Insurance Regulation
4%of exam
LicensingDIFIAppointmentsCEDiscipline
Federal Rules
3%of exam
FCRAGLBAACADo Not Call1033
General Concepts
7%of exam
RiskHazardsContractsAgencyAuthority
L&H Basics
17%of exam
Insurable InterestUnderwritingNeedsDeliveryPremiums
Life Products
9%of exam
TermWhole LifeUniversal LifeVariable LifeGroup Life
Life Provisions
15%of exam
BeneficiariesRidersNonforfeitureLoansSettlement
Annuities
7%of exam
ImmediateDeferredFixedIndexedPayouts
Health Provisions
8%of exam
ClaimsGraceReinstatementExclusionsProof
Disability Insurance
6%of exam
Own OccupationAny OccupationResidualEliminationBOE
Medical Plans
11%of exam
HMOPPOPOSACAHIPAA
Group Health
3%of exam
COBRACertificatesContributoryConversionCoordination
Seniors + LTC
5%of exam
MedicareMedicaidMedigapADLsLTC
Federal Tax
5%of exam
LIFOFIFOMECHSAHDHP
Quick Facts
- Exam
- Series 13-33
- License
- Life + A&H
- Body
- PSI / DIFI
- Items
- 150 items
- Time
- 2.5 hours
- Fee
- $59
- Pass
- 70%
- Attempts
- 4 per year
- Delivery
- Center or online
- CE
- 48 hours/4 years
Sell vs Solicit
Sell
- Exchange coverage
- Complete transaction
Solicit
- Urge purchase
- Attempt transaction
Both need licensing
Exam Map
- 13-33
- Combined AZ exam
- DIFI
- State regulator
- PSI
- Exam vendor
- 150 items
- Timed test
- 2.5 hours
- Time limit
- 70%
- Passing score
- $59
- Exam fee
- Four attempts
- Annual limit
AZ Licensing
- Age
- 18 minimum
- Lawful presence
- Identity proof
- Fingerprints
- Background check
- NIPR
- License application
- Apply window
- One year
- Business entity
- Separate license
- Variable authority
- Life required
- Assumed name
- Report to DIFI
Producer Duties
- Sell
- Exchange insurance
- Solicit
- Urge purchase
- Negotiate
- Advise terms
- Premiums
- Fiduciary funds
- Records
- Keep available
- Change info
- Notify DIFI
- Report actions
- Disclose discipline
- CE
- Renewal education
Unfair Practices
- Misrepresentation
- False policy statement
- Twisting
- Misleading replacement
- Churning
- Commission replacement
- Rebating
- Illegal inducement
- Defamation
- False insurer attack
- Boycott
- Coercive refusal
- Discrimination
- Unfair class treatment
- Fraud
- Intentional deception
Federal Law
- FCRA
- Consumer reports
- GLBA
- Privacy notices
- HIPAA
- Health privacy
- ACA
- Health reforms
- GINA
- Genetic limits
- 1033
- Felony consent
- DNC
- Call restrictions
- CAN-SPAM
- Email rules
Contract Keys
O C C L forms valid contracts.
OfferConsiderationCompetent partiesLegal purpose
Express vs Apparent
Express
- Written power
- Contract granted
Apparent
- Public impression
- Insurer allowed
Source controls authority
Risk + Contracts
- Risk
- Chance of loss
- Peril
- Loss cause
- Hazard
- Increases loss
- Indemnity
- Restore financially
- Aleatory
- Unequal exchange
- Adhesion
- Insurer drafted
- Unilateral
- One enforceable promise
- Conditional
- Duties required
Underwriting Basics
- Application
- Primary source
- Producer report
- Field notes
- MIB
- Fraud database
- Inspection
- Consumer report
- Medical exam
- Health evidence
- APS
- Physician report
- Preferred
- Best risk
- Substandard
- Extra risk
Term vs Whole
Term
- Temporary
- No cash value
Whole
- Permanent
- Cash value
Need duration decides
Life Product Picker
- Temporary need→Term(Low premium)
- Mortgage balance→Decreasing term(Declining face)
- Lifetime guarantee→Whole life(Fixed premium)
- Flexible premium→Universal life(Adjustable)
- Market risk wanted→Variable life(Securities)
- Two insureds→Joint life(First death)
- Estate liquidity→Survivorship(Second death)
- Employee class→Group life(Master policy)
Life Products
- Level term
- Level face
- Decreasing term
- Declining face
- Whole life
- Permanent fixed
- Limited pay
- Short premium period
- Universal life
- Flexible premium
- Variable life
- Separate accounts
- Indexed UL
- Index crediting
- Group life
- Master policy
Policy Roles
- Owner
- Controls rights
- Insured
- Covered life
- Applicant
- Requests policy
- Beneficiary
- Receives proceeds
- Primary
- First paid
- Contingent
- Backup paid
- Revocable
- Change allowed
- Irrevocable
- Consent required
Life Provisions
- Free look
- Refund review
- Grace period
- Late-pay window
- Incontestability
- Challenge limit
- Reinstatement
- Restore lapse
- Misstatement
- Benefit adjustment
- Assignment
- Transfer rights
- Policy loan
- Borrow cash
- Entire contract
- Policy + application
Riders + Options
- Waiver
- Disability premium waiver
- ADB
- Accidental death extra
- GIR
- Future purchase
- Accelerated
- Early death benefit
- Cash surrender
- Take cash
- Extended term
- Same face temporary
- Reduced paid-up
- Smaller permanent
- Dividend
- Participating return
Annuity Parties
Owner controls; annuitant measures.
OwnerAnnuitantBeneficiary
Owner vs Annuitant
Owner
- Controls contract
- Names beneficiary
Annuitant
- Measuring life
- May lack control
Control follows owner
Annuity Picker
- Income now→Immediate(Payout soon)
- Income later→Deferred(Accumulation first)
- Principal safety→Fixed(Guaranteed)
- Market upside→Indexed(Formula)
- Investment control→Variable(Separate accounts)
- Highest payment→Life only(No refund)
- Protect survivor→Joint survivor(Two lives)
- Minimum payout→Period certain(Guaranteed term)
Annuity Map
- Owner
- Controls contract
- Annuitant
- Measuring life
- Beneficiary
- Receives remainder
- Accumulation
- Pay-in phase
- Annuitization
- Payout phase
- Immediate
- Pays soon
- Deferred
- Pays later
- GMWB
- Withdrawal guarantee
Annuity Types
- Fixed
- Guaranteed crediting
- Variable
- Separate accounts
- Indexed
- Index formula
- Single premium
- One payment
- Flexible premium
- Multiple payments
- Life only
- Highest lifetime
- Period certain
- Guaranteed period
- Joint survivor
- Two lives
Claim Flow
Notice, forms, proof, payment, action.
NoticeFormsProofPaymentLegal action
Health Provisions
- Claim forms
- Insurer supplies
- Proof loss
- Claim evidence
- Time payment
- Pay promptly
- Legal actions
- Suit timing
- Reinstatement
- Restore coverage
- Change occupation
- Risk adjustment
- Illegal occupation
- Claim exclusion
- Intoxicants
- Claim exclusion
Own vs Any
Own occupation
- Cannot do job
- Stronger definition
Any occupation
- Cannot work anywhere
- Stricter claim
Any is harder
Disability Map
- Own occupation
- Own job disabled
- Any occupation
- Any work disabled
- Partial
- Limited duties
- Residual
- Income loss
- Presumptive
- Automatic total
- Elimination
- Waiting period
- Benefit period
- Payment duration
- BOE
- Business expenses
HMO vs PPO
HMO
- Gatekeeper
- Network focus
PPO
- Provider choice
- Higher flexibility
Flexibility costs more
Health Plan Picker
- Lowest network cost→HMO(Gatekeeper)
- Provider flexibility→PPO(Out-network)
- Referral blend→POS(Hybrid)
- Broad expense risk→Major medical(Comprehensive)
- High deductible→HDHP(HSA eligible)
- Lost earnings→Disability income(Income)
- Custodial care→LTC(ADLs)
- Medicare gaps→Medigap(Supplement)
Medical Plans
- HMO
- Gatekeeper network
- PPO
- Preferred network
- POS
- Referral blend
- Major medical
- Broad coverage
- Deductible
- Before plan pays
- Coinsurance
- Cost percentage
- Stop-loss
- OOP cap
- Preauthorization
- Advance approval
ACA + HIPAA
- EHB
- Essential benefits
- Dependent age
- To 26
- Metal tiers
- Cost sharing
- Preexisting
- ACA limited
- Portability
- Coverage movement
- Privacy
- Health information
- HSA
- Tax savings
- HDHP
- HSA plan
Group Health
- Master policy
- Employer owns
- Certificate
- Member evidence
- Contributory
- Employee pays
- Noncontributory
- Employer pays
- COBRA
- Continuation rights
- Conversion
- Individual switch
- Open enrollment
- Choice window
- Coordination
- Primary order
Medicare ABCD
A hospital, B medical, C advantage, D drugs.
HospitalMedicalAdvantageDrugs
Medicare vs Medicaid
Medicare
- Age/disability
- Federal program
Medicaid
- Need based
- State/federal
Eligibility differs
Medicare + LTC
- Part A
- Hospital insurance
- Part B
- Medical insurance
- Part C
- Advantage plans
- Part D
- Drug coverage
- Medigap
- Supplement gaps
- Medicaid
- Need-based aid
- ADLs
- Care triggers
- Custodial
- Daily assistance
HSA vs FSA
HSA
- HDHP required
- Portable balance
FSA
- Employer plan
- Use-or-lose
HSA travels
Tax + Accounts
- LIFO
- Gain first
- FIFO
- Basis first
- MEC
- Overfunded life
- 1035
- Tax-free exchange
- HSA
- Triple tax
- HRA
- Employer funded
- FSA
- Use-or-lose
- HDHP
- High deductible
Common Traps
Replacement Trap
Replacement disclosure ≠ Not casual comparison
Authority Trap
Apparent authority ≠ Not written power
Free Look Trap
Refund review ≠ Not grace period
Annuity Trap
Annuitant measures ≠ Owner controls
Disability Trap
Elimination waits ≠ Probation screens
Tax Trap
MEC loses loans ≠ Death benefit still tax-free
Guaranty Trap
Safety net ≠ Not sales pitch
COBRA Trap
Continuation right ≠ Not conversion policy
Last Minute
- 1.13-33 = 150 items
- 2.Four failures trigger wait
- 3.Apply within one year
- 4.DIFI regulates Arizona insurance
- 5.Premiums are fiduciary funds
- 6.Rebating is prohibited
- 7.Twisting uses deception
- 8.Whole life builds cash
- 9.Annuitant measures payout
- 10.HMO uses gatekeeper
- 11.LTC trigger = ADLs
- 12.HSA requires HDHP
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