Wisconsin Course Update November 2019
> Wisconsin Property & Casualty Addendum
WISCONSIN LIFE & HEALTH
Addendum: for use with Wisconsin Life and Health ExamFX online courses and study guide version 22225en/22227en, per exam outline update effective 11/16/19.
New Exam Breakdowns:
Wisconsin Life Insurance Examination
- 100 Questions
- Time Limit: 2 hours
- Passing Score: 70%
|
CHAPTER |
PERCENTAGE OF EXAM |
|
General Insurance |
10% |
|
Life Insurance Basics |
10% |
|
Life Insurance Policies |
12% |
|
Life Insurance Policy Provisions, Riders, and Options |
14% |
|
Annuities |
10% |
|
Qualified Plans |
4% |
|
Federal Tax Considerations for Life Insurance and Annuities |
5% |
|
Insurance Regulation |
35% |
Wisconsin Health Insurance Examination
- 100 Questions
- Time Limit: 2 hours
- Passing Score: 70%
|
CHAPTER |
PERCENTAGE OF EXAM |
|
General Insurance |
10% |
|
Accident and Health Insurance Basics |
8% |
|
Disability Income and Related Insurance |
8% |
|
Medical Plans |
8% |
|
Group Accident and Health Insurance |
8% |
|
Dental Insurance |
4% |
|
Medicare |
8% |
|
Long-Term Care Insurance |
8% |
|
Federal Tax Considerations for Accident and Health Insurance |
3% |
|
Insurance Regulation |
35% |
The following are content additions to supplement your existing text unless otherwise indicated:
ALL LINES
General Wisconsin Insurance Law
E. Marketing Practices
1. Types of Unfair Practices
Evidence of Insurance
No person may prepare, issue, request, or require a certificate of insurance or other document used for evidence of insurance to do any of the following:
- Contain information concerning the policy referenced by the certificate of insurance that is false, misleading, deceptive, unfairly discriminatory, or that otherwise violates public policy or law;
- Appear to alter, amend, or extend coverage provided by the policy referenced by the certificate of insurance;
- Alter the terms and conditions of any notice requirement in the policy.
It is illegal to alter a certificate of insurance or other document used for evidence of insurance after it is issued.
HEALTH
Medicare and Long-Term Care Insurance
D. Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) amended the Social Security act to change how physicians are reimbursed in an attempt to emphasize quality of care over volume and to reauthorize the Children's Health Insurance Program, among other improvements. MACRA also required the removal of Social Security numbers from all Medicare cards.
Quality Payment Program
Before MACRA was passed, payment increases for Medicare services were set by the Sustainable Growth Rate (SGR) law, which capped spending increases by growth in the Medicare population, allowing a modest amount for inflation. This meant, however, that as clinicians increased their utilization of services, the reimbursement for each unit of service had to be adjusted downward to hold costs constant.
MACRA created the Quality Payment Program, which
- Repeals the Sustainable Growth Rate formula;
- Changes the way that Medicare rewards clinicians for value over volume;
- Streamlines multiple quality programs under the new Merit Based Incentive Payments System (MIPS); and
- Gives bonus payments for participation in eligible alternative payment models (APMs).
With these changes, high-quality Medicare clinicians get payment increases while clinicians who aren’t meeting performance standards have their payments reduced.
Starting in 2019, physicians would choose from two payment models:
- The Merit-based Incentive Payment System (MIPS), under which health care professionals receive annual payment increases or decreases based on their performance; or
- The Alternative Payment Models (APMs), in which professionals who receive at least 25% of their Medicare revenue through an APM receive a 5% payment bonus.
Wisconsin Health Insurance Law
B. Coverages
Prescription Eye Drops
Any health plan that provides coverage for prescription eye drops must cover a refill of the prescription eye drops if
- The refill is requested when 75% or more of the days have elapsed from the later of
- The original date the prescription was distributed; or
- The date on which the most recent refill was distributed;
- The prescription allows for a refill of the prescription eye drops; and
- The requested refill does not exceed the number of refills allowed by the prescription.
Oral and Injected Chemotherapy
A disability insurance policy or self-insured health plan that covers injected or intravenous chemotherapy and oral chemotherapy may not require a higher copayment, deductible, or coinsurance amount for oral chemotherapy than it requires for injected or intravenous chemotherapy.
WISCONSIN PROPERTY & CASUALTY
Addendum: for use with Wisconsin Property and Casualty ExamFX online courses and study guide version 22196en/22197en, per exam outline update effective 11/16/19.
New Exam Breakdowns:
Wisconsin Property Insurance Examination
- 100 Questions
- Time Limit: 2 hours
- Passing Score: 70%
|
CHAPTER |
PERCENTAGE OF EXAM |
|
General Insurance |
8% |
|
Property and Casualty Insurance Basics |
13% |
|
Dwelling Policy |
4% |
|
Homeowners Policy |
18% |
|
Commercial Package Policy (CPP) |
9% |
|
Businessowners Policy |
9% |
|
Other Coverages and Options |
4% |
|
Insurance Regulation |
35% |
NOTE: Auto Insurance is no longer part of the Wisconsin Property exam.
Wisconsin Casualty Insurance Examination
- 100 Questions
- Time Limit: 2 hours
- Passing Score: 70%
|
CHAPTER |
PERCENTAGE OF EXAM |
|
General Insurance |
8% |
|
Property and Casualty Insurance Basics |
13% |
|
Auto Insurance |
14% |
|
Commercial Package Policy |
10% |
|
Businessowners Policy |
10% |
|
Workers Compensation Insurance |
5% |
|
Other Coverages and Options |
5% |
|
Insurance Regulation |
35% |
NOTE: Homeowners Policy is no longer part of the Wisconsin Casualty exam.
The following are content additions to supplement your existing text unless otherwise indicated:
ALL LINES
General Wisconsin Insurance Law
E. Marketing Practices
1. Types of Unfair Practices
Evidence of Insurance
No person may prepare, issue, request, or require a certificate of insurance or other document used for evidence of insurance to do any of the following:
- Contain information concerning the policy referenced by the certificate of insurance that is false, misleading, deceptive, unfairly discriminatory, or that otherwise violates public policy or law;
- Appear to alter, amend, or extend coverage provided by the policy referenced by the certificate of insurance;
- Alter the terms and conditions of any notice requirement in the policy.
It is illegal to alter a certificate of insurance or other document used for evidence of insurance after it is issued.