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State Regulations by Joseph Donovan, ChFC, CLU

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Syllabus
Course Information
Course title: "State Regulations" - Intermediate Continuing Education
Course number: OLT # INSCE006   
Course description: 2 Hrs. OnLine CE course designed to meet State Continuing Education requirements. (In Maryland the course is worth 1 credit hour.)

No classroom attendance required. The credit is earned in the virtual classroom. This intermediate level State Regulations course is acceptable for all licensed agents and adjusters. The course presents an explanation of the State's regulation of insurance, Unauthorized transactions of insurance, MEWA, out of state health insurance contracts, Unfair Trade Practices Law, Licensee regulation, and Health Insurance Fraud.
Location: Completely online - available through OnLine Training and our resellers.
Meeting day(s): 7 days/week
Meeting time(s): 24 hours/day
Prerequisite(s): You must be a licensed Insurance agent.
Course Goals
Course Goals:

The primary goals of this course include all of the following:

  • To provide the student of insurance with a brief history of insurance and the model legislation dealing with unauthorized transaction of insurance and the unfair trade practices.
  • And to educate the student about prohibited insurance practices and the reporting requirements for licenses.
Course Outcomes
Course Outcomes: The student will pass each exam with a score of 70% or better, and after passing all exams will receive his/her Certificate of Completion.
Course Outline
It is important to note that not all pages are standard 8x11 pages.

A page is the length required to express an idea or subtopic.

Therefore, some pages may consist of only a few sentences.
Syllabus  Minutes
 Module 
Unit One - Definition of Terms 5
A

I. Types of State Insurers

 
A/2
II. Insurance Transaction  
A/3
III. NAIC, ERISA, MEWA  
A/4
III. Licensee Terms  
A/5
Unit Two - States Regulation of Insurance
5

B
I. Historical Overview  
B/2
II. Paul versus Virginia  
B/3

III. SEUA case

 
B/4
IV. McCarran-Ferguson Act  
B/5

V. Financial Modernization Act

  
B/6

VI. State Department of Insurance

  
B/7
VII. Duties & Functions of the Department of Insurance
 
B/8
Unit Three - Unauthorized Transaction of Insurance Act 5
C
I. Introduction  
C/1

II. Definitions

 

C/2

III. Certificate of Authorization Required

 
C/3

IV. Penalties

  1. Penalty for violation by an unauthorized insurer
  2. Penalty for violation by an insurance producer
  

C/4

C/5

V. Primary Methods Used by Unauthorized Entities

 
C/6
Unit Four - Multiple Employer Welfare Arrangement Act (MEWA) 10

D
I. Overview
 
D/1

II. ERISA

 

D/2

III. Multiple Employer Welfare Arrangements (MEWA)

  

D/3

IV. Group Welfare Benefit Plans

  

D/4

V. Other Plans that are State Regulated

  

D/5
VI. MEWA Requirements
 
D/6

Unit Five - Out-of-State Health Insurance Contracts

 5
E

I. Introduction

 
E/1

II. Out-of-State Insurance Contract Requirements

  

E/2

III. Group Contract Exceptions

  1. Employee Groups
  2. Associations
  3. Credit Unions
  4. Blanket Health Insurance Groups
  5. Franchise Group Health Contracts
  

 

E/3
Unit Six - Unfair Trade Practices Law 25

F
I. Introduction
 
F/1

II. Misrepresentations & False Advertising of Insurance Policies

 

F/2

III. False Statements & Enteries

  

F/3

IV. Unfair Discrimination

 

F/4
V. Unfair Claim Settlement Practices
 
F/5

VI. Misrepresentation in Insurance Applications

 
F/6

VII. Free Insurance Prohibited

 

F/7

VIII. False Claims for Obtaining or Retaining Insurance Funds

  

F/8
VIIII. Refusal to Insure
 
F/9

X. Prohibited Marketing Practices

 

F/10

F/11

XI. Policyholders Bill of Rights

 

F/12

XII. Use of Credit Reports in Insurance

 

F/13
Review
15  
Unit Seven - Licensee Regulation 15

G
I. Licensee Reporting Requirements
 
G/2

II. Grounds for Compulsory Suspension or Revocation of License

 

G/3

III. Grounds for Discretionary Suspension or Revocation of License

 

G/4

IV. Licensing Regulation

 

G/5
V. Unlicense Transactions Prohibited
 
G/6

Unit Eight - Health Insurance Fraud

 20
H

I. Anti-fraud Insurance Law

  
H/2

II. Health Insurance Fraudulent Practices

  1. Definition of Terms
  2. What the GOA Investigation Found
  3. How the Data was Developed
  4. Characteristics of the Entities
  5. Unauthorized Entities
  6. Background Information
  

H/3

H/4 - H/9
Final Exam - for grade
15  
COURSE TOTALS
 2 hours  
Instructor Information
Name: Joseph Donovan
Email: donovan@oltraining.com
Office location: 2669 Forest Hill Blvd Ste. 207, WPB, FL 33406
Office hours: Call for an Appointment
Phone: 561-283-0333 or toll free 866-357-0841
Biography: Joseph Donovan, ChFC, CLU has been in the insurance industry for the last twenty years and has been an insurance instructor for the last eighteen. He holds a Master of Science degree in Financial Services (MSFS) from the American College in Bryn Mawr, PA. Besides being an insurance CE course provider and instructor he is currently an adjunct professor for Palm Beach Community College in Florida.

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Last Updated: June 19th, 2008 by Maria Torres-Arbona