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WFG > Quick notes 3 > Flashcards

Quick notes 3 Flashcards

1
Q

California Insurance Code

A
  • body of laws governing insurance business in this state
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2
Q

Commissioner

A
  • Enforces the law.
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3
Q

Legislature

A
  • Makes the law.
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4
Q

Key Person =

A

vice president

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5
Q

Policy + Application =

A

Entire contract

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6
Q

Peril –

A

Chance of loss occurring

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7
Q

Pure Risk –

A

Insurable, chance of loss without possibility of gain

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8
Q

Speculative Risk –

A

Uninsurable, chance of loss / gain (example: Casino)

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9
Q

Peril –

A

cause of loss

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10
Q

Hazard –

A

Increase chance of loss

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11
Q

Moral Hazard –

A

Mental attitude / behavior (example: dishonest, fraudulent)

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12
Q

Morale Hazard –

A

human carelessness, irresponsibility, or reckless

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13
Q

Physical Hazard -

A

smoking

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14
Q

Deferred Annuity (2 stages)

A
  1. AccumulationPeriod(payin)
  2. Annuity(payout)
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15
Q

Indemnity –

A

Make as whole again, restore financial status to the position they were in prior loss

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16
Q

Fiduciary –

A

handling money

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17
Q

Legal -

A

Based on court decision

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18
Q

Group insurance –

A

no medical needed

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19
Q

Individual –

Insurance

A

requires medical information.

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20
Q

Law of larger #s –

A

the larger the # the more predictable the loss
- Used to predict losses to establish rates
- Benefits the insured
- Mortality & Morbidity tables are based

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21
Q

Mortality –

A

life expectancy

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22
Q

Morbidity –

A

Illness or disability

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23
Q

MGA –

A

5% POLICYHOLDER SURPLUS

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24
Q

Balancing preferred & poor risk –

A

profitable distribution of exposures

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25
Q

Aleatory –

A

benefit paid contingent upon a future claim

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26
Q

ESOP Employee Stock Ownership Plan

A

– pension plan, company stocks to employees

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27
Q

Representation –

A

Statements made at time of application

28
Q

Consideration =

A

Exchange of values, applicant money, company offer life insurance

29
Q

Transacting Insurance:

A

NETS (Negotiations, Execution, Transaction, Solicitation)

30
Q

Term:

A

offers protection only, no cash value.

31
Q

TSA (403b)-

A

taxable upon withdrawal

32
Q

Tax Sheltered Annuities-

A

before tax contribution. Offered to public teachers, non-profit organization.

33
Q

Traditional IRA-

A

contribution/interest earned are TAXABLE.

34
Q

Roth Ira-

A

withdrawal prior age 59 1⁄2 is not taxed nor penalty. May withdraw at any time.

35
Q

Keogh Plan –

A

for self employed, soleprop,

36
Q

Conditional receipt –

A

obligates ins company to pay death claims. 3 conditions met: 1st premium, lab work is done, and all statements in the application are true and correct.

37
Q

Binding Receipt-

A

guarantees coverage after initial premium is paid

38
Q

Endowment –

A

Life ins. plan where insured receives face amount if they live until the end of the specified period, if die prematurely beneficiaries receives the face amount.

39
Q

Life license 24 hrs CE course;

A

Health – 24 hrs CE; Life & Health – 24 hrs

40
Q

Annuity CE Req

A

8 hrs initially; 4 hrs renewal

41
Q

3 branches of gov’t:

A

Legislative – enacts laws
Judicial – makes decisions
Executive – makes rulings; exercises judicial powers

42
Q

Classification of Insurers:

A
  1. Admitted complied with all requirements by DOI; receives certificate of authority for every class of insurance, can be domestic, foreign, or alien

Non-admitted – has not applies, denied

  1. Domestic, Foreign or alien
    Domestic – organized under the laws of State of CA, can be admitted or non- admitted
    Foreign – another State, can be admitted or non-admitted
    Alien – Outside the US
43
Q

Blanket Policy:

A

insured are not individually identified on the policy; rather it insures the entire class (Blanket Health Insurance Coverage).

44
Q

Types of Insurers:

A

1.Stock Insurance (Nonparticipating) - making profit for the stockholders. Stock co. sells shares to raise money, later company will share profit thru dividends to
stock holders not policy holders thus nonparticipating
2. Mutual Insurance – No stockholders, instead owners are the policyholders, this type is participating, company pay policy dividends
3. Fraternal Ins. Co. Known for their social, charitable activities. Sells insurance to members only
4. Captive Insurer, group of affiliated org. forms

45
Q

CLHIGA –

A

protection policyholders of life health annuities

46
Q

Basic coverage benefits:

A

80%, 250k per life and up to 100k cash value

47
Q

Discontinuance of Group Life & Disability

A

Discontinuance of Group Life & Disability

48
Q

CHLIGA-

A

Life & Health

49
Q

CIGA –

A

Prop & Casualty

50
Q

ACCIDENT & HEALTH REVIEW
Social Insurance System-Old, Age, Survivor, Disability, & Health Ins(OASDHI)

A

1) Retirementbenefitsfortheelderly
2) Survivorshipbenfordepof deceased workers
3) Disability
4) Medbenefitforelderly-medicare

51
Q

Classification of Status:

A
  1. FullyInsured:1QCage21until61or yr before you die or yr before disability
  2. Disability Ins: 20 QC during last 10 yrs and you’re fully insured
  3. CurrentlyIns:Atleast6SScredits during last 13 qtr ending calendar qtr she died, entitles disability or retirement benefits
52
Q

Blackout Period:

A

Widow/Widower receives income until youngest reaches age 16, then benefit ceases (blackout period) Until widow reach age 60
Widow will recd full retirement at age 65

53
Q

OASDHI Benefits

A
  1. Retirement
  2. SurvivorBenefits
  3. Disability Benefits: Total & Permanent. Waiting Period 5 months, Check will be on the 6th month
  4. Medicare: Helps cost of health care, does not cover all med expenses or LTC
    Part A paid FICA payroll tax 1.45+1.45
54
Q

Medicare 4 Parts

A

Part A-Hosp patient care, hospital insurance, SNF, some HH and Hospice. SS credits 40 calendar quarters-fully insured.
Part B- Pays Doctor services such as: outpatient or urgent care, outpatient physical/speech therapies, ambulance, medical equipment/supplies, and medical services not paid from Part A. Optional, everyone must pay monthly premium
Part C- Managed Care. Must continue to pay Part B to enroll Managed Care, provided by commercial companies
Part D- Medications prescribe for treatments is optional and pays premium.

55
Q

Part A-

A

Hosp patient care, hospital insurance, SNF, some HH and Hospice. SS credits 40 calendar quarters-fully insured.

56
Q

Part B-

A

Pays Doctor services such as: outpatient or urgent care, outpatient physical/speech therapies, ambulance, medical equipment/supplies, and medical services not paid from Part A. Optional, everyone must pay monthly premium

57
Q

Part C-

A

Part C- Managed Care. Must continue to pay Part B to enroll Managed Care, provided by commercial companies

58
Q

Part D-

A

Part D- Medications prescribe for treatments is optional and pays premium.

59
Q

Worker’s Comp
Part I:
Part II:

A

Part I: coverage
Part II: Employers liability

60
Q

DOI

A

claim, agent must reply within 10 days

61
Q

Estoppel.-

A

given up right, cant get it back

62
Q

HMO

A
  • specialists Cannot act as gatekeeper.
63
Q

Maternity Leave

A
  • 12 weeks per FMLA policy (unpaid
64
Q

WorkersComp

A
  • covers occupational, job related injury or sickness
  • 24 hours coverage including ER services
65
Q

Medicare

A
  • covers medical expenses, not disability income.
66
Q

Specified Disease Policy (example: cancer) -

A

Dread disease or limited policy

WFG (5 decks)

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