PSI Services LLC
3210 E Tropicana
Las Vegas, NV 89121
(888) 818-5822
E-mail: examschedule@psionline.com
https://home.psiexams.com/#/home
PENNSYLVANIA INSURANCE DEPARTMENT
LICENSING EXAMINATION
CANDIDATE INFORMATION BOOKLET
A Message from the Commissioner .......................... 2
The Licensure Process ........................................ 2
Fingerprint Requirements .................................... 4
Examination Payment and Scheduling Procedures ........ 4
Fees ................................................... 4
On-line Testing at a PSI test site ................. 5
Testing remotely .................................... 8
Rescheduling/Canceling an Examination ....... 9
Re-taking a Failed Examination .................. 9
Missed Appointment or Late Cancellation ....... 9
Exam Accommodations ............................. 9
English as a Second Language ..................... 9
Emergency Examination Site Closing ............. 9
Examination Site Location .................................... 9
Reporting to the Examination Site ......................... 10
Required Identification ........................... 10
Security Procedures ................................ 11
Taking the Examination by Computer ...................... 11
Identification Screen .............................. 11
Tutorial .............................................. 12
Test Question Screen .............................. 12
Remote Online Proctored Exam .................. 12
Examination Review ............................... 14
Score Reporting ............................................... 14
Duplicate Score Reports ........................... 14
Experimental Items ................................ 14
Tips for Preparing for your License Examination ......... 14
Obtaining your License ....................................... 14
Continuing Education ......................................... 15
Additional Licensing Information ........................... 15
Examination Content Outlines and Study Materials ...... 15
Exam Accommodations Request Form ...... End of Booklet
Please refer to our website to check for the most updated information at https://home.psiexams.com/#/home
Copyright © 2020 by PSI Services LLC Effective 7/1/2020
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A MESSAGE FROM THE COMMISSIONER
This Candidate Information Booklet provides information about
the examination and application process for becoming licensed
to sell, solicit, negotiate or provide insurance or other services
and products in the Commonwealth of Pennsylvania.
Before being issued a license, you must pass an examination to
prove your knowledge of insurance statutes, regulations,
products and services. When you have successfully completed
your examination, you will be eligible to apply to the
Pennsylvania Insurance Department (the Department) for your
license.
The Department has contracted with PSI to conduct its
examination program. The Department and PSI work together to
ensure that examinations meet statutory requirements and
professional exam development standards.
Once a license is issued to an individual as an insurance
producer, the licensee may then secure insurer appointments to
represent the specific insurer if so desired. Please remember
that you may not engage in the business of insurance or viatical
settlements until the Department has issued to you one of the
various licenses explained in this Candidate Information
Booklet.
We wish you well in preparing for your examination and remind
you that Act 147 of 2002 requires all insurance producers to
complete 24 credit hours of continuing education courses each
biennial license cycle to be eligible to renew their license.
Any questions about the license examinations should be
directed to PSI. After you have successfully completed your
examination(s), questions regarding the application process to
obtain your license should be directed to the Department’s
Bureau of Licensing and Enforcement via e-mail at ra-in-
THE LICENSURE PROCESS
You must be licensed to sell, solicit or negotiate insurance in
the Commonwealth of Pennsylvania, or be appropriately
licensed to transact other insurance related functions such as
appraise physical damage to motor vehicles. To be licensed
there are various requirements you need to fulfill such as pre-
licensing education and testing requirements. The licensing
requirements are different, depending upon which license you
would like to apply for and your status as a resident or a non-
resident applicant.
To be licensed, you must:
Complete any necessary pre-licensing requirements;
Pass the required examination(s) for the type of
license you are applying for; and
After passing the examination use the kiosk at the PSI
test site to complete your license application online at
www.sircon.com/pennsylvania or www.nipr.com, or
you may apply using your own computer.
If required, submit applicable application materials
Note: Passing an examination does not guarantee that you will
be issued a license. You must submit your license application to
the Department within one year of passing the exam. Issuance
of a license depends on review and approval of all license
application materials.
For licensing information, please contact:
Pennsylvania Insurance Department
Bureau of Licensing and Enforcement
1209 Strawberry Square
Harrisburg, Pennsylvania 17120
Phone: 717.787.3840
Fax: 717.787.8553
Web site: www.insurance.pa.gov
E-mail: ra-in[email protected]
PRE-LICENSING EDUCATION REQUIREMENTS
Initial insurance producer applicants must first complete 24
hours of pre-licensing education credits. A list of approved
courses can be found at http://www.sircon.com/pennsylvania.
▪ Select Look up education courses or transcript.
▪ Select Approved Courses Inquiry.
▪ Choose Pennsylvania and select Submit.
▪ Change the Education Type to Pre-Licensing Education.
▪ Select your preferred instruction method or leave
blank and select Submit.
▪ By selecting the provider name, you will then be given
contact information and a link to available course
offerings for that particular provider.
▪ Once you have completed your pre-licensing education
credits, you will be issued a certificate of completion
and the provider will upload your course completion
information to Vertafore/SIRCON.
WAIVER OF EXAMINATION
Some initial insurance producer candidates may be exempt
from the pre-licensing education and examination requirement,
depending on the type of professional designation held and/or
the line of authority desired. The following classes of applicants
are exempt from pre-licensing and written examination
requirements:
▪ A business entity;
▪ A candidate who possesses the Professional Designation
CLU-Chartered Life Underwriter applying for Life or
Accident and Health Line;
▪ A candidate who has the Professional Designation
CPCU-Chartered Property and Casualty Underwriter
applying for Property, Casualty or Accident and Health
Line of Authority;
▪ A candidate who has the Professional Designation CIC-
Certified Insurance Counselor applying for Life,
Accident and Health or Property and Casualty Line of
Authority;
▪ A person who is licensed in another state as an
Insurance Producer for the same lines of authority for
which the person desires to be licensed in
Pennsylvania;
▪ A person who has a line of authority limited to Limited
Line Credit Insurance;
▪ A person who has a line of authority limited to a
Limited Line; and
▪ An individual whose line of authority will be restricted
to domestic mutual fire insurance and will be with a
company writing only coverage other than insurance
upon automobiles as authorized by Section 202(B)(1)
through (3) of the Act of May 17, 1921, known as the
Insurance Company Law of 1921.
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Note: If you request an examination waiver, fingerprints are
still required before an initial resident insurance producer
license will be issued. See the Department’s Web site at
www.insurance.pa.gov for more information.
TYPES OF LICENSES
In accordance with Pennsylvania statutes and regulations, the
Department grants the licenses listed below.
Life and Health
Exam Series
Life Insurance, Annuities and Accident and
Health
16-01 and 16-02, or
16-03
Life Insurance and Annuities
16-01
Accident and Health
16-02
Variable Life & Variable Annuity
No exam (requires
FINRA registration)
Property
Exam Series
Fire and Allied Lines
16-04 or 16-06
Inland Marine and Motor Vehicle Physical
Damage
16-04 or 16-06
Domestic Mutual Fire (issued only to domestic
mutual fire companies)
No exam
Casualty
Exam Series
Casualty and Allied Lines
16-05 or 16-06
Accident and Health
16-02 or 16-03
Bonds: All Classes
16-05 or 16-06
Liability other than Motor Vehicle
16-05 or 16-06
Workers’ Compensation Insurance
16-05 or 16-06
Miscellaneous
Exam Series
Nonprofit Hospitalization
16-02 or 16-03
Title Insurance
16-10
Health Maintenance Organization
16-02 or 16-03
Nonresidents
See Page 3
Securities Investment Loss
16-05
Other Licenses
Exam Series
Surplus Lines Producer
16-09
Public Adjuster
16-19*
Motor Vehicle Physical Damage Appraiser
16-20 **
Personal Lines
16-16
Viatical Settlement Broker
16-17
*The examination content outline and more specific
information on taking this examination is available in the
Pennsylvania Public Adjuster Candidate Information Booklet
located online at https://home.psiexams.com/#/home.
**The examination content outline and more specific
information on taking this examination is available in the
Pennsylvania Motor Vehicle Physical Damage Appraiser
Candidate Information Booklet located online at
https://home.psiexams.com/#/home.
Combination examinations. A separate examination is given for
each major line of insurance. Combination Line examinations
(Life, Accident and Health; or Property and Casualty) combine
the content of the single-line examinations. You must pass the
overall examination to obtain a license in either line.
RESIDENT LICENSING REQUIREMENTS
Resident Insurance Producer
In order to qualify as a Pennsylvania resident insurance
producer, you must:
▪ Be at least 18 years of age;
▪ Maintain a primary residence or business location in
the Commonwealth of Pennsylvania;
▪ Possess the requisite professional competence, general
fitness and integrity of character;
▪ Be able to read and write English, with or without
visual or mechanical aids for the visually handicapped;
and
▪ Pass the appropriate examination(s) required by
statute 40 P.S. 310.5.
▪ Initial resident individual producer applicants are
required to be fingerprinted
Title Insurance Agent license
A title insurance agent means an authorized person, firm,
association, corporation or partnership, other than a bona fide
salaried employee of the title insurer who, on behalf of the
title insurer, performs the following acts, in conjunction with
the issuance of a title insurance report or policy:
▪ Determines insurability and issues title insurance
reports or policies or both; and
▪ Performs one or more of the following:
- Collects or disburses premiums, escrow or other
funds;
- Handles escrow, settlements or closings;
- Solicits or negotiates title insurance business; or
- Records closing documents.
An applicant for a Title Insurance Agent license is required to:
▪ Pass the Title Insurance Agent examination (applies to
both resident and nonresident applicants); and
▪ After passing the examination use the kiosk at the PSI
test site to complete your license application online at
www.sircon.com/pennsylvania or www.nipr.com, or
you may apply using your own computer.
▪ Fingerprints are required for both resident and non-
resident Title Insurance Agent applicants.
Surplus Lines license
A surplus lines producer is an individual, partnership or
corporation licensed by the Department to place insurance
coverage with an approved non-admitted company and who
may receive a commission for placing the coverage.
Under Article XVI of the Insurance Company Law (40 P.S.
Section 991.1601 et seq.), an applicant for a Resident Surplus
Lines Producer license shall:
▪ Be currently licensed in good standing as a resident
Pennsylvania Property and Casualty insurance
producer;
▪ Pass the Pennsylvania Surplus Lines examination—there
are no exemptions;
▪ After passing the examination use the kiosk at the PSI
test site to complete your license application online at
www.sircon.com/pennsylvania or www.nipr.com, or
you may apply using your own computer;
and
▪ If there is a partnership or corporation involved, a
separate business entity application must also be
submitted. Applicants can contact the Department for
the application and statement of regulations.
▪ Surplus Lines applicants do not require
fingerprinting.
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NONRESIDENT LICENSING REQUIREMENTS
A nonresident holds a resident license in a U.S. state or
territory other than the Commonwealth of Pennsylvania. A
nonresident applicant for an insurance producer license shall
submit to the Department:
▪ As individuals: An application through
www.sircon.com/pennsylvania or www.nipr.com.
▪ As business entities: An application through
www.sircon.com/pennsylvania or www.nipr.com by
the designated licensee.
More information is available at www.insurance.pa.gov.
Reciprocal Agreements
Nonresident applicants shall be subject to the same burdens or
prohibitions placed upon Pennsylvania residents who apply for a
nonresident license in their home state.
Examinations for any lines of authority (other than Title
Insurance) will be waived for a nonresident insurance producer
license, provided that: 1) the application is for the same line of
authority held in the applicant’s “home” state; and 2) the
applicant’s home state grants a waiver of examination to
Pennsylvania resident insurance producers. See section 40 P.S.
310.10.
Note: Nonresident title insurance agent license applicants must
pass the Title Insurance Agent examination and submit
fingerprints.
Surplus Lines Producer license
A nonresident Surplus Lines Producer license may only be
obtained for the purpose of placing business on behalf of a
Pennsylvania resident with an eligible surplus lines insurer. An
applicant shall:
▪ Be currently licensed in Pennsylvania as a nonresident
property and casualty insurance producer, either pass
Pennsylvania’s surplus lines examination or hold
surplus lines authority in his/her home state and apply
under the reciprocity provision of Act 147 of 2002; and
▪ Submit an application online at
www.sircon.com/pennsylvania or www.nipr.com and
pay all fees by credit card. If there is a partnership or
corporation involved, a licensing application for the
business entity must also be submitted online at
www.sircon.com/pennsylvania or www.nipr.com.
FINGERPRINT REQUIREMENTS
Act 147 of 2002, 40 P.S. 310.5, requires initial resident
insurance producer applicants to provide fingerprint samples to
the Pennsylvania Insurance Department. The Department uses
this information to receive national criminal history background
information from the Federal Bureau of Investigation (FBI). This
applies to all initial applicants for a resident insurance producer
license and applicants for a nonresident insurance producer
license who do not qualify to apply for a license under
reciprocity.
Note Limited Lines applicants who do not need to take either
pre-examination education or an examination, still need to
submit fingerprint samples. Title agent applicants do need to
take an examination and submit fingerprint samples.
Fingerprints are not required for the following applicants:
Motor Vehicle Physical Damage Appraiser (MVPDA), Non-resident
Public Adjuster, Non-resident Producer, Viatical Settlement
Broker, Surplus Lines, Add qualification applicants (those
already licensed and wish to add a line of authority to your
existing license).
FINGERPRINT PROCESS
The following fingerprinting guidelines apply to applicants for a
new insurance producer license or title agent license:
▪ After passing the examination use the kiosk at the PSI test
site to complete your license application online at
www.sircon.com/pennsylvania or www.nipr.com, or you
may apply using your own computer.
▪ Fingerprinting is required of all applicants for a new
resident producer license and must be done at an IdentoGO
enrollment center. Applicants are required to register
online via the IdentoGO website at
https://uenroll.identogo.com or by telephone at 844-321-
2101 Monday through Friday, 8 A.M. to 6 P.M. EST.
Following registration, the applicant will be provided with
a registration number which they will take with them when
they go to the IdentoGO site for fingerprinting. Applicants
must be registered with IdentoGO prior to arriving at a
fingerprinting site. When registering online an applicant
must use the appropriate service code assigned to the
Insurance Department, which is 1KG8Q3. Using the correct
service code ensures the background check is processed for
the correct agency and submitted for the correct purpose.
▪ The total fingerprinting fee is $23.85. Payment is made at
the IdentoGO center after the applicant’s fingerprints have
been submitted. Credit card, debit card, certified check
or money order, are the only payment methods accepted.
No cash transactions or personal checks will be accepted.
▪ As a reminder, individuals should not register for a
fingerprinting appointment and submit their fingerprints
until after they have passed any examination
requirements and applied for licensure. Any fingerprint
results received without a corresponding license
application will be destroyed, and individuals will be
required to repay the fingerprinting fee and resubmit
their fingerprints at an IdentoGO center.
Fingerprint results will be returned to the Department from the
FBI. The Department will review and evaluate the results as
well as the license application to determine if all standards for
licensure have been met.
EXAMINATION PAYMENT AND SCHEDULING
PROCEDURES
It is your responsibility to contact PSI to pay and schedule for
an examination. There is no limit to the number of times you
may take an examination if you fail.
Examination
Examination
Series
Examination
Fees
Life Insurance
16-01
$43.00
Accident and Health
16-02
$43.00
Life, Accident and Health
16-03
$53.00
Property and Allied Lines
16-04
$43.00
Casualty and Allied Lines
16-05
$43.00
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Property and Casualty
16-06
$53.00
Surplus Lines Producer
16-09
$43.00
Title Insurance Agent
16-10
$43.00
Personal Lines
16-16
$43.00
Viatical Settlement Broker
16-17
$43.00
ONLINE (https://home.psiexams.com/#/home)
For the fastest and most convenient examination scheduling process, register for your examinations online by accessing PSI’s
registration Website: Click Here
1. Select “SIGN UP” to create an account.
2. On a mobile phone, you need to select the icon on the top left corner. Then select “LOG IN” to create an account.
3. You will be prompted to create an account with PSI
IMPORTANT
You must enter your First and Last name
exactly as it is displayed on your government
issued ID.
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4. After you submit the form, you will get a message that your account was created successfully. Click on “Login to Continue”.
Note: The username is the email address you entered when creating the
account.
5. You are now ready to schedule. Select the Jurisdiction, Account and the Test.
6. You will enter your personal information.
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7. You will enter payment.
8. You will now select if you want to test at a PSI test site or Remotely proctored online from a computer at a remote location.
DELIVERY MODE TEST CENTER
1. Enter the “City or Postal Code” and select “Preferred Month” to take the Exam. Then select “Search Exam Center”.
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2. Click on the preferred test site.
3. Then click on the date and time to make an appointment to take the Exam.
You are now scheduled and will receive an email confirmation.
DELIVERY MODE REMOTE ONLINE PROCTORED EXAM
1. Select Country and Time zone.
Select the date and time you will be taking the exam. DO NOT HIT CONTINUE. YOU MUST FIRST CHECK THE COMPATIBILTY OF
YOUR COMPUTER to include Audio/Video Check, Webcam Check and System Check. You must use Google Chrome Browser. Please
note that if your computer performs any system update (i.e. software, server, firewall, webcam, etc.) from the time you
schedule your exam to when you attempt to launch your exam, you may experience issues with your compatibility. It is best to
conduct another compatibility check on the machine that you will be taking your exam at least 24 hours prior to your scheduled
exam. You may also check your compatibility before or after registering for your exam by clicking here.
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If you have any questions regarding your compatibility check, or if you experience issues launching your exam, you may contact our
remote proctoring technical support team at (844) 267-1017. You may also initiate a chat after you close the Secure Browser Software
by clicking here.
You are now scheduled and will receive an email confirmation.
RESCHEDULING/CANCELING AN EXAMINATION APPOINTMENT
You may cancel and reschedule an examination appointment
without forfeiting your fee if your cancellation notice is
received 2 days before the scheduled examination date. For
example, for a Monday appointment, the cancellation notice
would need to be received on the previous Saturday. You may
reschedule online at https://home.psiexams.com/#/home. or
call PSI at 888-818-5822.
Note: A voice mail or email message is not an acceptable
form of cancellation. Please use the PSI Website or call PSI
and speak directly to a Customer Service Representative.
RETAKING A FAILED EXAMINATION
It is not possible to make a new examination appointment on
the same day you have taken an examination; this is due to
processing and reporting scores. A candidate who tests
unsuccessfully on a Wednesday can call the next day, Thursday,
and retest as soon as Friday, depending upon space availability.
You may schedule online at
https://home.psiexams.com/#/home or call PSI at 888-818-
5822.
MISSED APPOINTMENT OR LATE CANCELLATION
If you miss your appointment, you will not be able to take the
examination as scheduled, further you will forfeit your
examination fee, if you:
▪ Do not cancel your appointment 2 days before the scheduled
examination date;
▪ Do not appear for your examination appointment;
▪ Arrive after examination start time;
▪ Do not present proper identification when you arrive for the
examination.
EXAM ACCOMMODATIONS
All PSI examination centers are equipped to provide access in
accordance with the Americans with Disabilities Act (ADA) of
1990, and exam accommodations will be made in meeting a
candidate's needs. A candidate with a disability or a candidate
who would otherwise have difficulty taking the examination
must follow the instructions on the Exam Accommodations
Request Form at the end of this Candidate Information Booklet.
ENGLISH AS A SECOND LANGUAGE
Upon receipt of a personal letter requesting the authorization and
a letter from your English instructor or sponsoring company (on
letterhead), certifying that English is not your primary language, a
candidate will be granted time and one-half to complete the
examination. Please use the Exam Accommodations Request
Form at the end of this Candidate Information Booklet to submit
your request and provide the required documents.
EXAMINATION SITE CLOSING FOR AN EMERGENCY
In the event that severe weather or another emergency forces
the closure of an examination site on a scheduled examination
date, your examination will be rescheduled. PSI personnel will
attempt to contact you in this situation. However, you may
check the status of your examination schedule by calling 888-
818-5822. Every effort will be made to reschedule your
examination at a convenient time as soon as possible. You will
not be penalized. You will be rescheduled at no additional
charge.
EXAMINATION SITE LOCATIONS
The following directions are generated from the most current
mapping services available. However, new road construction
and highway modifications may result in some discrepancies. If
you are not familiar with the specific area of the examination
site, please consult a reliable map prior to your examination
date.
Allentown
1620 Pond Road, Suite 50
Allentown, PA 18104
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Take Route 22, exit Cedar Crest Blvd North. Turn Right on North Cedar
Crest Blvd. Turn left onto Winchester, then turn right onto Pond.
Bristol
1200 Veteran's Highway, Suite B4
Bristol, PA 19007
On I-95 toward Bristol Township, exit Bristol then turn right at the
stoplight. Office is the second building on the left. There are many
entrances, but use the entrance under the clock tower.
Cranberry Township
Cranberry Corporate Business Center
213 Executive Dr., Suite 150
Cranberry Township, PA 16066
From I-79 exit Cranberry-Mars Route 228, go West. Cross over Route 19
onto Freedom Road. Go three traffic lights then turn right onto
Executive Drive. Building is directly across from Hampton Inn.
Erie
2700 W. 21st Street, Suite 21 & 22
Erie, PA 16506
From Interstate 79 North, take the West 26th St., exit 182, or Rt. 20
West. Just after the 2nd light you'll see Bonnel Auto Sales on your right.
Lowell Ave runs along the side of the Bonnel Auto Sales, make a right
onto Lowell. Stay on Lowell until it intersects with West 21st St. Make
the left onto 21st and our building sits on that corner. The 2700 is
written across the front of the building.
From I 79 South coming from Erie proper same directions 26th St., exit
182 or Rt. 20 West right at Bonnel Auto Sales on Lowell. Stay on Lowell
until West 21st St intersects. The office at 2700 West 21st St. sits on the
left corner across the street from where you are now at the yield sign.
Greensburg
DiCesare Building
116 E. Pittsburgh St., Suite 101
Greensburg, PA 15601
From Route 30 East or West, exit Business 66 North (NB. NOT Turnpike
66.) Go about 1.5 miles into downtown Greensburg. Turn right in the
direction of Route 30 East at the lights between First Commonwealth
Bank and Citizen's Bank. Building will be about 500 feet on right, past the
YMCA but before Co Go's garage.
Harrisburg
2300 Vartan Way, Suite 245
Harrisburg, PA 17110
From 83 North towards Harrisburg, take 581 West. Take I-81 North, exit
Progress Avenue (exit 69) and turn left at the exit. Go approximately 1
mile to Vartan Way. Turn Right. Make immediate left into parking lot.
From I-81 South, exit Progress Avenue and turn left at the exit. Go
approximately 1 mile to Vartan Way. Turn Right. Make immediate left
into parking lot.
Note: 2300 Vartan Way faces Progress Avenue. PSI is in the building with
4 radio stations, including Hot 92 and Wink 104.
King of Prussia
601 South Henderson Road, Suite 205
King of Prussia, PA 19406
Going East: Take I-76 East and exit #330 toward Gulph Mills. Turn left at
the bottom of the ramp at the 1
st
traffic light (Gulph Road). Go North on
Gulph. Turn right at the 3
rd
traffic light (S Henderson Rd).
Going West: Take I-76 West and exit #330 toward Gulph Mills. Keep left
at the fork in the ramp. Turn slight left onto Balligomingo Road. Turn
right onto Trinity Lane and continue to follow Trinity. Turn slight left
onto Swedeland Rd. Turn slight right onto S. Gulph Road. Turn slight
right onto S. Henderson Rd.
Philadelphia (Bala Cynwyd)
One Bala Avenue, Suite 310
Bala Cynwyd, PA 19004
From I-76 exit City Line Avenue. Follow City Line Avenue South. The
building is on Bala and City Line (next to the Bala Cynwyd railroad
station). Note: This is NOT Bala Plaza.
Pittsburgh
Towne Center
1789 South Braddock Avenue, Suite 296
Pittsburgh, PA 15218
From I-376 East, go through Squirrel Hill tunnels. Exit #77 toward
Swissville. Turn slight left onto Monongahela Avenue. Turn right on
South Braddock Avenue (IN THE EDGEWOOD TOWNE CENTER OFFICE
BUILDING).
All candidates should report to the PSI office 30 minutes prior to the
published session time, and no earlier. If candidates wish to arrive
earlier, they must wait in the Security Office's designated areas on the
first floor, or outside of the building. The building management does not
allow candidates to wait in the hallways, and/or common areas of other
floors, including our own floor. Thank you for your cooperation.
Scranton
1125 Lackawanna Trail Rts 6&11
Clarks Summit, PA 18411
From I-81N take Exit 194 (Clarks Summit) and merge onto US6W/US/11N.
Continue on Routes 6 & 11 for approximately 3 miles until you see the
Agway building on the left side of the road. Just before the Agway
building, make a U-turn. After making the U turn you will see 2 houses
before you see the PSI parking lot. PSI is located in a long brown brick
building which is set back from the highway. There is a small red and
white sign located at the entrance to the parking lot.
(If approaching from the opposite direction (US6S/US11E) PSI is located
on the right, approximately 100 feet after the Agway building).
Additionally, PSI has examination centers in many other regions
across the United States. You may take the written
examination at any of these locations by following the
instructions on the Exam Accommodations Request Form found
at the end of this Booklet.
REPORTING TO THE EXAMINATION SITE
On the day of the examination, you should arrive 30 minutes
before your appointment. This extra time is for sign-in,
identification, and familiarizing you with the examination
process. If you arrive late, you may not be admitted to the
examination site and you will forfeit your examination
registration fee.
Person(s) accompanying an examination candidate may not wait
in the examination center, inside the building or on the
building's property. This applies to guests of any nature,
including drivers, children, friends, family, colleagues or
instructors.
REQUIRED IDENTIFICATION
Candidates must register for the exam with their LEGAL first
and last name as it appears on their government issued
identification. All required identification below must match the
first and last name under which the candidate is registered.
Candidates are required to bring one (1) form of valid (non-
expired) signature bearing identification to the test site. If the
candidate fails to bring proper identification or the candidate
names do not match, the candidate will not be allowed to test
and their examination fee will not be refunded.
• Primary Identification: All candidates must provide 1
form of identification. ID must contain candidate’s
photo, signature, and be valid and unexpired. Allowable
forms of identification are as follows:
- State issued driver’s license
- State issued identification card
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- US Government Issued Passport
- US Government Issued Military Identification Card
- US Government Issued Alien Registration Card
- Canadian Government Issued ID
- US Employment Authorization Card
• Pre-licensing education certificate (applies only to
initial resident producer applicants):
If the test is marked with a “Yes” in the chart below,
candidates must present their pre-licensing education
certificate or an education verification letter from the
Pennsylvania Insurance Department. If you fail, this
must be presented for every attempt thereafter.
Candidates will not be allowed to test without an
education certificate or an education verification letter.
A pre-licensing certificate is valid for one year from date
of completion; an education verification letter is valid
for one year from the date it was written). AN
ELECTRONIC VERSION OR HARD COPY WILL BE
ACCEPTED.
Examination
Examination
Series
*Prelicense
Certificate
Required?
Life Insurance
16-01
Yes
Accident and Health
16-02
Yes
Life, Accident and Health
16-03
Yes
Property and Allied Lines
16-04
Yes
Casualty and Allied Lines
16-05
Yes
Property and Casualty
16-06
Yes
Personal Lines
16-16
Yes
Viatical Settlement Broker
16-17
No
Motor Vehicle Physical Damage
Appraiser
16-20
No
Public Insurance Adjuster
16-19
No
Surplus Lines Producer
16-09
No
Title Insurance Agent
16-10
No
*Note: Candidates adding a Line of Authority must present their
current license instead of the pre-licensing education
certificate.
SECURITY PROCEDURES
The following security procedures apply during examinations
administered at a PSI examination site:
▪ All examination sites will provide ear plugs upon request
▪ Calculators provided by PSI are allowed.
▪ You will be given a piece of scratch paper and a pencil.
These will be returned to the proctor at the end of your
examination.
▪ All personal belongings of candidates should be placed in
the secure storage provided at each site prior to entering
the examination room. Personal belongings include, but
are not limited to, the following items:
- Electronic devices of any type, including cellular /
mobile phones, recording devices, electronic
watches, cameras, pagers, laptop computers, tablet
computers (e.g., iPads), music players (e.g., iPods),
smart watches, radios, or electronic games.
- Bulky or loose clothing or coats that could be used to
conceal recording devices or notes. For security
purposes outerwear such as, but not limited to: open
sweaters, cardigans, shawls, scarves, hoodies, vests,
jackets and coats are not permitted in the testing
room. In the event you are asked to remove the
outerwear, appropriate attire, such as a shirt or
blouse should be worn underneath.
- Hats or headgear not worn for religious reasons or as
religious apparel, including hats, baseball caps, or
visors.
- Other personal items, including purses, notebooks,
reference or reading material, briefcases, backpacks,
wallets, pens, pencils, other writing devices, food,
drinks, and good luck items.
▪ Although secure storage for personal items is provided at
the examination site for your convenience, PSI is not
responsible for any damage, loss, or theft of any personal
belongings or prohibited items brought to, stored at, or left
behind at the examination site. PSI assumes no duty of care
with respect to such items and makes no representation
that the secure storage provided will be effective in
protecting such items. If you leave any items at the
examination site after your examination and do not claim
them within 30 days, they will be disposed of or donated,
at PSI’s sole discretion.
▪ During the check in process, all candidates will be asked if
they possess any prohibited items. Candidates may also be
asked to empty their pockets and turn them out for the
proctor to ensure they are empty. The proctor may also ask
candidates to lift up the ends of their sleeves and the
bottoms of their pant legs to ensure that notes or recording
devices are not being hidden there.
▪ Proctors will also carefully inspect eyeglass frames, tie
tacks, or any other apparel that could be used to harbor a
recording device. Proctors will ask to inspect any such
items in candidates’ pockets.
▪ If prohibited items are found during check-in, candidates
shall put them in the provided secure storage or return
these items to their vehicle. PSI will not be responsible for
the security of any personal belongings or prohibited items.
▪ Any candidate possessing prohibited items in the
examination room shall immediately have his or her test
results invalidated, and PSI shall notify the examination
sponsor of the occurrence.
▪ Any candidate seen giving or receiving assistance on an
examination, found with unauthorized materials, or who
violates any security regulations will be asked to surrender
all examination materials and to leave the examination
center. All such instances will be reported to the
examination sponsor.
▪ Copying or communicating examination content is violation
of a candidate’s contract with PSI, and federal and state
law. Either may result in the disqualification of
examination results and may lead to legal action.
▪ Once candidates have been seated and the examination
begins, they may leave the examination room only to use
the restroom, and only after obtaining permission from the
proctor. Candidate will not receive extra time to complete
the examination.
TAKING THE EXAMINATION BY COMPUTER
The examination will be administered via computer. You will
be using a mouse and computer keyboard.
IDENTIFICATION SCREEN
You will be directed to a semiprivate testing station to take the
examination. When you are seated at the testing station, you
will be prompted to confirm your name, identification number,
and the examination for which you are registered.
12
TUTORIAL
Before you start your examination, an introductory tutorial is
provided on the computer screen. The time you spend on this
tutorial, up to 15 minutes, DOES NOT count as part of your
examination time. Sample questions are included following the
tutorial so that you may practice answering questions, and
reviewing your answers.
TEST QUESTION SCREEN
The “function bar” at the top of the test question screen
provides mouse-click access to the features available while
taking the examination.
One question appears on the screen at a time. During the
examination, minutes remaining will be displayed at the top of
the screen and updated as you record your answers.
IMPORTANT: After you have entered your responses, you will
later be able to return to any question(s) and change your
response, provided the examination time has not run out.
Question types. The questions in your licensing exam are
multiple choice. Each provides four options from which you
choose your answer.
Question formats. Three different multiple-choice formats are
used. Each format is showing in the following examples. An
asterisk (*) indicates the correct answer in each sample
question.
Format 1 – Incomplete Sentence:
Actual cash value is generally accepted to mean:
A. Original purchase price of the property
B. Market value at the time of the loss
C. Cost to replace at the time of loss plus appreciation
*D. Cost to replace at the time of loss, less depreciation
Format 2 – Direct Question:
Which one of the following is covered under the Liability
Coverage of the Business Auto Coverage Form?
A. Workers compensation
*B. Explosion
C. Expected injury
D. Pollution
Format 3 – All of the following except:
The Business Auto Coverage Form covers losses from all of the
following under comprehensive coverage EXCEPT:
A. Fire
B. Vandalism
*C. Freezing
D. Theft
REMOTE ONLINE PROCTORED EXAMINATION
Proctors for online testing will communicate with candidates on-screen during the test and pause the exam whenever unauthorized
persons or activity appear on video monitors or in audio recordings. The proctor will pause the exam whenever a candidate leaves the
testing station, or an interruption occurs. The proctor may end the test if an interruption is not corrected appropriately. Immediate on-
screen results will be displayed on your screen once you complete BOTH your exam AND the survey following the exam. Paper score
reports will not be available upon completion of the exam for this remotely proctored location. A military ID will not be accepted for a
remotely proctored exam, however, all other Identification noted above are acceptable for this delivery mode.
Before your exam begins, please be aware of the following testing rules:
✓ Please be reminded that earbuds, earphones, hats, caps, hood, shades or anything that can be placed on the head or
face is NOT allowed.
✓ Food, Drinks, or Breaks are not allowed. All personal items must be removed from the work area.
✓ Candidates are not allowed to have scratch paper.
✓ You are not allowed to leave the station during the exam. If you need to use the restroom before the exam begins,
please do so now.
✓ Please do your best to avoid covering your mouth for the whole duration of exam. Be aware that
talking/whispering/mouthing is not allowed during exam.
✓ You must keep both of your hands on or above the desktop during the exam.
✓ Also note that under no circumstances are you allowed to take a screenshot or photo of the exam or the exam results at
any time during or after the session.
Violating any of these rules will result in a warning and may result in exam termination.
13
BE SURE TO CHECK THE COMPATIBILTY OF YOUR COMPUTER to include Audio/Video Check, Webcam Check and System Check. Prior
to scheduling, click here. You must use Google Chrome Browser.
Please note that if your computer performs any system update (i.e. software, server, firewall, webcam, etc.) from the time you
schedule your exam to when you attempt to launch your exam, you may experience issues with your compatibility. It is best to
conduct another compatibility check on the machine that you will be taking your exam at least 24 hours prior to your scheduled
exam. You may also check your compatibility before or after registering for your exam by clicking here.
LAUNCHING THE EXAMINATION
You can launch the examination up to 30 minutes before the scheduled start time.
If you have any questions regarding your compatibility check, or if you experience issues launching your exam, you may contact our
remote proctoring technical support at (844) 267-1017. You may also initiate a chat after you close the Secure Browser Software by
clicking here.
14
EXAMINATION REVIEW
PSI, in cooperation with the Department, will be continually
evaluating the examinations being administered to ensure that
the examinations accurately measure competency in the
required knowledge areas. Comments may be entered on the
computer keyboard during the examination. Your comments
regarding the questions and the examinations are welcomed.
Comments will be analyzed by PSI examination development
staff. While PSI does not respond to individuals regarding these
comments, all substantive comments are reviewed. If a
discrepancy is found during the comment review, PSI and the
Department may re-evaluate candidates’ results and adjust
them accordingly. This is the only review of the examination
available to you.
SCORE REPORTING
Your score will be displayed on screen at the end of the
examination and a score report will be emailed to you. If you
fail, the emailed score report will include the diagnostic report
indicating your strengths and weaknesses by examination type.
Candidates taking a remotely proctored exam: Please note that
you must select to end both the exam portion and survey
portion of your test in order to receive your on-screen results
and emailed score report. If you do not receive your emailed
score report, you may reach out to [email protected].
You may request a duplicate score report after your
your name, candidate ID number and confirmation number.
Your candidate ID number and confirmation number is on your
exam confirmation email. Please allow up to 72 hours to
receive your duplicate score report.
EXPERIMENTAL ITEMS
In addition to the number of examination items specified in the
"Examination Content Outlines", a small number (5 to 10) of
"experimental" questions may be administered to candidates
during the examinations. These questions will not be scored and
sufficient time to answer them is included in the examination
time. The administration of such non-scored experimental
questions is an essential step in developing future licensing
examinations.
TIPS FOR PREPARING FOR YOUR LICENSE
EXAMINATION
The following suggestions will help you prepare for your
examination.
▪ Only consider the actual information given in the question,
do not read into the question by considering any
possibilities or exceptions.
▪ Planned preparation increases your likelihood of passing.
▪ Start with a current copy of this Candidate Information
Booklet and use the examination content outline as the
basis of your study.
▪ Read study materials that cover all the topics in the
content outline.
▪ Take notes on what you study. Putting information in
writing helps you commit it to memory and it is also an
excellent business practice.
▪ Discuss new terms or concepts as frequently as you can
with colleagues. This will test your understanding and
reinforce ideas.
▪ Your studies will be most effective if you study frequently,
for periods of about 45 to 60 minutes. Concentration tends
to wander when you study for longer periods of time.
OBTAINING YOUR LICENSE
Immediately after you pass your examination, use the kiosk at
the PSI test site to complete your license application online at
www.sircon.com/pennsylvania or www.nipr.com, or you may
apply using your own computer. If you are applying for a new
resident insurance producer license or title agent license, you
will also be required to provide fingerprints.
NOTE: You must provide fingerprints to permit the
Department to obtain a criminal history record report from
the FBI. See page 3 for details.
It is your responsibility to ensure that the application has been
properly completed and that the information is accurate.
Applications that are found to contain inaccurate or untruthful
responses may be denied. The Department strongly suggests
that you complete the paper application for an individual
resident insurance producer found online at
www.insurance.pa.gov and retain it as a reference to expedite
submitting your application electronically at the exam center.
STATUS OF LICENSE
After the Department has verified that you have passed the
required examination and that you have met all standards for
licensure, the Department will issue the appropriate license. The
license will list the line or lines of authority granted, if
applicable. You may view the status of your license application
on the Department’s Web site at www.insurance.pa.gov. Once
your license has been issued, you may print your license from the
web site. Please be advised that the Department no longer mails
licenses.
INITIAL INSURANCE PRODUCER FEES
▪ Resident insurance producer or title agent application fee =
$55
▪ Non-resident title agent application fee = $110
▪ Fingerprinting fee = $23.85 (paid at an IdentoGO enrollment
center upon fingerprint submission)
▪ Online service fees (if submitting your licensing application
electronically) will be charged and may vary – the
approximate fee is $12.50
PAPER APPLICATIONS
The option to apply using a paper application is only available if
you are unable to apply online. Be advised that the paper
licensing process will take considerably longer than the electronic
method. If you must apply via paper, an application can be
obtained from the Department’s web site at
www.insurance.pa.gov. You must include a cover letter
explaining why you are unable to apply online; otherwise, the
application will be returned along with a letter telling you to
apply online.
15
OTHER LICENSE APPLICATION FORMS
Different application forms are required for Partnerships or
Corporations, Surplus Lines Producers, Viatical Settlement
Brokers, Motor Vehicle Damage Appraisers and Public Adjusters.
All applications are available from the Department’s web site at
www.insurance.pa.gov. or upon request from the Department.
Again, to expedite review of your application, you should file
your application via Vertafore/SIRCON at
www.sircon.com/pennsylvania and pay appropriate fees with a
credit card.
The examination content outline and more specific information
on taking this examination is available in the Pennsylvania
Public Adjuster Candidate Information Booklet located online
at https://home.psiexams.com/#/home.
The examination content outline and more specific information
on taking this examination is available in the Pennsylvania
Motor Vehicle Physical Damage Appraiser Candidate
Information Booklet located online at
https://home.psiexams.com/#/home.
CONTINUING EDUCATION
Licensed insurance producers are required to complete a
minimum of 24 hours of continuing education credits to maintain
their license. Failure to complete the minimum 24-hour
requirement during your two-year licensing cycle will result in
the termination of your license. See www.insurance.pa.gov for
more information.
Insurance producers should not take any approved CE courses
until they receive their license as they will not receive credit for
any course taken before the issue date of their license.
Information on continuing education can be obtained from the
Department’s web site at www.insurance.pa.gov or by calling
717-787-3840.
ADDITIONAL LICENSING INFORMATION
Additional appointments. To obtain appointments with
additional companies, for powers for which you are already
qualified, you must enter into an agreement with the new
company regarding the additional appointment. The insurance
company is then responsible for reporting the appointment
information to the Department. Title agents must have an
appointment by a title insurer prior to transacting any business
(40 P.S. 910-24.1).
Amended license. An amended license consists of adding an
additional line of authority or status to an active license.
There is a $25 fee to amend an existing active license. An
amended licensing application can be submitted online at
www.sircon.com/pennsylvania. No pre-licensing education or
fingerprint submission is required to amend a license by adding a
line of authority to an existing active producer license.
Reporting requirements. All licensees are required to report
name or address changes as well as criminal charges and
convictions to the Department within 30 days.
Uniformity of licenses. A corporation or partnership must be
properly licensed. In order for a partnership or corporation to be
licensed, there must be a licensed individual designated as the
responsible licensee for the entity (corporation) and hold the
same line(s) of authority the entity is requesting.
Corporations. Business entities (corporations and partnerships)
should submit a licensing application online at
www.sircon.com/pennsylvania.
Fictitious Names. For any licensee, any assumed or fictitious
name, style or designation must be filed with the Department for
approval prior to using the alias or fictitious name. See
instructions for this process at www.insurance.pa.gov.
EXAMINATION CONTENT OUTLINES AND
STUDY MATERIALS
STUDY MATERIALS
In addition to any pre-licensing education that is required for
the examination you are taking, you are free to use materials of
your choice to prepare for the examination. Manuals have been
prepared by different publishers to assist candidates specifically
in preparing for license exams. Because of the number and the
diversity of approach of these publications, neither the
Department nor PSI reviews or approves study materials.
However, the following sources may be a starting point in your
search for study materials.
Pennsylvania Insurance Laws and Pennsylvania Insurance
Regulations, BHM Insurance Services, (302) 678-8795; (800) 543-
3635.
Purdon’s Pennsylvania Statutes Annotated, Titles 40 and 41:
Insurance, West, (800) 733-2889; http://www.westgroup.com
Pennsylvania statutes. The examinations contain a section on
Pennsylvania statutes. In addition to your study materials, you
may wish to consult a standard statute reference, such as those
available at most public or law libraries in Pennsylvania.
EXAMINATION CONTENT OUTLINES
Following are the individual examination content outlines
indicating the examination time limit, minimum score required
to pass, subject area and the number of items in each area.
These outlines are the basis of the examination. Each
examination will contain questions about the subjects in its
outline. In order to pass the examination, you must achieve a
minimum score of 70%.
16
PENNSYLVANIA PRODUCER’S EXAMINATION FOR LIFE INSURANCE
SERIES 16-01
100 Items – 120 Minutes
1.0 INSURANCE REGULATION (14%)
1.1
Licensing
Process and types
Requirements (40 P.S. § 310.1, 310.3-310.14)
Resident/nonresident (40 P.S. § 310.3–310.5, 310.10)
Temporary license (40 P.S. § 310.9)
Managers and exclusive general agents (40 P.S. §
310.1, 310.31)
Maintenance and duration
Change in address (40 P.S. § 310.11(19))
Renewal (40 P.S. § 310.8)
Duty to report administrative or criminal actions (40
P.S. § 310.78)
Assumed names (40 P.S. § 310.7)
Continuing education (40 P.S. § 310.8(b), 310.6(a), 31
Pa. Code Ch. 39a)
Inactivity due to military or extenuating circumstances
(40 P.S. § 310.8)
Disciplinary actions
License denial, nonrenewal, suspension, or revocation
(40 P.S. § 310.91, 310.11)
Penalties and fines for violations (40 P.S. §§ 310.12,
310.41a, 310.91, 1171.11)
Cease and desist order (40 P.S. §§ 310.91, 1171.9)
Civil
Criminal
Hearings
Consent agreement
1.2
State regulation
Acts constituting insurance transactions
Negotiate, sell, solicit (40 P.S. §§ 310.1, 310.3, 310.8,
310.11)
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Certificate of authority (40 P.S. §§ 47, 47a, 420)
Solvency (40 P.S. §§ 72, 112)
Policy forms and rates (40 P.S. §§ 510, 776.1–776.7,
1181–1199, 1221–1238)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10); 31 Pa. Code Ch. 146)
Producer regulation
Fiduciary responsibility (40 P.S. § 310.96; 31 Pa. Code
Ch. § 37.81)
Examination of books and records (40 P.S. § 323.3-4)
Producer disclosure requirements (40 P.S. § 310.71(b))
Commissions and fees (40 P.S. §§ 310.72–310.74)
Prohibited acts (40 P.S. § 310.11)
Appointment procedures
Producer appointment (40 P.S. § 310.71, 31 Pa Code
37.61)
Appointment termination (40 P.S. § 310.71a)
Unfair insurance practices (40 P.S. §§ 1171.1 1171.5)
Rebates and Inducements (40 P.S. §§
310.45, 310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48,
1171.5(a)(1),(2))
Twisting (40 P.S. §§ 473)
False advertising (40 P.S. § 1171.5; 31 Pa. Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Misappropriation of funds (40 P.S. §§ 310.11(4), 310.42)
Unfair discrimination (40 P.S. § 1171.5; 31 Pa. Code §
145.4)
Replacement (40 P.S. § 625, 31 Pa Code Ch. 81)
Privacy of consumer financial information (40 P.S. §
310.77(a); 31 Pa. Code §§ 146a.1–.44)
Insurance fraud regulation (40 P.S. §§ 325.1–325.62; 18
Pa. C.S. § 4117)
1.3
Federal Regulation
Fair Credit Reporting Act
Fraud and False Statements (18 USC Sections 1033 and
1034)
Privacy (Gramm-Leach-Bliley)
National Do Not Call List
2.0 GENERAL INSURANCE CONCEPTS (10%)
2.1
Risk
Methods of Handling Risk (e.g., Avoidance, Retention,
Sharing, Reduction, Transfer)
Elements of Insurable Risks
Definitions (e.g., Risk, Hazard, Peril, Loss)
2.2
Classifications of Insurers
Mutual, Stock
Admitted, Non-Admitted
Foreign, Domestic, Alien
2.3
Elements of a Contract
Consideration
Competent Parties
Legal Purpose
Offer
Acceptance
2.4
Authority and Powers of Producers
Express
Implied
Apparent
The Law of Agency
2.5
Legal Interpretations Affecting Contracts
Reasonable Expectations
Indemnity
Good Faith
Fraud
Warranties, Representations, Misrepresentations, and
Concealment
3.0 LIFE INSURANCE BASICS (20%)
3.1
Insurable Interest (40 P.S. § 512)
17
3.2
Personal Uses of Life Insurance
Survivor Protection
Estate Creation
Liquidity
Estate Conservation
Asset Protection
3.3
Determining Amount of Personal Life Insurance
Human Life Value Approach
Needs Approach
3.4
Business Uses of Life Insurance
Buy-Sell Funding
Key Person
Executive Compensation
3.5
Viatical and life settlements
Disclosure to consumers (40 P.S. § 626.7)
General rules (40 P.S. § 626.8)
Definitions (40 P.S. § 626.2)
3.6
Classes of life insurance policies
Group versus individual
Permanent versus term
Participating versus nonparticipating
Fixed versus variable life insurance
General account versus separate account (40 P.S. §
506.2; 31 Pa. Code Ch. 82.41-.51)
Regulation of variable life insurance (31 Pa. Code Ch.
82.1, .14, .81)
3.7
Factors in Premium Determination
Mortality
Interest
Expense
3.8
Premium Frequency
3.9
Producer responsibilities
Sales presentations
Advertising (31 Pa. Code Ch. 51.1–.36, .42)
Life and Health Insurance Guaranty Association (40 P.S. §
991.1717)
Life insurance disclosure statement (31 Pa. Code Ch. 83)
Illustrations (40 P.S. § 625.7–625.8)
Life insurance surrender comparison index disclosure (31
Pa. Code Ch. 83.51–.57)
3.10
Field Underwriting
Application Procedures
Warranties and Representations
3.11
Policy Delivery
Effective Date of Coverage
Premium Collection
Statement of Good Health
Delivery receipt requirement (40 P.S. § 625.4)
3.12
Company Underwriting
Sources of Information
Classifications of Risk (Preferred, Standard, Substandard,
Declined)
Selection criteria and unfair discrimination (40 P.S. §
477a)
3.13
Classification of Risks
Preferred
Standard
Substandard
4.0 TYPES OF LIFE INSURANCE POLICIES (17%)
4.1
Term Life Insurance
Level
Decreasing
Increasing Term
Renewable Term
4.2
Whole (Permanent, Ordinary) Life Insurance
Single Premium
Continuous Premium
Limited Payment Life
Adjustable Life
4.3
Universal Life
4.4
Index Whole Life
4.5
Specialized Policies
Joint Life
Survivorship Life
Juvenile
Return of Premium Term Insurance
4.6
Group Life Insurance
Eligible Groups
Characteristics of Group Life Insurance
Conversion to individual policy (40 P.S. § 532.7)
5.0 LIFE INSURANCE POLICY PROVISIONS, OPTIONS, AND RIDERS
(22%)
5.1
Standard Life Insurance Provisions (40 P.S. § 510)
Ownership
Assignment
Right to Examine (Free Look) (40 P.S. § 510C (a), (2), (3),
(b1))
Payment of Premiums (a)
Grace Period (b)
Misstatement of Age/Sex (e)
Incontestability (c)
Reinstatement (k)
Entire Contract (d)
Payment of claims (l)
Prohibited provisions including backdating (40 P.S. § 511)
5.2
Beneficiary Designation Options
Individuals
Classes
Estates
Minors
Trusts
5.3
Types of Beneficiaries
Revocable versus Irrevocable
Primary and Contingent
5.4
Beneficiary-Related Clauses
Common Disaster
Spendthrift
Effects of Divorce on Designation of Beneficiaries (20 Pa
C.S.A.§ 6111.2)
5.5
Settlement Options
Cash Payment (Lump Sum)
Interest Only
Life Income
Fixed-Period
Fixed-Amount Installments
Retained Asset Account
5.6
Nonforfeiture Options
18
Cash Surrender Value
Extended Term
Reduced Paid-Up Insurance
5.7
Policy Loan and Withdrawal Options
Loans
Automatic Premium Loans
Withdrawals Partial Surrenders
5.8
Dividend Options
Paid-Up Additions
Cash Payment (Lump Sum)
One Year Term
Reduction of Premium
Accumulation at Interest
5.9
Disability Riders
Waiver of Premium
Disability Income Benefit
Payor Benefit Life
5.10
Riders Covering Additional Insureds
Spouse
Children
Family
5.11
Riders Affecting Death Benefit Amount
Accidental Death
Guaranteed Insurability
Cost of Living
Return of Premium
Accelerated (Living) Benefit Provision Rider
Conditions for payment (31 Pa. Code Ch. 90f.3)
Effect on death benefit (31 Pa. Code Ch. 90f.3)
Exclusions and restrictions (31 Pa. Code Ch. 90f.4)
Long-Term Care Rider
5.12
Policy Exclusions
6.0 ANNUITIES (12%)
6.1
Annuity Principles and Concepts
Accumulation Period versus Annuity Period
Owner, Annuitant, and Beneficiary
Right to Examine (40 P.S. § 510D)
6.2
Immediate versus Deferred Annuities
6.3
Annuity (Benefit) Payment Options
Life Contingency Options
Annuities Certain
Pure Life versus Life with Guaranteed Minimum
Single Life versus Multiple Life
6.4
Annuity Products
Fixed Annuities
Equity Indexed Annuities
Immediate Annuities
Variable annuities
Assets in a separate account (31 Pa. Code Ch. 85.21–
.27)
Regulation of variable annuities (SEC, FINRA and
Pennsylvania) (31 Pa. Code Ch. 85.1–.4)
Suitability of annuities (Act 48 of 2018)
6.5
Uses of Annuities
Lump-Sum Settlements
Retirement Income
Education
7.0 FEDERAL TAX CONSIDERATIONS FOR LIFE INSURANCE (5%)
12a
Requirements of Life Insurance Qualified Plans
12b
Federal Tax Considerations for Qualified Plans
Withdrawals
Rollovers versus Transfers
12c
Qualified Plan Types, Characteristics, and Purchasers
Individual Retirement Accounts (IRAs; Traditional versus
Roth; Immediate Annuity)
401k
403b
12d
Taxation of Personal Life Insurance
Premiums
Dividends
Settlements
12e
Modified Endowment Contracts (MECs)
PENNSYLVANIA PRODUCER’S EXAMINATION FOR ACCIDENT AND
HEALTH INSURANCE
SERIES 16-02
100 Items – 120 Minutes
1.0 INSURANCE REGULATION (13%)
1.1
Licensing
Process and types
Requirements (40 P.S. § 310.1, 310.3-310.14)
Resident/nonresident (40 P.S. § 310.3–310.5, 310.10)
Temporary license (40 P.S. § 310.9)
Managers and exclusive general agents (40 P.S. §
310.1, 310.31)
Maintenance and duration
Change in address (40 P.S. § 310.11(19))
Renewal (40 P.S. § 310.8)
Duty to report administrative or criminal actions (40
P.S. § 310.78)
Assumed names (40 P.S. § 310.7)
Continuing education (40 P.S. § 310.8(b), 310.6(a), 31
Pa. Code Ch. 39a)
Waiver due to military or extenuating circumstances
(40 P.S. § 310.8)
Disciplinary actions
License denial, nonrenewal, suspension, or revocation
(40 P.S. § 310.91, 310.11)
Penalties and fines for violations (40 P.S. §§ 310.12,
310.41a, 310.91, 1171.11)
Cease and desist order (40 P.S. §§ 310.91, 1171.9)
Civil
Criminal
Hearings
Consent agreement
1.2
State regulation
Acts constituting insurance transactions
Negotiate, sell, solicit (40 P.S. §§ 310.1, 310.3, 310.8,
310.11)
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Certificate of authority (40 P.S. §§ 47, 47a, 420)
Solvency (40 P.S. §§ 72, 112)
19
Policy forms and rates (40 P.S. §§ 510, 776.1–776.7,
1181–1199, 1221–1238)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10); 31 Pa. Code Ch. 146)
Producer regulation
Fiduciary responsibility (40 P.S. § 310.96; 31 Pa. Code
Ch. § 37.81)
Examination of books and records (40 P.S. § 323.3-4)
Producer disclosure requirements (40 P.S. § 310.71(b))
Commissions and fees (40 P.S. §§ 310.72–310.74)
Prohibited acts (40 P.S. § 310.11)
Appointment procedures
Producer appointment (40 P.S. § 310.71, 31 Pa Code
37.61)
Appointment termination (40 P.S. § 310.71a)
Unfair insurance practices (40 P.S. §§ 1171.1 1171.5)
Rebates and Inducements (40 P.S. §§
310.45, 310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48,
1171.5(a)(1),(2))
Twisting (40 P.S. §§ 473)
False advertising (40 P.S. § 1171.5; 31 Pa. Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Misappropriation of funds (40 P.S. §§ 310.11(4), 310.42)
Unfair discrimination (40 P.S. § 1171.5; 31 Pa. Code §
145.4)
Replacement (40 P.S. § 625, 31 Pa Code Ch. 81)
Privacy of consumer financial information (40 P.S. §
310.77(a); 31 Pa. Code §§ 146a.1–.44)
Insurance fraud regulation (40 P.S. §§ 325.1–325.62; 18
Pa. C.S. § 4117)
1.3
Federal Regulation
Fair Credit Reporting Act
Fraud and False Statements (18 USC Sections 1033 and
1034)
Privacy (Gramm-Leach-Bliley)
National Do Not Call List
Affordable Care Act
2.0 GENERAL INSURANCE CONCEPTS (10%)
2.1
Risk
Methods of Handling Risk (e.g., Avoidance, Retention,
Sharing, Reduction, Transfer)
Elements of Insurable Risks
Definitions (e.g., Risk, Hazard, Peril, Loss)
2.2
Classifications of Insurers
Mutual, Stock
Admitted, Non-Admitted
Foreign, Domestic, Alien
2.3
Elements of a Contract
Consideration
Competent Parties
Legal Purpose
Offer
Acceptance
2.4
Authority and Powers of Producers
Express
Implied
Apparent
The Law of Agency
2.5
Legal Interpretations Affecting Contracts
Reasonable Expectations
Indemnity
Good Faith
Fraud
Warranties, Representations, Misrepresentations, and
Concealment
3.0 ACCIDENT AND HEALTH INSURANCE BASICS (10%)
3.1
Producer responsibilities
Sales presentations
Advertising (31 Pa. Code Ch. 51.1–.36, .42)
Life and Health Insurance Guaranty Association (40 P.S. §
991.1717)
Outline of coverage (40 P.S. § 991.1111; 31 Pa. Code Ch.
88.181)
3.2
Field Underwriting
Application Procedures
Warranties and Representations
3.3
Policy Delivery
Effective Date of Coverage
Premium Collection
Statement of Good Health
Delivery receipt requirement (40 P.S. § 625.4)
3.4
Company Underwriting
Sources of Information
Classifications of Risk (Preferred, Standard, Substandard,
Declined)
3.5
Definitions of Perils
Accidental Injury
Sickness
3.6
Types of Losses and Benefits
Loss of Income from Disability (Short-Term/Long-Term
Disability)
Medical Expense
Long-Term Care Expense
Prescriptions
3.7
Limited Health Insurance Policies
Accidental Death and Dismemberment
Hospital Indemnity
Critical Illness/Dread Disease (31 Pa. Code Ch. 88.169,
.193)
Vision Care
Hearing
Dental
3.8
Common exclusions from coverage (31 Pa. Code Ch.
88.84)
Pre-existing conditions (31 Pa. Code Ch. 88.51)
Intentionally self-inflicted injuries (1)(ii)
War or act of war (1)(i)
Elective cosmetic surgery (1)(vii)
Conditions covered by workers compensation (1)(iii)
Commission of or attempt to commit a felony
3.9
Classification of Risks
Preferred
Standard
20
Substandard
3.10
Considerations in replacing health insurance
Pre-existing conditions
Waiting periods
Benefits, limitations and exclusions
Underwriting requirements
Producer's liability for errors and omissions
Pennsylvania replacement requirements (31 Pa. Code
Ch. 88.101–.103)
4.0 INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICY
PROVISIONS (13%)
4.1
Required Provisions (40 P.S. § 753(A))
Time Limit on Certain Defenses (2)
Grace Period (3)
Reinstatement (4)
Claim Forms (6)
Proof of Loss (7)
Time of Payment of Claims (8)
Physical Examinations and Autopsy (10)
Legal Actions (11)
Entire Contract (1)
Payment of Claims (9)
Change of Beneficiary (12)
Notice of Claim (5)
4.2
General Policy Provisions (40 P.S. § 753(B))
Change of Occupation (1)
Misstatement of Age/Sex (2)
Other insurance in this insurer (3)
Insurance with other insurers
Expense-incurred benefits (4)
Other benefits (5)
Unpaid premium (7)
Cancellation (8)
Conformity with state statutes (9)
Illegal Occupation (10)
Intoxicants, Narcotics, or Other Controlled Substances
(11)
4.3
Other General Provisions
Right to Examine/Free Look (40 P.S. § 752(A)(10); 31 Pa.
Code Ch. 89.73)
Insuring Clause
Consideration Clause
Renewability Clause
Coinsurance
Probationary Period
Elimination Period
Exclusions
5.0 DISABILITY INCOME AND RELATED INSURANCE (10%)
5.1
Benefits Determination for Disability
Indemnity
5.2
Qualifications of Disability
Total (Own Occupation, Any Occupation)
Partial (31 Pa. Code Ch. 88.138)
Permanent
Presumptive
Recurrent
Residual (31 Pa. Code Ch. 88.139)
Inability to Perform Duties (31 Pa. Code Ch. 88.137)
Occupational versus Non-Occupational
5.3
Individual Disability Income Insurance
Basic Total Disability Plan
Cost of Living Rider
Future Increase Option Rider
Change of Occupation
Other Cash Benefits
Refund Provisions
Exclusions
Waiver of Premium
Probationary Period
Elimination Period
Benefit Limits
Relation of earnings to insurance (40 P.S. § 753(B)(6))
Pennsylvania minimum benefit standards (31 Pa. Code Ch.
88.167)
5.4
Unique Aspects of Individual Disability Underwriting
Occupational Considerations
Benefit Limits
Policy Issuance Alternatives
5.5
Group Disability Income Insurance
Short-Term Disability
Long-Term Disability
Coordination of Benefits (Workers' Compensation Benefits
and Social Insurance) (77 P.S. § 511 et seq)
At-Work Benefits
5.6
Business Disability Insurance
Key Employee Disability Income
Disability Buy-Sell Policy
Business Overhead Expense
5.7
Social Security Disability
Qualification for Disability Benefits
Definition of Disability
Waiting Period
6.0 MEDICAL PLANS (14%)
6.1
Medical Plan Concepts
Fee-for-Service
Prepaid
Specified Coverage
Comprehensive Coverage
Dependent Coverage
6.2
Provisions and Clauses
Deductibles
Stop-Loss Provision
Impairment Rider
6.3
Types of Medical Plans
Basic Plans
Major Medical Insurance
Health Maintenance Organizations (HMOs)
Preferred Provider Organzations (PPOs)
Point-of-Service (POS) Plans
6.4
Cost Containment in Health Care Delivery
Managed Care
Preventive Care
Outpatient Benefits
Utilization Management
Preauthorization
Gatekeeper
21
6.5
Health Insurance Portability and Accountability Act
(HIPAA) (40 P.S. § 981-1)
Eligibility Requirements
Terms
Privacy
Portability
6.6
Pennsylvania mandated benefits (individual and group)
Postpartum coverage (40 P.S. § 1583)
Routine pap smears (40 P.S. § 1574(2))
Treatment for alcohol abuse and dependency (40 P.S. §§
908-1–908-8)
Serious mental illness (40 P.S. § 764g)
Annual gynecological examinations (40 P.S. § 1574(1))
Cancer therapy (40 P.S. § 764b)
Mammography coverage (40 P.S. § 764c)
Childhood immunizations (40 P.S. § 3503)
Dependent child age limit (31 Pa. Code Ch. 88.32)
Coverage of adopted children (40 P.S. § 775.1)
Newborn child coverage (40 P.S. §§ 771–775.2; 31 Pa.
Code Ch. 89.201–.209)
Physically handicapped/mentally retarded children (40
P.S. § 752(A)(9))
Medical foods (40 P.S. § 3901-3909)
Orally administered chemotherapy medication (Act 73 of
2016)
Mental health parity and addiction equity (40 P.S. § 908-
11-908-16)
7.0 GROUP HEALTH INSURANCE (9%)
7.1
Characteristics of Group Health Insurance
Group Contract
Certificate of Coverage
Eligible Groups
Contributory versus Non-Contributory
7.2
Employer Group Health Insurance
Underwriting Criteria
Eligibility for Insurance
Pre-existing conditions (31 Pa. Code Ch. 89.402–.406)
Conversion of Coverage (40 P.S. §§ 756.2, 981-9)
Open Enrollment
Probation Period
Coordination of Benefits
7.3
COBRA
Eligibility
Duration of Coverage
Premium
8.0 DENTAL INSURANCE (2%)
8.1
Categories of dental treatment
Diagnostic and preventive
Restorative
Oral surgery
Endodontics
Periodontics
Prosthodontics
Orthodontics
8.2
Indemnity plans
Choice of providers
Scheduled versus nonscheduled plans
Benefit categories
Diagnostic/preventive services
Basic services
Major services
Deductibles and coinsurance
Combination plans
Exclusions
Limitations
Predetermination of benefits
8.3
Employer group dental expense
Integrated deductibles versus stand-alone plans
Minimizing adverse selection
9.0 HEALTH INSURANCE FOR SENIOR CITIZENS AND SPECIAL NEEDS
INDIVIDUALS (14%)
9.1
Medicare
Administration
Eligibility
Part A
Part B
Part C
Part D
Medicare Select
9.2
Medicare Supplement Insurance
Open Enrollment (31 Pa. Code Ch 89.778)
Types of Plans
Standardized Plan Benefits
Pennsylvania regulations and required provisions
Standards for marketing (31 Pa. Code Ch. 89.786)
Advertising (31 Pa. Code Ch. 89.785)
Appropriateness of recommended purchase and excessive
coverage (31 Pa. Code Ch. 89.787)
Replacement (40 P.S. § 3108; 31 Pa. Code Ch. 89.784,
.789)
Minimum benefit standards (40 P.S. § 3105)
Required disclosure provisions (40 P.S. § 3107; 31 Pa.
Code Ch. 89.783)
Permitted compensation arrangements (31 Pa. Code Ch.
89.782)
Guaranteed issue (31 Pa. Code Ch. 89.790)
9.3
Other options for individuals with Medicare
Employer Group Health Plans
Medicaid
9.4
Long-Term Care Policies
Eligibility for Benefits
Benefit Periods and Amounts
Exclusions
Guaranteed Insurability Rider
Cost of Living Rider
9.5
Levels of Long-Term Care
Skilled
Intermediate
Custodial
9.6
Types of Long-Term Care
Comprehensive Coverage
Home Health
Adult Daycare
Respite Care
Community Care
Partnership Coverage
9.7
Long-Term Care Pennsylvania regulations and required
22
provisions
Outline of coverage (40 P.S. § 991.1111; 31 Pa. Code Ch.
89a.107, 126)
Right to examine (free look) (40 P.S. § 991.1110)
Pre-existing conditions (40 P.S. §§ 991.1105(c), 1107)
Continuation and conversion (31 Pa. Code Ch. 89a.105)
Unintentional lapse (31 Pa. Code Ch. 89a.106)
Required disclosure provisions (31 Pa. Code Ch. 89a.107)
Inflation protection (31 Pa. Code Ch. 89a.112)
Nonforfeiture benefit (31 Pa. Code Ch. 89a.123)
Benefit triggers (31 Pa. Code Ch. 89a.124, 125)
Replacement (31 Pa. Code Ch. 89a.113, 122)
Standards for marketing (31 Pa. Code Ch. 89a.120)
Suitability of recommended purchase (31 Pa. Code Ch.
89a.121)
Shopper's guide (31 Pa. Code Ch. 89a.127)
Permitted compensation arrangements (31 Pa. Code Ch.
89a.129)
Penalties (31 Pa. Code Ch. 89a.128)
10.0 FEDERAL TAX CONSIDERATIONS FOR HEALTH INSURANCE (5%)
10.1
Health Insurance Premiums and Benefits
Individual
Group
Disability Income
Business Disability Insurance
Medical Expense
Long-Term Care
10.2
Consumer-Driven Health Plans
Health Savings Accounts (HSAs)
Health Reimbursement Accounts (HRAs)
Flexible Spending Accounts (FSAs)
PENNSYLVANIA PRODUCER’S EXAMINATION FOR
LIFE, ACCIDENT AND HEALTH INSURANCE
SERIES 16-03
150 Items – 170 Minutes
1.0 INSURANCE REGULATION (21%)
1.1
Licensing
Process and types
Requirements (40 P.S. § 310.1, 310.3-310.14)
Resident/nonresident (40 P.S. § 310.3–310.5, 310.10)
Temporary license (40 P.S. § 310.9)
Managers and exclusive general agents (40 P.S. §
310.1, 310.31)
Maintenance and duration
Change in address (40 P.S. § 310.11(19))
Renewal (40 P.S. § 310.8)
Duty to report administrative or criminal actions (40
P.S. § 310.78)
Assumed names (40 P.S. § 310.7)
Continuing education (40 P.S. § 310.8(b), 310.6(a), 31
Pa. Code Ch. 39a)
Waiver due to military or extenuating circumstances
(40 P.S. § 310.8)
Disciplinary actions
License denial, nonrenewal, suspension, or revocation
(40 P.S. § 310.91, 310.11)
Penalties and fines for violations (40 P.S. §§ 310.12,
310.41a, 310.91, 1171.11)
Cease and desist order (40 P.S. §§ 310.91, 1171.9)
Civil
Criminal
Hearings
Consent agreement
1.2
State regulation
Acts constituting insurance transactions
Negotiate, sell, solicit (40 P.S. §§ 310.1, 310.3, 310.8,
310.11)
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Certificate of authority (40 P.S. §§ 47, 47a, 420)
Solvency (40 P.S. §§ 72, 112)
Policy forms and rates (40 P.S. §§ 510, 776.1–776.7,
1181–1199, 1221–1238)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10); 31 Pa. Code Ch. 146)
Producer regulation
Fiduciary responsibility (40 P.S. § 310.96; 31 Pa. Code
Ch. § 37.81)
Examination of books and records (40 P.S. § 323.3-4)
Producer disclosure requirements (40 P.S. § 310.71(b))
Commissions and fees (40 P.S. §§ 310.72–310.74)
Prohibited acts (40 P.S. § 310.11)
Appointment procedures
Producer appointment (40 P.S. § 310.71, 31 Pa Code
37.61)
Appointment termination (40 P.S. § 310.71a)
Unfair insurance practices (40 P.S. §§ 1171.1-1171.5)
Rebates and Inducements (40 P.S. §§
310.45, 310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48,
1171.5(a)(1),(2))
Twisting (40 P.S. §§ 473)
False advertising (40 P.S. § 1171.5; 31 Pa. Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Misappropriation of funds (40 P.S. §§ 310.11(4), 310.42)
Unfair discrimination (40 P.S. § 1171.5; 31 Pa. Code §
145.4)
Replacement (40 P.S. § 625, 31 Pa Code Ch. 81)
Privacy of consumer financial information (40 P.S. §
310.77(a); 31 Pa. Code §§ 146a.1–.44)
Insurance fraud regulation (40 P.S. §§ 325.1–325.62; 18
Pa. C.S. § 4117)
Federal Regulation
Fair Credit Reporting Act
Fraud and False Statements (18 USC Sections 1033 and
1034)
Privacy (Gramm-Leach-Bliley)
National Do Not Call List
Affordable Care Act
2.0 GENERAL INSURANCE CONCEPTS (7%)
23
2.1
Risk
Methods of Handling Risk (e.g., Avoidance, Retention,
Sharing, Reduction, Transfer)
Elements of Insurable Risks
Definitions (e.g., Risk, Hazard, Peril, Loss)
2.2
Classifications of Insurers
Mutual, Stock
Admitted, Non-Admitted
Foreign, Domestic, Alien
2.3
Elements of a Contract
Consideration
Competent Parties
Legal Purpose
Offer
Acceptance
2.4
Authority and Powers of Producers
Express
Implied
Apparent
The Law of Agency
2.5
Legal Interpretations Affecting Contracts
Reasonable Expectations
Indemnity
Good Faith
Fraud
Warranties, Representations, Misrepresentations, and
Concealment
3.0 LIFE, ACCIDENT, AND HEALTH INSURANCE BASICS (14%)
3.1
Insurable Interest (40 P.S. § 512)
3.2
Personal Uses of Life Insurance
Survivor Protection
Estate Creation
Liquidity
Estate Conservation
Asset Protection
3.3
Determining Amount of Personal Life Insurance
Human Life Value Approach
Needs Approach
3.4
Business Uses of Life Insurance
Buy-Sell Funding
Key Person
Executive Compensation
3.5
Viatical and life settlements
Disclosure to consumers (40 P.S. § 626.7)
General rules (40 P.S. § 626.8)
Definitions (40 P.S. § 626.2)
3.6
Classes of life insurance policies
Group versus individual
Permanent versus term
Participating versus nonparticipating
Fixed versus variable life insurance
General account versus separate account (40 P.S. §
506.2; 31 Pa. Code Ch. 82.41-.51)
Regulation of variable life insurance (31 Pa. Code Ch.
82.1, .14, .81)
3.7
Factors in Premium Determination
Mortality
Interest
Expense
3.8
Premium Frequency
3.9
Producer responsibilities
Sales presentations
Advertising (31 Pa. Code Ch. 51.1–.36, .42)
Life and Health Insurance Guaranty Association (40 P.S. §
991.1717)
Life insurance disclosure statement (31 Pa. Code Ch. 83)
Illustrations (40 P.S. § 625.7–625.8)
Life insurance surrender comparison index disclosure (31
Pa. Code Ch. 83.51–.57)
3.10
Field Underwriting
Application Procedures
Warranties and Representations
3.11
Policy Delivery
Effective Date of Coverage
Premium Collection
Statement of Good Health
Delivery receipt requirement (40 P.S. § 625.4)
3.12
Company Underwriting
Sources of Information
Classifications of Risk (Preferred, Standard, Substandard,
Declined)
Selection criteria and unfair discrimination (40 P.S. §
477a)
3.13
Definitions of Perils
Accidental Injury
Sickness
3.14
Types of Losses and Benefits
Loss of Income from Disability (Short-Term/Long-Term
Disability)
Medical Expense
Long-Term Care Expense
Prescriptions
3.15
Limited Health Insurance Policies
Accidental Death and Dismemberment
Hospital Indemnity
Critical Illness/Dread Disease (31 Pa. Code Ch. 88.169,
.193)
Vision Care
Hearing
Dental
3.16
Common exclusions from coverage (31 Pa. Code Ch.
88.84)
Pre-existing conditions (31 Pa. Code Ch. 88.51)
Intentionally self-inflicted injuries (1)(ii)
War or act of war (1)(i)
Elective cosmetic surgery (1)(vii)
Conditions covered by workers' compensation (1)(iii)
Commission of or attempt to commit a felony
3.17
Classification of Risks
Preferred
Standard
Substandard
3.18
Considerations in replacing health insurance
Pre-existing conditions
Waiting periods
Benefits, limitations and exclusions
Underwriting requirements
24
Producer's liability for errors and omissions
Pennsylvania replacement requirements (31 Pa. Code
Ch. 88.101–.103)
4.0 TYPES OF LIFE INSURANCE POLICIES (8%)
4.1
Term Life Insurance
Level
Decreasing
Increasing Term
Renewable Term
4.2
Whole (Permanent, Ordinary) Life Insurance
Single Premium
Continuous Premium
Limited Payment Life
Adjustable Life
4.3
Universal Life
4.4
Index Whole Life
4.5
Specialized Policies
Joint Life
Survivorship Life
Juvenile
Return of Premium Term Insurance
4.6
Group Life Insurance
Eligible Groups
Characteristics of Group Life Insurance
Conversion to individual policy (40 P.S. § 532.7)
5.0 LIFE INSURANCE POLICY PROVISIONS, OPTIONS, AND RIDERS
(13%)
5.1
Standard Life Insurance Provisions (40 P.S. § 510)
Ownership
Assignment
Right to Examine (Free Look) (40 P.S. § 510C (a), (2), (3),
(b1))
Payment of Premiums (a)
Grace Period (b)
Misstatement of Age/Sex (e)
Incontestability (c)
Reinstatement (k)
Entire Contract (d)
Payment of claims (l)
Prohibited provisions including backdating (40 P.S. § 511)
5.2
Beneficiary Designation Options
Individuals
Classes
Estates
Minors
Trusts
5.3
Types of Beneficiaries
Revocable versus Irrevocable
Primary and Contingent
5.4
Beneficiary-Related Clauses
Common Disaster
Spendthrift
Effects of Divorce on Designation of Beneficiaries (20 Pa
C.S.A.§ 6111.2)
5.5
Settlement Options
Cash Payment (Lump Sum)
Interest Only
Life Income
Fixed-Period
Fixed-Amount Installments
Retained Asset Account
5.6
Nonforfeiture Options
Cash Surrender Value
Extended Term
Reduced Paid-Up Insurance
5.7
Policy Loan and Withdrawal Options
Loans
Automatic Premium Loans
Withdrawals Partial Surrenders
5.8
Dividend Options
Paid-Up Additions
Cash Payment (Lump Sum)
One Year Term
Reduction of Premium
Accumulation at Interest
5.9
Disability Riders
Waiver of Premium
Disability Income Benefit
Payor Benefit Life
5.10
Riders Covering Additional Insureds
Spouse
Children
Family
5.11
Riders Affecting Death Benefit Amount
Accidental Death
Guaranteed Insurability
Cost of Living
Return of Premium
Accelerated (Living) Benefit Provision Rider
Conditions for payment (31 Pa. Code Ch. 90f.3)
Effect on death benefit (31 Pa. Code Ch. 90f.3)
Exclusions and restrictions (31 Pa. Code Ch. 90f.4)
Long-Term Care Rider
Policy Exclusions
6.0 ANNUITIES (9%)
6.1
Annuity Principles and Concepts
Accumulation Period versus Annuity Period
Owner, Annuitant, and Beneficiary
Right to Examine (40 P.S. § 510D)
6.2
Immediate versus Deferred Annuities
6.3
Annuity (Benefit) Payment Options
Life Contingency Options
Annuities Certain
Pure Life versus Life with Guaranteed Minimum
Single Life versus Multiple Life
6.4
Annuity Products
Fixed Annuities
Equity Indexed Annuities
Immediate Annuities
Variable annuities
Assets in a separate account (31 Pa. Code Ch. 85.21–
.27)
Regulation of variable annuities (SEC, FINRA and
Pennsylvania) (31 Pa. Code Ch. 85.1–.4)
Suitability of annuities (Act 48 of 2018)
6.5
Uses of Annuities
25
Lump-Sum Settlements
Retirement Income
Education
7.0 INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICY
PROVISIONS (7%)
7.1
Required Provisions (40 P.S. § 753(A))
Time Limit on Certain Defenses (2)
Grace Period (3)
Reinstatement (4)
Claim Forms (6)
Proof of Loss (7)
Time of Payment of Claims (8)
Physical Examinations and Autopsy (10)
Legal Actions (11)
Entire Contract (1)
Payment of Claims (9)
Change of Beneficiary (12)
Notice of Claim (5)
7.2
General Policy Provisions (40 P.S. § 753(B))
Change of Occupation (1)
Misstatement of Age/Sex (2)
Other insurance in this insurer (3)
Insurance with other insurers
Expense-incurred benefits (4)
Other benefits (5)
Unpaid premium (7)
Cancellation (8)
Conformity with state statutes (9)
Illegal Occupation (10)
Intoxicants, Narcotics, or Other Controlled Substances
(11)
7.3
Other General Provisions
Right to Examine/Free Look (40 P.S. § 752(A)(10); 31 Pa.
Code Ch. 89.73)
Insuring Clause
Consideration Clause
Renewability Clause
Coinsurance
Probationary Period
Elimination Period
Exclusions
8.0 DISABILITY INCOME AND RELATED INSURANCE (4%)
8.1
Benefits Determination for Disability
Indemnity
8.2
Qualifications of Disability
Total (Own Occupation, Any Occupation)
Partial (31 Pa. Code Ch. 88.138)
Permanent
Presumptive
Recurrent
Residual (31 Pa. Code Ch. 88.139)
Inability to Perform Duties (31 Pa. Code Ch. 88.137)
Occupational versus Non-Occupational
8.3
Individual Disability Income Insurance
Basic Total Disability Plan
Cost of Living Rider
Future Increase Option Rider
Change of Occupation
Other Cash Benefits
Refund Provisions
Exclusions
Waiver of Premium
Probationary Period
Elimination Period
Benefit Limits
Relation of earnings to insurance (40 P.S. § 753(B)(6))
Pennsylvania minimum benefit standards (31 Pa. Code
Ch. 88.167)
8.4
Unique Aspects of Individual Disability Underwriting
Occupational Considerations
Benefit Limits
Policy Issuance Alternatives
8.5
Group Disability Income Insurance
Short-Term Disability
Long-Term Disability
Coordination of Benefits (Workers' Compensation
Benefits and Social Insurance) (77 P.S. § 511 et seq)
At-Work Benefits
8.6
Business Disability Insurance
Key Employee Disability Income
Disability Buy-Sell Policy
Business Overhead Expense
8.7
Social Security Disability
Qualification for Disability Benefits
Definition of Disability
Waiting Period
9.0 MEDICAL PLANS (4%)
9.1
Medical Plan Concepts
Fee-for-Service
Prepaid
Specified Coverage
Comprehensive Coverage
Dependent Coverage
9.2
Provisions and Clauses
Deductibles
Stop-Loss Provision
Impairment Rider
9.3
Types of Medical Plans
Basic Plans
Major Medical Insurance
Health Maintenance Organizations (HMOs)
Preferred Provider Organzations (PPOs)
Point-of-Service (POS) Plans
9.4
Cost Containment in Health Care Delivery
Managed Care
Preventive Care
Outpatient Benefits
Utilization Management
Preauthorization
Gatekeeper
9.5
Health Insurance Portability and Accountability Act
(HIPAA) (40 P.S. § 981-1)
Eligibility Requirements
Terms
Privacy
Portability
26
9.6
Pennsylvania mandated benefits (individual and group)
Postpartum coverage (40 P.S. § 1583)
Routine pap smears (40 P.S. § 1574(2))
Treatment for alcohol abuse and dependency (40 P.S.
§§ 908-1–908-8)
Serious mental illness (40 P.S. § 764g)
Annual gynecological examinations (40 P.S. § 1574(1))
Cancer therapy (40 P.S. § 764b)
Mammography coverage (40 P.S. § 764c)
Childhood immunizations (40 P.S. § 3503)
Dependent child age limit (31 Pa. Code Ch. 88.32)
Coverage of adopted children (40 P.S. § 775.1)
Newborn child coverage (40 P.S. §§ 771–775.2; 31 Pa.
Code Ch. 89.201–.209)
Physically handicapped/mentally retarded children (40
P.S. § 752(A)(9))
Medical foods (40 P.S. § 3901-3909)
Orally administered chemotherapy medication (Act 73
of 2016)
Mental health parity and addiction equity (40 P.S. §
908-11--908-16)
10.0 GROUP HEALTH INSURANCE (3%)
10.1
Characteristics of Group Health Insurance
Group Contract
Certificate of Coverage
Eligible Groups
Contributory versus Non-Contributory
10.2
Employer Group Health Insurance
Underwriting Criteria
Eligibility for Insurance
Pre-existing conditions (31 Pa. Code Ch. 89.402–.406)
Conversion of Coverage (40 P.S. §§ 756.2, 981-9)
Open Enrollment
Probation Period
Coordination of Benefits
10.3
COBRA
Eligibility
Duration of Coverage
Premium
11.0 DENTAL INSURANCE (1%)
11.1
Categories of dental treatment
Diagnostic and preventive
Restorative
Oral surgery
Endodontics
Periodontics
Prosthodontics
Orthodontics
11.2
Indemnity plans
Choice of providers
Scheduled versus nonscheduled plans
Benefit categories
Diagnostic/preventive services
Basic services
Major services
Deductibles and coinsurance
Combination plans
Exclusions
Limitations
Predetermination of benefits
11.3
Employer group dental expense
Integrated deductibles versus stand-alone plans
Minimizing adverse selection
12.0 HEALTH INSURANCE FOR SENIOR CITIZENS AND SPECIAL NEEDS
INDIVIDUALS (7%)
12.1
Medicare
Administration
Eligibility
Part A
Part B
Part C
Part D
Medicare Select
12.2
Medicare Supplement Insurance
Open Enrollment (31 Pa. Code Ch 89.778)
Types of Plans
Standardized Plan Benefits
Pennsylvania regulations and required provisions
Standards for marketing (31 Pa. Code Ch. 89.786)
Advertising (31 Pa. Code Ch. 89.785)
Appropriateness of recommended purchase and
excessive coverage (31 Pa. Code Ch. 89.787)
Replacement (40 P.S. § 3108; 31 Pa. Code Ch. 89.784,
.789)
Minimum benefit standards (40 P.S. § 3105)
Required disclosure provisions (40 P.S. § 3107; 31 Pa.
Code Ch. 89.783)
Permitted compensation arrangements (31 Pa. Code
Ch. 89.782)
Guaranteed issue (31 Pa. Code Ch. 89.790)
12.3
Other options for individuals with Medicare
Employer Group Health Plans
Medicaid
12.4
Long-Term Care Policies
Eligibility for Benefits
Benefit Periods and Amounts
Exclusions
Guaranteed Insurability Rider
Cost of Living Rider
12.5
Levels of Long-Term Care
Skilled
Intermediate
Custodial
12.6
Types of Long-Term Care
Comprehensive Coverage
Home Health
Adult Daycare
Respite Care
Community Care
Partnership Coverage
12.7
Long-Term Care Pennsylvania regulations and required
provisions
Outline of coverage (40 P.S. § 991.1111; 31 Pa. Code Ch.
89a.107, 126)
Right to examine (free look) (40 P.S. § 991.1110)
Pre-existing conditions (40 P.S. §§ 991.1105(c), 1107)
27
Continuation and conversion (31 Pa. Code Ch. 89a.105)
Unintentional lapse (31 Pa. Code Ch. 89a.106)
Required disclosure provisions (31 Pa. Code Ch. 89a.107)
Inflation protection (31 Pa. Code Ch. 89a.112)
Nonforfeiture benefit (31 Pa. Code Ch. 89a.123)
Benefit triggers (31 Pa. Code Ch. 89a.124, 125)
Replacement (31 Pa. Code Ch. 89a.113, 122)
Standards for marketing (31 Pa. Code Ch. 89a.120)
Suitability of recommended purchase (31 Pa. Code Ch.
89a.121)
Shopper's guide (31 Pa. Code Ch. 89a.127)
Permitted compensation arrangements (31 Pa. Code Ch.
89a.129)
Penalties (31 Pa. Code Ch. 89a.128)
13.0 FEDERAL TAX CONSIDERATIONS FOR LIFE AND HEALTH
INSURANCE (2%)
13.1
Requirements of Life Insurance Qualified Plans
13.2
Federal Tax Considerations for Qualified Plans
Withdrawals
Rollovers versus Transfers
13.3
Qualified Plan Types, Characteristics, and Purchasers
Individual Retirement Accounts (IRAs; Traditional versus
Roth; Immediate Annuity)
401k
403b
13.4
Taxation of Personal Life Insurance
Premiums
Dividends
Settlements
13.5
Modified Endowment Contracts (MECs)
13.6
Health Insurance Premiums and Benefits
Individual
Group
Disability Income
Business Disability Insurance
Medical Expense
Long-Term Care
13.7
Consumer-Driven Health Plans
Health Savings Accounts (HSAs)
Health Reimbursement Accounts (HRAs)
Flexible Spending Accounts (FSAs)
PENNSYLVANIA PRODUCER’S EXAMINATION FOR
PROPERTY AND ALLIED LINES INSURANCE
SERIES 16-04
100 Items – 120 Minutes
1.0 INSURANCE REGULATION (21%)
1.1
Licensing
Process and types
Requirements (40 P.S. § 310.1, 310.3-310.14)
Resident/nonresident (40 P.S. § 310.3–310.5, 310.10)
Temporary license (40 P.S. § 310.9)
Managers and exclusive general agents (40 P.S. §
310.1, 310.31)
Maintenance and duration
Change in address (40 P.S. § 310.11(19))
Renewal (40 P.S. § 310.8)
Duty to report administrative or criminal actions (40
P.S. § 310.78)
Assumed names (40 P.S. § 310.7)
Continuing education (40 P.S. § 310.8(b), 310.6(a), 31
Pa. Code Ch. 39a)
Waiver due to military or extenuating circumstances
(40 P.S. § 310.8)
Disciplinary actions
License denial, nonrenewal, suspension, or revocation
(40 P.S. § 310.91, 310.11)
Penalties and fines for violations (40 P.S. §§ 310.12,
310.41a, 310.91, 1171.11)
Cease and desist order (40 P.S. §§ 310.91, 1171.9)
Civil
Criminal
Hearings
Consent agreement
1.2
State regulation
Acts constituting insurance transactions
Negotiate, sell, solicit (40 P.S. §§ 310.1, 310.3, 310.8,
310.11)
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Certificate of authority (40 P.S. §§ 47, 47a, 420)
Solvency (40 P.S. §§ 72, 112)
Policy forms and rates (40 P.S. §§ 510, 776.1–776.7,
1181–1199, 1221–1238)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10); 31 Pa. Code Ch. 146)
Producer regulation
Fiduciary responsibility (40 P.S. § 310.96; 31 Pa. Code
Ch. § 37.81)
Examination of books and records (40 P.S. § 323.3-4)
Producer disclosure requirements (40 P.S. § 310.71(b))
Commissions and fees (40 P.S. §§ 310.72–310.74)
Prohibited acts (40 P.S. § 310.11)
Appointment procedures
Producer appointment (40 P.S. § 310.71, 31 Pa Code
37.61)
Appointment termination (40 P.S. § 310.71a)
Unfair insurance practices (40 P.S. §§ 1171.1-1171.5)
Rebates and Inducements Prohibited (40 P.S. §§
310.45, 310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48,
1171.5(a)(1),(2))
Twisting (40 P.S. §§ 473)
False advertising (40 P.S. § 1171.5; 31 Pa. Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Misappropriation of funds (40 P.S. §§ 310.11(4), 310.42)
Unfair discrimination (40 P.S. § 1171.5; 31 Pa. Code §
145.4)
Agency Termination (40 P.S. § 241, Act 143)
Privacy of consumer financial information (40 P.S. §
310.77(a); 31 Pa. Code §§ 146a.1–.44)
28
Insurance fraud regulation (40 P.S. §§ 325.1–325.62; 18
Pa. C.S. § 4117)
1.3
Federal regulation
Fair Credit Reporting Act
Fraud and False Statements (18 USC Sections 1033 and
1034)
Privacy (Gramm-Leach-Bliley)
Terrorism Risk Insurance Act
Motor Carrier Act (MCS-90 and others)
Other federal regulations (e.g., Do Not Call List;
https://www.donotcall.gov/)
2.0 GENERAL INSURANCE CONCEPTS (11%)
2.1
Risk
Methods of Handling Risk (e.g., Avoidance, Retention,
Sharing, Reduction, Transfer)
Elements of Insurable Risks
Definitions (e.g., Risk, Hazard, Peril, Loss)
2.2
Classifications of Insurers
Mutual, Stock
Admitted, Non-Admitted
Foreign, Domestic, Alien
2.3
Elements of a Contract
Consideration
Competent Parties
Legal Purpose
Offer
Acceptance
2.4
Authority and Powers of Producers
Express
Implied
Apparent
The Law of Agency
2.5
Legal Interpretations Affecting Contracts
Reasonable Expectations
Indemnity
Good Faith
Fraud
Warranties, Representations, Misrepresentations, and
Concealment
3.0 PROPERTY INSURANCE BASICS (22%)
3.1
Insurable Interest
3.2
Underwriting
Purpose
Process
Results
3.3
Rate Development
Types
Components
Basis
3.4
Types of Hazards
3.5
Types of Loss
Direct
Indirect
3.6
Loss valuation
Actual Cash Value
Replacement Cost
Functional Replacement Cost
Market Value
Agreed Value
Valued Policy
3.7
Basic Types of Construction
3.8
Policy Structure
Declarations
Definitions
Insuring Agreement
Supplementary Coverage
Conditions
Exclusions
Endorsements
3.9
Policy Conditions
Insureds
Policy Period
Policy Territory
Cancellation and Non-Renewal (40 P.S. 1171.5 (a)(9); 31
Pa Code Ch. 59; 40 P.S. §3401 et seq.)
Deductibles
Other insurance (e.g. Primary and Excess, Pro Rata,
Nonconcurrency, Contribution by Equal Shares)
3.10
Coinsurance
Purpose
Definition
Calculation
Penalties
Total versus Partial Loss
3.11
Specific, Scheduled, and Blanket Insurance
3.12
Named Insured Provisions
First Named Insured versus Other Insureds
Duties After Loss
Assignment
Waiver of Rights
3.13
Insurer Provisions
Liberalization
Subrogation
Claim Settlement Options
Duty to Defend
3.14
Third-Party Provisions
Loss Payable Clause
No Benefit to the Bailee
Leinholder's rights
3.15
Pennsylvania Laws, Regulations and Required Provisions
Pennsylvania Property and Casualty Insurance
Guaranty Association (40 P.S. §§ 991.1801–.1820)
Standard fire policy (40 P.S. § 636)
Cancellation and nonrenewal
Private residential (40 P.S. § 1171.5(a)(9); 31 Pa.
Code Ch. 59.6)
Commercial (40 P.S. §§ 3401–3407; 31 Pa. Code Ch.
113.81–.88)
Basic property insurance — death of named insured
(40 P.S. § 636.1(a))
Binders (40 P.S. § 636)
Insurance consultation services exemption (40 P.S. §§
1841–1844)
Federal Terrorism Risk Insurance Program (15 USC 6701;
Public Law 107–297, 109–144, 110–160)
4.0 DWELLING POLICY CONCEPTS (7%)
4.1
Dwelling Policy ('14)
29
Characteristics
Eligibility
Purpose
Policy Definitions
4.2
Coverage Forms Specifying Perils Insured Against
DP-1 Basic
DP-2 Broad
DP-3 Special
4.3
Property Coverages
Dwelling
Other Structures
Personal Property
Fair Rental Value
Additional Living Expense
4.4
Dwelling Policy Exclusions
4.5
Dwelling Policy Conditions
4.6
Dwelling Policy Endorsements
Special Provisions - Pennsylvania (DP 01 37)
Automatic Increase in Insurance Coverage (Inflation
Protection) (DP 04 11)
Dwelling Under Construction (DP 11 43)
Theft Coverage (DP 04 72)
Personal Liability Supplement
5.0 HOMEOWNERS POLICY CONCEPTS (16%)
5.1
Homeowners Policy ('11)
Characteristics
Eligibility
Purpose
Policy Definitions
5.2
Perils Insured Against
Basic
Broad
Special
5.3
Homeowners Policy Coverage Forms
Broad (HO-2)
Special (HO-3)
Contents Broad (HO-4)
Unit-Owners (HO-6)
Modified Coverages (HO-8)
5.4
Property Coverages
Dwelling
Other Structures
Personal Property
Loss of Use
Additional Coverages
5.5
Liability Coverages
Personal Liability
Medical Payments to Others
5.6
Homeowners Policy Exclusions
Vacant versus Unoccupied
5.7
Homeowners Policy Conditions
Standard Mortgage Clause
5.8
Homeowners Policy Endorsements
Business Pursuits (HO 24 71)
Home Day Care (HO 04 97)
Personal Injury (HO 24 82)
Personal Property Replacement Cost - Pennsylvania (HO
23 63)
Watercraft (HO 24 75)
Identity Theft
Water and Sewer Backup
Special Provisions - Pennsylvania (HO 01 37)
Limited Fungi, Wet or Dry Rot, or Bacteria (HO 04 26, HO
04 27)
Permitted Incidental Occupancies (HO 04 42)
Identity Fraud Expense (HO 04 55)
Earthquake Coverage (HO 04 54)
5.9
Scheduled Personal Property/Personal Articles Floater
(HO 04 61)
6.0 COMMERCIAL PROPERTY POLICIES ('12) (11%)
6.1
Commercial Package Policy
Purpose
Definition
Coverage parts
6.2
Commercial Policy Components
Declarations
Conditions
Insuring Agreements
Exclusions
Interline Endorsements
6.3
Commercial Property Forms
Coverage Forms for Building and Business Personal
Property
Builders Risk
Business Income
Extra Expense
Legal Liability
Cause of Loss Forms
6.4
Commercial Property Endorsements
Ordinance or Law (CP 04 05)
Peak Season Limit of Insurance (CP 12 30)
Spoilage (CP 04 40)
Value Reporting Form (CP 13 10)
6.5
Commercial Inland Marine
Definitions
Conditions and Exclusions
Coverages (e.g. Transportation, Contractor's Floater,
Equipment)
6.6
Equipment Breakdown Coverages
Equipment Breakdown Protection Coverage Form (EB 00
20)
Selected endorsement
Actual Cash Value (EB 99 59)
6.7
Farm Property
Definitions
Conditions and Exclusions
Coverages
Farm property coverage form ('03)
Livestock coverage form
Mobile agricultural machinery and equipment coverage
form
7.0 BUSINESSOWNERS ('13) POLICY — PROPERTY (8%)
7.1
Characteristics and purpose
7.2
Businessowners Section I — Property
Coverage
Exclusions
Limits of insurance
30
Deductibles
Loss conditions
General conditions
Optional coverages
Definitions
7.3
Businessowners Section III — Common Policy Conditions
7.4
Selected endorsements
Protective safeguards (BP 04 30)
Utility services — direct damage (BP 04 56)
Utility services — time element (BP 04 57)
8.0 OTHER TYPES OF PROPERTY INSURANCE (4%)
8.1
Farmowners/Ranchowners Policy
8.2
Mobile Home Policy
8.3
Purpose of Difference in Conditions
8.4
Flood Insurance
Private vs. NFIP
Eligibility
Coverage
Limits
Deductibles
8.5
Residual markets including FAIR Plans (40 P.S. §§
1600.101–.103)
8.6
Federal Crop Insurance (RMA)
8.7
Ocean Marine
Major coverages
Hull insurance
Cargo insurance
Freight insurance
Implied warranties
Perils
General and particular average
8.8
Other policies
Aircraft hull
Boatowners
Personal watercraft
Recreational vehicles
PENNSYLVANIA PRODUCER’S EXAMINATION FOR CASUALTY AND
ALLIED LINES INSURANCE
SERIES 16-05
100 Items – 120 Minutes
1.0 INSURANCE REGULATION (23%)
1.1
Licensing
Process and types
Requirements (40 P.S. § 310.1, 310.3-310.14)
Resident/nonresident (40 P.S. § 310.3–310.5, 310.10)
Temporary license (40 P.S. § 310.9)
Managers and exclusive general agents (40 P.S. §
310.1, 310.31)
Maintenance and duration
Change in address (40 P.S. § 310.11(19))
Renewal (40 P.S. § 310.8)
Duty to report administrative or criminal actions (40
P.S. § 310.78)
Assumed names (40 P.S. § 310.7)
Continuing education (40 P.S. § 310.8(b), 310.6(a), 31
Pa. Code Ch. 39a)
Waiver due to military or extenuating circumstances
(40 P.S. § 310.8)
Disciplinary actions
License denial, nonrenewal, suspension, or revocation
(40 P.S. § 310.91, 310.11)
Penalties and fines for violations (40 P.S. §§ 310.12,
310.41a, 310.91, 1171.11)
Cease and desist order (40 P.S. §§ 310.91, 1171.9)
Civil
Criminal
Hearings
Consent agreement
1.2
State regulation
Acts constituting insurance transactions
Negotiate, sell, solicit (40 P.S. §§ 310.1, 310.3, 310.8,
310.11)
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Certificate of authority (40 P.S. §§ 47, 47a, 420)
Solvency (40 P.S. §§ 72, 112)
Policy forms and rates (40 P.S. §§ 510, 776.1–776.7,
1181–1199, 1221–1238)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10); 31 Pa. Code Ch. 146)
Producer regulation
Fiduciary responsibility (40 P.S. § 310.96; 31 Pa. Code
Ch. § 37.81)
Examination of books and records (40 P.S. § 323.3-4)
Producer disclosure requirements (40 P.S. § 310.71(b))
Commissions and fees (40 P.S. §§ 310.72–310.74)
Prohibited acts (40 P.S. § 310.11)
Appointment procedures
Producer appointment (40 P.S. § 310.71, 31 Pa Code
37.61)
Appointment termination (40 P.S. § 310.71a)
Unfair insurance practices (40 P.S. §§ 1171.1-1171.5)
Rebates and Inducements (40 P.S. §§
310.45, 310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48,
1171.5(a)(1),(2))
Twisting (40 P.S. §§ 473)
False advertising (40 P.S. § 1171.5; 31 Pa. Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Misappropriation of funds (40 P.S. §§ 310.11(4), 310.42)
Unfair discrimination (40 P.S. § 1171.5; 31 Pa. Code §
145.4)
Agency Termination (40 P.S. § 241, Act 143)
Privacy of consumer financial information (40 P.S. §
310.77(a); 31 Pa. Code §§ 146a.1–.44)
Insurance fraud regulation (40 P.S. §§ 325.1–325.62; 18 Pa.
C.S. § 4117)
1.3
Federal regulation
Fair Credit Reporting Act
31
Fraud and False Statements (18 USC Sections 1033 and
1034)
Privacy (Gramm-Leach-Bliley)
Terrorism Risk Insurance Act
Motor Carrier Act (MCS-90 and others)
Other federal regulations (e.g., Do Not Call List;
https://www.donotcall.gov/)
2.0 GENERAL INSURANCE CONCEPTS (13%)
2.1
Risk
Methods of Handling Risk (e.g., Avoidance, Retention,
Sharing, Reduction, Transfer)
Elements of Insurable Risks
Definitions (e.g., Risk, Hazard, Peril, Loss)
2.2
Classifications of Insurers
Mutual, Stock
Admitted, Non-Admitted
Foreign, Domestic, Alien
2.3
Elements of a Contract
Consideration
Competent Parties
Legal Purpose
Offer
Acceptance
2.4
Authority and Powers of Producers
Express
Implied
Apparent
The Law of Agency
2.5
Legal Interpretations Affecting Contracts
Reasonable Expectations
Indemnity
Good Faith
Fraud
Warranties, Representations, Misrepresentations, and
Concealment
3.0 CASUALTY INSURANCE BASICS (22%)
3.1
Damages
Compensatory versus Punitive
General versus Special
3.2
Liability
Absolute
Strict
Vicarious
3.3
Underwriting
Purpose
Process
Results
3.4
Rate Development
Types
Components
Basis
3.5
Types of Hazards
3.6
Negligence
Torts
Elements of a Negligent Act
Defense Against Negligence
3.7
Accident versus Occurrence
3.8
Policy Structure
Declarations
Definitions
Insuring Agreement
Supplementary Coverage
Conditions
Exclusions
Endorsements
3.9
Policy Conditions
Insureds
Policy Period
Policy Territory
Cancellation and Non-Renewal (40 P.S. 1171.5 (a)(9); 31
Pa Code Ch. 59; 40 P.S. §991.2001 et seq.; 40 P.S. §3401
et seq.)
Deductibles
Other insurance (e.g. Primary and Excess, Pro Rata,
Nonconcurrency, Contribution by Equal Shares)
3.10
Limits of Liability
Per Accident
Per Occurrence
Per Person
Aggregate
Split
Combined Single Limit
3.11
Named Insured Provisions
First Named Insured versus Other Insureds
Duties After Loss
Assignment
Waiver of Rights
3.12
Insurer Provisions
Liberalization
Subrogation
Claim Settlement Options
Duty to Defend
3.13
Third-Party Provisions
Loss Payable Clause
No Benefit to the Bailee
Leinholder's rights
3.14
Pennsylvania Laws, Regulations and Required Provisions
Pennsylvania Property and Casualty Insurance Guaranty
Association (40 P.S. §§ 991.1801–.1820)
Cancellation and nonrenewal
Private residential (40 P.S. § 1171.5(a)(9); 31 Pa.
Code Ch. 59.6)
Private passenger auto (40 P.S § 991.2001 et seq.)
Commercial (40 P.S. §§ 3401–3407; 31 Pa. Code Ch.
113.81–.88)
Insurance consultation services exemption (40 P.S. §§
1841–1844)
Federal Terrorism Risk Insurance Program (15 USC 6701;
Public Law 107–297, 109–144, 110–160)
4.0 PERSONAL AUTOMOBILE POLICY (6%)
4.1
Personal Automobile Policy (75 Pa. C.S. Ch. 17 §§ 1701–
1799)
Definitions
General Provisions
Conditions
Duties After an Accident
Endorsements
Amendment of policy provisions — Pennsylvania (PP
32
01 51)
Towing and labor costs (PP 03 03)
Extended non-owned coverage for named individual
(PP 03 06)
Miscellaneous type vehicle (PP 03 23)
Joint ownership coverage (PP 03 34)
4.2
Motor Vehicle Financial Responsibility Law (75 Pa. C.S.
Ch. 17 §§ 1701–1799)
4.3
Personal Automobile Policy Liability ('05)
Tort Election (Full or limited) (75 Pa. C.S. Ch. 17 §§ 1705)
Bodily Injury and Property Damage
Supplementary Payments
Persons Insured
Exclusions
4.4
Personal Injury Protection/First Party Benefits (75 Pa.
C.S. Ch. 17 §§ 1711-1725)
4.5
Pennsylvania Automobile Insurance Plan (75 Pa. C.S.
1741–1744)
4.6
Uninsured/Underinsured Motorist Coverage (40 P.S. §
2000; 75 Pa. C.S. 1731, 1733–1734, 1736, 1738)
4.7
Physical Damage (75 Pa. C.S. Ch. 17 §§ 1792)
4.8
Proof of coverages (75 Pa. C.S. Ch. 17 §§ 1781-1787)
5.0 COMMERCIAL AUTOMOBILE POLICY ('13) (5%)
5.1
Commercial Automobile Policy (75 Pa. C.S. Ch. 17 §§
1701 et seq)
Definitions
Provisions and Conditions
Duties After an Accident
Endorsements
5.2
Commercial Automobile Policy Liability
Bodily Injury and Property Damage
Supplementary Payments
Persons Insured
Exclusions
5.3
Physical Damage
5.4
Other Commercial Automobile forms (e.g., Motor
Carrier, Auto Dealers)
5.5
Proof of coverages (75 Pa. C.S. Ch. 17 §§ 1781-1787)
5.6
Selected endorsements
Lessor — additional insured and loss payee (CA 20 01)
Mobile equipment (CA 20 15)
Drive other car coverage (CA 99 10)
Individual named insured (CA 99 17)
5.7
Commercial carrier regulations
The Motor Carrier Act of 1980
Endorsement for motor carrier policies of insurance for
public liability (MCS-90)
6.0 COMMERCIAL GENERAL LIABILITY ('13) (8%)
6.1
Commercial Policy Components
Declarations
Conditions
Interline Endorsements
6.2
Commercial General Liability coverages
Bodily Injury and Property Damage
Personal and Advertising Injury
Medical Payments
Fire Damage
Supplementary Payments
6.3
Elements of Commercial General Liability
Conditions
Definitions
Exclusions
6.4
Occurrence versus Claims-Made
6.5
Claims-Made Features
Trigger
Retroactive Date
Prior Acts
Extended Reporting Periods
Claim Information
6.6
Commercial General Liability Exposures
Premises and Operations
Products and Completed Operations
Contractual Liability
7.0 COMMERCIAL CRIME ('15) (3%)
7.1
Definitions
7.2
Insuring Agreements
7.3
Coverage Form Classifications (types of coverage forms
only)
7.4
Other crime coverages
Lessees of Safe Deposit Boxes (CR 04 09)
Securities Deposited with Others (CR 04 10)
Guests' Property (CR 04 11)
Safe Depository (CR 04 12)
8.0 BUSINESSOWNERS ('13) POLICY — LIABILITY (8%)
8.1
Characteristics and purpose
8.2
Businessowners Section II — Liability
Coverages
Exclusions
Who is an insured
Limits of insurance
General conditions
Definitions
8.3
Businessowners Section III — Common Policy Conditions
8.4
Selected endorsements
Hired and non-owned auto liability (BP 04 04)
9.0 WORKERS' COMPENSATION INSURANCE (8%)
9.1
Definitions
9.2
Coverages
Workers' Compensation Insurance
Employers Liability Insurance
Other States Insurance
Self-insured employers and employer groups (77 P.S. §
501)
State Workers Insurance Fund (77 P.S. § 2601 et seq)
9.3
Benefits (77 P.S. § 511 et seq)
Death
Medical
Survivor
Rehabilitation
Lost Wages
9.4
Levels of Disability
Permanent Partial
Permanent Total
Temporary Partial
Temporary Total
Impairment Rating
9.5
Accident versus Occupational Disease and Illness
33
9.6
Federal Laws
Federal Employers Liability Act (FELA) (45 USC 51– 60)
Jones Act (46 USC 688)
Longshore and Harbor Workers' Compensation Act (33 USC
904)
Federal Mine Safety and Health Act (30 USC 801-944)
Migrant Farm Workers
9.7
Pennsylvania Workers Compensation Act (Title 77)
Exclusive remedy (77 P.S. §§ 72, 481)
Employment covered (required, elective) (77 P.S. §§ 1,
21–22, 461–463, 676)
Covered injuries (77 P.S. §§ 41, 411, 411.2, 431, 602, 631)
Occupational disease (77 P.S. §§ 27.1, 413)
Benefits provided (77 P.S. §§ 511, 511.2, 512–514, 516,
531, 541–542, 561–562, 582, 717.1)
Subsequent injury fund (77 P.S. § 517)
9.8
Rating and Job Classification
Experience Rating
Premium Basis
9.9
Claim Reporting Procedures
10.0 OTHER TYPES OF CASUALTY INSURANCE (4%)
10.1
Specialty Liability Insurance
Directors and Officers
Professional/Errors and Omissions
Employment Practices
Employee Benefits
Internet Liability and Network Protection
10.2
Surety Bonds
Types
Parties to a Bond
10.3
Personal Umbrella, Commercial Umbrella, and Excess
Policies (DL 98 01, CU 00 01)
Underlying Limits
Self-Insured Retention
Defense Costs
Follow Form
10.4
Alternative funding mechanisms
Risk retention groups (40 P.S. §§ 991.1501–.1506)
Risk purchasing groups (40 P.S. §§ 991.1508–.1512)
10.5
Ocean Marine
Protection and Indemnity
10.6
Other policies
Aircraft liability
Boatowners
PENNSYLVANIA PRODUCER’S EXAMINATION FOR
PROPERTY AND CASUALTY INSURANCE
SERIES 16-06
150 Items – 170 Minutes
1.0 INSURANCE REGULATION (20%)
1.1
Licensing
Process and types
Requirements (40 P.S. § 310.1, 310.3-310.14)
Resident/nonresident (40 P.S. § 310.3–310.5, 310.10)
Temporary license (40 P.S. § 310.9)
Managers and exclusive general agents (40 P.S. §
310.1, 310.31)
Maintenance and duration
Change in address (40 P.S. § 310.11(19))
Renewal (40 P.S. § 310.8)
Duty to report administrative or criminal actions (40
P.S. § 310.78)
Assumed names (40 P.S. § 310.7)
Continuing education (40 P.S. § 310.8(b), 310.6(a), 31
Pa. Code Ch. 39a)
Inactivity due to military or extenuating circumstances
(40 P.S. § 310.8)
Disciplinary actions
License denial, nonrenewal, suspension, or revocation
(40 P.S. § 310.91, 310.11)
Penalties and fines for violations (40 P.S. §§ 310.12,
310.41a, 310.91, 1171.11)
Cease and desist order (40 P.S. §§ 310.91, 1171.9)
Civil
Criminal
Hearings
Consent agreement
1.2
State regulation
Acts constituting insurance transactions
Negotiate, sell, solicit (40 P.S. §§ 310.1, 310.3, 310.8,
310.11)
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Certificate of authority (40 P.S. §§ 47, 47a, 420)
Solvency (40 P.S. §§ 72, 112)
Policy forms and rates (40 P.S. §§ 510, 776.1–776.7,
1181–1199, 1221–1238)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10); 31 Pa. Code Ch. 146)
Producer regulation
Fiduciary responsibility (40 P.S. § 310.96; 31 Pa. Code
Ch. § 37.81)
Examination of books and records (40 P.S. § 323.3-4)
Producer disclosure requirements (40 P.S. § 310.71(b))
Commissions and fees (40 P.S. §§ 310.72–310.74)
Prohibited acts (40 P.S. § 310.11)
Appointment procedures
Producer appointment (40 P.S. § 310.71, 31 Pa Code
37.61)
Appointment termination (40 P.S. § 310.71a)
Unfair insurance practices (40 P.S. §§ 1171.1-1171.5)
Rebates and Inducements (40 P.S. §§
310.45, 310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48,
1171.5(a)(1),(2))
Twisting (40 P.S. §§ 473)
False advertising (40 P.S. § 1171.5; 31 Pa. Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Misappropriation of funds (40 P.S. §§ 310.11(4), 310.42)
Unfair discrimination (40 P.S. § 1171.5; 31 Pa. Code §
145.4)
34
Agency Termination (40 P.S. § 241, Act 143)
Privacy of consumer financial information (40 P.S. §
310.77(a); 31 Pa. Code §§ 146a.1–.44)
Insurance fraud regulation (40 P.S. §§ 325.1–325.62; 18
Pa. C.S. § 4117)
1.3
Federal Regulation
Fair Credit Reporting Act
Fraud and False Statements (18 USC Sections 1033 and
1034)
Privacy (Gramm-Leach-Bliley)
Terrorism Risk Insurance Act
Motor Carrier Act (MCS-90 and others)
Other federal regulations (e.g., Do Not Call List;
https://www.donotcall.gov/)
2.0 GENERAL INSURANCE CONCEPTS (8%)
2.1
Risk
Methods of Handling Risk (e.g., Avoidance, Retention,
Sharing, Reduction, Transfer)
Elements of Insurable Risks
Definitions (e.g., Risk, Hazard, Peril, Loss)
2.2
Classifications of Insurers
Mutual, Stock
Admitted, Non-Admitted
Foreign, Domestic, Alien
2.3
Elements of a Contract
Consideration
Competent Parties
Legal Purpose
Offer
Acceptance
2.4
Authority and Powers of Producers
Express
Implied
Apparent
The Law of Agency
2.5
Legal Interpretations Affecting Contracts
Reasonable Expectations
Indemnity
Good Faith
Fraud
Warranties, Representations, Misrepresentations, and
Concealment
3.0 PROPERTY AND CASUALTY INSURANCE BASICS (14%)
3.1
Insurable Interest
3.2
Damages
Compensatory versus Punitive
General versus Special
3.3
Liability
Absolute
Strict
Vicarious
3.4
Underwriting
Purpose
Process
Results
3.5
Rate Development
Types
Components
Basis
3.6
Types of Hazards
3.7
Types of Loss
Direct
Indirect
3.8
Loss valuation
Actual Cash Value
Replacement Cost
Functional Replacement Cost
Market Value
Agreed Value
Valued Policy
3.9
Basic Types of Construction
3.10
Negligence
Torts
Elements of a Negligent Act
Defense Against Negligence
3.11
Accident versus Occurrence
3.12
Policy Structure
Declarations
Definitions
Insuring Agreement
Supplementary Coverage
Conditions
Exclusions
Endorsements
3.13
Policy Conditions
Insureds
Policy Period
Policy Territory
Cancellation and Non-Renewal (40 P.S. 1171.5 (a)(9); 31
Pa Code Ch. 59; 40 P.S. §991.2001 et seq.; 40 P.S. §3401
et seq.)
Deductibles
Other insurance (e.g. Primary and Excess, Pro Rata,
Nonconcurrency, Contribution by Equal Shares)
3.14
Limits of Liability
Per Accident
Per Occurrence
Per Person
Aggregate
Split
Combined Single Limit
3.15
Coinsurance
Purpose
Definition
Calculation
Penalties
Total versus Partial Loss
3.16
Specific, Scheduled, and Blanket Insurance
3.17
Named Insured Provisions
First Named Insured versus Other Insureds
Duties After Loss
Assignment
Waiver of Rights
3.18
Insurer Provisions
Liberalization
Subrogation
Claim Settlement Options
35
Duty to Defend
3.19
Third-Party Provisions
Loss Payable Clause
No Benefit to the Bailee
Leinholder's rights
3.20
Pennsylvania Laws, Regulations and Required Provisions
Pennsylvania Property and Casualty Insurance Guaranty
Association (40 P.S. §§ 991.1801–.1820)
Standard fire policy (40 P.S. § 636)
Cancellation and nonrenewal
Private residential (40 P.S. § 1171.5(a)(9); 31 Pa. Code
Ch. 59.6)
Commercial (40 P.S. §§ 3401–3407; 31 Pa. Code Ch.
113.81–.88)
Private passenger auto (40 P.S § 991.2001 et seq.)
Basic property insurance — death of named insured (40
P.S. § 636.1(a))
Binders (40 P.S. § 636)
Insurance consultation services exemption (40 P.S. §§
1841–1844)
Federal Terrorism Risk Insurance Program (15 USC 6701;
Public Law 107–297, 109–144, 110–160)
4.0 DWELLING POLICY CONCEPTS (4%)
4.1
Dwelling Policy ('14)
Characteristics
Eligibility
Purpose
Policy Definitions
4.2
Coverage Forms Specifying Perils Insured Against
DP-1 Basic
DP-2 Broad
DP-3 Special
4.3
Property Coverages
Dwelling
Other Structures
Personal Property
Fair Rental Value
Additional Living Expense
4.4
Dwelling Policy Exclusions
4.5
Dwelling Policy Conditions
4.6
Dwelling Policy Endorsements
Special Provisions - Pennsylvania (DP 01 37)
Automatic Increase in Insurance Coverage (Inflation
Protection) (DP 04 11)
Dwelling Under Construction (DP 11 43)
Theft Coverage (DP 04 72)
Personal Liability Supplement
5.0 HOMEOWNERS POLICY CONCEPTS (7%)
5.1
Homeowners Policy ('11)
Characteristics
Eligibility
Purpose
Policy Definitions
5.2
Perils Insured Against
Basic
Broad
Special
5.3
Homeowners Policy Coverage Forms
Broad (HO-2)
Special (HO-3)
Contents Broad (HO-4)
Unit-Owners (HO-6)
Modified Coverages (HO-8)
5.4
Property Coverages
Dwelling
Other Structures
Personal Property
Loss of Use
Additional Coverages
5.5
Liability Coverages
Personal Liability
Medical Payments to Others
5.6
Homeowners Policy Exclusions
Vacant versus Unoccupied
5.7
Homeowners Policy Conditions
Standard Mortgage Clause
5.8
Homeowners Policy Endorsements
Business Pursuits (HO 24 71)
Home Day Care (HO 04 97)
Personal Injury (HO 24 82)
Personal Property Replacement Cost - Pennsylvania (HO
23 63)
Watercraft (HO 24 75)
Identity Theft
Water and Sewer Backup
Special Provisions - Pennsylvania (HO 01 37)
Limited Fungi, Wet or Dry Rot, or Bacteria (HO 04 26, HO
04 27)
Permitted Incidental Occupancies (HO 04 42)
Identity Fraud Expense (HO 04 55)
Earthquake Coverage (HO 04 54)
Scheduled Personal Property/Personal Articles Floater
(HO 04 61)
6.0 PERSONAL AUTOMOBILE POLICY (10%)
6.1
Personal Automobile Policy (75 Pa. C.S. Ch. 17 §§ 1701–
1799)
Definitions
General Provisions
Conditions
Duties After an Accident
Endorsements
Amendment of policy provisions — Pennsylvania (PP 01
51)
Towing and labor costs (PP 03 03)
Extended non-owned coverage for named individual
(PP 03 06)
Miscellaneous type vehicle (PP 03 23)
Joint ownership coverage (PP 03 34)
6.2
Motor Vehicle Financial Responsibility Law (75 Pa. C.S.
Ch. 17 §§ 1701–1799)
6.3
Personal Automobile Policy Liability ('05)
Tort Election (Full or limited) (75 Pa. C.S. Ch. 17 §§
1705)
Bodily Injury and Property Damage
Supplementary Payments
Persons Insured
Exclusions
6.4
Personal Injury Protection/First Party Benefits (75 Pa.
36
C.S. Ch. 17 §§ 1711-1725)
6.5
Pennsylvania Assigned Risk Plan (75 Pa. C.S. 1741–1744)
6.6
Uninsured/Underinsured Motorist Coverage (40 P.S. §
2000; 75 Pa. C.S. 1731, 1733–1734, 1736, 1738)
6.7
Physical Damage (75 Pa. C.S. Ch. 17 §§ 1792)
6.8
Proof of coverages (75 Pa. C.S. Ch. 17 §§ 1781-1787)
7.0 COMMERCIAL AUTOMOBILE POLICY ('13) (5%)
7.1
Commercial Automobile Policy (75 Pa. C.S. Ch. 17 §§
1701 et seq)
Definitions
Provisions and Conditions
Duties After an Accident
Endorsements
7.2
Commercial Automobile Policy Liability
Bodily Injury and Property Damage
Supplementary Payments
Persons Insured
Exclusions
7.3
Physical Damage
7.4
Other Commercial Automobile forms (e.g., Motor
Carrier, Auto Dealers)
7.5
Proof of coverages (75 Pa. C.S. Ch. 17 §§ 1781-1787)
7.6
Selected endorsements
Lessor — additional insured and loss payee (CA 20 01)
Mobile equipment (CA 20 15)
Drive other car coverage (CA 99 10)
Individual named insured (CA 99 17)
7.7
Commercial carrier regulations
The Motor Carrier Act of 1980
Endorsement for motor carrier policies of insurance for
public liability (MCS-90)
8.0 COMMERCIAL PROPERTY POLICIES ('12) (7%)
8.1
Commercial Package Policy
Purpose
Definition
Coverage parts
8.2
Commercial Policy Components
Declarations
Conditions
Insuring Agreements
Exclusions
Interline Endorsements
8.3
Commercial Property Forms
Coverage Forms for Building and Business Personal
Property
Builders Risk
Business Income
Extra Expense
Legal Liability
Cause of Loss Forms
8.4
Commercial Property Endorsements
Ordinance or Law (CP 04 05)
Peak Season Limit of Insurance (CP 12 30)
Spoilage (CP 04 40)
Value Reporting Form (CP 13 10)
8.5
Commercial Inland Marine
Definitions
Conditions and Exclusions
Coverages (e.g. Transportation, Contractor's Floater,
Equipment)
8.6
Equipment Breakdown Coverages
Equipment Breakdown Protection Coverage Form (EB 00
20)
Selected endorsement
Actual Cash Value (EB 99 59)
8.7
Farm Property
Definitions
Conditions and Exclusions
Coverages
Farm property coverage form ('03)
Livestock coverage form
Mobile agricultural machinery and equipment coverage
form
9.0 COMMERCIAL GENERAL LIABILITY ('13) (7%)
9.1
Commercial Policy Components
Declarations
Conditions
Interline Endorsements
9.2
Commercial General Liability coverages
Bodily Injury and Property Damage
Personal and Advertising Injury
Medical Payments
Fire Damage
Supplementary Payments
9.3
Elements of Commercial General Liability
Conditions
Definitions
Exclusions
9.4
Occurrence versus Claims-Made
9.5
Claims-Made Features
Trigger
Retroactive Date
Prior Acts
Extended Reporting Periods
Claim Information
9.6
Commercial General Liability Exposures
Premises and Operations
Products and Completed Operations
Contractual Liability
10.0 COMMERCIAL CRIME ('15) (2%)
10.1
Definitions
10.2
Insuring Agreements
10.3
Coverage Form Classifications (types of coverage forms
only)
10.4
Other crime coverages
Lessees of Safe Deposit Boxes (CR 04 09)
Securities Deposited with Others (CR 04 10)
Guests' Property (CR 04 11)
Safe Depository (CR 04 12)
11.0 BUSINESSOWNERS ('13) POLICY — PROPERTY (3%)
11.1
Characteristics and purpose
11.2
Businessowners Section I — Property
Coverage
Exclusions
Limits of insurance
Deductibles
Loss conditions
General conditions
37
Optional coverages
Definitions
11.3
Businessowners Section II — Liability
Coverages
Exclusions
Who is an insured
Limits of insurance
General conditions
Definitions
11.4
Businessowners Section III — Common Policy Conditions
11.5
Selected endorsements
Hired and non-owned auto liability (BP 04 04)
Protective safeguards (BP 04 30)
Utility services — direct damage (BP 04 56)
Utility services — time element (BP 04 57)
12.0 WORKERS' COMPENSATION INSURANCE (5%)
12.1
Definitions
12.2
Coverages
Workers' Compensation Insurance
Employers Liability Insurance
Other States Insurance
Self-insured employers and employer groups (77 P.S. §
501)
State Workers Insurance Fund (77 P.S. § 2601 et seq)
12.3
Benefits (77 P.S. § 511 et seq)
Death
Medical
Survivor
Rehabilitation
Lost Wages
12.4
Levels of Disability
Permanent Partial
Permanent Total
Temporary Partial
Temporary Total
Impairment Rating
12.5
Accident versus Occupational Disease and Illness
12.6
Federal Laws
Federal Employers Liability Act (FELA) (45 USC 51– 60)
Jones Act (46 USC 688)
Longshore and Harbor Workers' Compensation Act (33
USC 904)
Migrant Farm Workers
Federal Mine Safety and Health Act (30 USC 801-944)
12.7
Pennsylvania Workers Compensation Act (Title 77)
Exclusive remedy (77 P.S. §§ 72, 481)
Employment covered (required, elective) (77 P.S. §§ 1,
21–22, 461–463, 676)
Covered injuries (77 P.S. §§ 41, 411, 411.2, 431, 602,
631)
Occupational disease (77 P.S. §§ 27.1, 413)
Benefits provided (77 P.S. §§ 511, 511.2, 512–514, 516,
531, 541–542, 561–562, 582, 717.1)
Subsequent injury fund (77 P.S. § 517)
12.8
Rating and Job Classification
Experience Rating
Premium Basis
12.9
Claim Reporting Procedures
13.0 OTHER TYPES OF PROPERTY AND CASUALTY INSURANCE (8%)
13.1
Specialty Liability Insurance
Directors and Officers
Professional/Errors and Omissions
Employment Practices
Employee Benefits
Internet Liability and Network Protection
13.2
Surety Bonds
Types
Parties to a Bond
13.3
Personal Umbrella, Commercial Umbrella, and Excess
Policies (DL 98 01, CU 00 01)
Underlying Limits
Self-Insured Retention
Defense Costs
Follow Form
13.4
Farmowners/Ranchowners Policy
13.5
Mobile Home Policy
13.6
Purpose of Difference in Conditions
13.7
Flood Insurance
Private vs. NFIP
Eligibility
Coverage
Limits
Deductibles
13.8
Residual markets including FAIR Plans (40 P.S. §§
1600.101–.103)
13.9
Alternative funding mechanisms
Risk retention groups (40 P.S. §§ 991.1501–.1506)
Risk purchasing groups (40 P.S. §§ 991.1508–.1512)
13.10
Federal Crop Insurance (RMA)
13.11
Ocean Marine
Major coverages
Hull insurance
Cargo insurance
Freight insurance
Implied warranties
Perils
General and particular average
Protection and Indemnity
13.12
Other policies
Aircraft hull
Aircraft liability
Boatowners
Personal watercraft
Recreational vehicles
PENNSYLVANIA PRODUCER’S EXAMINATION FOR
SURPLUS LINES INSURANCE
SERIES 16-09
60 Items – 80 Minutes
1.0 INSURANCE REGULATION 20% (12 ITEMS)
1.1
Licensing regulation for surplus lines
Purpose (40 P.S. § 991.1601)
Definitions (40 P.S. § 991.1602)
Who may be licensed (40 P.S. §§ 991.1603, .1615)
Individuals
38
Corporations and partnerships
Current licensing requirements (40 P.S. § 991.1615(b))
Disciplinary actions
Grounds (40 P.S. § 991.1623)
Penalties (40 P.S. §§ 310.91, 1171.11, 991.1624–.1625)
Renewals (40 P.S. § 991.1615)
Authority of license (40 P.S. §§ 991.1616)
1.2
Unfair insurance practices (40 P.S. §§ 1171.1–.11,
1171.13–.15)
1.3
Act 147 of 2002 (40 P.S. § 310.11; 40 P.S. §§ 310.71–
310.74)
Prohibited acts (40 P.S. § 310.11)
Commissions and fees (40 P.S. §§ 310.72–310.74)
Producer disclosure (40 P.S. § 310.71)
2.0 SURPLUS LINES MARKETS AND PRACTICES 80% (48 ITEMS)
2.1
Nonadmitted market
Insurance exchanges
Foreign insurers
2.2
Alien insurers
London market
Lloyd's of London
Other London companies
Other alien markets
2.3
Alternative markets
Risk retention groups (40 P.S. §§ 991.1501–1506)
Purchasing groups (40 P.S. §§ 991.1502, .1508–1512)
Independently procured insurance (40 P.S. § 991.1602,
.1622)
2.4
Eligible surplus lines insurers
Requirements (40 P.S. § 991.1605; 31 Pa. Code Ch.
124.9–.10)
List of eligible surplus lines insurers (40 P.S. §
991.1605(b))
Withdrawal of eligibility (40 P.S. § 991.1607)
Service of process (40 P.S. § 991.1624)
2.5
Surplus lines coverages
Characteristics and uses
Types of coverages available
2.6
Requirements for placement of surplus lines insurance
(40 P.S. §§ 991.1604, 991.1612)
Diligent search
Declarations (40 P.S. § 991.1609; 31 Pa. Code Ch.
124.5–.6)
Exempt risks (40 P.S. § 991.1610, 991.1604)
Notice to insured (40 P.S. § 991.1608, 31 Pa. Code §
124.2)
Unlicensed insurer
Pennsylvania Property and Casualty Insurance Guaranty
Association (40 P.S. §§ 991.1801–.1820)
Evidence of insurance (40 P.S. § 991.1612; 31 Pa. Code
Ch. 124.4)
2.7
Authority of surplus lines licensee
Binding (40 P.S. §§ 991.1614, .1618; 31 Pa. Code § 124.3)
2.8
Records of licensee
Content of records (40 P.S. § 991.1619(a))
Maintenance (40 P.S. § 991.1619(b), (c))
Reporting (40 P.S. § 991.1620, 991.1621)
2.9
Surplus lines tax (40 P.S. §§ 991.1621–1622)
Amount
Collection
Remittance
Tax report
2.10
Surplus lines advisory organization (40 P.S. § 991.1611)
Surplus lines stamping fee
Functions
PENNSYLVANIA PRODUCER’S EXAMINATION FOR
TITLE INSURANCE
SERIES 16-10
60 Items – 80 Minutes
1.0 INSURANCE REGULATION 12%
1.1
Licensing
Process (40 P.S. § 310.5)
Persons to be licensed
General requirements (40 P.S. §§ 310.5–310.8)
Title producer additional requirements (40 P.S. §§
910-24, 24.1, 910.26.1, 910.07)
Appointment procedures (40 P.S. §§ 310.71, 910-26)
Maintenance and duration
Expiration (40 P.S. § 910-26)
Renewal (40 P.S. § 310.8)
Reporting of actions (40 P.S. § 310.78)
Assumed names (40 P.S. § 310.7)
Address change (40 P.S. § 310.11(19))
Continuing education (40 P.S. § 910-26)
Disciplinary actions
Cease and desist order (40 P.S. § 1171.9)
Revocation, suspension, nonrenewal or denial of
license (40 P.S. § 310.91)
Fines (40 P.S. §§ 310.91, 1171.11)
1.2
State regulation
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Solvency (40 P.S. §§ 910-32–35)
Rates (40 P.S. §§ 910-37–39)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10))
Examination of title required (40 P.S. § 910-7)
Producer regulation
Charges for extra services (31 Pa. Code Ch. 125)
Unfair inducements and marketing practices in
obtaining title insurance business (40 P.S. § 910-31; 31
Pa. Code Ch. 125)
Record keeping (40 P.S. § 910-27)
Prohibited acts (40 P.S. § 310.11)
Unfair insurance trade practices
Rebates and Inducements (40 P.S. §§
310.45, 310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48,
1171.5(a)(1),(2))
Twisting (40 P.S. § 473)
False advertising (40 P.S. §§ 910-47, 1171.5; 31 Pa.
Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
39
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Unfair discrimination (40 P.S. § 1171.5)
1.3
Federal regulation
Fair Credit Reporting Act (15 USC 1681–1681d)
Fraud and false statements (18 USC 1033, 1034)
2.0 GENERAL INSURANCE 3%
2.1
Concepts
Risk management key terms
Risk
Exposure
Hazard
Peril
Loss
Methods of handling risk
Avoidance
Retention
Sharing
Reduction
Transfer
Elements of insurable risks
Adverse selection
Insurable interest
Law of large numbers
Reinsurance
2.2
Producers
Law of agency
Insurer as principal
Producer/insurer relationship
Authority and powers of producers
Express
Implied
Apparent
Responsibilities to the applicant/insured
2.3
Contracts
Elements of a legal contract
Offer and acceptance
Consideration
Competent parties
Legal purpose
Distinct characteristics of an insurance contract
Contract of adhesion
Aleatory contract
Personal contract
Unilateral contract
Conditional contract
Legal interpretations affecting contracts
Ambiguities in a contract of adhesion
Reasonable expectations
Indemnity
Utmost good faith
Representations/misrepresentations
Warranties
Concealment
Fraud
Waiver and estoppel
3.0 REAL PROPERTY 10%
3.1
Concepts, principles and practices
Definition of real property
Types of real property
Title to real property
Marketable title
3.2
Acquisition and transfer of real property
Conveyances
Encumbrances
Adverse possession
Condemnation
Riparian Rights
Escheats
Involuntary transfer
Abandonment
Judicial sales
Decedents' estates
Intestate
Testate
Trusts
Types of joint ownership
Tenants in common
Joint tenancy
Tenants by the entirety
Acknowledgments
Legal capacity of parties
Individuals
Corporations
General partnerships
Limited partnerships
Fictitious names
Trust agreements
Limited Liability Company (LLC)
3.3
Legal descriptions
Types of legal descriptions
Types of measurements used
Language of legal descriptions
Structure and format
Interpretation
4.0 TITLE INSURANCE 23%
4.1
Title insurance principles
Risks covered by title insurance
Risk of error in public records
Hidden off-record title risks
Risk of omission and commission by producer
Entities that can be insured; need for insurance
Individual
Commercial
Interests that can be insured
Fee simple estate
Leasehold estate
Life estate
Easements
Title insurance forms
Commitments
Owner's policy
Loan policy
Leasehold policy
Enhanced policies
40
Title insurance policy structure and provisions
Insuring provisions
Schedule A
Schedule B — Exceptions from coverage
Exclusions from coverage
Conditions and stipulations
Endorsements
4.2
Title searching techniques
Hard copy index
Computer index
Chain sheet
5.0 TITLE EXCEPTIONS AND PROCEDURES FOR CLEARING TITLE 21%
5.1
Principles and concepts
General exceptions
Voluntary and involuntary liens
Federal liens
Judgments
Taxes and assessments
Surveys
Condominiums
Water rights
Mineral rights
Equitable interests
Attachments
Executions
Covenants
Conditions
Restrictions
5.2
Special problem areas and concerns
Acknowledgments
Mechanic's lien
Bankruptcy
Probate
Good faith
Foreclosure
Claims against the title
Lis pendens
5.3
Principle of clearing title
Releases
Assignments
Subordinations
Affidavits
6.0 REAL ESTATE TRANSACTIONS 31%
6.1
Escrow principles
Escrow terminology
Types of escrows
Escrow contracts
Fiduciary responsibilities of Title Agents (40 P.S. §§
310.96, 910-24.2)
6.2
Document preparation regulations and requirements
Deeds
Mortgages
Notes
Releases
Acknowledgment forms
6.3
Settlement/closing procedures for all types of closings
Scheduling of closing
Types of documents used
FHA requirements
VA requirements
Real Estate Settlement Procedures Act (RESPA)
Insured closing protection
Recording and disbursement procedures
Settlement statement, lender and government entity
requirements
Contract sales
All-inclusive trust deed
Lot sales
Loan closings
Exchanges (including 1031)
6.4
Recording
Types of records
Types of recording systems
Requirements to record
Recording steps
Acknowledgments
Presumptions
PENNSYLVANIA PRODUCER’S EXAMINATION FOR
PERSONAL LINES INSURANCE
SERIES 16-16
100 Items – 120 Minutes
1.0 INSURANCE REGULATION (17%)
1a
Licensing
Process and types
Requirements (40 P.S. § 310.1, 310.3-310.14)
Resident/nonresident (40 P.S. § 310.3–310.5, 310.10)
Temporary license (40 P.S. § 310.9)
Managers and exclusive general agents (40 P.S. §
310.1, 310.31)
Maintenance and duration
Change in address (40 P.S. § 310.11(19))
Renewal (40 P.S. § 310.8)
Duty to report administrative or criminal actions (40
P.S. § 310.78)
Assumed names (40 P.S. § 310.7)
Continuing education (40 P.S. § 310.8(b), 310.6(a), 31
Pa. Code Ch. 39a)
Waiver due to military or extenuating circumstances
(40 P.S. § 310.8)
Disciplinary actions
License denial, nonrenewal, suspension, or revocation
(40 P.S. § 310.91, 310.11)
Penalties and fines for violations (40 P.S. §§ 310.12,
310.41a, 310.91, 1171.11)
Cease and desist order (40 P.S. §§ 310.91, 1171.9)
Civil
Criminal
Hearings
Consent agreement
1c
State regulation
Acts constituting insurance transactions
Negotiate, sell, solicit (40 P.S. §§ 310.1, 310.3, 310.8,
310.11)
41
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Certificate of authority (40 P.S. §§ 47, 47a, 420)
Solvency (40 P.S. §§ 72, 112)
Policy forms and rates (40 P.S. §§ 510, 776.1–776.7,
1181–1199, 1221–1238)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10); 31 Pa. Code Ch. 146)
Producer regulation
Fiduciary responsibility (40 P.S. § 310.96; 31 Pa. Code
Ch. § 37.81)
Examination of books and records (40 P.S. § 323.3-4)
Producer disclosure requirements (40 P.S. § 310.71(b))
Commissions and fees (40 P.S. §§ 310.72–310.74)
Prohibited acts (40 P.S. § 310.11)
Appointment procedures
Producer appointment (40 P.S. § 310.71, 31 Pa Code
37.61)
Appointment termination (40 P.S. § 310.71a)
Unfair insurance practices (40 P.S. §§ 1171.1-1171.5)
Rebates and Inducements (40 P.S. §§
310.45, 310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48,
1171.5(a)(1),(2))
Twisting (40 P.S. §§ 473)
False advertising (40 P.S. § 1171.5; 31 Pa. Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Misappropriation of funds (40 P.S. §§ 310.11(4), 310.42)
Unfair discrimination (40 P.S. § 1171.5; 31 Pa. Code §
145.4)
Agency Termination (40 P.S. § 241, Act 143)
Privacy of consumer financial information (40 P.S. §
310.77(a); 31 Pa. Code §§ 146a.1–.44)
Insurance fraud regulation (40 P.S. §§ 325.1–325.62; 18
Pa. C.S. § 4117)
1b
Federal regulation
Fair Credit Reporting Act
Fraud and False Statements (18 USC Sections 1033 and
1034)
Privacy (Gramm-Leach-Bliley)
Other federal regulations (e.g., Do Not Call List;
https://www.donotcall.gov/)
2.0 GENERAL INSURANCE CONCEPTS (13%)
2a
Risk
Methods of Handling Risk (e.g., Avoidance, Retention,
Sharing, Reduction, Transfer)
Elements of Insurable Risks
Definitions (e.g., Risk, Hazard, Peril, Loss)
2b
Classifications of Insurers
Mutual, Stock
Admitted, Non-Admitted
Foreign, Domestic, Alien
2c
Elements of a Contract
Consideration
Competent Parties
Legal Purpose
Offer
Acceptance
2d
Authority and Powers of Producers
Express
Implied
Apparent
The Law of Agency
2e
Legal Interpretations Affecting Contracts
Reasonable Expectations
Indemnity
Good Faith
Fraud
Warranties, Representations, Misrepresentations, and
Concealment
3.0 PROPERTY AND CASUALTY INSURANCE BASICS (25%)
3.1
Insurable Interest
3.2
Damages
Compensatory versus Punitive
General versus Special
3.3
Liability
Absolute
Strict
Vicarious
3.4
Underwriting
Purpose
Process
Results
3.5
Rate Development
Types
Components
Basis
3.6
Types of Hazards
3.7
Types of Loss
Direct
Indirect
3.8
Loss valuation
Actual Cash Value
Replacement Cost
Functional Replacement Cost
Market Value
Agreed Value
Valued Policy
3.9
Basic Types of Construction
3.10
Negligence
Torts
Elements of a Negligent Act
Defense Against Negligence
3.11
Accident versus Occurrence
3.12
Policy Structure
Declarations
Definitions
Insuring Agreement
Supplementary Coverage
Conditions
Exclusions
Endorsements
3.13
Policy Conditions
42
Insureds
Policy Period
Policy Territory
Cancellation and Non-Renewal (40 P.S. 1171.5 (a)(9); 31
Pa Code Ch. 59; 40 P.S. §991.2001 et seq.)
Deductibles
Other insurance (e.g. Primary and Excess, Pro Rata,
Nonconcurrency, Contribution by Equal Shares)
3.14
Limits of Liability
Per Accident
Per Occurrence
Per Person
Aggregate
Split
Combined Single Limit
3.15
Coinsurance
Purpose
Definition
Calculation
Penalties
Total versus Partial Loss
3.16
Specific, Scheduled, and Blanket Insurance
3.17
Named Insured Provisions
First Named Insured versus Other Insureds
Duties After Loss
Assignment
Waiver of Rights
3.18
Insurer Provisions
Liberalization
Subrogation
Claim Settlement Options
Duty to Defend
3.19
Third-Party Provisions
Loss Payable Clause
No Benefit to the Bailee
Leinholder's rights
3.20
Pennsylvania Laws, Regulations and Required Provisions
Pennsylvania Property and Casualty Insurance Guaranty
Association (40 P.S. §§ 991.1801–.1820)
Standard fire policy (40 P.S. § 636)
Cancellation and nonrenewal
Private residential (40 P.S. § 1171.5(a)(9); 31 Pa.
Code Ch. 59.6)
Private passenger auto (40 P.S § 991.2001 et seq.)
Basic property insurance — death of named insured
(40 P.S. § 636.1(a))
Binders (40 P.S. § 636)
Insurance consultation services exemption (40 P.S. §§
1841–1844)
Federal Terrorism Risk Insurance Program (15 USC 6701;
Public Law 107–297, 109–144, 110–160)
4.0 DWELLING POLICY CONCEPTS (9%)
4a
Dwelling Policy ('14)
Characteristics
Eligibility
Purpose
Policy Definitions
4b
Coverage Forms Specifying Perils Insured Against
DP-1 Basic
DP-2 Broad
DP-3 Special
4c
Property Coverages
Dwelling
Other Structures
Personal Property
Fair Rental Value
Additional Living Expense
4d
Dwelling Policy Exclusions
4e
Dwelling Policy Conditions
4f
Dwelling Policy Endorsements
Special Provisions - Pennsylvania (DP 01 37)
Automatic Increase in Insurance Coverage (Inflation
Protection) (DP 04 11)
Dwelling Under Construction (DP 11 43)
Theft Coverage (DP 04 72)
Personal Liability Supplement
5.0 HOMEOWNERS POLICY CONCEPTS (15%)
5.1
Homeowners Policy ('11)
Characteristics
Eligibility
Purpose
Policy Definitions
5.2
Perils Insured Against
Basic
Broad
Special
5.3
Homeowners Policy Coverage Forms
Broad (HO-2)
Special (HO-3)
Contents Broad (HO-4)
Unit-Owners (HO-6)
Modified Coverages (HO-8)
5.4
Property Coverages
Dwelling
Other Structures
Personal Property
Loss of Use
Additional Coverages
5.5
Liability Coverages
Personal Liability
Medical Payments to Others
5.6
Homeowners Policy Exclusions
Vacant versus Unoccupied
5.7
Homeowners Policy Conditions
Standard Mortgage Clause
5.8
Homeowners Policy Endorsements
Business Pursuits (HO 24 71)
Home Day Care (HO 04 97)
Personal Injury (HO 24 82)
Personal Property Replacement Cost - Pennsylvania (HO
23 63)
Watercraft (HO 24 75)
Identity Theft
Water and Sewer Backup
Special Provisions - Pennsylvania (HO 01 37)
Limited Fungi, Wet or Dry Rot, or Bacteria (HO 04 26, HO
04 27)
43
Permitted Incidental Occupancies (HO 04 42)
Identity Fraud Expense (HO 04 55)
Earthquake Coverage (HO 04 54)
5.9
Scheduled Personal Property/Personal Articles Floater
(HO 04 61)
6.0 PERSONAL AUTOMOBILE POLICY (17%)
6.1
Personal Automobile Policy (75 Pa. C.S. Ch. 17 §§ 1701–
1799)
Definitions
General Provisions
Conditions
Duties After an Accident
Endorsements
Amendment of policy provisions — Pennsylvania (PP
01 51)
Towing and labor costs (PP 03 03)
Extended non-owned coverage for named individual
(PP 03 06)
Miscellaneous type vehicle (PP 03 23)
Joint ownership coverage (PP 03 34)
6.2
Motor Vehicle Financial Responsibility Law (75 Pa. C.S.
Ch. 17 §§ 1701–1799)
6.3
Personal Automobile Policy Liability ('05)
Tort Election (Full or limited) (75 Pa. C.S. Ch. 17 §§
1705)
Bodily Injury and Property Damage
Supplementary Payments
Persons Insured
Exclusions
6.4
Personal Injury Protection/First Party Benefits (75 Pa.
C.S. Ch. 17 §§ 1711-1725)
6.5
Pennsylvania Automobile Insurance Plan (75 Pa. C.S.
1741–1744)
6.6
Uninsured/Underinsured Motorist Coverage (40 P.S. §
2000; 75 Pa. C.S. 1731, 1733–1734, 1736, 1738)
6.7
Physical Damage (75 Pa. C.S. Ch. 17 §§ 1792)
6.8
Proof of coverages (75 Pa. C.S. Ch. 17 §§ 1781-1787)
7.0 OTHER TYPES OF PROPERTY AND CASUALTY INSURANCE (4%)
7.1
Personal Umbrella and Excess Policies (DL 98 01)
Underlying Limits
Self-Insured Retention
Defense Costs
Follow Form
7.2
Mobile Home Policy
7.3
Purpose of Difference in Conditions
7.4
Flood Insurance
Private vs. NFIP
Eligibility
Coverage
Limits
Deductibles
7.5
Residual markets including FAIR Plans (40 P.S. §§
1600.101–.103)
7.6
Other policies
Boatowners
Personal watercraft
Recreational vehicles
PENNSYLVANIA EXAMINATION FOR VIATICAL SETTLEMENT BROKER
SERIES 16-17
60 Items – 80 Minutes
1.0 INSURANCE REGULATION 20%
1.1
Licensing
Process (40 P.S. § 626.3)
Types of licensees
Viatical settlement broker (40 P.S. § 626.2)
Viatical settlement provider (40 P.S. § 626.2)
Maintenance and duration
Renewal (40 P.S. § 626.3(e))
Disciplinary actions
Cease and desist order (40 P.S. §§ 1171.8–.10)
Revocation, suspension or denial of license (40 P.S. §
626.4)
Penalties (40 P.S. § 1171.11, 626.12)
1.2
State regulation
Commissioner's general duties and powers (40 P.S. §§
310.2, 1171.7)
Company regulation
Solvency (40 P.S. §§ 72, 112)
Policy forms (40 P.S. §§ 510, 776.1–776.7)
Unfair claims settlement practices (40 P.S. §
1171.5(a)(10); 31 Pa. Code Ch. 146)
Licensee regulation
Fiduciary responsibility (40 P.S. § 310.96)
Examination of books and records (40 P.S. §§ 626.16,
1171.5)
Unfair insurance practices
Rebates and Inducements Prohibited (40 P.S. §§ 310.45,
310.46, 1171.5(a)(8))
Misrepresentation (40 P.S. §§ 310.47–.48, 1171.5
(a)(1),(2)
Twisting (40 P.S. §§ 473, 1171.4)
False advertising (40 P.S. § 1171.5; 31 Pa. Code Ch. 51)
Defamation (40 P.S. § 1171.5(a)(3); 31 Pa. Code Ch.
51)
Boycott, coercion or intimidation (40 P.S. §
1171.5(a)(4))
Misappropriation of funds (40 P.S. §§ 310.11(4), 310.42,
310.96)
Unfair discrimination (40 P.S. § 1171.5; 31 Pa. Code §
145.4)
Privacy of consumer financial and health information (31
Pa. Code §§ 146a.1–.44, 146b)
Insurance fraud regulation (40 P.S. §§ 325.1–.3, .21–.24,
.41–.47, .61–.62; 18 Pa. C.S. 4117)
Fraudulent viatical settlement act (40 P.S. § 626.2)
1.3
Federal regulation
Fraud and false statements (18 USC §§ 1033, 1034)
State securities regulation
2.0 GENERAL INSURANCE 5%
2.1
Concepts
Risk management key terms
Risk
Exposure
Hazard
Peril
44
Loss
Methods of handling risk
Avoidance
Retention
Sharing
Reduction
Transfer
Elements of insurable risks
Adverse selection
Law of large numbers
Reinsurance
2.2
Contracts
Elements of a legal contract
Offer and acceptance
Consideration
Competent parties
Legal purpose
Distinct characteristics of an insurance contract
Contract of adhesion
Aleatory contract
Personal contract
Unilateral contract
Conditional contract
Legal interpretations affecting contracts
Ambiguities in a contract of adhesion
Reasonable expectations
Indemnity
Utmost good faith
Representations/misrepresentations
Warranties
Concealment
Fraud
Waiver and estoppel
3.0 LIFE INSURANCE POLICIES 25%
3.1
Term life insurance
Level term
Annual renewable term
Level premium term
Life expectancy contract
Term-to-65 contract
Decreasing term
3.2
Whole life insurance
Continuous premium (straight life)
Limited payment
Single premium
Current assumption
3.3
Flexible premium policies
Adjustable life
Universal life
Equity indexed universal life
Variable universal life
3.4
Specialized policies
Joint life (first-to-die)
Survivorship life (second-to-die)
3.5
Group life insurance
Characteristics of group plans
Types of plan sponsors
Group underwriting requirements
Conversion to individual policy (40 P.S. § 532.7)
4.0 LIFE INSURANCE POLICY PROVISIONS, OPTIONS AND RIDERS 15%
4.1
Standard provisions (40 P.S. § 510)
Ownership
Assignment
Entire contract (d)
Modifications
Right to examine (free look) (40 P.S. § 510c(a))
Payment of premiums (a)
Grace period (b)
Reinstatement (k)
Incontestability (c)
Misstatement of age (e)
Exclusions
Payment of claims (l)
Prohibited provisions including backdating (40 P.S. § 511)
Insurable interest (40 P.S § 512)
4.2
Beneficiaries
Designation options
Individuals
Classes
Estates
Minors
Trusts
Revocable versus irrevocable
Common disaster clause
Spendthrift clause
4.3
Settlement options
Cash payment
Interest only
Fixed-period installments
Fixed-amount installments
Life income
Single life
Joint and survivor
4.4
Nonforfeiture options
Cash surrender value
Extended term
Reduced paid-up insurance
4.5
Policy loans and withdrawal options
Cash loans
Automatic premium loans
Withdrawals or partial surrenders
4.6
Dividend options
Cash payment
Reduction of premium payments
Accumulation at interest
One-year term option
Paid-up additions
Paid-up insurance
4.7
Disability riders
Waiver of premium
Waiver of cost of insurance
Disability income benefit
4.8
Accelerated (living) benefit provision/rider
Conditions for payment (31 Pa. Code Ch. 90f.3)
Effect on death benefit (31 Pa. Code Ch. 90f.3)
Exclusions and restrictions (31 Pa. Code Ch. 90f.4)
45
4.9
Riders covering additional insureds
Spouse/other-insured term rider
Children's term rider
Family term rider
4.10
Riders affecting the death benefit amount
Accidental death
Guaranteed insurability
Cost of living
Return of premium
5.0 VIATICAL SETTLEMENT PRINCIPLES AND PRACTICES 35%
5.1
Parties to a viatical settlement (40 P.S. § 626.2)
Viator
Viatical settlement provider
Viatical settlement broker
Viatical settlement purchaser
Financing entity
Independent escrow agent
5.2
Definitions (40 P.S. § 626.2)
Chronically ill
Terminally ill
Viatical settlement contract
Related provider trust
5.3
Application process
Disclosures (including Broker commission disclosure) (40
P.S. § 626.7)
Required documents (40 P.S. § 626.8)
Confidentiality (40 P.S. § 626.6)
5.4
Procedure
Rules of conduct (40 P.S. § 626.8)
Viator proceeds (40 P.S. § 626.8(i))
Advertising (40 P.S. § 626.2)
Right to rescind (40 P.S. § 626.7(a)(5), .8(h))
Prohibited activities (40 P.S. § 626.9)
PENNSYLVANIA PUBLIC INSURANCE ADJUSTER EXAMINATION
SERIES 16-19
60 Items – 80 Minutes
1.0 INSURANCE REGULATION (15%)
1.1
Licensing
Definitions (63 P.S. § 1601)
Application procedures and requirements (63 P.S. §§
1602.1, 1602.2, 1602.5)
Fees
Fingerprinting
1.2
Qualifications (63 P.S. § 1602)
1.3
Surety bond (63 P.S. § 1604)
1.4
Maintenance and duration
Continuing education requirements (63 P.S. § 1602.4)
Renewal procedures (63 P.S. § 1602.4)
Contract requirements (63 P.S. § 1605)
1.5
Disciplinary actions
Cease and desist orders (40 P.S. §§ 1171.8–.10)
Prohibited acts (63 P.S. § 1606)
Penalties for violations (63 P.S. §§ 1606, 1607)
Change in address (63 P.S. § 1606(18))
1.6
Claim settlement laws and regulations (40 P.S. §§
1171.1–.11, .13; 31 Pa. Code §§ 146.1–.10)
1.7
Role of the adjuster
Duties and responsibilities
Independent adjuster versus public adjuster
Resident versus nonresident public adjuster
Relationship to the legal profession
1.8
Federal Regulation
Fraud and False Statements (18 USC Sections 1033 and
1034)
Privacy (Gramm-Leach-Bliley)
2.0 GENERAL INSURANCE CONCEPTS (14%)
2.1
Classifications of Insurers
Admitted, Non-Admitted
Foreign, Domestic, Alien
2.2
Elements of a Contract
Consideration
Competent Parties
Legal Purpose
Offer
Acceptance
2.3
Legal Interpretations Affecting Contracts
Reasonable Expectations
Indemnity
Utmost Good Faith
Fraud
Warranties, Representations, Misrepresentations, and
Concealment
2.4
Pennsylvania laws, regulations and required provisions
Pennsylvania Property and Casualty Insurance
Guaranty Association (40 P.S. §§ 991.1801–.1820)
Standard fire policy (40 P.S. § 636)
Cancellation and nonrenewal (Act 205 40 P.S. 1171.5
& Act 86 40 P.S. 3401)
Private residential (40 P.S. § 1171.5(a); 31 Pa. Code
Ch. 59)
Commercial (40 P.S. §§ 3401–3407; 31 Pa. Code §§
113.81–.88)
Basic property insurance — death of named insured
(40 P.S. § 636.1)
Binders (40 P.S. § 636)
Insurance consultation services exemption (40 P.S. §§
1841–1844)
Federal Terrorism Insurance Program (15 USC 6701;
Public Law 107–297, 109–144, 110–160)
3.0 PROPERTY AND CASUALTY INSURANCE BASICS (19%)
3.1
Types of Hazards
3.2
Types of Perils
Named
Special
3.3
Types of Loss
Direct
Indirect
3.4
Loss Valuation
Actual Cash Value
Replacement Cost
Functional Replacement Cost
46
Market Value
Agreed Value
Valued Policy
3.5
Basic Types of Construction
3.6
Negligence
Elements of a Negligent Act
Defense Against Negligence
3.7
Accident versus Occurrence
3.8
Policy Structure
Declarations
Definitions
Insuring Agreement
Supplementary Coverage
Conditions
Exclusions
Endorsements
3.9
Policy Conditions
Insureds
Policy Period
Policy Territory
Cancellation and Non-Renewal (40 P.S. 1171.5 (a)(9); 31
Pa Code Ch. 59; 40 P.S. §991.2001 et seq.; 40 P.S. §3401
et seq.)
Deductibles
Other Insurance (e.g. Primary and Excess, Pro Rata,
Nonconcurrency, Contribution by Equal Shares)
3.10
Coinsurance
Purpose
Definition
Calculation
Penalties
Total versus Partial Loss
3.11
Specific, Scheduled, and Blanket Insurance
3.12
Vacant versus Unoccupied
3.13
Named Insured Provisions
First Named Insured versus Other Insureds
Duties After Loss
Assignment
Waiver of Rights
3.14
Insurer Provisions
Liberalization
Claim Settlement Options
Duty to Defend
3.15
Third-Party Provisions
Standard Mortgage Clause
Loss Payable Clause
No Benefit to the Bailee
4.0 DWELLING POLICY CONCEPTS (6%)
4.1
Dwelling Policy ('14)
Characteristics
Eligibility
Purpose
Policy Definitions
4.2
Coverage Forms Specifying Perils Insured Against
DP-1 Basic
DP-2 Broad
DP-3 Special
4.3
Property Coverages
Coverage A - Dwelling
Coverage B - Other Structures
Coverage C - Personal Property
Coverage D - Fair Rental Value
Coverage E - Additional Living Expense
4.4
Dwelling Policy Exclusions
4.5
Dwelling Policy Conditions
4.6
Dwelling Policy Endorsements
Special provisions — Pennsylvania (DP 01 37)
Automatic Increase in Insurance Coverage (Inflation
Protection) (DP 04 11)
Dwelling Under Construction (DP 11 43)
Broad Theft Coverage (DP 04 72)
5.0 HOMEOWNERS POLICY CONCEPTS (10%)
5.1
Homeowners Policy ('11 PA Version) — Section I
Characteristics
Eligibility
Purpose
Policy Definitions
5.2
Perils Insured Against
Basic
Broad
Special
5.3
Homeowners Policy Coverage Forms
Broad (HO-2)
Special (HO-3)
Contents Broad (HO-4)
Unit-Owners (HO-6)
Modified Coverages (HO-8)
5.4
Property Coverages
Coverage A - Dwelling
Coverage B - Other Structures
Coverage C - Personal Property
Coverage D - Loss of Use
Additional Coverages
5.5
Homeowners Policy Exclusions
5.6
Homeowners Policy Conditions
5.7
Homeowners Policy Endorsements
Business Pursuits
Home Day Care (HO 04 97)
Personal Property Replacement Cost — Pennsylvania
(HO 23 63)
Watercraft
Special Provisions - Pennsylvania (HO 01 37)
47
Limited Fungi, Wet or Dry Rot, or Bacteria (HO 04 26,
HO 04 27)
Permitted Incidental Occupancies (HO 04 42)
5.8
Scheduled Personal Property/Personal Articles Floater
(HO 04 61)
6.0 COMMERCIAL PROPERTY POLICIES ('12) (8%)
6.1
Commercial Package Policy
Purpose
Definition
Coverage Parts
6.2
Commercial Policy Components
Declarations
Conditions
Insuring Agreements
Exclusions
Interline Endorsements
6.3
Commercial Property Forms
Coverage Forms for Building and Business Personal
Property
Builders Risk
Business Income
Extra Expense
Legal Liability
Cause of Loss Forms
6.4
Commercial Property Endorsements
Ordinance or Law (CP 04 05)
Peak Season Limit of Insurance (CP 12 30)
Spoilage (CP 04 40)
Value Reporting Form (CP 13 10)
6.5
Equipment Breakdown Coverages ('13)
Equipment breakdown protection coverage form (EB
00 20)
Selected endorsement
Actual cash value (EB 99 59)
6.6
Farm Property
Definitions
Conditions and Exclusions
Coverages
Farm property coverage form ('03)
Livestock coverage form
Mobile agricultural machinery and equipment coverage
form
7.0 COMMERCIAL INLAND MARINE (3%)
7.1
Definitions
Conditions and Exclusions
Coverages (e.g. Transportation, Contractor's Floater,
Equipment)
8.0 BUSINESSOWNERS ('13) POLICY — PROPERTY (6%)
8.1
Characteristics and purpose
8.2
Businessowners Section I — Property
Coverage
Exclusions
Limits of insurance
Deductibles
Loss conditions
General conditions
Optional coverages
Definitions
8.3
Businessowners Section III — Common Policy Conditions
8.4
Selected endorsements
Protective safeguards (BP 04 30)
Utility services — direct damage (BP 04 56)
Utility services — time element (BP 04 57)
9.0 OTHER TYPES OF INSURANCE POLICIES (4%)
9.1
Farmowners/Ranchowners Policy
9.2
Mobile Home Policy
9.3
Flood Insurance
Private vs. NFIP
Eligibility
Coverage
Limits
Deductibles
9.4
Federal Crop (RMA)
9.5
Ocean Marine
Major coverages
Hull insurance
Cargo insurance
Freight insurance
Implied warranties
Perils
General and particular average
9.6
Other policies
Aircraft hull
Boatowners
Difference in conditions
10.0 ADJUSTMENT PROCESS (15%)
10.1
Claim Notification Process
Date of Loss
Location
Parties Involved
10.2
Investigation and Evaluation of Loss/Claim Information
Determination of Applicable Coverage
Inquiry into Relevant Information
Purpose of Loss Reserves
10.3
Remedies for Disputes
Appraisal
Mediation
Arbitration
Litigation
10.4
Finalization of Claim
Denial
Settlement
48
Closing Claim
PENNSYLVANIA MOTOR VEHICLE PHYSICAL DAMAGE
APPRAISER EXAMINATION
SERIES 16-20
100 Items – 200 Minutes
1.0 INSURANCE REGULATION 11%
1.1
Authority of the Insurance Commissioner (63 P.S. § 860)
1.2
Licensing requirements
Qualifications (63 P.S. § 853; 31 Pa. Code Ch. 62.2)
Grounds for license denial (63 P.S. § 856)
Display (63 P.S. § 861)
1.3
Maintenance and duration (63 P.S. § 854)
1.4
Disciplinary actions
Suspensions or revocations (63 P.S. § 855-856)
Fines or imprisonment (63 P.S. § 859)
1.5
Conduct standards (63 P.S. § 861; 31 Pa. Code Ch. 62.3)
1.6
Federal regulation
Fair Credit Reporting Act (15 USC 1681–1681d)
Fraud and false statements (18 USC 1033, 1034)
2.0 INSURANCE BASICS 1%
2.1
Insurance principles and concepts
Insurable interest
Causes of loss (perils)
Direct versus indirect loss
Valuation
Actual cash value
Stated amount
2.2
Common auto policy provisions
Insureds — named, first named, additional
Deductibles
Loss payable clause
Abandonment
Salvage
3.0 AUTO INSURANCE 2%
3.1
Personal auto ('05)
Coverage for damage to your auto
Collision
Other than collision
Deductibles
Transportation expenses
Exclusions
General provisions
Selected endorsements
Miscellaneous type vehicle (PP 03 23)
3.2
Commercial auto ('13)
Section I — Covered autos
Section III — Physical damage
Exclusions
4.0 APPRAISING AUTO PHYSICAL DAMAGE CLAIMS 46%
4.1
Role of the appraiser (63 P.S. § 860; 31 Pa. Code Ch.
62.1)
4.2
Duties of insured after a loss
Notice to insurer
Minimizing the loss
Proof of loss
Inspection and appraisal of vehicle (63 P.S. § 861)
Special requirements
4.3
Determining value and loss
Adjustment procedure
Salvage (31 Pa. Code Ch. 62.3)
Appraisal (31 Pa. Code Ch. 62.3)
Depreciation
Repair or replacement (31 Pa. Code Ch. 62.3)
Repair options and procedures (31 Pa. Code Ch. 62.3)
"Like kind and quality" (31 Pa. Code Ch. 62.3)
Aftermarket parts (31 Pa. Code Ch. 62.1; 62.3)
Partial versus total loss
Constructive total loss
4.4
Vehicle inspection
Proper vehicle identification and options ID (63 P.S.
§861)
Evaluate with regard to circumstances of accident
Estimate of repairs form
4.5
Vehicle parts and construction
Body
Front end
Rear body
Quarter panels
Doors
Roof
Bumpers/urethane repairs
Lamps
Cowl
Firewall
Floor pan
Rocker panels
Pillars
Substructure
Frame
Unibody
Mechanical
Engine
Cooling system
Electrical system/computers
Exhaust system
Fuel system
Heating and air conditioning systems
Brakes/ABS
Steering
Suspension
Transmission
Air bags/SRS (seat belts)
Glass
Tires
Interior
Paint
4.6
Auto arson and fraud
5.0 APPRAISING AUTO PHYSICAL DAMAGE CLAIMS — PRACTICAL
APPLICATIONS 40%
5.1
Vehicle value, loss, parts and construction
Appraisal (31 Pa. Code Ch. 62.3)
Repair or replacement (ex. "like-kind and quality",
49
aftermarket parts) (31 Pa. Code Ch. 62.3)
Partial versus total loss
Constructive total loss
Body
Front end
Rear body
Quarter panels
Doors
Roof
Bumpers/urethane repairs
Lamps
Cowl
Firewall
Floor pan
Rocker panels
Pillars
Frame
Mechanical
Engine
Cooling system
Electrical system/computers
Exhaust system
Fuel system
Heating and air conditioning systems
Brakes/ABS
Steering
Suspension
Transmission
Air bags/SRS (seat belts)
Glass
Tires/wheels
Interior
Seats
Dash
Paint and Finish
Accessories (ex. Graphics, running boards, trailer hitch,
bug screens, auxiliary lighting, tinted glass)
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