Course 2-40 Online Insurance H (Seguros de Salud)

Lessons

Course 2-40 Introduction

Author: Dolphy Insurance School

ENGLISH STEPS TO OBTAIN RESIDENT LICENSING HEALTH & LIFE INCLUDING VARIABLE ANNUITIES                 Applying for a new license will take approximately 7-14 business days upon receipt of all required Information.…

Course 2-40 Lesson 1 Page 11

Author: Dolphy Insurance School

página 11/22 Reinsurers: Reinsurance is a disposition through which an insurance company transfers a portion of the risk to another insurer. Reinsurance companies determine the area to provide and share…

Course 2-40 Lesson 1 Page 13

Author: Dolphy Insurance School

página 13/22  1.6.1.  Captive vs. Independent Agent The main classifications of Agents are the following: Captive Agent Independent Agent A Captive Agent (also known as career agent) works for one…

Course 2-40 Lesson 1 Page 15

Author: Dolphy Insurance School

página 15/22 INTERVENTION BY THE SEC (1959): A year later, the Securities and Exchange Commission (SEC) presented its own challenge to the industry. The variables and variable life insurance annuities…

Course 2-40 Lesson 1 Page 18

Author: Dolphy Insurance School

página 18/22 1.10.2. Florida Life and Health Guaranty Association (FIGA) Florida Statutes govern the nonprofit Guarantee Payment of Life and Health Insurance. The purpose of the Florida Insurance Guaranty Association…

Course 2-40 Lesson 1 Page 19

Author: Dolphy Insurance School

página 19/22 SECTION 1.11: Rating Services   These companies are usually paid a fee for several insurance companies to provide these qualifications. Each of these independent rating services focuses on…

Course 2-40 Lesson 1 Page 20

Author: Dolphy Insurance School

página 20/22 Keep records of the copies of the Notification of Application Regarding Replacement Life Insurance; forms of requested comparative information, any proposed sale used, and any registration replacement. Everything…

Course 2-40 Lesson 2 Page 3

Author: Dolphy Insurance School

página 3/6 2.2.1. Aleatory Random contingency contracts are unequal potential gains or losses for both parties to the insurance contract. Dollar values exchanged cannot be equal. In random contracts there…

Course 2-40 Lesson 2 Page 5

Author: Dolphy Insurance School

página 5/6 Implied Authority implied authority; the authority is not given in writing, but is necessary for the agent to transact insurance. implied authority is conjecture that even though certain…

Course 2-40 Lesson 3 page 4

Author: Dolphy Insurance School

página 4/14 11.2.1. Individual Health Insurance Individual health insurance is issued by commercial insurers and service organizations such as contracts between the insured and the company. Although all companies have…

Course 2-40 Lesson 3 page 7

Author: Dolphy Insurance School

página 7/14 11.4.2.  Business Needs for Health Insurance Companies are made up of individuals, and business needs are important. As HMOs are emphasized in preventive health care, health insurance allows…

Course 2-40 Lesson 3 page 9

Author: Dolphy Insurance School

página 9/14 COBRA Consolidated Omnibus Budget Reconciliation Act of 1985 The Consolidated Omnibus Budget Reconciliation Act of 1985 – COBRA is a federal law guaranteeing an employee the right to…

Course 2-40 Lesson 3 page 10

Author: Dolphy Insurance School

página 10/14 Group Basic Medical Expense   Basic medical insurance – hospital, surgical and medical expenses – is available for groups. Benefits have been recently extended for most insurers. This…

Course 2-40 Lesson 4 page 2

Author: Dolphy Insurance School

página 2/17 PART II: PRINCIPLES OF HEALTH INSURANCE LESSON 12: HEALTH INSURANCE PROVIDERS SECTION 12.1: Commercial Insurance Providers   Service providers are different from insurance companies. Service providers have subscribers…

Course 2-40 Lesson 4 page 4

Author: Dolphy Insurance School

página 4/17 Prepaid Limited Health Service Organization – PLHSO A PLHSO is any person, corporation, partnership, or other entity, that in exchange for an advance payment, is compromised to provide…

Course 2-40 Lesson 4 page 5

Author: Dolphy Insurance School

página 5/17 The contract, certificate, or member handbook must be accompanied by an identification card containing at least the following:   The name that the organization offers or the contract…

Course 2-40 Lesson 4 page 8

Author: Dolphy Insurance School

página 8/17 Exclusive Provider Organization (EPO) Exclusive Provider means a provider of healthcare, or a group of providers of healthcare, which have established a written agreement with the insurer to…

Course 2-40 Lesson 4 page 14

Author: Dolphy Insurance School

página 14/17 12.6.3. Medicare Part C – Medicare Advantage Due to increased eligible participants, programs and Medicare options have been renovated to include Medicare Part C (formerly known as Medicare…

Course 2-40 Lesson 5 page 2

Author: Dolphy Insurance School

página 2/8 SECTION 13.1: Purpose of Medical Expense Insurance Basic medical expenses insurance (often referred to as first dollar insurance) pays benefits “in advance” without the patient having to pay…

Course 2-40 Lesson 5 page 3

Author: Dolphy Insurance School

página 3/8 Medical Reimbursement Plan – Medical Indemnity Plan Medical Reimbursement Plan and Medical Indemnity Plan are two different approaches with respect to medical plans. In a medical reimbursement plan,…

Course 2-40 Lesson 5 page 7

Author: Dolphy Insurance School

página 7/8 Family deductibles and out-of-pocket expense caps are twice as individual spending. HSA individuals that are 55 years and older can make additional catch -up contributions of $1,000 (2012,…

Course 2-40 Lesson 6 page 2

Author: Dolphy Insurance School

página 2/6 SECTION 14.1: Purpose of Disability Income Insurance The need for disability income often overlooked. People often associate it with a life insurance, health insurance and even with annuities…

Course 2-40 Lesson 6 page 3

Author: Dolphy Insurance School

página 3/6 Using the approach of percent-of-income gains (percent-of-earnings approach) policies may vary the amount of benefits to be paid according to the length of disability. For example, the company…

Course 2-40 Lesson 6 page 6 end

Author: Dolphy Insurance School

página 6/6 14.5.2. Social Security Rider Social Security Annex provides additional income when social security benefits (Social Security, Workers Compensation and Government Programs) are not being received by the insured;…

Course 2-40 Lesson 7 page 1 ACCIDENTAL DEATH INSURANCE AND DISMEMBER (SEGURO DE MUERTE ACCIDENTAL Y DESMEMBRAMIENTO)

Author: Dolphy Insurance School

página 1/3 LESSON 15: ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE-AD&D SUBJECT AD&D Benefits Other Forms of AD&D  ————————————————————————————————————————————-   LECCION 15: SEGURO DE MUERTE, ACCIDENTAL Y DESMEMBRAMIENTO-AD&D  TEMAS Beneficios AD&D Otras…

Course 2-40 Lesson 8 page 2

Author: Dolphy Insurance School

página 2/13 SECTION 16.1: Medicare Supplement Policies The protection of our elderly citizens; the high costs of medical care includes plans to provide long-term care and supplemental insurance plans. NAIC…

Course 2-40 Lesson 8 page 4

Author: Dolphy Insurance School

página 4/13 DISCLOSURE An insurance policy care qualified long-term (long-term care insurance), must include a statement of disclosure or disclosure within policy and within the statement of coverage, the policy…

Course 2-40 Lesson 8 page 7

Author: Dolphy Insurance School

página 7/13 Acute Illness Acute illness is a serious illness that with proper medical treatment, the patient should receive a full recovery (such as influenza) Chronic Illness Chronic illness is…

Course 2-40 Lesson 8 page 9

Author: Dolphy Insurance School

página 9/13 In general, these associations have four objectives: To stimulate the availability of high quality, safe private long-term care Remove the fear of impoverishment resulting from the need to…

Course 2-40 Lesson 9 page 2

Author: Dolphy Insurance School

página 2/7 SECTION 17.1: NAIC Model Health Insurance Policy Provisions NAIC (National Association of Insurance Commissioners) developed the Uniform Act Provisions Health Insurance Policies in which 23 provisions described order.…

Course 2-40 Lesson 9 page 6

Author: Dolphy Insurance School

página 6/7 Waiver for Impairment Impairment exemptions are used in those areas where a person may have preexisting conditions and still be considered uninsurable. These exemptions exempt specific reasons for…

Course 2-40 Lesson 10 page 2

Author: Dolphy Insurance School

página 2/6 SECTION 18.1: Major Risk Factors in Health Insurance Key factors evaluated in the underwriting process health insurance are often the same as in all insurance underwriting processes, with…

Course 2-40 Lesson 10 page 5

Author: Dolphy Insurance School

página 5/6 SECTION 18.4: Managed Care Managed Care Organizations (MCO) include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO) and Exclusive Provider Organizations (EPO). These contain medical costs and is…

Course 2-40 Lesson 11 page 2

Author: Dolphy Insurance School

página 2/28 SECTION 19.1: Financial Services Regulation   19.1.1. Department of Financial Services The Department of Financial Services is headed by the Chief Financial Officer and the Commissioner of Insurance,…

Course 2-40 Lesson 11 page 3

Author: Dolphy Insurance School

página 3/28 The Office, within existing resources, can spend the funds for professional development of its employees, including, but not limited to, professional fees for employees who are required to…

Course 2-40 Lesson 11 page 5

Author: Dolphy Insurance School

página 5/28 19.1.3. Office of Financial Regulation In addition to other powers conferred by Florida Statutes, the Office of Financial Regulations provides: [Sec. 655.012]   General Supervisory Powers; Rulemaking:  …

Course 2-40 Lesson 11 page 6

Author: Dolphy Insurance School

página 6/28 19.1.4. The State Legislature The State Legislature establishes and maintains the legal framework of state laws on insurance (Insurance Code / The Insurance Code). The legislature established the…

Course 2-40 Lesson 11 page 13

Author: Dolphy Insurance School

página 13/28 Section 19.4: Code of Ethics The National Association of Life Underwriters (The National Association of Life Underwriters) works for the best interest of policyholders and development opportunities of…

Course 2-40 Lesson 11 page 14

Author: Dolphy Insurance School

página 14/28 How do you approach the Code of Ethics defamation? Knowingly making, publishing, broadcasting or circulating, directly or indirectly, or assisting, incitement, or encourage manufacturing, publishing, broadcasting or circulating…

Course 2-40 Lesson 11 page 18

Author: Dolphy Insurance School

página 18/28 Required and optional coverage The word “primary care physician” or “doctor” (“physician” or “medical doctor”) when used in any insurance policy health service plan health care, or other…

Course 2-40 Lesson 11 page 21

Author: Dolphy Insurance School

página 21/28 Section 19.9: Retirement Plans Florida law does not regulate retirement plans. ERISA supersedes any state law. ERISA administers standards for funding, participation and vesting, termination of insurance, disclosure,…

Course 2-40 Lesson 11 page 25

Author: Dolphy Insurance School

página 25/28 Guaranteed-Issue Basis: It means an insurance policy to be offered to an employer, employee or dependent of the employee, regardless of their health status, preexisting conditions, or claims…

Course 2-40 Lesson 11 page 27

Author: Dolphy Insurance School

página 27/28 Fair Marketing Standards Each carrier employer small (small employer carrier) must actively market the plan coverage health benefits, including standard health benefit basic plans and including any later…

Course 2-40 Lesson 12 pag 1 AGENT LICENSING (LICENCIAS DE AGENTES)

Author: Dolphy Insurance School

página 1/9   LESSON 20 AGENT LICENSING. DEFINITIONS SUBJECT Licensing Maintaining a License Unfair Trade Practices Unfair Claims Settlement Practices Definitions  ——————————————————————————————————————————- LECCIÓN 20 AGENTES LICENCIADOS. DEFINICIONES SUBJECT / TEMAS…

Course 2-40 Lesson 12 pag 2

Author: Dolphy Insurance School

página 2/9 Section 20.1: Licensing The Florida statutes provide that no person may be, act as, or advertising or advertise himself as an insurance agent, insurance adjuster or customer representative…

Course 2-40 Lesson 12 pag 5

Author: Dolphy Insurance School

página 5/9 Acciones Penales y Administrativas / Criminal and Administrative Actions)   Administrativa / Administrative Dentro de 30 días después de la disposición final de una acción administrativa tomada en…

Course 2-40 Lesson 12 pag 6

Author: Dolphy Insurance School

página 6/9 SECCIÓN 20.3: PRACTICAS DESLEALES DE COMERCIO / UNFAIR TRADE PRACTICES   Las sanciones en Florida por violar la Ley de Prácticas Comerciales Desleales son libertad condicional, suspensión o…

Course 2-40 Lesson 12 pag 8

Author: Dolphy Insurance School

página 8/9   SECCIÓN 20.5: DEFINICIONES / DEFINITIONS   Transacción de Seguros / Insurance Transaction. Las disposiciones del Código de Seguros definen el término transacciones de seguros como:   solicitud…

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