VA Regulation & Licensing
16%of exam
Life Insurance & Annuities
37%of exam
Life Policy ProvisionsLife Types & RidersNonforfeiture & SettlementAnnuity Best InterestReplacement RulesLife & Annuity Tax
Health & Disability
36%of exam
Senior & Special Needs
11%of exam
Quick Facts
- Exam
- Series 11-01
- Credential
- VA Life & Health Producer
- Time
- 150 minutes
- Pass
- 70% combined score
- Fee
- $35 per attempt
- Provider
- Prometric
- Questions
- 140 scored + 10 pretest
- CE
- 16 or 24 hrs biennial
CE Hours Mnemonic
One line means 16; two-plus lines means 24
Single: 16 hrsMulti: 24 hrsAlways: 3 ethicsCap: 75% insurer
CE & License Picker
- One license type held→16 CE hours(incl. 3 ethics)
- Two+ license types held→24 CE hours(8 hrs per type)
- New resident applicant→Exam + Fieldprint(Both required)
- Nonresident applicant→Home-state license only(No VA exam)
- License lapses too long→Must retest(CE alone insufficient)
- Address or name changes→Report within 30 days
VA Regulatory Structure
- SCC
- State Corporation Commission
- BOI
- Bureau of Insurance
- Commissioner of Insurance
- Appointed by SCC
- Title 38.2
- VA insurance statute
- 14 VAC
- VA insurance regulations
- Domestic insurer
- Chartered in Virginia
- Foreign insurer
- Chartered other US state
- Alien insurer
- Chartered outside US
- Certificate of Authority
- Required to transact business
Licensing & Fees
- Exam vendor
- Prometric
- Passing score
- 70% combined
- Exam fee
- $35 per attempt
- Fingerprint vendor
- Fieldprint (~$34.95)
- Application fee
- $15 to BOI
- Result validity
- 12 months
- Nonresident license
- No VA exam needed
- Appointment
- Insurer files to authorize
- Pre-licensing education
- Not required in VA
CE & Renewal
- Single license CE
- 16 hrs biennial
- Multi license CE
- 24 hrs biennial
- Ethics minimum
- 3 hours every cycle
- Insurer-provided CE cap
- Max 75%
- Carryover
- Not allowed
- Renewal cycle
- Birth month, year parity
- Change reporting
- Within 30 days
- Lapsed too long
- Must retest if terminated
Unfair Trade Practices
- Misrepresentation
- False or misleading statement
- False advertising
- Deceptive net impression
- Rebating
- Inducement not in contract
- Twisting
- Misrepresents to replace policy
- Churning
- Same-insurer replacement scheme
- Coercion
- Threat to force purchase
- Defamation
- False claim vs competitor
- Unfair discrimination
- Same class, different terms
- Willful penalty
- Up to $5,000
Free Look Numbers
Life 10, Replace 30, LTC 30, Health 10
Life: 10 daysReplacement: 30 daysLTC: 30 daysHealth/DI: 10 days
Twisting vs Churning
Twisting
- Misrepresentation to replace
- Any insurer involved
- Induces the switch
Churning
- Same insurer replacement
- Uses existing cash value
- Generates new commission
Different company vs same
Free Look Period Picker
- Individual life policy→10 days(Full refund)
- Life/annuity replacing coverage→30 days(Enhanced window)
- Individual annuity, no replace→10 days
- Individual health/DI policy→10 days
- Long-term care policy→30 days
- Annuity replacement (14VAC5-30)→10 days minimum(Insurer-set)
Life Policy Provisions
- Free look (life)
- 10 days
- Free look (replacement)
- 30 days
- Incontestability
- 2 years from issue
- Suicide clause
- 2 years, refund only
- Grace period
- 31 days, benefit reduced
- Reinstatement window
- 3 years, with interest
- Misstatement of age
- Adjusts benefit, never voids
- Entire contract
- Policy + application only
Annuity Best Interest CDCD
Care, Disclosure, Conflict, Documentation drive every recommendation
C: know consumerD: CN01 formC: manage conflictsD: written record
Fixed vs Variable Annuity
Fixed Annuity
- Guaranteed interest rate
- Insurance product only
- No securities license
Variable Annuity
- Sub-account investment risk
- Also a security
- Needs Series 6/7
Guaranteed vs market risk
Replacement Suitability Path
- Existing coverage will lapse→Trigger 14VAC5-30 replacement(Signed notice required)
- Signed replacement notice done→Submit to replacing insurer
- Replacing insurer gets app→Notify existing insurer(Within 5 business days)
- Existing insurer notified→May attempt conservation
- New policy issued→30-day free look(Clocks restart)
- Recommendation not documented→Best-interest failure risk
Life Types & Riders
- Term life
- Level premium, no cash value
- Whole life
- Permanent, guaranteed cash value
- Universal life
- Flexible premium, adjustable benefit
- Variable life
- Sub-accounts, investment risk
- Waiver of premium rider
- Waives premium if disabled
- Accelerated death benefit rider
- Early payout, terminal illness
- Guaranteed insurability rider
- Buy more, no exam
- Payor rider
- Waives premium if payor dies
- Accidental death rider
- Extra benefit, accidental death
Nonforfeiture & Settlement
- Cash surrender
- Lump-sum cash value
- Reduced paid-up
- Smaller, fully paid policy
- Extended term
- Default option, term coverage
- Interest only
- Insurer holds, pays interest
- Fixed period
- Equal payments, set years
- Fixed amount
- Set payments until exhausted
- Life income
- Payments for lifetime
Annuity Best Interest 14VAC5-45
- Care obligation
- Reasonable basis, know product
- Disclosure obligation
- CN01 form, before recommendation
- Conflict obligation
- Identify, manage, or disclose
- Documentation obligation
- Written basis, retained record
- CN02 form
- Consumer refuses information
- CN03 form
- Purchase not based on recommendation
- Annuity training
- One-time 4 credit hours
- Consumer profile
- Age, income, objectives, risk
Replacement Rules 14VAC5-30
- Replacement notice
- Signed, left with applicant
- Insurer notice deadline
- 5 business days
- Replacement free look
- 30 days
- Restarted clocks
- New incontestability, suicide period
- Twisting
- Different insurer, misrepresentation
- Churning
- Same insurer, new commission
- Records retention
- 5 years minimum
- Conservation right
- Existing insurer may retain
Life & Annuity Tax
- Lump sum death benefit
- Income-tax-free
- Installment interest
- Taxable portion only
- Withdrawal taxation
- LIFO, gains first
- Early withdrawal penalty
- 10% before 59.5
- Annuitization
- Exclusion ratio, basis tax-free
- 1035 exchange
- Tax-free annuity/life swap
- Qualified plans
- 401k, 403b, 457 plans
Federal COBRA vs VA Mini-COBRA
Federal COBRA
- 20+ employees
- 18-36 months
- 60-day election
VA Mini-COBRA
- 2-19 employees
- Up to 12 months
- 31-day election
Employer size sets track
Health Continuation Picker
- Employer has 20+ workers→Federal COBRA(18-36 months)
- Employer has 2-19 workers→VA mini-COBRA(Up to 12 months)
- Employee fired for misconduct→No COBRA rights
- Small group, 2-50 employees→Guaranteed issue plan
- Group life member terminates→31-day conversion right
- Medicare-eligible, wants supplement→Check Medigap OEP or GI
Health Policy Basics
- HMO
- Network only, PCP referral
- PPO
- In/out network, no referral
- POS
- HMO + PPO hybrid
- EPO
- Network only, no referral
- Deductible
- Paid before coverage starts
- Coinsurance
- Shared cost percentage
- Copay
- Flat fee per visit
- Out-of-pocket max
- Insured's annual cost cap
- Indemnity plan
- Reimburses, any provider
Guaranteed Issue vs Renewable
Guaranteed Issue
- Must accept applicant
- No health screening
- Getting the policy
Guaranteed Renewable
- Must renew policy
- Premium may rise
- Keeping the policy
Getting vs keeping coverage
Individual Health Provisions
- Free look (health)
- 10 days
- Essential Health Benefits
- 10 ACA categories
- Guaranteed issue
- Must accept all applicants
- Guaranteed renewable
- Cannot deny renewal
- Noncancelable
- Premium and benefits locked
- Conditionally renewable
- Renew only if conditions met
- Notice of claim
- Within 20 days
- Proof of loss
- Within 90 days
- Legal action window
- 60 days to 3 years
HMO vs PPO
HMO
- PCP gatekeeper required
- In-network only
- Lower premium
PPO
- No referral needed
- In and out network
- Higher premium
Restricted vs flexible network
Disability Income
- Own occupation
- Cannot do own job
- Any occupation
- Cannot do any job
- Elimination period
- Waiting period before benefits
- Benefit period
- How long benefits pay
- Residual disability
- Partial income replacement
- Individually-paid premium
- Benefits tax-free
- Employer-paid premium
- Benefits taxable
Noncancelable vs Guaranteed Renewable
Noncancelable
- Premium locked forever
- Insurer cannot cancel
- Strongest DI protection
Guaranteed Renewable
- Insurer must renew
- Premium rises by class
- Cannot single out insured
Locked rate vs class rate
Group Health & COBRA
- Federal COBRA
- 20+ employees, 18-36 months
- VA mini-COBRA
- 2-19 employees, up to 12mo
- Mini-COBRA notice
- 14 days from event
- Mini-COBRA election
- 31 days from notice
- COBRA premium
- Up to 102% of cost
- Small group market
- 2-50 employees, guaranteed issue
- Gross misconduct
- Disqualifies COBRA continuation
- Group life conversion
- 31 days, no evidence
ACA Marketplace & Tax
- Bronze tier
- ~60% actuarial value
- Silver tier
- ~70% actuarial value
- Gold tier
- ~80% actuarial value
- Platinum tier
- ~90% actuarial value
- Premium tax credit
- Scales with income
- Cost-sharing reduction
- Silver plans only
- VA Marketplace
- vainsurancemarketplace.gov, own platform
- Mental health parity
- Equal to medical benefits
Guaranty Association Caps
300 death, 100 cash, 250 annuity, 350 aggregate
Life death: $300kCash value: $100kAnnuity: $250kAggregate: $350k
Medigap OEP vs Birthday Rule
OEP
- One-time, age 65
- 6-month window
- Any plan A-N
Birthday Rule
- Annual, every year
- 60-day window
- Equal-or-lesser plan only
Once vs every year
Medicare & Medigap
- Medicare Part A
- Hospital coverage
- Medicare Part B
- Medical coverage
- Medicare Part C
- Medicare Advantage
- Medicare Part D
- Prescription drugs
- Medigap OEP length
- 6 months
- OEP trigger
- Age 65 and Part B
- GI trigger window
- 63 days after loss
- VA Birthday Rule
- 60 days after birthday
- Plans C & F
- Closed after Jan 2020
- Trial right
- 12 months back to Medigap
LTC & Guaranty Assoc
- LTC free look
- 30 days
- LTC ADL trigger
- 2 of 6 ADLs
- LTC training
- 8 hrs initial, 4 refresher
- Partnership Program
- Dollar-for-dollar Medicaid protection
- Guaranty death benefit
- $300,000 cap
- Guaranty cash value
- $100,000 cap
- Guaranty annuity
- $250,000 cap
- Guaranty health plan
- $500,000 cap
- Guaranty aggregate cap
- $350,000 per life
- No advertising rule
- Never a selling point
- Medicaid expansion
- 138% FPL, since 2019
- FAMIS
- VA's CHIP, ~200% FPL
Common Traps
Guaranteed issue vs renewable
Issue = getting policy ≠ Renewable = keeping policy
Twisting vs churning
Twisting = different insurer ≠ Churning = same insurer
Life free look vs LTC
Life/health = 10 days ≠ LTC/replace = 30 days
Federal vs VA COBRA
Federal = 18-36 months ≠ VA mini = 12 months
Medigap OEP vs Birthday Rule
OEP = one-time only ≠ Birthday Rule = annual
Rebating vs coercion
Rebating = inducement offered ≠ Coercion = threat used
Death benefit vs cash value cap
Death benefit = $300k ≠ Cash value = $100k
Agent vs broker
Agent = represents insurer ≠ Broker = represents applicant
Last Minute
- 1.Series 11-01: 140 scored, 10 pretest
- 2.150 minutes total; 70% to pass
- 3.$35 exam fee via Prometric
- 4.Fieldprint fingerprints cost about $34.95
- 5.CE: 16 hrs single, 24 multi
- 6.Ethics: 3 hours every renewal
- 7.Life free look: 10 days
- 8.Replacement free look: 30 days
- 9.Grace period: 31 days
- 10.VALIFEGA aggregate cap: $350,000 per life
- 11.Never advertise Guaranty Association coverage
- 12.Federal 20+ employees; VA mini 2-19
- 13.Medigap OEP 6 months, one-time only
- 14.VA Medicaid expansion: 138% FPL
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