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LIFE:

Introduction

Exam Breakdown – revised exam breakdown

Connecticut Life Insurance Examination
85 Total Questions (75 scored, 10 pretest)

Completing the Application, Underwriting, and Delivering the Policy

Gramm-Leach-Bliley Act (GLBA) Privacy

The Gramm-Leach-Bliley Act stipulates that in general, an insurance company may not disclose nonpublic personal information to a nonaffiliated third party except for the following reasons:

The Gramm-Leach-Bliley Act requires 2 disclosures to a customer (a consumer who has an ongoing financial relationship with a financial institution):

The customer must also receive an annual privacy disclosure, and have the right to opt out, or choose not to have their private information shared with other parties.

Types of Policies

E. Annuities

Payout Options

Annuity payment options specify how annuity funds are to be paid out. They are very similar to the settlement options used in life insurance that determine how the policy proceeds are distributed to the beneficiaries.

Life Contingency Options - Pure Life vs. Life with Guaranteed Minimum

The life annuity will pay a specific amount for the remainder of the annuitant’s life. With pure life, also known as life-only or straight life, this payment ceases at the annuitant's death (no matter how soon in the annuitization period that occurs). This option provides the highest monthly benefits for an individual annuitant. Under this option, while the annuity payments are guaranteed for the lifetime of the annuitant, there is no guarantee that all the proceeds will be fully paid out.

Under the life with guaranteed minimum settlement option, if the annuitant dies before the principal amount has been paid out, the remainder of the principal amount will be refunded to the beneficiary. This option is also called refund life. It guarantees that the entire principal amount will be paid out.

There are two types of refund life annuities:

Note, however, that any unpaid annuity benefits following the death of an annuitant are taxable when paid to the beneficiary.

Life with period (term) certain is another life contingency payout option. Under this option, the annuity payments are guaranteed for the lifetime of the annuitant, and for a specified period of time for the beneficiary. For example, a life income with a 20-year period certain option would provide the annuitant with an income while he is living (for the entire life). If, however, the annuitant dies shortly after payments begin, the payments will be continued to a beneficiary for the remainder of the period (for a total of 20 years).

Single Life vs. Multiple Life

Single life annuities cover one life, and annuity payments are made with reference to one life only. Contributions can be made with a single premium or on a periodic premium basis with subsequent values accumulating until the contract is annuitized.

Multiple life annuities cover 2 or more lives. The most common multiple life annuities are joint life, and joint and survivor.

Joint Life

Joint life is a payout arrangement where two or more annuitants receive payments until the first death among the annuitants, and then payments stop.

Joint and Survivor

The joint and survivor arrangement is a modification of the life income option in that it guarantees an income for two recipients that neither can outlive. Although it is possible for the surviving recipient(s) to receive payments in the same amount as the first recipient to die, most contracts provide that the surviving recipients will receive a reduced payment after the first recipient dies. Most commonly, this option is written as “joint and ½ survivor” or "joint and 2/3 survivor,” in which the surviving beneficiary receives ½ or 2/3 of what was received when both beneficiaries were alive. This option is commonly selected by a couple in retirement. As with the life income option, there is no guarantee that all the proceeds will be paid out if both beneficiaries die shortly after the installments begin.

Annuities Certain (Types)

In contrast with life contingency benefit payment options, annuities certain are short-term annuities that limit the amounts paid to a certain fixed period or until a certain fixed amount is liquidated.

With fixed-period installments, the annuitant selects the time period for the benefits, and the insurer determines how much each payment will be, based on the value of the account and future earnings projections. This option pays for a specified amount of time only, whether or not the annuitant is living.

With fixed-amount installments, the annuitant selects how much each payment will be, and the insurer determines how long the benefits will be paid by analyzing the value of the account and future earnings. This option pays a specific amount until funds are exhausted, whether or not the annuitant is living.

Life Policy Provisions, Riders and Options

C. Beneficiary Designations

Designation by Class

A class of beneficiary is using a designation such as "my children." This term can be vague if the insured has been married more than once, has adopted children, or has children out of wedlock.

An example of a class that is less vague is "children of the union of Jane Smith and James Smith." Many insurers encourage the insured to name each child specifically and to state the percentage of benefit they are to receive.

When naming beneficiaries, it is most prudent to be specific by naming each individual and by designating the exact amount to be given for that individual. Two class designations are available for use when an insured chooses to "group" the beneficiaries: per capita and per stirpes. Per capita, meaning by the head, evenly distributes benefits among the living named beneficiaries. Per stirpes, meaning by the bloodline, distributes the benefits of a beneficiary who died before the insured to that beneficiary's heirs.

D. Policy Riders – additional riders

Disability Income

With the disability income rider, in the event of disability the insurer will waive the policy premiums and pay a monthly income to the insured. The amount paid is normally based on a percentage of the face amount of the policy to which it is attached.

Cost of Living

The cost of living rider addresses the inflation factor by automatically increasing the amount of insurance without evidence of insurability from the insured. The face value of the policy may be increased by a cost of living factor tied to an inflation index such as the Consumer Price Index (CPI).

HEALTH:

Introduction

Exam Breakdown – revised breakdown

Connecticut Accident and Health Insurance Examination

85 Total Questions (75 scored, 10 pretest)

Types of Health Policies

A. Medical Expense Insurance

Health Reimbursement Accounts (HRAs)

Health Reimbursement Accounts (HRAs) consist of funds set aside by employers to reimburse employees for qualified medical expenses, such as deductibles or coinsurance amounts. Employers qualify for preferential tax treatment of funds placed in an HRA in the same way that they qualify for tax advantages by funding an insurance plan. Employers can deduct the cost of a health reimbursement account as a business expense.

The following are key characteristics of HRAs:

• They are contribution healthcare plans, not defined benefit plans;
• Not a taxable employee benefit;
• Employers' contributions are tax deductible;
• Employees can roll over unused balances at the end of the year;
• Employers do not need to advance claims payments to employees or healthcare providers during the early months of the plan year;
• Provided with employer dollars, not employee salary reductions;
• Permit the employer to reduce health plan costs by coupling the HRA with a high-deductible (and usually lower-cost) health plan; and
• Balance the group purchasing power of larger employers and smaller employers.

HRAs are open to employees of companies of all sizes; however, the employer determines eligibility and contribution limits.

An HRA has no statutory limit. Limits may be set by employer, and rollover at the end of the year based on employer discretion. Former employees, including retirees, can have continued access to unused HRAs, but this is done at the employer's discretion. HRAs remain with the originating employer and do not follow an employee to new employment.

D. Long-Term Care

Eligibility for Benefits

Normally to be eligible for benefits from a long-term care policy, the insured must be unable to perform some of the activities of daily living (ADLs). Activities of daily living include bathing, dressing, toileting, transferring positions (also called mobility), continence, and eating.

Property and Casualty

Addendum: for use with Connecticut Property and Casualty online course and study guide, version 15045en/15046en per testing provider update effective 9/1/12.

CASUALTY

Chapter V. Auto Insurance

A. Laws

1. Connecticut Motor Vehicle Financial Responsibility Law

Uninsured/Underinsured Motorist – new section:

Connecticut law requires that each automobile liability policy issued must include uninsured/underinsured motorists (UM/UIM) coverage in limits equal to the policy's bodily injury and property damage coverage.

Connecticut law requires that the insured agree to any reduction in UM/UIM limits. This consent must be in writing and include the following statement: "When you sign this form, you are choosing a reduced premium, but you are also choosing not to purchase certain valuable coverage which protects you and your family. If you are uncertain about how this decision will affect you, you should get advice from your insurance agent or another qualified advisor."

No insurance company doing business in the state may limit the time within which any suit may be brought against it to a period of less than 3 years. In the case of an underinsured motorist, the insured may toll any limitation period by:

• Notifying the insurer, prior to the expiration of the limitation period, of any claim; or
• Demanding arbitration no more than 180 days after the exhaustion of all applicable limits of liability.

Insurers must include in their automobile policies bodily injury and property damage liability in an amount equal to the state's minimum financial responsibility requirements (20/40/10). Uninsured motorist coverage must also be included. The law further provides that policies for automobile insurance must meet certain minimum standards for insuring agreements, exclusions, conditions, and other terms applicable to the bodily injury liability, property damage liability, medical payments, and uninsured motorist coverages under such policies. Policies must also include coverage for the cost of bonds to release attachments.

All authorized auto liability insurers must offer Underinsured Motorist conversion coverage, for an additional premium. This coverage protects insureds legally entitled to recover damages from owners or operators of underinsured motor vehicles. Each insurer is obligated under this coverage to pay the insured up to the limits for this coverage, after the limits of liability under all bodily injury liability bonds or insurance policies applicable at the time of the accident have been exhausted by payment of judgments or settlements. If the insured purchases this coverage, the Underinsured Motorist coverage will not be reduced on account of any payment by or on behalf of any third party.

Disclosure of Automobile Liability Policy Limits – new section:

Insurers must provide a written disclosure of an insured's auto policy limits within 30 days of a written request by the insured or a person acting on the insured's behalf who submitted a claim for bodily injuries or death caused in a motor vehicle collision by an insured. The request for disclosure must be sent by certified mail to the insurance adjuster or the last known insurer's business address.

Chapter VI. Commercial Package Policy (CPP)

C. Commercial Crime

3. Coverages – section revised/expanded (page 76):

Common policy provisions applicable to crime coverage forms (both discovery and loss sustained) specify the following general exclusions:

• Acts committed by You, Your partners or Your members: Loss resulting from acts committed by the insured or the insured's partners or members, as well as acts of managers, directors, employees or representatives learned of by the insured before the policy period
• Confidential information: Loss resulting from unauthorized disclosure of the insured's or other person's confidential information (e.g. patents, trade secrets, or customer lists)
• Government action: Loss due to governmental authority's seizure or destruction of property
• Indirect losses: e.g. expenses incurred while establishing the amount of loss
• Legal fees, costs and expenses: Legal expenses related to legal action
• Nuclear hazards
• Pollution: Loss or damage caused by or resulting from pollution, including discharge, dispersal, seepage, release or escape of any solid, liquid, gaseous or thermal contaminant (such as smoke, vapor, fumes, acids, chemicals, or waste)
• War or military action: Losses or damage resulting from war, warlike action by a military force, rebellion, revolution, and similar actions

D. Farm Coverage (’06 ISO revisions)

2. Exclusions – section revised per ’06 ISO form (page 79):

Exclusions for Farm Liability coverage forms are the same as the exclusions found in the General Liability coverage form and Homeowners form, with a few additions specific to the nature of farm operations. These additional exclusions include the following:

• Use of any animal, with or without accessory vehicle, to provide rides for a fee or in connection with a fair, charitable event or a similar function;
• Use of any animal in a racing, speed or strength contest or a prearranged stunting activity at the site designated for the contest or activity;
• Rental or holding for rental of an insured location;
• Losses out of any premises where a building or structure is being constructed, other than a dwelling to be occupied by the insured or a farm structure for the insured’s use; and
• Bodily injury to any insured.

3. Additional Coverages – section revised per ’06 ISO form (page 80):

The farm liability ('06) coverage form policy provides the following additional coverages:

• Supplementary payments for Coverages H and I, including up to $250 a day for loss of earnings; and
• Damage to property of others, which is the same as is found in Personal Liability, with an exception that it will not apply to borrowed farm equipment.

4. Limits – section revised per ’06 ISO form (page 80):

Liability limits state that the most the insurer will pay in the result of a judgment against an insured is the limit stated in the policy. Any cost incurred by the insurer for the investigation or defense of a claim or suit will be paid by the insurer, over and above the limits shown in the policy. The limits apply separately to each consecutive annual period and to any remaining period of less than 12 months (starting with the beginning of the policy period shown in the Declarations.

Chapter VIII. Workers Compensation

E. Premium Computation  

Participation (Dividend) Plans – new section:

In some states, insurance companies are allowed to write participating policies. This means the insured is eligible for dividends (partial premium refund) if the experience during the policy term falls within guidelines established by the insurer at the inception of the policy term. Dividends are not guaranteed. To be eligible for participation, the account must generate a minimum amount of premium.

In the case of a group policy, the group must qualify for the dividend. In the event the group's loss experience is low, participating members may receive a dividend. No penalty is levied for a high loss experience.