Ok-Life-Accident-and-Health-or-Sickness-Producer Oklahoma Life, Accident, and Health or Sickness Producer Exam Questions and Answers

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.

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.

Aparticipating whole life insurance policyissued by a mutual insurer allows policyholders to receive areturn of divisible surplusin the form of dividends, which reflect the insurer’s excess profits. This is a feature of mutual insurers, as defined in Oklahoma’s regulations (Title 36 O.S. § 4002). Limited pay, continuous premium, and straight whole life policies do not inherently include dividends.

Option A: Incorrect. Limited pay whole life has a shorter premium payment period, not necessarily dividends.

Option B: Correct. A participating whole life policy provides dividends from surplus.

Option C: Incorrect. Continuous premium whole life refers to lifelong premium payments, not dividends.

Option D: Incorrect. Straight whole life is a general term, not specific to dividends.

A deliberate lie by an insured to obtain a lower premium constitutesfraud, defined in Oklahoma’s Insurance Code (Title 36 O.S. § 1204) as an intentional misrepresentation of material facts to deceive the insurer. Fraud can lead to policy rescission or legal penalties.

Option A: Incorrect. Omission is failing to disclose information, not actively lying.

Option B: Correct. A deliberate lie to lower premiums is fraud.

Option C: Incorrect. Concealment is withholding material information, not providing false information.

Option D: Incorrect. Aleatory refers to the uncertain nature of insurance contracts, not misrepresentation.

Medicare supplemental insurance(Medigap) covers gaps in Original Medicare (Parts A and B), such as deductibles, coinsurance, and certain costs not covered by Medicare. A core benefit, included in most Medigap plans (e.g., Plans A–N), is coverage for thefirst 3 pints of bloodeach year, which Medicare Part A does not cover. Other options like at-home recovery or prescription drugs are not core benefits, and preventive care is covered by Medicare, not Medigap.

Option A: Correct. The first 3 pints of blood is a core Medigap benefit.

Option B: Incorrect. At-home recovery is not a standard core benefit in most Medigap plans.

Option C: Incorrect. Prescription drug coverage is not a core Medigap benefit; it’s covered by Medicare Part D.

Option D: Incorrect. Preventive care is covered by Medicare Part B, not a core Medigap benefit.

This question falls under the Prometric content outline section on “Medicare,” which covers Medigap benefits.

TheStandard Nonforfeiture Law, codified in Oklahoma at Title 36 O.S. § 4029, requires life insurance policies with cash value to provide nonforfeiture benefits if the policyowner stops paying premiums. These benefits ensure the policyowner can access the accumulated cash value through options like a cash surrender value, extended term insurance, or reduced paid-up insurance, preventing total loss of the policy’s value.

Option A: Correct. If the policyowner stops paying premiums, the cash value must be made available per the nonforfeiture law.

Option B: Incorrect. Contractual changes are governed by policy provisions, not nonforfeiture laws.

Option C: Incorrect. Disability may trigger a waiver of premium rider, but it does not directly relate to nonforfeiture benefits.

Option D: Incorrect. Bankruptcy does not trigger nonforfeiture benefits; it may involve creditor claims but is unrelated to premium cessation.

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

In life insurance, aninsurable interestexists when the policyowner would suffer a financial loss or hardship from the insured’s death. Oklahoma law (Title 36 O.S. § 3604) requires insurable interest at the time the policy is purchased, typically based on a financial benefit from the insured’s continued life (e.g., spouse, business partner). Distant relationships or business ties alone are insufficient without financial dependency.

Option A: Correct. A financial benefit from the insured’s continued life establishes insurable interest.

Option B: Incorrect. A business relationship alone does not guarantee insurable interest without financial loss.

Option C: Incorrect. Distant family relationships may not qualify unless financial dependency exists.

Option D: Incorrect. Insurable interest must exist at policy purchase, not at the time of death.

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

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.

Ajoint life policy(first-to-die) covers both spouses under a single contract and pays the death benefit upon thefirst spouse’s death, as defined in Oklahoma’s life insurance regulations (Title 36 O.S. § 4002). This is often used for financial protection needs like mortgages.

Option A: Incorrect. “Dual capacity” is not a standard life insurance term.

Option B: Incorrect. Family term covers dependents but is not specific to first-to-die spousal coverage.

Option C: Incorrect. Whole life is a permanent policy type, not inherently joint.

Option D: Correct. A joint life policy pays on the first spouse’s death.

TheOklahoma Insurance Commissioner, an elected official under Title 36 O.S. § 301, has powers including conducting hearings, adopting rules and regulations, and overseeing complaints against insurance entities. However,enacting legislationis a function of the Oklahoma Legislature, not the Commissioner, who can only propose or influence legislation.

Option A: Incorrect (is a duty). The Commissioner can conduct hearings on insurance matters.

Option B: Correct (is not a duty). Enacting legislation is a legislative function, not the Commissioner’s role.

Option C: Incorrect (is a duty). The Commissioner adopts rules and regulations.

Option D: Incorrect (is a duty). The Commissioner has jurisdiction over insurance-related complaints.

Alevel term-to-age-65 life insurance policyprovides a fixed death benefit until the insured reaches age 65, as long as premiums are paid. Since Jim purchased a $200,000 policy at age 35 and dies at age 50 (before age 65), the full death benefit of $200,000 is payable, assuming the policy is in force.

Option A: Incorrect. $50,000 is not the policy’s face amount.

Option B: Incorrect. $100,000 is not the policy’s face amount.

Option C: Incorrect. $150,000 is not the policy’s face amount.

Option D: Correct. The $200,000 death benefit is paid, as it is a level term policy.

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

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.

Thecommon disaster provisionin a life insurance policy addresses situations where the insured and primary beneficiary die in the same accident. It typically includes a survivorship clause, presuming thebeneficiary outlived the insuredfor a specified period (e.g., 14–30 days) unless proven otherwise. This ensures the death benefit passes to the beneficiary’s estate or contingent beneficiaries, as outlined in Oklahoma’s life insurance provisions (Title 36 O.S. § 4001 et seq.).

Option A: Incorrect. The provision does not assume the insured outlived the beneficiary.

Option B: Correct. The insurer proceeds as if the beneficiary outlived the insured.

Option C: Incorrect. Simultaneous death is addressed differently under the Uniform Simultaneous Death Act, not the common disaster provision.

Option D: Incorrect. The provision does not treat the beneficiary as unnamed.

Replacementrefers to the act of terminating an existing insurance policy and purchasing a new one, often with the same or a different insurer. This is regulated in Oklahoma under O.A.C. 365:10-3-16 to protect consumers from misleading practices, requiring disclosures and suitability assessments.

Option A: Correct. Replacement is the term for exchanging a new policy for an existing one.

Option B: Incorrect. Enhancement is not a standard insurance term for this process.

Option C: Incorrect. Conversion refers to changing a policy type (e.g., term to whole life) without replacing it.

Option D: Incorrect. Renewal extends an existing policy, not exchanges it for a new one.

This question aligns with the Prometric content outline under “Considerations in Replacing Insurance,” which covers replacement regulations.

In Oklahoma, aninsurance produceris the term defined by law for an individual or entity licensed to sell, solicit, or negotiate insurance contracts. This is outlined in the Oklahoma Insurance Code, which requires producers to obtain a license to engage in these activities for life, accident, and health or sickness insurance.

Option A: Incorrect. An insurance adjuster investigates and settles claims, not negotiates the sale of insurance.

Option B: Correct. An insurance producer is the licensed individual who negotiates the sale of insurance, as defined by Oklahoma law.

Option C: Incorrect. An insurance appraiser evaluates property damage for claims, not related to selling insurance.

Option D: Incorrect. An insurance underwriter assesses risk and determines policy issuance, not sells insurance.

This question falls under the Prometric content outline section on “Licensing,” which includes knowledge of licensing requirements and definitions.

In Health Maintenance Organizations (HMOs), thegatekeeper strategyinvolves a primary care physician (PCP) who coordinates patient care and provides referrals to specialists. This ensures that care is managed efficiently and only necessary specialist visits are authorized, aligning with the HMO’s cost-containment model.

Option A: Incorrect. Refusing coverage for preexisting conditions is unrelated to the gatekeeper role and is regulated by HIPAA, not HMO strategy.

Option B: Correct. The gatekeeper strategy requires referrals from a PCP to see specialists, a hallmark of HMO plans.

Option C: Incorrect. HMOs encourage preventive care, not preventing service use, to manage costs.

Option D: Incorrect. Supplemental services at additional cost are not part of the gatekeeper strategy.

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

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.

Long-Term Care (LTC) insuranceis designed to cover services for individuals with chronic diseases or disabilities who need assistance with activities of daily living (ADLs) or have cognitive impairments. It often includes coverage for nursing home care, home-based care, assisted living, and respite care, as regulated in Oklahoma under Title 36 O.S. § 4426.1.

Option A: Incorrect. Medicare provides limited coverage for skilled nursing or home health care but not comprehensive LTC services.

Option B: Incorrect. Medicaid covers LTC for low-income individuals but is a government program, not a private insurance policy.

Option C: Correct. LTC insurance covers nursing home, home-based, and respite care for chronic conditions.

Option D: Incorrect. Group health insurance covers medical expenses but typically does not include LTC services.

This question falls under the Prometric content outline section on “Long-Term Care (LTC) Policies,” which covers LTC coverage and services.

Ahospital indemnity policypays a fixed daily, weekly, or monthly benefit directly to the insured for hospitalization, regardless of other insurance coverage or actual expenses incurred. This is a supplemental policy common in Oklahoma (Title 36 O.S. § 4405).

Option A: Incorrect. “Limited-amount per diem” is not a standard insurance term.

Option B: Incorrect. Blanket policies cover groups for specific risks, not individual hospitalization benefits.

Option C: Incorrect. Medigap covers Medicare gaps, not fixed hospitalization payments.

Option D: Correct. Hospital indemnity policies pay a fixed amount per day for hospitalization.

Theguaranteed insurability riderallows the insured to purchase additional life insurance at specified dates or life events (e.g., marriage, childbirth) without proving insurability, ensuring coverage despite health changes. This is a standard rider in Oklahoma (Title 36 O.S. § 4001 et seq.).

Option A: Incorrect. Guaranteed renewability applies to policy renewals, not additional coverage.

Option B: Correct. The guaranteed insurability rider allows additional insurance without underwriting.

Option C: Incorrect. A cost of living rider adjusts benefits for inflation, not additional coverage.

Option D: Incorrect. A disability income rider provides income replacement, not additional insurance.

Per IRS Publication 502,Long-Term Care (LTC) insurance premiumsare considered qualified medical expenses and may be tax deductible if the taxpayer’s total medical expenses exceed 10% of their adjusted gross income (AGI), subject to age-based limits on the deductible amount. Premiums for disability income insurance (group or personal) and accidental death and dismemberment (AD&D) insurance are not deductible as medical expenses, as they do not directly relate to medical care.

Option A: Correct. LTC insurance premiums are deductible as medical expenses, subject to limits.

Option B: Incorrect. Group disability insurance premiums are not deductible as medical expenses.

Option C: Incorrect. Personal disability income insurance premiums are not deductible.

Option D: Incorrect. AD&D insurance premiums are not deductible as medical expenses.

Long-Term Care (LTC) policies cover services for individuals with chronic conditions or disabilities, such as assistance with activities of daily living. Oklahoma regulations (Title 36 O.S. § 4426.1) allow LTC policies to exclude coverage for conditions like alcoholism or drug addiction, acts of war (especially military service), and self-inflicted injuries, as these are considered high-risk or intentional. However,Alzheimer’s diseaseis a core condition typically covered by LTC policies, as it is a common cause of long-term care needs.

Option A: Incorrect (excluded). Alcoholism or drug addiction is often excluded unless treatment is completed.

Option B: Incorrect (excluded). Acts of war, especially in military service, are standard exclusions.

Option C: Incorrect (excluded). Self-inflicted injuries are excluded as intentional acts.

Option D: Correct (not excluded). Alzheimer’s disease is typically covered by LTC policies.

Oklahoma insurance regulations require licensees, including insurance producers, to promptly notify the Insurance Commissioner of any change in their address to ensure accurate communication and compliance with licensing requirements. The Oklahoma Insurance Code, specifically Title 36 O.S. § 1435.13, mandates that "a licensee shall inform the Insurance Commissioner in writing of a change of address within thirty (30) days of the change." Failure to notify within this timeframe may result in administrative actions, such as fines or license suspension.

The Oklahoma Life, Accident, and Health or Sickness Producer Study Guide reinforces this requirement, stating, "Producers must notify the Oklahoma Insurance Department of any change in their business or residential address within 30 days to maintain compliance with licensing regulations." This makes option A the correct answer.

When applying for a life or health insurance policy in Oklahoma, the insurer’s underwriting process typically involves reviewing the applicant’smedical historyto assess risk, as permitted under Title 36 O.S. § 1204. This may include questions about personal and family health, but not all family illnesses need to be reported unless specifically requested. Physical examinations are not always required, and undiagnosed conditions are not expected to be recorded; the applicant must disclose known conditions truthfully.

Option A: Incorrect. Reporting all family illnesses is not mandatory unless relevant to underwriting questions.

Option B: Incorrect. A physical exam is not always required; it depends on the insurer’s underwriting guidelines.

Option C: Incorrect. Undiagnosed conditions cannot be recorded; only known conditions are reported.

Option D: Correct. The insured’s medical history may be reviewed and reported during underwriting.

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.

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.

Under Oklahoma’s Insurance Code (Title 36 O.S. § 1435.13), a producer who knowingly and willfully makes a fraudulent statement on an insurance application faces disciplinary actions, includingsuspension,revocation, orcensureof their license, as well as potential fines or criminal penalties.Discriminationis not a disciplinary action; it refers to unfair treatment and is unrelated to fraud penalties.

Option A: Incorrect (is a penalty). Suspension of the license is a possible consequence.

Option B: Incorrect (is a penalty). Revocation of the license is a possible consequence.

Option C: Correct (is not a penalty). Discrimination is not a disciplinary action for fraud.

Option D: Incorrect (is a penalty). Censure is a formal reprimand and a possible consequence.

Under Oklahoma’s Insurance Code (Title 36 O.S. § 1435.2),transacting insuranceincludes activities such as soliciting or selling insurance, engaging in preliminary negotiations for insurance contracts, and delivering insurance contracts or collecting premiums.Gathering prospective buyer information(e.g., lead generation) is not considered transacting insurance unless it involves direct solicitation or negotiation.

Option A: Incorrect (is transacting). Selling insurance is a core part of transacting insurance.

Option B: Incorrect (is transacting). Preliminary negotiations are included in transacting insurance.

Option C: Incorrect (is transacting). Delivering insurance contracts is part of transacting insurance.

Option D: Correct (is not transacting). Gathering prospective buyer information alone does not constitute transacting insurance.

This question falls under the Prometric content outline section on “State Insurance Statutes, Rules, and Regulations,” which covers the definition of transacting insurance.

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.

Term life insuranceprovides coverage for a specific period (e.g., 10, 20 years) at a lower premium cost than whole life insurance, making it ideal for individuals needing maximum death benefit protection but unable to afford the higher premiums of permanent insurance. Unlike whole life, term life does not accumulate cash value or allow policy loans.

Option A: Incorrect. Borrowing against policy values requires cash value, available in whole life, not term life.

Option B: Incorrect. Cash value accumulation is a feature of whole life, not term life.

Option C: Correct. Term life is appropriate for maximum protection at a lower cost when permanent insurance premiums are unaffordable.

Option D: Incorrect. Term life is not permanent insurance; whole life provides permanent coverage.

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

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.

Under Oklahoma insurance regulations (Title 36 O.S. § 1204 and O.A.C. 365:10-3-10), insurers are responsible for ensuring that all advertising materials comply with state laws, including maintaining control over thecontent and formto prevent misleading or deceptive practices. This includes ensuring advertisements are truthful, not disparaging, and compliant with regulatory standards.

Option A: Correct. Insurers must control the content and form of advertising to ensure compliance.

Option B: Incorrect. The cost of delivery is not a regulatory responsibility of insurers.

Option C: Incorrect. The cost of production is an internal business matter, not a regulatory requirement.

Option D: Incorrect. Communications between agents are not directly related to advertising content control.

This question is part of the Prometric content outline under “State Insurance Statutes, Rules, and Regulations,” which covers advertising regulations.

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.

Asurvivorship life policy(also called second-to-die insurance) covers two or more individuals and pays the death benefit upon the death of the last insured person. It is often used for estate planning, as opposed to ajoint life policy, which pays on the first death (Title 36 O.S. § 4002).

Option A: Incorrect. Universal life is a flexible single-life policy, not a multiple-person policy.

Option B: Correct. A survivorship life policy pays on the last insured’s death.

Option C: Incorrect. A joint life policy pays on the first insured’s death.

Option D: Incorrect. An annuity life policy is not a standard term; annuities are separate products.

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.

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.

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.

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.

Under Oklahoma’s Insurance Code (Title 36 O.S. § 1250.4), upon receiving notice of a claim, an insurer must furnish the claimant with forms for filing proof of loss within15 days. This ensures timely processing of claims and compliance with fair claims settlement practices.

Option A: Incorrect. 10 days is not the required timeframe.

Option B: Correct. Insurers must provide forms within 15 days.

Option C: Incorrect. 20 days exceeds the statutory requirement.

Option D: Incorrect. 30 days is too long under Oklahoma law.

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.

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.

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.

Theunpaid premium Uniform Optional Provisionin health insurance policies, as recognized in Oklahoma (Title 36 O.S. § 4405), allows the insurer to deduct any unpaid premiums from a claim payment if a claim becomes payable while premiums are overdue. This ensures the policy remains in force and the claim is paid, net of the owed premium.

Option A: Incorrect. The claim is not denied; the premium is deducted from the payment.

Option B: Incorrect. The policy is not cancelled; the unpaid premium is addressed via the claim.

Option C: Correct. The unpaid premium is deducted from the claim payment.

Option D: Incorrect. The claim is not delayed; the premium is settled with the claim payment.

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