy waives the policy’s premiums during a disability claim, ensuring the policy remains in force without the insured having to pay premiums while disabled. This typically begins after the elimination period, as outlined in Oklahoma’s health insurance provisions (Title 36 O.S. § 4405).

Option A: Correct. The waiver of premium pays the policy premium during a disability claim.

Option B: Incorrect. Premiums are waived only during disability, not for the insured’s lifetime.

Option C: Incorrect. Monthly benefits are not reduced to offset waived premiums.

Option D: Incorrect. The waiver begins after the elimination period, not immediately upon a doctor’s statement.

In Oklahoma, an insurance producer license is required for activities defined astransacting insurance, which includes selling, soliciting, or negotiating insurance contracts (Title 36 O.S. § 1435.2).Providing referrals(e.g., passing along contact information without discussing insurance products) does not constitute transacting insurance and does not require a license, provided no compensation is tied to the sale.

Option A: Correct. Providing referrals does not require a license if it avoids solicitation or negotiation.

Option B: Incorrect. Selling insurance requires a producer license.

Option C: Incorrect. Negotiating insurance requires a producer license.

Option D: Incorrect. Soliciting insurance requires a producer license.

Theautomatic premium loan (APL)provision in a life insurance policy with cash value allows the insurer to automatically borrow from the policy’s cash value to pay overdue premiums if the policyowner fails to pay by the end of the grace period (typically 31 days, per Title 36 O.S. § 4005). This prevents the policy from lapsing, provided sufficient cash value is available.

Option A: Incorrect. The APL provision does not cover loans from other policies.

Option B: Correct. The APL provision authorizes withdrawal to pay premiums due at the end of the grace period.

Option C: Incorrect. The APL provision prevents termination, not facilitates it.

Option D: Incorrect. Interest on policy loans is separate and not covered by the APL provision.

This question falls under the Prometric content outline section on “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers automatic premium loans.

In Oklahoma, asmall group health insurance planis defined under Title 36 O.S. § 6512 as coverage for employers with2 to 50 employees, aligning with federal standards under the Affordable Care Act (ACA). Companies with more than 50 employees are considered large groups and subject to different regulations.

Option A: Incorrect. 2 employees is the minimum for a small group plan, not the maximum.

Option B: Incorrect. 10 employees is below the maximum limit.

Option C: Incorrect. 40 employees is within the small group range.

Option D: Correct. A company with more than 50 employees is not eligible for a small group plan.

In Oklahoma, the minimum age for a person of competent legal capacity to contract for life and health insurance is18, as this is the age of majority under Oklahoma law (Title 15 O.S. § 13). Individuals under 18 may be insured (e.g., as dependents or under juvenile policies), but they cannot enter into insurance contracts themselves unless emancipated.

Option A: Incorrect. Age 15 is below the age of majority.

Option B: Incorrect. Age 16 is below the age of majority.

Option C: Correct. Age 18 is the minimum age for contracting insurance in Oklahoma.

Option D: Incorrect. Age 21 is not required; 18 is sufficient.

This question falls under the Prometric content outline section on “State Insurance Statutes, Rules, and Regulations,” which covers eligibility to contract insurance.

AMedicare supplement policy(Medigap) is designed to cover out-of-pocket costs not paid by Original Medicare (Parts A and B), such as deductibles, coinsurance, and copayments. The primary reason for purchasing Medigap is tofill the gapsin Medicare coverage, as outlined in Oklahoma’s regulations (Title 36 O.S. § 6217) and federal guidelines (CMS, Medicare & You Handbook). Dental services, long-term care, and prescription drugs are not typically covered by Medigap; these require separate plans (e.g., Medicare Part D for drugs).

Option A: Incorrect. Dental services are not covered by Medigap; they require separate dental insurance.

Option B: Incorrect. Long-term care is not covered by Medigap; it requires LTC insurance.

Option C: Incorrect. Prescription drugs are covered by Medicare Part D, not Medigap.

Option D: Correct. Medigap fills gaps in Medicare Parts A and B coverage.

Anaccelerated death benefit (ADB)provision allows an insured to receive a portion of the life insurance death benefit before death under specific conditions, such as aterminal illness. Theterminal illness settlement benefitis a form of ADB, providing funds for medical or personal needs, as regulated in Oklahoma (Title 36 O.S. § 4051).

Option A: Incorrect. A home care benefit relates to long-term care, not ADB.

Option B: Incorrect. A nonforfeiture extended term benefit is a policy lapse option, not an ADB.

Option C: Correct. A terminal illness settlement benefit is a type of accelerated death benefit.

Option D: Incorrect. A cost of living benefit adjusts benefits for inflation, not an ADB.

Underwriters use various sources to assess an applicant’s risk, including the application, Medical Information Bureau (MIB) reports, consumer reports, medical questionnaires, attending physician statements (APS), and physical examinations, as permitted under Oklahoma’s underwriting practices (Title 36 O.S. § 1204). However,genetic testingis generally restricted or prohibited for life and health insurance underwriting due to federal and state laws, such as the Genetic Information Nondiscrimination Act (GINA) of 2008, which limits the use of genetic information in health insurance decisions.

Option A: Incorrect. Medical questionnaires are a standard underwriting tool.

Option B: Incorrect. Attending physician statements provide medical history and are commonly used.

Option C: Incorrect. Physical examinations are often required for underwriting.

Option D: Correct. Genetic testing is typically not allowed for underwriting due to legal restrictions.

To become a resident insurance producer or adjuster in Oklahoma, as outlined in Title 36 O.S. § 1435.7 and § 1435.8, an applicant must: be at least 18 years old, be of good personal and business reputation (demonstrating trustworthiness and competency), successfully pass the required licensing examination, and be a resident of Oklahoma or intend to become one. However, there is no specific requirement to have lived in Oklahoma for 6 months or more prior to applying; residency is established by maintaining a principal place of residence or business in the state at the time of application.

Option A: Correct (not a requirement). Living in Oklahoma for 6 months or more is not explicitly required; residency status is sufficient.

Option B: Incorrect (is a requirement). Passing the licensing exam is mandatory.

Option C: Incorrect (is a requirement). Applicants must be at least 18 years old.

Option D: Incorrect (is a requirement). Good personal and business reputation is required.

A10-year level term life insurance policyhas a fixed premium and a fixed face amount (death benefit) for the entire 10-year term. The premium and death benefit remain constant, and there is no cash value or dividend accumulation, as term life is not a participating policy.

Option A: Incorrect. Conversion to whole life is an optional rider, not automatic at the end of the term.

Option B: Incorrect. In a level term policy, the premium does not increase during the term; it remains constant.

Option C: Incorrect. Term life policies do not pay dividends or accumulate cash value, so the face amount does not increase.

Option D: Correct. Both the premium and the $100,000 face amount remain constant for the 10-year term.

This question falls under the Prometric content outline section on “Life Products,” which covers term life insurance characteristics.

Permanent life insurance policies with a cash value (e.g., whole life, universal life) allow policyholders to take loans against the cash value. According to IRS guidelines and standard insurance principles, policy loans are not considered taxable income because they are treated as a debt against the policy’s cash value, not as income. However, if the policy lapses or is surrendered with an outstanding loan, the loan amount exceeding the policy’s basis may become taxable.

Option A: Incorrect. Policy loans do not accelerate benefits (e.g., death benefits or living benefits); they reduce the cash value and death benefit until repaid.

Option B: Correct. Policy loan proceeds are not treated as taxable income, as they are a loan against the policy’s cash value.

Option C: Incorrect. Policy loans are not subject to Federal estate tax unless the policy’s death benefit is included in the estate, which is unrelated to the loan itself.

Option D: Incorrect. Interest on policy loans is not nontaxable; it is charged by the insurer and does not generate income for the policyholder.

This question falls under the Prometric content outline section on “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which includes knowledge of policy loans and their tax implications.

Under Oklahoma’s Insurance Code (Title 36 O.S. § 309.2), the Oklahoma Insurance Commissioner is required to examine the financial condition ofdomestic insurersat least once every5 yearsto ensure solvency and compliance with state regulations. More frequent examinations may occur if issues arise, but 5 years is the minimum requirement.

Option A: Incorrect. 2 years is too frequent for the minimum requirement.

Option B: Incorrect. 4 years is not the specified interval.

Option C: Correct. Examinations are required at least every 5 years.

Option D: Incorrect. 6 years exceeds the required frequency.

Under Oklahoma’s Standard Nonforfeiture Law (Title 36 O.S. § 4029), a whole life insurance policy in force for at least 3 years that is surrendered due to non-payment of premiums within 60 days of the due date entitles the policyowner to acash surrender value, provided sufficient cash value has accumulated. This is one of the nonforfeiture options, alongside extended term or reduced paid-up insurance.

Option A: Correct. The insurer pays a cash surrender value upon surrender.

Option B: Incorrect. The grace period (typically 31 days) cannot be extended beyond policy terms.

Option C: Incorrect. Reimbursing all premiums is not a nonforfeiture option.

Option D: Incorrect. Refunding the premium is not applicable; cash value is paid.

Apreexisting conditionis defined in health insurance as a medical condition for which advice, diagnosis, care, or treatment was recommended or received within a specified period (commonly 6 months) before the effective date of coverage. In Oklahoma, group health insurance policies often include provisions limiting or excluding coverage for preexisting conditions for a certain period, as regulated by federal and state laws, including the Health Insurance Portability and Accountability Act (HIPAA).

Option A: Incorrect. An elimination period is the waiting period before benefits begin, typically in disability or long-term care policies, not related to preexisting conditions.

Option B: Incorrect. An affiliation period is a waiting period for late enrollees in HMOs under HIPAA, not tied to medical conditions.

Option C: Incorrect. A diagnosed condition is not a standard insurance term; it does not specifically denote the timeframe of prior treatment like a preexisting condition.

Option D: Correct. A preexisting condition matches the definition provided, as per Oklahoma and federal regulations.

This question aligns with the Prometric content outline under “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers health insurance exclusions and limitations.

Backdatinga life insurance policy involves setting the policy’s effective date earlier than the current date, often to secure a lower premium based on the insured’s younger age at the earlier date. This requires the policyowner to pay premiums for the backdated period, as permitted under Oklahoma insurance practices (Title 36 O.S. § 4001 et seq.).

Option A: Incorrect. Reinstating a lapsed policy involves restoring coverage after a lapse, not changing the effective date.

Option B: Incorrect. Excluding preexisting conditions applies to health insurance, not backdating life insurance.

Option C: Incorrect. Accepting late premiums relates to the grace period, not backdating.

Option D: Correct. Backdating makes the policy effective on an earlier date.

Thechange of beneficiary provisionallows the policyowner (often the insured) to change the beneficiary at any time unless the beneficiary is designated asirrevocable. An irrevocable beneficiary cannot be changed without their consent, as specified in Oklahoma’s life insurance regulations (Title 36 O.S. § 4001 et seq.).

Option A: Incorrect. Insurability of the beneficiary does not affect the right to change them.

Option B: Correct. An irrevocable beneficiary cannot be changed without their consent.

Option C: Incorrect. Power of attorney affects legal authority, not beneficiary changes.

Option D: Incorrect. A deceased beneficiary can be replaced without restriction.

Alife annuity(or straight life annuity) pays periodic payments to the annuitant until their death, at which point all payments cease, with no further benefits to beneficiaries. This contrasts with other annuity types, such as refund or joint-life annuities, which may continue payments or provide refunds.

Option A: Incorrect. “Terminal annuity” is not a standard insurance term.

Option B: Incorrect. “Finite annuity” is not a recognized annuity type.

Option C: Incorrect. A refund annuity provides a refund or continued payments to a beneficiary if the annuitant dies early.

Option D: Correct. A life annuity ceases payments upon the annuitant’s death.

This question falls under the Prometric content outline section on “Life Products,” which covers annuities and their features.

In insurance, a contract is effective when there is mutual consideration, offer, acceptance, and a meeting of the minds. For a health insurance contract, this occurs when the insured pays the initial premium (consideration from the insured) and the insurer issues the policy as applied for (acceptance by the insurer), as outlined in Oklahoma’s Insurance Code (Title 36 O.S. § 4401). The policy becomes binding at this point, assuming all other conditions (e.g., underwriting approval) are met.

Option A: Incorrect. Providing services occurs during claims, not when the contract is effective.

Option B: Incorrect. Paying the premium alone is not sufficient without policy issuance.

Option C: Correct. The contract is effective when the premium is paid and the policy is issued as applied for.

Option D: Incorrect. Signing by both parties is not typically required; issuance and premium payment suffice.

This question aligns with the Prometric content outline under “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers contract formation in health insurance.

In life and health insurance policies with family or dependent coverage riders, Oklahoma insurance regulations typically allow a 31-day period for the insured to notify the insurer of a newly-born child to add them to the policy for continued coverage. This aligns with standard provisions for automatic coverage of newborns, which often provide temporary coverage from birth (e.g., for 31 days) before requiring formal notification and premium adjustment to maintain coverage.

Option A: Correct. The insured has 31 days to notify the insurer to add a newly-born child, consistent with standard policy provisions and Oklahoma regulations.

Option B: Incorrect. 30 days is not the standard timeframe in Oklahoma for this purpose.

Option C: Incorrect. 21 days is too short and not aligned with typical insurance provisions.

Option D: Incorrect. 14 days is insufficient for the notification period in most policies.

This question is part of the Prometric content outline under “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers dependent coverage and policy provisions.

Afixed annuityprovides guaranteed, stable payments to the annuitant, but a key disadvantage is that the fixed payments may losepurchasing powerover time due to inflation, reducing their real value. This is a concern for long-term annuitants, as noted in Oklahoma’s annuity regulations (Title 36 O.S. § 4002).

Option A: Incorrect. Variable securities apply to variable annuities, not fixed annuities.

Option B: Incorrect. Fixed annuities guarantee a specific benefit amount.

Option C: Correct. Inflation can decrease the purchasing power of fixed payments.

Option D: Incorrect. Payment duration depends on the annuity type (e.g., life annuity), not a 2-year limit.

TheHealth Insurance Portability and Accountability Act (HIPAA)includes provisions from the Newborns’ and Mothers’ Health Protection Act (NMHPA) of 1996, which mandates that group health plans cannot restrict hospital stays for childbirth to less than 48 hours for a vaginal delivery or 96 hours for a cesarean section. This federal law applies to group health insurance plans in Oklahoma and ensures minimum coverage for maternity care.

Option A: Incorrect. COBRA allows continuation of group health coverage after certain events but does not mandate maternity stay durations.

Option B: Incorrect. Medicaid is a state-federal program for low-income individuals, not a law mandating hospital stays for childbirth.

Option C: Correct. HIPAA, via the NMHPA, guarantees the 48-hour hospital stay for regular deliveries.

Option D: Incorrect. ERISA governs employee benefit plans but does not specifically address maternity hospital stays.

This question is part of the Prometric content outline under “State Insurance Statutes, Rules, and Regulations,” which covers federal and state laws affecting health insurance.

Oklahoma law (Title 36 O.S. § 6060.9), aligned with the federal Newborns’ and Mothers’ Health Protection Act (NMHPA), requires health benefit plans providing maternity coverage to offer postpartum home care for mothers and newborns if childbirth occurs at home and the mother is discharged within48 hoursfor a vaginal delivery (or 96 hours for a cesarean section).

Option A: Incorrect. 24 hours is too short for required postpartum home care.

Option B: Correct. Postpartum home care is required if discharged within 48 hours for vaginal delivery.

Option C: Incorrect. 72 hours is not the standard timeframe.

Option D: Incorrect. 96 hours applies to cesarean deliveries, not vaginal.

In group medical insurance, themaster policyis the single contract issued to the employer or group sponsor (e.g., a trust or association) that outlines the terms, conditions, and coverage for the entire group. Individual employees receivecertificates of insurance, which summarize their coverage under the master policy but are not the contract itself.

Option A: Correct. The master policy is the contract issued to the employer for group medical insurance.

Option B: Incorrect. “Employer policy” is not a standard insurance term.

Option C: Incorrect. A certificate policy refers to the document given to individuals, not the group contract.

Option D: Incorrect. “Conglomerate policy” is not a recognized term in insurance.

This question falls under the Prometric content outline section on “Health Providers and Products,” which covers group health insurance structures.

Settlement options for life insurance or annuity policies determine how proceeds are paid to beneficiaries or annuitants. Common options includefixed period(payments over a set time),pure life income(payments for the annuitant’s lifetime), andlife income with period certain(payments for life with a guaranteed minimum period), as outlined in Oklahoma’s regulations (Title 36 O.S. § 4001 et seq.).Asset withdrawalis not a standard settlement option; it may refer to accessing funds but not a formal payout method.

Option A: Incorrect. Fixed period is a standard settlement option.

Option B: Incorrect. Pure life income is a standard settlement option.

Option C: Correct. Asset withdrawal is not a recognized settlement option.

Option D: Incorrect. Life income with period certain is a standard settlement option.

In a group medical plan with an80% coinsurance provisionand no deductible, the insurer pays 80% of covered medical expenses, and the insured pays the remaining 20%. For Laura’s $1,000 medical bill, the insurer covers 80% ($1,000 × 0.80 = $800), and Laura pays 20% ($1,000 × 0.20 = $200). This calculation aligns with standard health insurance cost-sharing provisions in Oklahoma (Title 36 O.S. § 6060.3).

Option A: Incorrect. Laura must pay her coinsurance share, not $0.

Option B: Correct. Laura pays $200 (20% of $1,000).

Option C: Incorrect. $800 is the insurer’s share, not Laura’s.

Option D: Incorrect. Laura does not pay the full $1,000; she pays only her coinsurance portion.

Universal life insurance is a flexible permanent life insurance product with a cash value component. Apartial surrenderallows the policyowner to withdraw a portion of the cash value, reducing both the cash value and, typically, the death benefit. Unlike a policy loan, a partial surrender does not need to be repaid, as it is a withdrawal of the policyowner’s own funds.

Option A: Incorrect. Partial surrenders are not loans and do not require repayment.

Option B: Incorrect. A partial surrender reduces the death benefit, not increases the face amount.

Option C: Incorrect. A partial surrender decreases the cash value, not increases it.

Option D: Correct. The surrender amount does not need to be repaid, as it is a withdrawal.

This question aligns with the Prometric content outline under “Life Products,” which covers universal life insurance features, including cash value options.