Studying life and health insurance can be a crucial step in becoming a licensed insurance professional or increasing your knowledge in this field.
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.
Remember to review your textbook, lecture notes, and practice exam questions to reinforce your understanding of these topics. Good luck with your studies!