LA Life & Health cheat sheet

The Commissioner of Insurance is elected statewide to a four-year term, heads the Louisiana Department of Insurance, and enforces the Insurance Code by licensing producers and insurers and issuing regulations.

A producer must hold a Louisiana license for each line sold and be appointed by the insurer; the licensee must notify the Commissioner within 30 days of a change of address, a name change, or any administrative action or criminal prosecution.

Louisiana producer licenses renew biennially and require 24 hours of approved continuing education per term, including at least 3 hours of ethics.

The appointing insurer must file notice of a producer appointment with the Commissioner, generally within 30 days after the first application is submitted.

Premiums collected belong to the insurer or the insured; a producer holds them in a fiduciary capacity and may not commingle them with personal funds or use them for personal expenses.

Prohibited acts include rebating (offering anything of value not stated in the contract), twisting (misrepresentation to induce a replacement), misrepresentation, false advertising, and unfair claim settlement practices.

Individual life insurance policies carry a free-look period (10 days in Louisiana) during which the owner may return the policy for a refund of premium.

The Louisiana Life and Health Insurance Guaranty Association pays limited benefits, subject to statutory caps, when a licensed member insurer becomes insolvent.

Transacting insurance without a license, or for an unauthorized insurer, is unlawful and subjects the producer to fines, cease-and-desist orders, and license suspension or revocation.

Insurance transfers pure risk (chance of loss only) to a pool of policyholders; speculative risk (chance of loss or gain) is not insurable.

An insurable risk is accidental, definite and measurable, calculable in advance, and spread over a large number of similar exposure units; catastrophic and uninsurable perils are excluded.

Peril is the cause of loss (fire, death, illness); hazard is a condition that increases the chance or severity of loss and may be physical, moral, or morale.

Adverse selection is the tendency of high-risk applicants to buy or keep coverage; underwriting, exclusions, and waiting periods control it.

The principle of indemnity restores the insured to the pre-loss financial position; life and health policies with stated benefits are valued contracts rather than strict indemnity.

Contract elements are offer and acceptance, consideration, legal purpose, and competent parties; insurance contracts are contracts of adhesion, aleatory, unilateral, and conditional.

Utmost good faith requires truthful representations; material misrepresentation, concealment, or fraud can void the contract or support a claim denial.

Agent authority is express (written in the agency agreement), implied (customary to the role), or apparent (created when the insurer's actions lead a third party to believe authority exists).

Other-insurance, coinsurance, and subrogation provisions prevent overpayment, over-insurance, and double recovery.

Insurable interest must exist at the time of application; it does not have to exist at the time of death.

A life premium has three components: mortality (expected claims), interest (assumed earnings on reserves), and expense (operating costs); more frequent payment modes increase the total annual cost.

The needs approach adds income replacement, debts, education costs, and final expenses and then subtracts existing resources; the human life value approach discounts the insured's future earnings.

Underwriting sources include the application (Part I general information, Part II medical), paramedical or medical exam, attending physician statement, MIB report, inspection report, and prescription history.

Term insurance provides pure death protection with no cash value; renewability lets the insured continue coverage without new underwriting, and convertibility exchanges term for permanent coverage without evidence of insurability.

Whole life charges a level premium and builds guaranteed cash value, maturing at the stated age; limited-pay and single-premium versions compress premiums into fewer years.

Group life is usually annually renewable term under a master contract, generally requires no individual evidence of insurability, and offers conversion privileges when group coverage ends.

Death benefits are generally received income-tax free by the beneficiary; cash value grows tax deferred; policy loans are not taxable while the policy remains in force.

Policy ownership rights include naming and changing the beneficiary, surrendering, borrowing or withdrawing, assigning the policy, and selecting settlement options; the insured has no rights unless also the owner.

A whole life policy endows at maturity; an outstanding loan plus interest is deducted from the death benefit or cash value.

Universal life offers flexible premiums and an adjustable death benefit; Option A is a level face amount, while Option B pays face amount plus accumulated cash value.

Variable life and variable universal life hold cash value in a separate account, place investment risk on the owner, and require both a state insurance license and a securities registration to sell.

Indexed universal life credits interest linked to an external index, subject to a cap and a floor; it is an insurance contract, not a registered security.

A policy that fails the 7-pay test becomes a modified endowment contract: withdrawals and loans are taxed income-first and a 10% penalty applies to taxable amounts before age 59 1/2.

An automatic premium loan provision or a change to a more frequent mode can prevent unintentional lapse; a lapse triggers the nonforfeiture options.

A 1035 exchange moves values tax free from a life policy, annuity, or endowment into a like contract.

Replacement rules require the producer to give the applicant a notice of replacement and to notify both the existing insurer and the replacing insurer.

Incontestability: after the policy has been in force two years, the insurer cannot rescind coverage or deny a claim for misstatements on the application; nonpayment of premium remains contestable.

A grace period of 30 or 31 days keeps coverage in force after a missed premium; reinstatement is typically allowed within 3 to 5 years with back premiums, interest, and proof of insurability.

The suicide clause limits payment to a return of premium if death by suicide occurs within the first two years; misstatement of age adjusts the benefit to what the premium would have purchased.

Nonforfeiture options: cash surrender, reduced paid-up (smaller lifetime coverage), and extended term (full face amount for a limited period).

Settlement options: lump sum, interest only, fixed period, fixed amount, and life income; straight life pays the largest income, while life with period certain or refund guarantees a minimum payout.

Dividend options: cash, reduce premium, accumulate at interest, paid-up additions, and one-year term.

Common riders: waiver of premium, disability income, accidental death (double indemnity), guaranteed insurability, term or child rider, accelerated death benefit, and long-term care or chronic illness.

Beneficiary types: primary and contingent, revocable and irrevocable, per stirpes (by bloodline) versus per capita (equally among survivors); proceeds cannot be paid directly to a minor.

A common disaster clause and the Uniform Simultaneous Death Act determine payout order when the insured and primary beneficiary die in the same event.

An annuity liquidates a sum of money over time and transfers longevity risk to the insurer; the accumulation phase is the pay-in period and the annuitization phase is the payout period.

Immediate annuities begin payments within one payment interval after purchase; deferred annuities accumulate value before payout.

Fixed annuities guarantee a minimum interest rate and a stated benefit; variable annuities invest in a separate account and are registered securities requiring a securities license; indexed annuities credit index-linked interest subject to a cap, floor, and participation rate.

Parties: the owner holds all contract rights, the annuitant's life measures the payout, and the beneficiary receives any survivor benefit.

Qualified annuities are funded with pre-tax dollars, so the entire payout is taxable; nonqualified annuities have after-tax basis recovered through the exclusion ratio.

Nonqualified withdrawals before annuitization are taxed LIFO (earnings first), and a 10% penalty applies to taxable amounts before age 59 1/2 unless an exception applies.

Surrender charges decline over the early contract years; free-withdrawal provisions typically allow up to 10% of accumulated value each year without charge.

Payout options include life only, life with period certain, joint and survivor, fixed amount, and fixed period; adding a guarantee lowers each periodic payment.

A market value adjustment may apply on some fixed or indexed contracts surrendered early when interest rates have changed since purchase.

Key cost-sharing terms: deductible (paid before benefits), coinsurance (the insured's percentage of covered charges), copayment (a flat fee per service), and out-of-pocket maximum.

Renewability, from least to most favorable to the insured: cancellable, optionally renewable, conditionally renewable, guaranteed renewable, and noncancellable (guaranteed renewable with a rate guarantee).

Uniform provisions: notice of claim within 20 days of loss, claim forms within 15 days, proof of loss within 90 days, and payment of claim within 30 days.

Grace periods based on premium mode are 7 days (weekly), 10 days (monthly), and 31 days (annual); coverage stays in force during the grace period.

Reinstatement restores coverage upon payment of overdue premium and evidence of insurability; the insurer is liable only for expenses beyond the premiums owed, and new preexisting periods may apply.

The health incontestability clause bars denial for misstatements after two years except for fraud; preexisting condition limitations have their own look-back and waiting periods.

Legal actions: the insured cannot sue before 60 days after proof of loss, and no action may be brought more than 3 years after proof of loss is required.

Coordination of benefits determines payment order so combined benefits never exceed 100% of the expense; the primary plan pays first and the secondary pays the remainder up to its limit.

Change of occupation may reduce benefits to what the premium would have purchased in the new class; physical exams and autopsies are at the insurer's expense.

Disability income benefits are a percentage of earned income (typically 60-70%), with longer elimination periods and shorter benefit periods lowering the premium; benefits are tax free if the insured paid the premiums.

Own-occupation definitions pay if the insured cannot perform their own occupation; any-occupation definitions pay only if unable to work in any gainful employment for which qualified.

Business disability coverages include key person disability, business overhead expense, and buy-sell funding.

Medical expense plans include basic hospital-surgical-medical, major medical, and comprehensive; managed care models are HMO (closed panel with gatekeeper), PPO (network discounts, no gatekeeper), POS, and EPO.

Medicare: Part A hospital coverage (premium free with 40 quarters), Part B medical insurance, Part C Medicare Advantage, and Part D prescription drugs; eligibility begins at 65, after 24 months of Social Security disability, or with ESRD.

Medicare enrollment: initial 7-month period around age 65, general enrollment January 1-March 31, and annual open enrollment October 15-December 7; Medigap plans are standardized (A-D, F, G, K, L, M, N) and Plan F is unavailable to those newly eligible after January 1, 2020.

Group health: contributory plans generally require at least 75% employee participation; COBRA continuation is 18 months for job loss, up to 29 months with a disability determination, and 36 months for dependents after death, divorce, or similar events.

Long-term care policies pay when the insured cannot perform 2 of 6 activities of daily living (bathing, dressing, eating, toileting, transferring, continence) or has cognitive impairment; they cover skilled, intermediate, and custodial care.

HSA-qualified high-deductible health plans permit tax-deductible contributions that roll over and grow tax free when paired with a qualified HDHP.

The Commissioner of Insurance is elected statewide to a four-year term and heads the Louisiana Department of Insurance.

Producers must be licensed for each line sold, appointed by the insurer, and must renew biennially.

Continuing education is 24 hours per two-year term, including at least 3 hours of ethics.

A producer must report a change of address, name change, administrative action, or criminal prosecution to the Commissioner within 30 days.

The insurer must notify the Commissioner of a producer appointment within 30 days after the first application is submitted.

Premiums collected are held in a fiduciary capacity and may not be commingled with the producer's personal funds.

Prohibited practices include rebating, twisting, misrepresentation, and unfair claim settlement practices.

Individual life policies include a free-look period (10 days) allowing return of the policy for a premium refund.

The Louisiana Life and Health Insurance Guaranty Association provides limited, statutorily capped protection if a member insurer becomes insolvent.

Insurance transfers pure risk to a pool; speculative risk is not insurable.

Insurable risks are accidental, measurable, definite, calculable, and spread over many similar exposure units.

Peril is the cause of loss; hazard is a condition that increases the chance or severity of loss.

Hazards are classified as physical, moral, or morale.

Adverse selection is the tendency of higher-risk applicants to seek coverage and is controlled by underwriting and exclusions.

The principle of indemnity restores the insured to the pre-loss position; life insurance is a valued contract.

Contract elements: offer and acceptance, consideration, legal purpose, and competent parties.

Insurance contracts are adhesion, aleatory, unilateral, and conditional.

Agent authority may be express, implied, or apparent; waiver and estoppel can prevent an insurer from denying a right it gave up.

Insurable interest must exist at the time of application, not necessarily at death.

Premium components are mortality, interest, and expense; more frequent payment modes cost more overall.

The needs approach totals obligations and subtracts resources; human life value discounts future earnings.

Underwriting sources include the application, medical exam, APS, MIB, and inspection report.

Term insurance has no cash value and may be renewable and convertible.

Renewable term continues coverage without new evidence of insurability.

Convertible term exchanges for permanent coverage without new evidence of insurability.

Group life is annually renewable term under a master contract with conversion rights on termination.

Death benefits are generally income-tax free and cash value grows tax deferred.

Owner's rights: change beneficiary, surrender, borrow, assign, and choose settlement options.

Whole life endows at maturity and builds guaranteed cash value; unpaid loans reduce the proceeds.

Universal life has flexible premiums and adjustable death benefits; Option A is level and Option B increases with cash value.

Variable life cash value is in a separate account and the owner bears investment risk.

Selling variable products requires a securities registration in addition to the insurance license.

Indexed universal life credits interest subject to a cap and a floor and is not a security.

Failing the 7-pay test creates a modified endowment contract with LIFO taxation and a 10% pre-59 1/2 penalty.

A 1035 exchange moves values tax free between like contracts.

Replacement requires notice to the applicant and to both the existing and replacing insurers.

After two years, the incontestability clause bars rescission for application misstatements; nonpayment is still contestable.

Grace period is 30 or 31 days; reinstatement requires back premiums, interest, and proof of insurability.

The suicide clause limits payment to a premium refund during the first two years.

Misstatement of age adjusts the benefit to the amount the premium would have purchased at the true age.

Nonforfeiture options are cash surrender, reduced paid-up, and extended term.

Settlement options include lump sum, interest only, fixed period, fixed amount, and life income.

Straight life income pays the largest payment because no minimum payout is guaranteed.

Dividend options are cash, reduce premium, accumulate at interest, paid-up additions, and one-year term.

Riders include waiver of premium, disability income, accidental death, guaranteed insurability, child term, and accelerated death benefit.

The accumulation phase builds value; the annuitization phase liquidates it.

Immediate annuities pay within one payment interval; deferred annuities pay later.

Fixed annuities guarantee a minimum rate; variable annuities use a separate account and are registered securities.

Indexed annuities credit index-linked interest subject to a cap, floor, and participation rate.

The owner holds contract rights; the annuitant's life measures the payout.

Qualified annuity payouts are fully taxable; nonqualified payouts recover basis through the exclusion ratio.

Nonqualified withdrawals before annuitization are taxed LIFO with a 10% penalty before age 59 1/2.

Surrender charges decline over time and free withdrawals typically allow 10% per year.

Adding a period certain or survivor benefit to a life payout lowers each periodic payment.

Deductible, coinsurance, and copayment are cost-sharing mechanisms; the out-of-pocket maximum caps insured cost.

Renewability runs from cancellable to optionally renewable, conditionally renewable, guaranteed renewable, and noncancellable.

Notice of claim is due within 20 days, claim forms within 15 days, and proof of loss within 90 days.

Claims must be paid within 30 days after proof of loss.

Grace periods are 7 days weekly, 10 days monthly, and 31 days annual.

Reinstatement requires overdue premium plus evidence of insurability and limits liability to amounts beyond premiums owed.

Health incontestability bars denial for misstatement after two years, except for fraud.

Suit cannot be filed before 60 days or after 3 years from the date proof of loss is required.

Coordination of benefits makes one plan primary so total payment never exceeds 100% of the expense.

Disability income replaces 60-70% of income; longer elimination periods and shorter benefit periods reduce premium.

Own-occupation definitions are broader and cost more than any-occupation definitions.

Benefits are tax free when the insured paid the premium and taxable when the employer paid it.

Managed care models: HMO (closed panel, gatekeeper), PPO (network discounts), POS, and EPO.

Medicare Part A covers hospital care, Part B covers medical care, Part C is Medicare Advantage, and Part D covers drugs.

Medicare eligibility begins at 65, after 24 months of disability benefits, or with ESRD.

COBRA continuation lasts 18 months for job loss, up to 29 months with disability, and 36 months for dependents.

Long-term care benefits trigger on inability to perform 2 of 6 ADLs or cognitive impairment.

Group contributory plans typically require at least 75% participation.

The Commissioner of Insurance is elected statewide to a four-year term and heads the Louisiana Department of Insurance.

A producer must hold a license for each line sold and be appointed by the insurer before soliciting or selling.

Licenses renew biennially with 24 hours of continuing education, including at least 3 hours of ethics.

A producer must notify the Commissioner within 30 days of an address change, name change, administrative action, or criminal prosecution.

The insurer must file notice of a producer appointment with the Commissioner within 30 days after the first application is submitted.

Premiums are held in a fiduciary capacity; commingling with personal funds is prohibited.

Rebating, twisting, misrepresentation, and unfair claim settlement practices are prohibited.

Individual life insurance policies have a 10-day free-look period.

Selling for an unauthorized insurer or without a license may result in fines, cease-and-desist orders, or license revocation.

Pure risk is insurable; speculative risk is not.

Insurable risks are accidental, definite, measurable, calculable, and spread over many similar units.

Peril is the cause of loss; hazard is a condition that increases the chance or severity of loss.

Hazards are physical, moral, or morale.

Adverse selection is controlled through underwriting, exclusions, and waiting periods.

Indemnity restores the insured to the pre-loss position; life insurance is a valued contract.

Contract elements are offer, acceptance, consideration, legal purpose, and competent parties.

Insurance contracts are adhesion, aleatory, unilateral, and conditional.

Agent authority is express, implied, or apparent; waiver and estoppel can bind the insurer.

Insurable interest is required at application, not at death.

Mortality, interest, and expense drive the premium.

Frequent premium modes increase total annual cost.

Human life value discounts future earnings; the needs approach nets obligations against resources.

Underwriting uses the application, exam, APS, MIB, and inspection report.

Term insurance has no cash value.

Renewable term continues without new evidence of insurability.

Convertible term becomes permanent coverage without new evidence of insurability.

Group life is annually renewable term with conversion rights and no individual underwriting.

Owner's rights include changing the beneficiary, surrendering, borrowing, assigning, and selecting settlement options.

Whole life endows at maturity and builds guaranteed cash value.

Universal life Option A is a level death benefit; Option B is face amount plus cash value.

Variable products place investment risk on the owner and require a securities registration.

Indexed universal life credits index-linked interest with a cap and a floor.

Failing the 7-pay test creates a modified endowment contract with LIFO taxation.

MEC withdrawals and loans may incur a 10% penalty before age 59 1/2.

A 1035 exchange moves values tax free between like contracts.

Replacement requires notice to the applicant and to both insurers.

Incontestability bars rescission for misstatement after two years; nonpayment remains contestable.

Grace period is 30 or 31 days.

Reinstatement requires back premiums, interest, and proof of insurability.

The suicide clause limits payment to a premium refund in the first two years.

Misstatement of age adjusts the benefit to the correct amount.

Nonforfeiture options are cash surrender, reduced paid-up, and extended term.

Settlement options include lump sum, interest only, fixed period, fixed amount, and life income.

Dividend options include cash, reduce premium, accumulate at interest, paid-up additions, and one-year term.

Riders include waiver of premium, accidental death, guaranteed insurability, child term, and accelerated death benefit.

Accumulation builds value; annuitization liquidates it.

Immediate annuities pay within one payment interval; deferred annuities pay later.

Fixed annuities guarantee a minimum rate; variable annuities use a separate account and are securities.

Indexed annuities credit interest subject to a cap, floor, and participation rate.

The owner holds all rights; the annuitant's life measures the payout.

Qualified payouts are fully taxable; nonqualified payouts use the exclusion ratio.

Nonqualified withdrawals are taxed LIFO with a 10% penalty before age 59 1/2.

Surrender charges decline over time; free withdrawals are typically 10% per year.

Guaranteed payout features lower the periodic payment.

Deductible, coinsurance, and copayment are cost-sharing features capped by the out-of-pocket maximum.

Renewability tiers: cancellable, optionally renewable, conditionally renewable, guaranteed renewable, noncancellable.

Notice of claim 20 days, claim forms 15 days, proof of loss 90 days.

Claims are paid within 30 days after proof of loss.

Grace periods are 7 days weekly, 10 days monthly, 31 days annual.

Reinstatement requires overdue premium and evidence of insurability.

Health incontestability bars denial for misstatement after two years, except fraud.

Suit may be filed no earlier than 60 days and no later than 3 years after proof of loss.

Coordination of benefits keeps total payments at or below 100% of the expense.

Disability income replaces 60-70% of income; longer elimination periods reduce premium.

Own-occupation definitions cost more than any-occupation definitions.

Employer-paid disability premiums produce taxable benefits; insured-paid premiums produce tax-free benefits.

Managed care models include HMO, PPO, POS, and EPO.

Medicare Parts A, B, C, and D cover hospital, medical, Advantage, and drugs respectively.

Medicare eligibility begins at 65, after 24 months of disability, or with ESRD.

COBRA lasts 18 months for job loss, up to 29 with disability, and 36 for dependents.

Long-term care triggers on 2 of 6 ADL losses or cognitive impairment.

Contributory group plans generally require 75% participation.

The Commissioner of Insurance is elected to a four-year term and heads the Louisiana Department of Insurance.

Producers must be licensed by line and appointed by the insurer.

Licenses renew biennially with 24 hours of continuing education, including 3 hours of ethics.

Report address changes, name changes, administrative actions, and criminal prosecutions within 30 days.

The insurer files appointment notice within 30 days after the first application.

Premiums are held in a fiduciary capacity; commingling is prohibited.

Rebating, twisting, misrepresentation, and unfair claim practices are prohibited.

Individual life policies have a 10-day free-look period.

The state guaranty association provides limited, capped protection on insolvency.

Pure risk is insurable; speculative risk is not.

Insurable risks are accidental, measurable, definite, and calculable across many exposure units.

Peril is the cause of loss; hazard is a condition increasing the chance or severity of loss.

Hazards are physical, moral, or morale.

Adverse selection is managed by underwriting, exclusions, and waiting periods.

Indemnity restores the pre-loss position; life insurance is a valued contract.

Contract elements: offer, acceptance, consideration, legal purpose, competent parties.

Insurance contracts are adhesion, aleatory, unilateral, and conditional.

Agent authority is express, implied, or apparent; waiver and estoppel may bind the insurer.

Insurable interest exists at application, not at death.

Premium factors are mortality, interest, and expense.

More frequent premium modes increase total annual cost.

Needs approach nets obligations against resources; human life value discounts future earnings.

Underwriting sources are the application, exam, APS, MIB, and inspection report.

Term insurance has no cash value.

Renewable term continues without new underwriting.

Convertible term becomes permanent without new underwriting.

Group life is annually renewable term with conversion rights.

Owner's rights: change beneficiary, surrender, borrow, assign, and choose settlement options.

Whole life endows at maturity and builds guaranteed cash value.

Universal life Option A is level; Option B equals face amount plus cash value.

Variable life uses a separate account; the owner bears investment risk and a securities license is required.

Indexed universal life credits interest with a cap and a floor and is not a security.

Failing the 7-pay test creates a MEC with LIFO taxation and a 10% penalty before age 59 1/2.

A 1035 exchange moves values tax free between like contracts.

Replacement requires notice to the applicant and to both insurers.

Unpaid loans reduce the death benefit and cash value.

Incontestability bars rescission for misstatement after two years; nonpayment is still contestable.

The grace period is 30 or 31 days.

Reinstatement requires back premiums, interest, and proof of insurability.

The suicide clause pays only a premium refund during the first two years.

Misstatement of age adjusts the benefit to the correct amount.

Nonforfeiture options: cash surrender, reduced paid-up, extended term.

Settlement options: lump sum, interest only, fixed period, fixed amount, life income.

Dividend options: cash, reduce premium, accumulate at interest, paid-up additions, one-year term.

Beneficiary designations may be primary or contingent, revocable or irrevocable, per stirpes or per capita.

Accumulation builds value; annuitization liquidates it.

Immediate annuities pay within one payment interval; deferred annuities pay later.

Fixed annuities guarantee a minimum rate; variable annuities use a separate account and are securities.

Indexed annuities apply a cap, floor, and participation rate.

The owner holds rights; the annuitant's life measures the payout.

Qualified payouts are fully taxable; nonqualified payouts use the exclusion ratio.

Nonqualified withdrawals are taxed LIFO with a 10% penalty before age 59 1/2.

Surrender charges decline over time; free withdrawals are typically 10% annually.

Guaranteed payout features reduce the periodic payment.

Deductible, coinsurance, and copayment are cost-sharing features capped by the out-of-pocket maximum.

Renewability tiers: cancellable, optionally renewable, conditionally renewable, guaranteed renewable, noncancellable.

Notice of claim 20 days, claim forms 15 days, proof of loss 90 days.

Claims are paid within 30 days after proof of loss.

Grace periods: 7 days weekly, 10 days monthly, 31 days annual.

Reinstatement requires overdue premium and evidence of insurability.

Health incontestability bars denial for misstatement after two years, except fraud.

Suit may be filed no earlier than 60 days and no later than 3 years after proof of loss.

Coordination of benefits caps total payment at 100% of the expense.

Disability income replaces 60-70% of income; longer elimination periods reduce premium.

Own-occupation definitions cost more than any-occupation definitions.

Employer-paid premiums produce taxable benefits; insured-paid premiums produce tax-free benefits.

Managed care models: HMO, PPO, POS, EPO.

Medicare Parts A, B, C, D cover hospital, medical, Advantage, and drugs.

Medicare eligibility begins at 65, after 24 months of disability, or with ESRD.

COBRA lasts 18 months for job loss, up to 29 with disability, 36 for dependents.

Long-term care triggers on 2 of 6 ADL losses or cognitive impairment.

Contributory group plans typically require 75% participation.

Commissioner of Insurance is elected to a four-year term and heads the Louisiana Department of Insurance.

Producers need a license by line plus an insurer appointment.

Renewal is biennial with 24 CE hours including 3 hours of ethics.

Report address changes, name changes, administrative actions, and criminal prosecutions within 30 days.

The insurer files appointment notice within 30 days after the first application.

Premiums are held in a fiduciary capacity; commingling is prohibited.

Rebating, twisting, misrepresentation, and unfair claim practices are prohibited.

Individual life policies carry a 10-day free look.

The guaranty association provides limited, capped protection on insurer insolvency.

Pure risk is insurable; speculative risk is not.

Insurable risks are accidental, measurable, definite, calculable, and widely spread.

Peril is the cause of loss; hazard increases the chance or severity of loss.

Hazards are physical, moral, or morale.

Adverse selection is controlled by underwriting, exclusions, and waiting periods.

Indemnity restores the pre-loss position; life insurance is valued, not indemnity.

Contract elements: offer, acceptance, consideration, legal purpose, competent parties.

Insurance contracts are adhesion, aleatory, unilateral, and conditional.

Authority is express, implied, or apparent; waiver and estoppel may bind the insurer.

Insurable interest must exist at application, not at death.

Premium factors: mortality, interest, expense.

Higher payment frequency increases total annual cost.

Needs approach nets obligations against resources; human life value discounts future earnings.

Underwriting sources: application, exam, APS, MIB, inspection report.

Term insurance builds no cash value.

Renewable term continues without new underwriting.

Convertible term becomes permanent without new underwriting.

Group life is annually renewable term with conversion rights.

Owner's rights include beneficiary changes, surrender, loans, assignment, and settlement options.

Whole life endows at maturity with guaranteed cash value.

Universal life Option A is level; Option B is face plus cash value.

Variable products use a separate account and require a securities registration.

Indexed universal life applies a cap and a floor and is not a security.

A MEC fails the 7-pay test and is taxed LIFO with a 10% pre-59 1/2 penalty.

A 1035 exchange moves values tax free between like contracts.

Replacement requires notice to the applicant and to both insurers.

Outstanding loans reduce both cash value and death benefit.

Incontestability bars rescission for misstatement after two years; nonpayment stays contestable.

Grace period: 30 or 31 days.

Reinstatement requires back premiums, interest, and proof of insurability.

Suicide clause pays a premium refund during the first two years.

Misstatement of age adjusts the benefit to the correct amount.

Nonforfeiture options: cash surrender, reduced paid-up, extended term.

Settlement options: lump sum, interest only, fixed period, fixed amount, life income.

Dividend options: cash, reduce premium, accumulate at interest, paid-up additions, one-year term.

Beneficiaries may be primary or contingent, revocable or irrevocable, per stirpes or per capita.

Accumulation builds value; annuitization liquidates it.

Immediate annuities pay within one payment interval; deferred pay later.

Fixed annuities guarantee a minimum rate; variable annuities are separate-account securities.

Indexed annuities apply a cap, floor, and participation rate.

The owner holds rights; the annuitant's life measures payout.

Qualified payouts are fully taxable; nonqualified payouts use the exclusion ratio.

Nonqualified withdrawals are LIFO with a 10% penalty before age 59 1/2.

Surrender charges decline; free withdrawals are typically 10% annually.

Guaranteed features lower the periodic payment.

Deductible, coinsurance, and copayment are capped by the out-of-pocket maximum.

Renewability: cancellable, optionally renewable, conditionally renewable, guaranteed renewable, noncancellable.

Notice of claim 20 days; claim forms 15 days; proof of loss 90 days.

Claims paid within 30 days after proof of loss.

Grace periods: 7 days weekly, 10 days monthly, 31 days annual.

Reinstatement requires overdue premium plus evidence of insurability.

Health incontestability bars denial after two years except for fraud.

Suit is barred before 60 days and after 3 years from proof of loss.

Coordination of benefits caps payment at 100% of the expense.

Disability income replaces 60-70% of income; longer elimination periods cut premium.

Own-occupation definitions cost more than any-occupation definitions.

Insured-paid premiums yield tax-free benefits; employer-paid premiums yield taxable benefits.

Managed care models: HMO, PPO, POS, EPO.

Medicare Parts A, B, C, D cover hospital, medical, Advantage, drugs.

Eligibility: age 65, 24 months of disability, or ESRD.

COBRA: 18 months job loss, up to 29 with disability, 36 for dependents.

Long-term care triggers on 2 of 6 ADLs or cognitive impairment.

Contributory group plans typically require 75% participation.