Free OH Life & Health Exam Flashcards

State agency that regulates insurance in Ohio. Headed by the Superintendent of Insurance, who is appointed by the Governor with Senate confirmation. Enforces Ohio Revised Code Title 39, licenses producers, approves forms, and handles consumer complaints.

The portion of Ohio statute containing insurance law: producer licensing, policy provisions, unfair practices, claims handling, and ODI authority. Chapter 3905 specifically governs insurance producers.

Ohio statute requiring resident producer applicants to submit fingerprints for a BCI and FBI criminal background check. Prints are taken through a WebCheck provider or PSI; results go directly to ODI.

Combined Life, Accident & Health producer exam: 150 questions, 2.5 hours, 70% passing score, $49 fee, administered by PSI. Candidates must present valid prelicense certificates for BOTH Life and A&H lines on test day.

20 hours of approved education per major line — so 40 hours total for combined Life + Accident & Health. Certificates are valid 180 calendar days from issuance and must be presented at the testing center.

Resident major-line producers complete 24 hours of CE every 2-year license cycle, including 3 hours of ethics. CE must be finished before the renewal deadline (last day of birth month).

Ohio resident producer licenses renew every 2 years by the last day of the licensee's birth month. A one-month late period is available with a $50 late fee; expiration of more than 12 months requires retaking the exam.

Producers must notify ODI within 30 days of changes to legal name, residence or business address, email, administrative actions by another state, or criminal charges/convictions. Failure to report can trigger fines or other discipline.

After licensure a producer must be appointed by an insurer to sell that company's products in Ohio. Appointments are filed with ODI, the appointing insurer is responsible for the producer's conduct, and a producer may hold multiple appointments.

10 days on new individual life insurance and annuity contracts, measured from policy delivery. Owner can return the policy for a full refund of premiums paid; no questions and no penalty.

Extended to 30 days when a new life insurance or annuity contract replaces an existing one. The longer window gives consumers time to compare the new and old coverage before forfeiting the original policy.

The replacing insurer must notify the existing insurer within 5 business days of receiving a replacement application. The existing insurer then has roughly 20 days to contact the owner and try to conserve the policy.

Inducing a policy owner to replace existing coverage through misrepresentation or incomplete comparison. Prohibited in Ohio; penalties include license suspension or revocation and per-violation fines.

Replacing a customer's policies repeatedly — often using cash values of the existing policy — to generate new commissions rather than to benefit the client. Prohibited as an unfair trade practice.

Nonprofit association of life and health insurers that protects Ohio policyholders if a member insurer becomes insolvent. Funded by assessments on member insurers; producers may NOT advertise OLHIGA as a sales inducement.

Typical Ohio limits per insured life: $300,000 life insurance death benefit, $100,000 life cash surrender value, $250,000 annuity present value, $500,000 major medical, and $300,000 disability or long-term care.

A reasonable expectation that the policy owner will suffer financial or emotional loss at the insured's death. In life insurance it must exist at policy issue (not at death) and is presumed between spouses and close family.

A contract drafted by one party (the insurer) and accepted by the other (the applicant) without negotiation. Ambiguities are interpreted against the insurer — the drafting party.

A contract in which the values exchanged are unequal: a small premium may yield a large benefit, or no benefit at all. Life and health insurance contracts are aleatory.

A warranty is guaranteed true and any breach voids the policy; a representation is believed true to the best of the applicant's knowledge. Statements in life and health applications are treated as representations, not warranties.

Pure protection for a stated period with no cash value. Premiums are lowest at issue; the policy pays only if the insured dies during the term. Common forms: level term, annually renewable term, and decreasing term.

Permanent coverage for the insured's entire life with level premiums, a guaranteed death benefit, and a guaranteed cash value that grows tax-deferred. Endows at age 100 or 121 depending on mortality table.

Permanent insurance with flexible premiums and an adjustable death benefit. Premiums fund a cash account credited with current interest; cost-of-insurance and expense charges are deducted monthly. Lapses if the account cannot cover charges.

Permanent insurance with fixed premium and a death benefit that varies with the performance of separate-account subaccounts chosen by the owner. Considered a security; producer must hold both a life license and a FINRA registration (Series 6 or 7).

Combines universal life's flexible premium and adjustable death benefit with variable life's separate-account investment options. Requires both an insurance license and a securities registration to sell.

A life policy that fails the IRS 7-pay test by being funded too quickly. Loans and withdrawals from a MEC are taxed LIFO (gain first) and may incur a 10% penalty before age 59½; the death benefit remains income-tax-free.

A tax-free exchange of like-kind insurance contracts. Allowed exchanges include life-to-life, life-to-annuity, annuity-to-annuity, and life or annuity to qualified long-term care. An annuity may NOT be exchanged for a life policy tax-free.

Death benefits paid in a lump sum to a named beneficiary are generally received income-tax-free. If paid in installments, the interest portion is taxable as ordinary income.

After a policy has been in force during the insured's lifetime for two years (the Ohio standard), the insurer may no longer contest the policy except for nonpayment of premium. Fraud may still be challenged depending on policy language.

Most life policies exclude death by suicide during the first two years (the Ohio standard). After the period expires, suicide is covered like any other cause of death. During the exclusion the insurer refunds premiums paid.

The number of days after the due date during which a premium may be paid without lapse. Ohio life insurance requires at least 31 days for annual/semi-annual premiums and 10 days for monthly premiums; coverage continues during the grace period.

Three guaranteed choices for a permanent policy owner who stops paying premiums: (1) take the cash surrender value, (2) reduced paid-up insurance, or (3) extended term insurance. Extended term is the automatic default if no choice is made.

Rider that waives policy premiums if the insured becomes totally disabled, typically after a 6-month elimination period. The policy continues in force as if premiums were being paid; coverage usually ends at age 60 or 65.

Allows a terminally ill insured to receive a portion of the death benefit before death, usually income-tax-free under IRC §101(g). The remaining death benefit at death is reduced by the accelerated payment plus any accrued interest.

Term-life rider that refunds all premiums paid if the insured survives the term. Premiums are significantly higher than standard term; the refund is generally received income-tax-free as a return of basis.

Annuity that credits a guaranteed minimum interest rate to the cash value and provides a guaranteed payout at annuitization. Principal is protected by the insurer's general account; not a security.

Annuity whose cash value and (often) payout fluctuate with separate-account investment performance. Considered a security; producer must hold a Series 6 or 7 registration along with a life insurance license to sell one in Ohio.

Ohio has adopted the NAIC Suitability in Annuity Transactions and best-interest standard. Producers must collect customer information (financials, objectives, liquidity), have a reasonable basis to believe the sale fits the consumer's needs, and document the analysis.

Qualified annuities are funded with pre-tax dollars inside a retirement plan (IRA, 403(b)) — entire distribution is taxable. Nonqualified annuities are funded with after-tax dollars — only the earnings portion of each payout is taxable (exclusion ratio).

Ohio individual accident and health policies provide a 10-day free-look from delivery. Medicare supplement and long-term care policies require a 30-day free-look under separate model regulations adopted by Ohio.

A health condition for which the insured received treatment or advice before coverage began. Under the ACA, ACA-compliant individual and group major medical plans cannot impose pre-existing condition exclusions; HIPAA still limits exclusions in non-ACA contexts.

The waiting period after a covered disability before benefits begin, similar to a deductible measured in days (commonly 30, 60, 90, or 180). Longer elimination periods lower the premium.

Own-occupation pays if the insured cannot perform the duties of their specific job; any-occupation pays only if the insured cannot work in any job they are reasonably suited for. Own-occ pays more often and costs more.

Hospital insurance covering inpatient hospital stays, skilled nursing facility care, hospice, and some home health. Funded by payroll taxes; most beneficiaries pay no Part A premium because they or a spouse earned at least 40 quarters of Medicare-covered work.

Medical insurance covering physician services, outpatient care, durable medical equipment, and preventive services. Requires a monthly premium based on income (IRMAA) and an annual deductible.

Private plan alternative to Original Medicare that bundles Parts A and B (usually D) and is offered by Medicare-contracted insurers. Often uses HMO or PPO networks and may add benefits like vision, dental, or hearing.

A 6-month one-time window beginning the first month a beneficiary is age 65 or older AND enrolled in Medicare Part B. During this window, Medigap plans are guaranteed-issue with no medical underwriting.

Underwriting evaluates the GROUP as a whole rather than each individual. Key factors: group purpose (must exist for reasons other than insurance), participation percentage (typically 75% contributory / 100% noncontributory), and size/turnover.

Federal law allowing qualified beneficiaries to continue employer group health coverage after a qualifying event. Continuation is generally 18 months (29 for disability, 36 for divorce or death of employee). Beneficiary pays up to 102% of the group premium.

The Health Insurance Portability and Accountability Act limits pre-existing condition exclusions in group plans, guarantees portability via creditable coverage, and protects PHI through the Privacy and Security Rules. Producers handling PHI must follow HIPAA safeguards.