NEW OK-LIFE-ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER DUMPS | OK-LIFE-ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER BEST STUDY MATERIAL

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New Ok-Life-Accident-and-Health-or-Sickness-Producer Dumps | Ok-Life-Accident-and-Health-or-Sickness-Producer Best Study Material

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Insurance Licensing Oklahoma Life, Accident, and Health or Sickness Producer Exam Sample Questions (Q53-Q58):

NEW QUESTION # 53
Under the unpaid premium Uniform Optional Provision, if there is an unpaid premium at the time a health claim becomes payable, then the

  • A. claim is delayed until payment of the premium.
  • B. claim is denied.
  • C. premium is deducted from the claim.
  • D. policy is cancelled.

Answer: C

Explanation:
Theunpaid premium Uniform Optional Provisionin health insurance policies, as recognized in Oklahoma (Title 36 O.S. § 4405), allows the insurer to deduct any unpaid premiums from a claim payment if a claim becomes payable while premiums are overdue. This ensures the policy remains in force and the claim is paid, net of the owed premium.
* Option A: Incorrect. The claim is not denied; the premium is deducted from the payment.
* Option B: Incorrect. The policy is not cancelled; the unpaid premium is addressed via the claim.
* Option C: Correct. The unpaid premium is deducted from the claim payment.
* Option D: Incorrect. The claim is not delayed; the premium is settled with the claim payment.
This question falls under the Prometric content outline section on "Provisions, Options, Exclusions, Riders, Clauses, and Rights," which covers health insurance policy provisions.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Accident and Health Insurance).
Oklahoma Insurance Department, Title 36 O.S. § 4405 (health insurance provisions).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.


NEW QUESTION # 54
An insurance producer whose license has been revoked continues to provide insurance services. Which of the following is TRUE?

  • A. This violation is a misdemeanor and can result in a fine of up to $500.
  • B. This individual could be committed to the custody of the Department of Corrections for up to 10 years.
  • C. This violation is a felony and can result in a fine of up to $5,000.
  • D. This violation can result in a fine of up to $10,000.

Answer: C

Explanation:
Under Oklahoma's Insurance Code (Title 36 O.S. § 1435.13), transacting insurance without a valid license, such as after revocation, is afelonypunishable by a fine of up to $5,000, imprisonment for up to 7 years, or both, depending on the severity and intent. This reflects the serious nature of unlicensed insurance activity.
* Option A: Incorrect. The fine limit is $5,000 for a felony, not $10,000.
* Option B: Correct. The violation is a felony with a fine up to $5,000.
* Option C: Incorrect. The violation is a felony, not a misdemeanor, with higher penalties.
* Option D: Incorrect. Imprisonment is up to 7 years, not 10 years.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: State- Specific Knowledge - Oklahoma Insurance Statutes).
Oklahoma Insurance Department, Title 36 O.S. § 1435.13 (penalties for unlicensed activity).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.


NEW QUESTION # 55
When would a supplemental attending physician's statement be appropriate for life or health insurance purposes?

  • A. At the request of the insurance company without knowledge or approval of the applicant.
  • B. As a matter of routine when the applicant signs the life insurance application.
  • C. At the request of the insurance company when it could affect the underwriting decision but with the consent of the applicant.
  • D. At the request of the insurance applicant to be submitted with the life insurance application.

Answer: C

Explanation:
Asupplemental attending physician's statement (APS)is requested by the insurer during underwriting when additional medical information is needed to assess the applicant's risk, particularly if it could affect the underwriting decision. Oklahoma regulations (Title 36 O.S. § 1204) and HIPAA require the applicant's consent for obtaining medical records, ensuring privacy and transparency.
* Option A: Incorrect. An APS is not routine; it's requested based on specific needs.
* Option B: Incorrect. The applicant's consent is required for medical information requests.
* Option C: Incorrect. Applicants typically do not request an APS; insurers do.
* Option D: Correct. An APS is appropriate when requested by the insurer with the applicant's consent for underwriting purposes.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Underwriting).
Oklahoma Insurance Department, Title 36 O.S. § 1204 (insurance business conduct).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.


NEW QUESTION # 56
Which one of the following types of benefits is often excluded from coverage under an HMO plan?

  • A. Out-of-area emergency services.
  • B. Physical examinations.
  • C. In-patient surgeries.
  • D. Adult routine eye examinations.

Answer: D

Explanation:
Health Maintenance Organizations (HMOs) focus on preventive and essential medical care within a network.
Adult routine eye examinationsare often excluded from HMO coverage, as they are considered non- essential or covered under separate vision plans. Other services like emergency care, physical exams, and surgeries are typically covered, as per Oklahoma's managed care regulations (Title 36 O.S. § 652 et seq.).
* Option A: Incorrect. Out-of-area emergency services are generally covered by HMOs.
* Option B: Correct. Adult routine eye examinations are often excluded or require separate coverage.
* Option C: Incorrect. Physical examinations are typically covered as preventive care.
* Option D: Incorrect. In-patient surgeries are covered as essential medical services.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Health Providers and Products).
Oklahoma Insurance Department, Title 36 O.S. § 652 et seq. (managed care plans).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.


NEW QUESTION # 57
How many employees are REQUIRED before an employer is subject to COBRA?

  • A. 50 employees
  • B. 30 employees
  • C. 20 employees
  • D. 31 employees

Answer: C

Explanation:
TheConsolidated Omnibus Budget Reconciliation Act (COBRA), as regulated under federal law (29 U.S.
C: § 1161 et seq.), requires employers with20 or more employeesto offer continuation of group health insurance coverage to employees and their dependents after certain qualifying events (e.g., termination of employment). This applies to private-sector employers and is enforced in Oklahoma.
* Option A: Correct. COBRA applies to employers with 20 or more employees.
* Option B: Incorrect. 30 employees is not the threshold.
* Option C: Incorrect. 31 employees is not the specific requirement.
* Option D: Incorrect. 50 employees is unrelated to COBRA's threshold.
This question aligns with the Prometric content outline under "State Insurance Statutes, Rules, and Regulations," which covers federal laws like COBRA.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: State- Specific Knowledge - Oklahoma Insurance Statutes).
Oklahoma Insurance Department, Title 36 O.S. § 6060.3 (health insurance regulations).
COBRA, 29 U.S.C. § 1161 et seq.


NEW QUESTION # 58
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