Ok-Life-Accident-and-Health-or-Sickness-Producer Leak Questions

Ahospital indemnity policypays a fixed daily, weekly, or monthly benefit directly to the insured for hospitalization, regardless of other insurance coverage or actual expenses incurred. This is a supplemental policy common in Oklahoma (Title 36 O.S. § 4405).

Option A: Incorrect. “Limited-amount per diem” is not a standard insurance term.

Option B: Incorrect. Blanket policies cover groups for specific risks, not individual hospitalization benefits.

Option C: Incorrect. Medigap covers Medicare gaps, not fixed hospitalization payments.

Option D: Correct. Hospital indemnity policies pay a fixed amount per day for hospitalization.

Theentire contract provision, as required by Oklahoma law (Title 36 O.S. § 4001 for life insurance, § 4405 for health), states that the insurance policy, along with any attached applications and endorsements, constitutes the entire contract between the insurer and policyowner. This ensures that no external documents can alter the agreement unless attached at issuance.

Option A: Incorrect. A certificate is issued to individuals under a group policy, not the entire contract.

Option B: Incorrect. A policy summary is a disclosure document, not part of the contract itself.

Option C: Correct. The entire contract provision includes the policy and attached application.

Option D: Incorrect. The application is part of the contract but not the provision itself.

This question aligns with the Prometric content outline under “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers mandatory policy provisions.

According to IRS guidelines (Publication 525), disability benefits from a group policy paid for by the employer are consideredtaxable incometo the employee because the premiums were not included in the employee’s taxable income. If the employee paid the premiums with after-tax dollars, the benefits would be tax-free.

Option A: Incorrect. Benefits are taxable if the employer paid the premiums.

Option B: Incorrect. Disability benefits are not deductible from gross income.

Option C: Correct. The benefits are taxable income.

Option D: Incorrect. Benefits are subject to income tax, not just Social Security or FUTA taxes.

Rebatingis the practice of offering or returning part of a commission, premium, or anything of value to an insured as an inducement to purchase an insurance policy. It is prohibited in Oklahoma under the Unfair Trade Practices Act (Title 36 O.S. § 1204) to ensure fair competition and prevent undue influence.

Option A: Incorrect. Coercion involves forcing someone to buy insurance, not offering inducements.

Option B: Incorrect. Defamation is making false statements harming reputation, not related to inducements.

Option C: Correct. Rebating involves giving value to induce a policy purchase.

Option D: Incorrect. Controlled business refers to writing insurance primarily for oneself or close associates, not inducements.

This question falls under the Prometric content outline section on “State Insurance Statutes, Rules, and Regulations,” which covers unfair trade practices.