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Insurance Licensing NY-Life-Accident-and-Health Exam Syllabus Topics:

SectionWeightObjectives
Insurance Regulation and General Principles20%- Insurance Concepts
  • 1. Risk Management and Insurable Interest
    • 2. Contract Law and Policy Structure
      - New York Insurance Code and Laws
      • 1. Licensing Requirements and Procedures
        • 2. Unfair Trade Practices
          • 3. Producer Responsibilities and Ethics
            Underwriting, Marketing and Sales Practices15%- Application and Underwriting Procedures
            • 1. Risk Classification and Selection
              - Sales and Customer Service
              • 1. Suitability and Disclosure Requirements
                Accident and Health Insurance35%- Government Health Programs
                • 1. Medicare and Medicaid
                  • 2. New York State Specific Programs
                    - Health Insurance Basics
                    • 1. Medical Expense and Disability Income
                      • 2. Group vs Individual Coverage
                        - Policy Provisions and Claims
                        • 1. Eligibility and Enrollment
                          • 2. Coordination of Benefits
                            Life Insurance Products and Provisions30%- Policy Provisions, Riders and Options
                            • 1. Beneficiary Designations
                              • 2. Non-forfeiture Values and Dividends
                                - Types of Life Insurance Policies
                                • 1. Annuities and Retirement Products
                                  • 2. Term, Whole Life, Universal Life

                                    Insurance Licensing New York Life, Accident and Health Insurance Agent/Broker Examination Series 17-55 Sample Questions:

                                    1. Clark will be doing business as an agent. When MUST he be appointed by the insurer?

                                    A) Within 20 days after commissions have been paid.
                                    B) Within 15 days of signing the agency contract.
                                    C) At the time the license application is submitted.
                                    D) Within 15 days of submitting his license application.


                                    2. Which of the following services must be provided by a health benefit plan issued on or after January 1, 2014?

                                    A) Long-term care services.
                                    B) Adult eye care services.
                                    C) Preventive health services.
                                    D) Adult dental care services.


                                    3. Which of the following groups is NOT eligible for the Healthy New York Program?

                                    A) Sole proprietors
                                    B) Working uninsured
                                    C) Small employers
                                    D) Large employers


                                    4. An insurer monitors the care an insured is receiving in the hospital to be sure that everything is proceeding according to schedule. This BEST describes

                                    A) benefit checking.
                                    B) concurrent review.
                                    C) precertification authorization.
                                    D) claims adjudication.


                                    5. Which of the following statements BEST describes a single premium cash value policy?

                                    A) It waives one future premium if the owner becomes disabled.
                                    B) It requires the policyowner to pay one premium annually.
                                    C) It requires only one payment to make the policy paid up.
                                    D) It provides for only one premium to be paid without evidence of insurability.


                                    Solutions:

                                    Question # 1
                                    Answer: B
                                    Question # 2
                                    Answer: C
                                    Question # 3
                                    Answer: D
                                    Question # 4
                                    Answer: B
                                    Question # 5
                                    Answer: C

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