NY Life & Health Exam Flashcards

Q: How many questions are on the New York Life & Health exam, and what is the passing score?

The New York Life, Accident & Health exam has 150 multiple-choice questions and a 150-minute time limit, with a 70% passing score (about 105 correct answers). It is administered by PSI Services LLC under contract to the New York Department of Financial Services (DFS) and costs $33 per attempt.

Q: How much pre-licensing education does New York require?

A combined Life, Accident & Health license requires 40 hours of DFS-approved pre-licensing education. Life-only and Accident & Health-only each require 20 hours. Live-classroom approvals require at least 20 classroom hours for the combined license, and a separate proctored Certification Exam at 70% in a single 90-minute sitting must be passed before scheduling the PSI state exam.

Q: What is New York Regulation 187?

Regulation 187 (11 NYCRR 224) imposes a best-interest standard on life insurance and annuity recommendations, effective August 1, 2019 for annuities and February 1, 2020 for life insurance. The producer must act with care, disclose compensation and conflicts, manage material conflicts, and document the basis for the recommendation, considering only the consumer's interests rather than the producer's compensation.

Q: What is the New York Life Insurance Company Guaranty Corporation?

The Life and Health Insurance Company Guaranty Corporation of New York protects residents when a member life or health insurer becomes insolvent, with a $500,000 aggregate-per-life cap across all covered individual benefits and a $1,000,000 cap for unallocated group annuity and funding-agreement benefits. Under Insurance Law Section 2329, producers may not use this guaranty protection as an inducement to buy insurance.

Q: How often must a New York Life & Health producer renew, and what CE is required?

Resident producer licenses renew every 2 years on a cycle tied to the licensee's birthday. Each cycle requires 15 hours of approved continuing education, including three mandatory one-hour topics: ethics & professionalism, insurance law, and diversity, inclusion & elimination of bias. Dual Life/Health and Property/Casualty licensees must complete 30 hours total, with at least 15 in each line of authority.

Q: What is the difference between DBL and Paid Family Leave in New York?

Disability Benefits Law (DBL) covers the employee's own off-the-job illness or injury, paying 50% of average weekly wages up to $170 per week for up to 26 weeks after a 7-day waiting period, and is employer-funded. Paid Family Leave (PFL) covers bonding with a new child, caring for a family member, or assisting during active military deployment, paying 67% of average weekly wage for up to 12 weeks (2026 cap $1,228.53/week), funded entirely by employee payroll deductions. The two combined cannot exceed 26 weeks in any 52-week period.

Question 1

Why is there no 'New York Department of Insurance'?

Accepted Answer

New York merged its Insurance Department and Banking Department into the Department of Financial Services (DFS) in 2011 under the Financial Services Law. DFS regulates insurance, banking, and other financial services, so a standalone 'NY Department of Insurance' no longer exists — answer choices using that name are outdated and wrong.

Question 2

How is New York's Superintendent of Financial Services chosen?

Accepted Answer

The Superintendent is appointed by the Governor with State Senate confirmation and serves at the pleasure of the Governor — never elected. This differs from states with an elected insurance commissioner; any answer choice saying New York's top insurance regulator is 'elected by voters' is incorrect.

Question 3

Insurance Law vs. Title 11 NYCRR — who writes each?

Accepted Answer

The New York Legislature passes the Insurance Law (the statute). The Superintendent of Financial Services adopts regulations in Title 11 of the NYCRR (the operating detail that implements the statute). Confusing the two flips who writes what — statutes come from lawmakers, regulations from the Superintendent.

Question 4

Regulation 60 vs. 64 vs. 187 — what does each cover?

Accepted Answer

Regulation 60 governs replacement of life insurance and annuities (disclosure and comparison). Regulation 64 governs unfair claim settlement practices and claim-handling timelines. Regulation 187 imposes the best-interest standard on life and annuity recommendations. Examiners swap the numbers to test you — map each number to its subject.

Question 5

What does 'prior-approval state' mean for New York life policy forms?

Accepted Answer

Under NY Insurance Law Section 3201, no life insurance policy may be delivered in New York until DFS approves the form. Unlike 'file-and-use' states, insurers must wait for affirmative approval before selling a form — prohibited or misleading provisions are screened out at the front end, before any consumer sees them.

Question 6

How many pre-licensing education hours for a combined NY Life, Accident & Health license?

Accepted Answer

40 hours total — 20 attributable to Life and 20 to Accident & Health, from a DFS-approved provider. For live-classroom approvals, at least 20 hours must be in a supervised classroom; approved online courses use forced progression with seat-time timers. New York caps study at 8 hours per day.

Question 7

What must a candidate earn before scheduling the PSI state exam?

Accepted Answer

A Certificate of Completion, issued only after passing the provider's proctored Certification Exam at 70% in a single 90-minute sitting. PSI will not register the candidate without it, and the certificate stays valid for 2 years — pass the state exam within that window or repeat the education.

Question 8

Who administers the New York insurance licensing exam?

Accepted Answer

PSI Services LLC delivers New York insurance licensing exams, at PSI test centers or via remote online proctoring. Prometric and Pearson VUE administer other programs but not the New York producer exam — answer choices naming them are distractors.

Question 9

Insurance agent vs. broker in New York — whom does each represent?

Accepted Answer

An agent is appointed by and represents the insurer(s); an agent's knowledge and actions are imputed to the insurer. A broker represents the consumer placing coverage, not the insurer. The distinction drives agency-law consequences on the exam — including whose knowledge can bind the carrier.

Question 10

Who handles fingerprinting for NY insurance license applicants?

Accepted Answer

IdentoGO (IDEMIA), the state's electronic fingerprint vendor, transmits results directly to DFS for a criminal-history review. A criminal record is not an automatic bar — DFS weighs the nature of the offense, time elapsed, and rehabilitation. Crimes involving fraud, dishonesty, or breach of trust bear most directly on insurance fitness, and certain felonies require federal 1033 written consent.

Question 11

When does a New York resident producer license renew?

Accepted Answer

Every 2 years on a cycle tied to the licensee's date of birth — not a fixed calendar date. Two producers licensed the same day can have different renewal deadlines. The producer is responsible for tracking their own expiration; missing a DFS reminder is not a defense.

Question 12

What three mandatory one-hour topics sit inside the 15-hour CE requirement?

Accepted Answer

Ethics & professionalism, insurance law, and diversity, inclusion & elimination of bias — three distinct one-hour topics, not collapsible into one. The remaining electives fill out 15 total hours per 2-year cycle for Life, Accident & Health producers. Older study notes that list only '1 hour ethics' are out of date.

Question 13

CE hours for a producer holding both L&H and P&C licenses?

Accepted Answer

30 hours total per cycle, with at least 15 hours in each line of authority. The mandatory ethics, insurance law, and diversity/inclusion topics still apply. Combining lines doubles the total — it does not collapse to a single 15-hour obligation, and excess hours cannot carry over to the next cycle.

Question 14

What happens if a New York producer's license has been expired more than 2 years?

Accepted Answer

DFS generally will not reinstate it; the individual must re-qualify as a new applicant through re-examination and re-application. A short lapse may be curable by completing outstanding CE and paying fees, but a long lapse forces starting over — complete CE early and renew before the birthday deadline.

Question 15

Free-look period on a new vs. replacement New York life policy?

Accepted Answer

10 days minimum on a new individual life policy (NYIL Section 3203). A replacement under Regulation 60 extends the free look to 60 days. The 20-day figure in Reg 60 is the existing insurer's deadline to furnish in-force data — it is NOT the consumer's free look, despite what older study notes claim.

Question 16

How long is the incontestability period on a New York life policy?

Accepted Answer

2 years from issue (NYIL Section 3203(a)(3)). After that, the insurer cannot contest the policy except for nonpayment of premium (and a narrow fraud-in-procurement carve-out the statute allows). Reinstatement restarts a fresh contestable period limited to statements in the reinstatement application.

Question 17

What does the insurer pay if suicide occurs within 2 years of issue?

Accepted Answer

Only a refund of premiums paid — not the face amount. NYIL Section 3203(a)(2) caps the suicide exclusion at 2 years (sane or insane). After 2 years, suicide is a fully covered cause of death and the full face amount is payable, so the beneficiary's recovery depends entirely on when the death occurs.

Question 18

What happens if the insured's age was misstated on the application?

Accepted Answer

The benefit is adjusted to what the premium paid would have purchased at the correct age — the policy is not voided. If a 45-year-old's policy was issued on a 40-year-old's premium, the death claim is reduced, not denied. This 'adjust, don't void' rule is the misstatement-of-age provision in action.

Question 19

What readability standard does New York impose on life and annuity forms?

Accepted Answer

NYIL Section 3102 requires individual life and annuity forms to score at least 45 on the Flesch Reading Ease scale, use at least 10-point type, and present captioned sections so a consumer can locate key provisions. A non-compliant form is disapproved by DFS before it can be sold — plain-language compliance is a filing gate.

Question 20

Regulation 187 — best interest vs. suitability?

Accepted Answer

Reg 187 (11 NYCRR 224) raised New York from a suitability standard to a best-interest standard: the recommendation must reflect the care, skill, prudence, and diligence a prudent person would use, considering only the consumer's interests — not the producer's compensation. It is higher than suitability but below a full fiduciary duty; 'fiduciary' is a common wrong-answer distractor.

Question 21

When did Regulation 187 take effect for annuities vs. life insurance?

Accepted Answer

August 1, 2019 for annuity transactions; February 1, 2020 for life insurance transactions. The Court of Appeals upheld the rule as constitutional in October 2022, but that is the constitutional-ruling date, not the effective date — examiners swap these dates to test you.

Question 22

What four obligations does Regulation 187 impose on a producer?

Accepted Answer

Care (a reasonable basis that the product is in the consumer's best interest), disclosure (role, products offered, sources and types of compensation), conflict-of-interest (manage material conflicts; don't let incentives drive the recommendation), and documentation (retain the basis for the recommendation). All four must be met for every covered life or annuity recommendation.

Question 23

What training must a producer complete before recommending a New York annuity?

Accepted Answer

A one-time general best-interest / Reg 187 course (commonly four credit hours) plus product-specific training for each annuity product before soliciting it. The insurer must verify both — selling without the required training is itself a violation, independent of whether the sale was otherwise appropriate.

Question 24

Free-look window on a new vs. replacement annuity?

Accepted Answer

10 days on a new (non-replacement) individual annuity under NYIL Section 3219. A replacement under Regulation 60 extends the free look to 60 days, with an unconditional refund of premium (or, for variable/MVA contracts, the cash surrender value plus all deducted charges). Surrender charges do NOT apply during the free-look window.

Question 25

What transactions trigger Regulation 60?

Accepted Answer

Any new life policy or annuity where existing coverage is lapsed, forfeited, surrendered, reduced in value, borrowed against to fund the new contract, converted to reduced paid-up or extended term, or amended to reduce benefits. Treating a replacement as a fresh sale to skip the paperwork is itself a violation — the full Reg 60 process must be followed.

Question 26

When must the Appendix 10C IMPORTANT Notice be delivered?

Accepted Answer

No later than the time of application — the replacing producer hands the applicant the IMPORTANT Notice Regarding Replacement before or as the application is signed. The signed Disclosure Statement is then due no later than the time of policy delivery. Separating these two deadlines is a tested distinction.

Question 27

What do the 20-day and 60-day figures under Regulation 60 mean?

Accepted Answer

The 20-day window is the existing insurer's deadline to furnish in-force data so the replacing producer can complete the Disclosure Statement. The 60-day window is the consumer's replacement free look. Mixing them up is the single most common error on this topic — they describe different obligations owed to different parties.

Question 28

Twisting vs. churning — what distinguishes them?

Accepted Answer

Twisting is misrepresenting facts to induce a policyholder to drop one insurer's policy and buy another (replacement across companies via misstatement). Churning is inducing replacement of the same customer's own policies, often using one policy's cash value to fund another with the same or affiliated insurer, mainly to generate new commissions. Both are prohibited and can bring license revocation.

Question 29

How does New York's pure community rating differ from the ACA?

Accepted Answer

New York forbids age as a rating factor on individual and small-group plans — no 3:1 age band and no tobacco surcharge. Only geographic region and family tier may vary the premium. A 60-year-old and a 25-year-old pay the same base premium for the same New York individual plan, unlike the federal ACA rule which permits age-based pricing.

Question 30

May a New York insurer deny or non-renew an individual health policy based on health?

Accepted Answer

No. New York requires guaranteed issue (issue to every applicant regardless of health) and guaranteed renewability in every market — individual, small group, and large group. An insurer may non-renew only for nonpayment, fraud or material misrepresentation, the insured moving out of the service area, or carrier withdrawal of the entire product with advance notice and a replacement offer.

Question 31

Where can a New Yorker claim Advance Premium Tax Credits or enroll in the Essential Plan?

Accepted Answer

Only through NY State of Health, the state-run ACA marketplace. New York operates a state-based exchange rather than using HealthCare.gov, and subsidies cannot be applied to off-exchange purchases. Cost-Sharing Reductions attach only to Silver metal-tier plans, and the Essential Plan covers adults up to roughly 250% of the federal poverty level.

Question 32

What does Timothy's Law require?

Accepted Answer

Mental health and substance-use benefits must be provided at full parity with medical and surgical benefits — no higher copays, separate deductibles, or more restrictive visit or day limits. Named for 12-year-old Timothy O'Clair and effective 2007, it complements the federal MHPAEA and is the specifically New York mandate the exam expects you to name.

Question 33

How long can a dependent stay on a parent's New York group health plan?

Accepted Answer

Through age 29 under New York's Age 29 law — beyond the federal ACA age-26 mandate — if the young adult is unmarried, has no other employer coverage, and lives or works in New York. The extension is a distinctively New York fact and is often at the young adult's own cost; it is not automatic.

Question 34

How does New York's Medigap open enrollment differ from most states?

Accepted Answer

New York requires continuous, year-round guaranteed issue — an insurer must sell any Medigap plan to any applicant any day of the year, with no medical underwriting and no pre-existing waiting period. Most states guarantee issue only during the federal 6-month window after the beneficiary turns 65 and enrolls in Part B; outside that window they permit underwriting.

Question 35

How may Medigap premiums vary by the insured's age in New York?

Accepted Answer

They may not — New York requires community rating on Medigap, banning both issue-age and attained-age rating. An 85-year-old pays the same base rate as a 65-year-old for the identical plan. Community-wide increases for inflation or claims can still occur; what is barred are age-based differences. The trade-off is that New York's base Medigap premiums are among the highest in the nation.

Question 36

Which Medigap plans are closed to people newly eligible for Medicare on or after January 1, 2020?

Accepted Answer

Plans C and F, because both cover the Medicare Part B deductible. The MACRA rule closed them to new eligibles starting January 1, 2020. People eligible before that date may still hold or buy them; new eligibles typically choose Plan G as the comprehensive alternative.

Question 37

May a producer sell Medigap to a Medicaid recipient or sell a second Medigap policy?

Accepted Answer

No to both. Selling Medigap to someone enrolled in Medicaid is prohibited because it duplicates coverage the consumer already has, and selling a duplicate Medigap policy is also banned. Replacing one Medigap policy with another requires a signed replacement notice. The correct action when faced with either scenario is to decline the sale and explain why.

Question 38

What does New York's Disability Benefits Law (DBL) pay?

Accepted Answer

DBL covers off-the-job illness or injury (and pregnancy disability), paying 50% of average weekly wages up to a maximum of $170 per week for up to 26 weeks in any 52-week period, after a 7-day waiting period. The $170 weekly cap has been unchanged since 1989 and is the number most-tested. On-the-job injuries go to Workers' Compensation, not DBL.

Question 39

Paid Family Leave (PFL) vs. DBL — what is the difference?

Accepted Answer

PFL pays 67% of the employee's average weekly wage for up to 12 weeks (2026 cap $1,228.53/week) for bonding with a new child, caring for a family member with a serious health condition, or assisting during active military deployment; it is funded entirely by employee payroll deductions. DBL covers the employee's own off-the-job disability at 50% up to $170/week for 26 weeks and is employer-funded. The two combined cannot exceed 26 weeks in 52.

Question 40

What must a producer complete before selling LTC in New York?

Accepted Answer

A one-time 8-hour LTC training course, in addition to holding an accident and health license. To market the NY State Partnership for Long-Term Care product specifically, the producer must also complete the additional Partnership certification training. Ongoing CE is required, and suitability — including how the surrender period fits the client's age and liquidity — must be documented for each sale.

Question 41

Total Asset Protection vs. Dollar-for-Dollar under the NY LTC Partnership?

Accepted Answer

Under Total Asset Protection, Medicaid disregards all of the policyholder's assets after Partnership benefits exhaust (NY's distinctive option). Under Dollar-for-Dollar, the protected amount equals the dollar value of benefits the policy paid. Both let the insured qualify for Medicaid Extended Coverage without spending down to the standard asset limit, but Total Asset Protection shields more wealth.

Question 42

What is rebating, and what are the narrow permitted exceptions?

Accepted Answer

Rebating is offering valuable consideration not stated in the policy as an inducement to buy — prohibited under NYIL Section 2324 for both the producer who offers and the applicant who knowingly accepts. Narrow permitted exceptions include participating-policy dividends specified in the contract, bona fide loss-prevention services, value-added services disclosed and offered uniformly, and a producer retaining the commission on a policy on the producer's own life.

Question 43

Under Regulation 64, how many business days does an insurer have to acknowledge and to affirm or deny a claim?

Accepted Answer

15 business days to acknowledge receipt of the claim, and 15 business days to affirm or deny liability after receiving all requested proof-of-loss items. Suspected-arson claims get an extended 30-business-day window. These are exact figures, heavily tested — older study guides often state them incorrectly.

Question 44

What is commingling, and why is it serious?

Accepted Answer

Commingling is mixing premiums held in a fiduciary capacity with personal or operating funds, prohibited under NYIL Section 2120. Premiums must sit in a clearly designated trust or premium account and be remitted to the insurer promptly per the agency agreement. Commingling is among the fastest paths to license revocation and possible criminal larceny charges, plus mandatory restitution.

Question 45

Civil penalty amounts for non-willful vs. willful unfair practices?

Accepted Answer

Up to $1,000 per violation for non-willful acts and up to $5,000 per willful violation under NYIL Section 2406, in addition to license suspension or revocation. Willful twisting or churning can also be prosecuted as a misdemeanor. Each itemized unfair practice is independently chargeable, so a single act can implicate several violations at once.

Question 46

What is the New York group life conversion privilege?

Accepted Answer

Under NYIL Section 3220, an insured whose coverage ends or reduces may convert to an individual policy within 31 days with no evidence of insurability. The converted policy may not be term — it is a permanent (typically whole life) form at the carrier's standard rate for the insured's attained age, capped at the group amount lost. If the insured dies during the 31-day window, the full group amount is payable even if no application was made.

Question 47

What happens if the group life conversion notice is given late or not at all?

Accepted Answer

Notice must be given within 15 days before or after the triggering event. If given 15–90 days late, the conversion window extends to 45 days after notice. If no notice is given within 90 days, the right expires at the end of day 90. The protective accommodation, not automatic expiration, applies when the insurer delays notice.

Question 48

New York small-group size and mini-COBRA coverage?

Accepted Answer

New York defines a small group as 1–100 full-time-equivalent employees — broader than the federal 50-employee default — triggering guaranteed issue and community rating. Federal COBRA applies to employers with 20+ employees; New York mini-COBRA covers groups under 20 and extends total continuation to a combined 36 months. COBRA premium may reach 102% of the group rate.

Question 49

What are the 2-year and 15-day rules under NY Insurance Law Article 78 (Life Settlements)?

Accepted Answer

A policy generally cannot be settled during the 2-year period after issuance (an anti-STOLI safeguard), and the owner has an unconditional right to rescind until 15 days after receiving the proceeds. If the provider fails to give written notice of the rescission right, that right is tolled 30 days after notice is finally given. Providers and brokers must be licensed by DFS.

Question 50

Why is Stranger-Originated Life Insurance (STOLI) illegal in New York?

Accepted Answer

STOLI lacks insurable interest at issue — an outside investor finances a policy on someone's life intending to become the beneficiary, treating human life as a speculative investment and creating moral hazard. Insurable interest must exist at issue; the 2-year ownership rule under Article 78 is the legal weapon that blocks STOLI. A legitimate life settlement, by contrast, involves a policy originally taken out for a real need and later sold.

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