§3119.EXHIBIT F. COURSE OF STUDY – ACCIDENT/HEALTH

Course of Study Content Requirements				Time Distribution Requirements
I.	Types of policies and coverages			30%
	A.	Disability income
	B.	Accidental death and dismemberment and other indemnity plans
	C.	Medical expense insurance
	D.	Medicare and Medicare supplements
	E.	Medicaid
	F.	Limited coverage plans ( cancer plans and travel accident)

 

II.	Policy provisions, options and benefits			30%
	A.	Entire contract
	B.	Insuring clause
	C.	Free look (ten day, twenty day)
	D.	Consideration clause
	E.	Owner's rights
	F.	Change of beneficiaries
	G.	Grace period
	H.	Probationary (waiting) period
	I.	Reinstatement
	J.	Time limit on certain defenses
	K.	Misstatement of age
	L.	Waiver of premiums
	M.	Exclusions
	N.	Payment of claims
	O.	Notice of claims
	P.	Claim forms
	Q.	Proof of loss
	R.	Legal actions
	S.	Time of payment of claims
	T.	Physical examinations and autopsy
	U.	Change of occupation
	V.	Illegal occupation
	W.	Nonduplication and coordination of benefits (e.g., primary vs. excess benefits)
	X.	Group conversions

 

III.	Completing the application and delivering the policy			10%
	A.	Completing the application and obtaining necessary signatures
	B.	Warranties and Representations
	C.	Complying with provision of Fair Credit Reporting Act and Illinois Insurance Privacy Act
	D.	Explaining the effect of the application with money
	E.	Explaining the effect of the application without money
	F.	The underwriting process
	G.	Delivery and explanation of the policy

 

IV.	Group insurance, taxation, and other insurance concepts			16%
	A.	Group insurance
	B.	Occupational vs. nonoccupational coverage
	C.	Total vs. partial disability
	D.	Social Security benefits and taxes
	E.	Service organizations (e.g., Blue Cross/Blue Shield, HMO)
	F.	Tax treatment of premiums and proceeds of insurance contracts (e.g., disability and medical expense)

 

V.	Other provisions affecting insurance benefits			14%
	A.	Deductibles
	B.	Elimination (waiting) period
	C.	Coinsurance
	D.	Preexisting conditions
	E.	Renewability provisions (e.g., noncancellable, guaranteed renewable, conditionally renewable, optionally renewable)
	F.	Covered medical expenses

 

(Source:  Amended at 20 Ill. Reg. 10340, effective July 19, 1996)