Studying life and health insurance can be a crucial step in becoming a licensed insurance professional or increasing your knowledge in this field.
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| life and health insurance |
Here's a study guide to help you get started:
1. Understanding Life Insurance
- Definition of life insurance and its purpose.
- Types of life insurance policies (term life, whole life, universal life, variable life) and their features.
Key terms:
- premium, death benefit, cash value, beneficiaries.
- Factors that affect life insurance premiums.
- Riders and endorsements: examples and their impact on policy coverage.
2. Health Insurance Basics
- Introduction to health insurance and its importance.
- Types of health insurance plans (individual, group, government-sponsored) and their characteristics.
- Key terms: deductible, copayment, coinsurance, out-of-pocket maximum.
- Understanding health insurance networks: PPO, HMO, EPO, POS.
- Pre-existing conditions and their impact on health insurance coverage.
- Essential health benefits under the Affordable Care Act (ACA).
3. Health Insurance Marketplace
- Overview of the Health Insurance Marketplace (also known as the Exchange).
- Enrollment periods and special enrollment periods.
- Eligibility requirements for subsidies and cost-sharing reductions.
- Navigating and comparing health insurance plans on the Marketplace.
- How to apply for health insurance through the Marketplace.
4. Insurance Underwriting and Risk Assessment
- The role of underwriting in insurance.
- Risk factors considered during underwriting for life and health insurance.
- Medical underwriting process and the role of medical exams.
- Importance of disclosing accurate information during the underwriting process.
- Underwriting decisions: standard, substandard, preferred, and declined.
5. Policy Provisions and Riders
- Common policy provisions and their significance (grace period, policy reinstatement, incontestability clause).
- Optional policy riders (waiver of premium, accelerated death benefit, accidental death benefit) and their benefits.
- Policy exclusions and limitations to be aware of.
6. Claims and Benefits
- Process of filing insurance claims for life and health insurance.
- Understanding benefit payments and claim settlements.
- Coordination of benefits when covered under multiple insurance plans.
- Explanation of Benefits (EOB) and its role in claims processing.
7. Ethical and Legal Considerations
- Ethical responsibilities of insurance professionals.
- Laws and regulations governing the insurance industry.
- Consumer protection laws and rights.
- Privacy and confidentiality of customer information.
8. Other Insurance Concepts
Annuities
- types, features, and uses.
Disability insurance
- definition, types, and benefit calculations.
- Long-term care insurance: coverage and eligibility.
- Medicare and Medicaid: overview and differences.