100% PASS 2025 INSURANCE LICENSING OK-LIFE-ACCIDENT-AND-HEALTH-OR-SICKNESS-PRODUCER MARVELOUS FREE UPDATES

100% Pass 2025 Insurance Licensing Ok-Life-Accident-and-Health-or-Sickness-Producer Marvelous Free Updates

100% Pass 2025 Insurance Licensing Ok-Life-Accident-and-Health-or-Sickness-Producer Marvelous Free Updates

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Insurance Licensing Oklahoma Life, Accident, and Health or Sickness Producer Exam Sample Questions (Q152-Q157):

NEW QUESTION # 152
A group major medical policy is written with a $1,000 deductible, 80/20 coinsurance, and an out-of-pocket maximum of $3,000. The insured goes into the hospital for a covered procedure. The total cost of the procedure is $5,000. How much does the insured have to pay towards the $5,000 total?

  • A. $5,000
  • B. $3,000
  • C. $1,000
  • D. $1,800

Answer: B

Explanation:
To calculate the insured's payment:
* Deductible: The insured pays the first $1,000 of the $5,000 procedure cost.
* Remaining cost: $5,000 - $1,000 = $4,000.
* Coinsurance: The policy has 80/20 coinsurance, so the insurer pays 80% ($3,200) and the insured pays
20% ($800) of the $4,000.
* Total paid by insured: $1,000 (deductible) + $800 (coinsurance) = $1,800.
* Out-of-pocket maximum: The policy's $3,000 out-of-pocket maximum caps the insured's total payments. Since $1,800 is less than $3,000, the insured pays $1,800. However, the question asks for the total paid "towards the $5,000," and the out-of-pocket maximum of $3,000 suggests a cap on total liability for covered expenses. In this context, the correct interpretation is that the insured's payment is capped at the out-of-pocket maximum if applicable, but standard calculation yields $1,800, and the answer options suggest a possible intent for the maximum.
Upon review, the correct calculation yields $1,800 (Option C), but the out-of-pocket maximum of $3,000 (Option B) may be the intended answer if the question implies the maximum liability. Given the standard insurance calculation,Option C ($1,800)is mathematically correct, butOption B ($3,000)aligns with the out- of-pocket maximum as a potential cap. Since the calculation is clear, we selectC.
Corrected answer: C
Explanation of Calculation:
* Deductible: $1,000.
* Coinsurance: 20% of $4,000 = $800.
* Total: $1,000 + $800 = $1,800.
* The out-of-pocket maximum ($3,000) is not reached, so the insured pays $1,800.
* Option A: Incorrect. The insured does not pay the full $5,000 due to insurer contributions.
* Option B: Incorrect. The $3,000 out-of-pocket maximum is not reached; the calculated payment is
$1,800.
* Option C: Correct. The insured pays $1,800 based on the deductible and coinsurance.
* Option D: Incorrect. The $1,000 deductible alone does not account for coinsurance.
This question aligns with the Prometric content outline under "Provisions, Options, Exclusions, Riders, Clauses, and Rights," which covers health insurance cost-sharing provisions.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Accident and Health Insurance).
Oklahoma Insurance Department, Title 36 O.S. § 6060.3 (health insurance policy provisions).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.


NEW QUESTION # 153
Every licensee must keep records pertaining to insurance transactions for how many years?

  • A. 0
  • B. 1
  • C. 2
  • D. 3

Answer: D

Explanation:
Oklahoma insurance law requires licensed insurance producers to maintain records of insurance transactions for a minimum of5 years, as specified in Title 36 O.S. § 1435.13. This ensures compliance with regulatory oversight and allows for audits or investigations by the Oklahoma Insurance Department.
* Option A: Incorrect. 3 years is insufficient per Oklahoma law.
* Option B: Correct. Licensees must keep records for 5 years.
* Option C: Incorrect. 7 years exceeds the requirement.
* Option D: Incorrect. 10 years is not mandated by Oklahoma insurance regulations.
This question falls under the Prometric content outline section on "State Insurance Statutes, Rules, and Regulations," which includes recordkeeping requirements.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: State- Specific Knowledge - Licensing Requirements).
Oklahoma Insurance Department, Title 36 O.S. § 1435.13 (producer recordkeeping).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.


NEW QUESTION # 154
An example of a false financial statement is which one of the following?

  • A. An insurance producer mails out hateful postcards about a local insurer.
  • B. An insurance producer published an untrue newspaper advertisement about another producer.
  • C. An insurance producer hands out flyers about another producer's criminal past.
  • D. An insurance producer posts information about a profitable insurer going bankrupt.

Answer: D

Explanation:
Afalse financial statementin the context of insurance refers to a misrepresentation of an insurer's financial condition, such as falsely claiming insolvency or bankruptcy, which is prohibited under Oklahoma's Unfair Trade Practices Act (Title 36 O.S. § 1204). This can mislead consumers and harm the insurer's reputation.
Option B directly involves a false claim about an insurer's financial status.
* Option A: Incorrect. An untrue advertisement about another producer is defamation or misrepresentation, not a financial statement.
* Option B: Correct. Posting false information about an insurer's bankruptcy is a false financial statement, violating Oklahoma law.
* Option C: Incorrect. Flyers about a criminal past are defamatory but not related to financial statements.
* Option D: Incorrect. Hateful postcards are unprofessional but do not constitute a false financial statement.
This question is part of the Prometric content outline under "State Insurance Statutes, Rules, and Regulations," which covers unfair trade practices.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: State- Specific Knowledge - Oklahoma Insurance Statutes).
Oklahoma Insurance Department, Title 36 O.S. § 1204 (unfair trade practices).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.


NEW QUESTION # 155
A new mother is guaranteed a 48-hour hospital stay after a regular delivery of a child under which federal law and regulations for group health insurance?

  • A. COBRA.
  • B. ERISA.
  • C. HIPAA.
  • D. Medicaid.

Answer: C

Explanation:
TheHealth Insurance Portability and Accountability Act (HIPAA)includes provisions from the Newborns' and Mothers' Health Protection Act (NMHPA) of 1996, which mandates that group health plans cannot restrict hospital stays for childbirth to less than 48 hours for a vaginal delivery or 96 hours for a cesarean section. This federal law applies to group health insurance plans in Oklahoma and ensures minimum coverage for maternity care.
* Option A: Incorrect. COBRA allows continuation of group health coverage after certain events but does not mandate maternity stay durations.
* Option B: Incorrect. Medicaid is a state-federal program for low-income individuals, not a law mandating hospital stays for childbirth.
* Option C: Correct. HIPAA, via the NMHPA, guarantees the 48-hour hospital stay for regular deliveries.
* Option D: Incorrect. ERISA governs employee benefit plans but does not specifically address maternity hospital stays.
This question is part of the Prometric content outline under "State Insurance Statutes, Rules, and Regulations," which covers federal and state laws affecting health insurance.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: State- Specific Knowledge - Oklahoma Insurance Statutes).
Oklahoma Insurance Department, Title 36 O.S. § 6060.9 (maternity benefits).
HIPAA, Newborns' and Mothers' Health Protection Act, 29 U.S.C. § 1185.


NEW QUESTION # 156
Under the unpaid premium Uniform Optional Provision, if there is an unpaid premium at the time a health claim becomes payable, then the

  • A. policy is cancelled.
  • B. premium is deducted from the claim.
  • C. claim is denied.
  • D. claim is delayed until payment of the premium.

Answer: B

Explanation:
Theunpaid premium Uniform Optional Provisionin health insurance policies, as recognized in Oklahoma (Title 36 O.S. § 4405), allows the insurer to deduct any unpaid premiums from a claim payment if a claim becomes payable while premiums are overdue. This ensures the policy remains in force and the claim is paid, net of the owed premium.
* Option A: Incorrect. The claim is not denied; the premium is deducted from the payment.
* Option B: Incorrect. The policy is not cancelled; the unpaid premium is addressed via the claim.
* Option C: Correct. The unpaid premium is deducted from the claim payment.
* Option D: Incorrect. The claim is not delayed; the premium is settled with the claim payment.
This question falls under the Prometric content outline section on "Provisions, Options, Exclusions, Riders, Clauses, and Rights," which covers health insurance policy provisions.
:
Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section:
General Knowledge - Accident and Health Insurance).
Oklahoma Insurance Department, Title 36 O.S. § 4405 (health insurance provisions).
Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing.


NEW QUESTION # 157
......

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