Ok-Life-Accident-and-Health-or-Sickness-Producer Exam Dumps : Oklahoma Life, Accident, and Health or Sickness Producer Exam

Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs) are two common types of managed care plans in health insurance. According to standard insurance study materials for the Oklahoma Life, Accident, and Health or Sickness Producer exam, a key distinction between PPOs and HMOs lies in the flexibility of provider choice. PPOs allow members to choose from a broader network of doctors and medical service providers, both in-network and out-of-network, without requiring a referral from a primary care physician. HMOs, in contrast, typically restrict members to in-network providers and require a designated primary care physician to coordinate care.

Option A: Incorrect. PPO plans often provide coverage for out-of-state medical services, especially within their network or through out-of-network benefits, though at potentially higher costs. This is not a defining characteristic compared to HMOs.

Option B: Correct. PPOs are known for offering more choices of doctors and medical service providers, as they do not mandate a primary care physician or referrals for specialists, unlike HMOs.

Option C: Incorrect. HMOs require members to designate a primary care physician, while PPOs do not.

Option D: Incorrect. While PPOs offer flexibility, the ability to see a physician on a walk-in basis is not a standard feature distinguishing them from HMOs, as both may vary in appointment requirements.

This aligns with the Prometric exam content outline under “Health Providers and Products,” which emphasizes understanding differences between health insurance plans like HMOs and PPOs.

Oklahoma insurance law requires licensed insurance producers to maintain records of insurance transactions for a minimum of5 years, as specified in Title 36 O.S. § 1435.13. This ensures compliance with regulatory oversight and allows for audits or investigations by the Oklahoma Insurance Department.

Option A: Incorrect. 3 years is insufficient per Oklahoma law.

Option B: Correct. Licensees must keep records for 5 years.

Option C: Incorrect. 7 years exceeds the requirement.

Option D: Incorrect. 10 years is not mandated by Oklahoma insurance regulations.

This question falls under the Prometric content outline section on “State Insurance Statutes, Rules, and Regulations,” which includes recordkeeping requirements.

Acancelablehealth insurance policy allows the insurer to cancel the policy at any time during the term with proper notice, typically for reasons like non-payment or fraud, as permitted under Oklahoma’s regulations (Title 36 O.S. § 4405). Other policy types, like optionally renewable (insurer can refuse renewal at term end), conditionally renewable (renewal subject to conditions), or term (fixed duration), do not typically allow mid-term cancellation.

Option A: Incorrect. Optionally renewable policies can be non-renewed at term end, not cancelled mid-term.

Option B: Incorrect. Term policies (life or health) run for a fixed period and are not typically cancelled mid-term.

Option C: Incorrect. Conditionally renewable policies restrict renewal, not mid-term cancellation.

Option D: Correct. A cancelable policy allows mid-term cancellation by the insurer.