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

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

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

                                    Question 1

                                    What information must be included in the statement accompanying an insurance claim payment made by an insurer?

                                    A. The coverage under which the payment is being made
                                    B. The reinsurance carrier involved
                                    C. The agent ' s name and address
                                    D. A list of all claimants involved


                                    Question 2

                                    Insurance agents have duties and responsibilities to the insured and the insurer. Which of the following responsibilities does an agent owe the insured during the policy year?

                                    A. Help the insured file and follow up on claims.
                                    B. Pay the insured ' s premiums if they are unable to do so.
                                    C. Notify the insurance department when claims are paid.
                                    D. Work with rating bureaus to establish insurer ratings.


                                    Question 3

                                    According to the Affordable Care Act, a child can remain on a parent ' s health benefit plan until the child

                                    A. graduates from college.
                                    B. marries.
                                    C. reaches age 26.
                                    D. reaches age 19.


                                    Question 4

                                    Which of the following statements BEST describes a disability elimination period?

                                    A. A qualifying period.
                                    B. A dollar deductible rather than a time deductible.
                                    C. A benefit or utilization period.
                                    D. A time deductible rather than a dollar deductible.


                                    Question 5

                                    When a provider does NOT have an agreement with the insurer for payment, they will be reimbursed

                                    A. a relative fee.
                                    B. an absolute fee.
                                    C. a non-scheduled plan customary fee.
                                    D. a usual, customary, and reasonable fee.


                                    Solutions:

                                    Question 1
                                    Answer: A
                                    Question 2
                                    Answer: A
                                    Question 3
                                    Answer: C
                                    Question 4
                                    Answer: D
                                    Question 5
                                    Answer: D

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