Accident & Health study plan
Accident & Health · Give each week a clear focus.
8 weeks · About 7 hours per week
Insurance Regulation and Licensing & Ethical Practices and Consumer Protection
List the major categories of producer licensing requirements (prelicensing, exam, appointment, renewal) and state the purpose of each
Distinguish among the roles of producer, broker, and insurer in a health insurance transaction
Identify at least six unfair trade practices and explain what makes each one a violation
Describe the consequences of commingling funds and of rebating, using a hypothetical scenario you write yourself
Your checkpoint
A one-page regulatory cheat sheet covering licensing steps, producer authority, and 6+ unfair trade practices, self-quizzed to 90% recall
General Insurance Concepts and Principles & Accident and Health Insurance Basics
Define and contrast the concepts of risk, peril, hazard, and loss exposure with one original example each
Explain indemnity, insuring clause, and the principle of utmost good faith as they apply to health contracts
Differentiate representations, warranties, concealment, and fraud, and state the effect of each on a claim
Classify the major categories of health coverage (individual, group, disability income, medical expense) by who buys them and what they replace
Your checkpoint
A 25-question self-written practice set on general principles and health basics, scored and error-logged by concept
Health Insurance Policy Provisions, Riders, and Exclusions
Sequence the mandatory and optional uniform policy provisions in the order they typically appear and state the purpose of each
Explain the timeframes attached to grace period, reinstatement, claims filing, and time of payment of claims
Differentiate riders from exclusions and give an original example of a rider that expands coverage and one that limits it
Apply the entire contract, free look, and legal actions provisions to a claim scenario you construct
Your checkpoint
A provisions timeline table (provision, purpose, key timeframe) plus 15 original application questions answered at 80% or better
Disability Income Insurance
Distinguish own-occupation from any-occupation definitions and predict how each changes benefit eligibility
Calculate a benefit period payout and a residual/partial disability payment from numbers you invent
Explain the relationship among elimination period, benefit period, and premium
Identify the purpose of noncancelable, guaranteed renewable, and conditionally renewable renewability clauses
Your checkpoint
A worked disability income problem set (5 original calculation scenarios) with correct answers and a one-paragraph explanation of each
Medical Expense Insurance and Managed Care
Compare basic medical expense coverages (hospital, surgical, physician) with major medical and state what each pays
Explain coinsurance, deductibles, out-of-pocket maximums, and stop-loss limits and compute a member's cost share in an original example
Differentiate HMO, PPO, POS, and indemnity plans by network rules, referrals, and cost controls
Describe utilization review, preauthorization, and case management as managed care cost-control tools
Your checkpoint
A cost-share worksheet solving 5 original medical expense scenarios (deductible, coinsurance, OOP max) with a comparison grid of the four plan types
Group Health Insurance
Explain group underwriting factors and why individual medical evidence is typically not required
Describe COBRA continuation, conversion privileges, and coordination of benefits in your own words
Differentiate contributory from noncontributory plans and state the enrollment implication of each
Identify the purpose of group disability and group dental/vision coverages
Your checkpoint
A group benefits summary sheet covering eligibility, COBRA, conversion, and COB, validated by answering 20 original questions at 85% or better
Government Health Programs (Medicare, Medicaid, and Related) & Annuities and Retirement Planning
Map Medicare Parts A, B, C, and D to what each covers and who is eligible
Distinguish Medicare from Medicaid by funding source, eligibility, and administration
Explain how annuities accumulate and pay out, and contrast immediate with deferred annuities
Describe the role of qualified retirement plans and how annuities can support retirement income
Your checkpoint
A two-column Medicare vs. Medicaid comparison plus an annuity terms glossary, self-tested to 90% recall
Insurance Regulation and Licensing & General Insurance Concepts and Principles & Accident and Health Insurance Basics & Health Insurance Policy Provisions, Riders, and Exclusions & Disability Income Insurance & Medical Expense Insurance and Managed Care & Group Health Insurance & Government Health Programs (Medicare, Medicaid, and Related) & Annuities and Retirement Planning & Ethical Practices and Consumer Protection
Assemble a weighted practice exam that mirrors domain percentages and complete it under timed conditions
Review every missed item and tag it to a domain and a specific concept gap
Re-drill your three weakest concepts until you can explain each aloud without notes
Confirm licensing and ethics rules one final time, since they are commonly tested
Your checkpoint
A completed timed 100-question practice exam with a scored error log and a one-page 'final gaps' sheet showing all weak concepts resolved
Milestones
Week 2: Score 80% or higher on the self-written general principles and health basics set, with every missed concept logged
Week 4: Correctly solve all 5 disability income calculation scenarios and explain benefit-period and elimination-period interactions without notes
Week 6: Score 85% or higher on the group benefits question set and correctly compute cost share in all 5 medical expense scenarios
Week 8: Score 80% or higher on the timed 100-question weighted practice exam with no domain below 70%