Exam terms

Texas Life & Health Insurance License exam terms

489 terms to know, grouped by exam module. Each links to its definition and the lesson that uses it.

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Types of life insurance policies

Policy riders, provisions, options, and exclusions

Completing the application, underwriting, and delivering the policy

Actual delivery Used in Policy delivery and explaining the contract to the client
Aleatory contract Used in Insurance contract law and its unique characteristics
Anti-money-laundering (AML) program Used in USA PATRIOT Act, anti-money-laundering, and Gramm-Leach-Bliley privacy
Assignment Used in Insurance contract law and its unique characteristics
Attending physician's statement Used in Underwriting: insurable interest, medical information, and risk classification
Binding receipt (temporary insurance agreement) Used in Collecting the initial premium and issuing the receipt
Cash on delivery Used in Collecting the initial premium and issuing the receipt
Clean sheeting Used in Application mechanics: signatures, changes, and incomplete applications
Competent parties Used in Insurance contract law and its unique characteristics
Conditional contract Used in Insurance contract law and its unique characteristics
Conditional receipt (insurability type) Used in Collecting the initial premium and issuing the receipt
Consideration Used in Insurance contract law and its unique characteristics
Constructive delivery Used in Policy delivery and explaining the contract to the client
Contract of adhesion Used in Insurance contract law and its unique characteristics
Delivery receipt Used in Policy delivery and explaining the contract to the client
Entire contract provision Used in Policy delivery and explaining the contract to the client
Exclusion rider Used in Policy delivery and explaining the contract to the client
Flat extra Used in Underwriting: insurable interest, medical information, and risk classification
Free-look period Used in Policy delivery and explaining the contract to the client
Health information authorization Used in Replacement and point-of-sale disclosures (HIPAA, HIV consent)
Insurable interest Used in Underwriting: insurable interest, medical information, and risk classification
Integration Used in USA PATRIOT Act, anti-money-laundering, and Gramm-Leach-Bliley privacy
Layering Used in USA PATRIOT Act, anti-money-laundering, and Gramm-Leach-Bliley privacy
Legal purpose Used in Insurance contract law and its unique characteristics
Non-guaranteed elements Used in Policy delivery and explaining the contract to the client
Nonpublic personal information (NPI) Used in USA PATRIOT Act, anti-money-laundering, and Gramm-Leach-Bliley privacy
Opt-out (GLBA) Used in USA PATRIOT Act, anti-money-laundering, and Gramm-Leach-Bliley privacy
Personal contract Used in Insurance contract law and its unique characteristics
Placement Used in USA PATRIOT Act, anti-money-laundering, and Gramm-Leach-Bliley privacy
Premium rating Used in Policy delivery and explaining the contract to the client
Proposed insured Used in Application mechanics: signatures, changes, and incomplete applications
Replacement Used in Replacement and point-of-sale disclosures (HIPAA, HIV consent)
Replacement notice Used in Replacement and point-of-sale disclosures (HIPAA, HIV consent)
Risk classification Used in Underwriting: insurable interest, medical information, and risk classification
Statement of continued good health Used in Policy delivery and explaining the contract to the client
Strike and initial Used in Application mechanics: signatures, changes, and incomplete applications
Substandard (rated) Used in Underwriting: insurable interest, medical information, and risk classification
Suspicious activity reporting Used in USA PATRIOT Act, anti-money-laundering, and Gramm-Leach-Bliley privacy
Table rating Used in Underwriting: insurable interest, medical information, and risk classification
Twisting Used in Replacement and point-of-sale disclosures (HIPAA, HIV consent), Policy delivery and explaining the contract to the client
Unfair discrimination Used in Underwriting: insurable interest, medical information, and risk classification
Unilateral contract Used in Insurance contract law and its unique characteristics
Utmost good faith Used in Insurance contract law and its unique characteristics

Retirement and other insurance concepts

Types of health and accident insurance policies

Health policy provisions, clauses, and riders

Social insurance

Currently insured Used in Social Security benefits (disability and retirement)
Delayed retirement credits Used in Social Security benefits (disability and retirement)
Disability insured Used in Social Security benefits (disability and retirement)
Dual eligible Used in Medicaid
End-stage renal disease Used in Medicare Parts A, B, C, and D
Estate recovery Used in Medicaid
Full retirement age (FRA) Used in Social Security benefits (disability and retirement)
Fully insured Used in Social Security benefits (disability and retirement)
Late-enrollment penalty Used in Medicare Parts A, B, C, and D
Look-back period Used in Medicaid
MA-PD plan Used in Medicare Parts A, B, C, and D
Mandatory eligibility groups Used in Medicaid
Maximum family benefit Used in Social Security benefits (disability and retirement)
Medicaid Used in Medicaid
Medically needy Used in Medicaid
Medicare Part A Used in Medicare Parts A, B, C, and D
Medicare Part B Used in Medicare Parts A, B, C, and D
Medicare Part C (Medicare Advantage) Used in Medicare Parts A, B, C, and D
Medicare Part D Used in Medicare Parts A, B, C, and D
OASDI Used in Social Security benefits (disability and retirement)
Original Medicare Used in Medicare Parts A, B, C, and D
Quarters of coverage Used in Social Security benefits (disability and retirement)
Retirement earnings test Used in Social Security benefits (disability and retirement)
Spousal impoverishment protection Used in Medicaid
State plan Used in Medicaid
Substantial gainful activity Used in Social Security benefits (disability and retirement)

Other insurance concepts

Allowable expense Used in Nonduplication and coordination of benefits
Any occupation Used in Disability classifications: total, partial, recurrent, and residual
Assigned risk plan Used in Workers' compensation
Automatic premium withdrawal Used in Modes of premium payment
Benefit period Used in Disability classifications: total, partial, recurrent, and residual
Birthday rule Used in Nonduplication and coordination of benefits
Capitation Used in Managed care concepts
Children's term rider Used in Dependent children benefits
Class designation Used in Primary and contingent beneficiaries
Collateral assignment Used in Owner's rights
Contingent (secondary) beneficiary Used in Primary and contingent beneficiaries
Conversion privilege Used in Dependent children benefits
Coordination of benefits Used in Nonduplication and coordination of benefits
Cost basis Used in Tax treatment of premiums and proceeds
Double recovery Used in Subrogation
Elimination (waiting) period Used in Disability classifications: total, partial, recurrent, and residual
Employers liability (Part Two) Used in Workers' compensation
EPO (exclusive provider organization) Used in Managed care concepts
Exclusion ratio Used in Tax treatment of premiums and proceeds
Exclusive remedy Used in Workers' compensation
Experience modification factor Used in Workers' compensation
Family policy Used in Dependent children benefits
Free-look period Used in Owner's rights
Grace period Used in Modes of premium payment
HMO (health maintenance organization) Used in Managed care concepts
Irrevocable beneficiary Used in Owner's rights
Limiting age Used in Dependent children benefits
List billing Used in Modes of premium payment
Modal premium Used in Modes of premium payment
No-fault Used in Workers' compensation
Non-occupational coverage Used in Occupational versus non-occupational classification
Nonduplication of benefits Used in Nonduplication and coordination of benefits
Occupational coverage Used in Occupational versus non-occupational classification
Own occupation Used in Disability classifications: total, partial, recurrent, and residual
Partial disability Used in Disability classifications: total, partial, recurrent, and residual
Payor benefit rider Used in Dependent children benefits
Policyowner Used in Owner's rights
POS (point of service) plan Used in Managed care concepts
PPO (preferred provider organization) Used in Managed care concepts
Preauthorization Used in Managed care concepts
Premium payment mode Used in Modes of premium payment
Presumptive disability Used in Disability classifications: total, partial, recurrent, and residual
Primary beneficiary Used in Primary and contingent beneficiaries
Primary care physician (PCP) Used in Managed care concepts
Primary plan Used in Nonduplication and coordination of benefits
Recurrent disability Used in Disability classifications: total, partial, recurrent, and residual
Residual (partial) disability Used in Disability classifications: total, partial, recurrent, and residual
Revocable beneficiary Used in Primary and contingent beneficiaries
Settlement option Used in Owner's rights
Subrogation Used in Subrogation
Tax-deferred Used in Tax treatment of premiums and proceeds
Tertiary beneficiary Used in Primary and contingent beneficiaries
Third-party ownership Used in Owner's rights
Total disability Used in Disability classifications: total, partial, recurrent, and residual
Utilization review Used in Managed care concepts
Waiver of subrogation Used in Subrogation
Workers' compensation Used in Workers' compensation

Field underwriting procedures

Texas statutes common to life and health insurance

Texas statutes for life insurance

Automatic (default) nonforfeiture benefit Used in Nonforfeiture law
Bona fide group Used in Group life insurance rules
Buyer's Guide Used in Life insurance marketing, advertising, and the buyer's guide
Cash surrender value Used in Nonforfeiture law
Certificate of insurance Used in Group life insurance rules
Churning Used in Replacement duties for life insurance
Conservation Used in Replacement duties for life insurance
Continuation and conversion Used in Group life insurance rules
Credit disability insurance Used in Credit life insurance
Credit life insurance Used in Credit life insurance
Creditor Used in Credit life insurance
Debtor Used in Credit life insurance
Decreasing term Used in Credit life insurance
Entire contract provision Used in Individual life policy provisions, free look, and grace period
Evidence of insurability Used in Individual life policy provisions, free look, and grace period
Extended term insurance Used in Nonforfeiture law
Free look Used in Individual life policy provisions, free look, and grace period
Grace period Used in Individual life policy provisions, free look, and grace period
Incontestability Used in Individual life policy provisions, free look, and grace period
Insured member Used in Group life insurance rules
Internal replacement Used in Replacement duties for life insurance
Lapse Used in Individual life policy provisions, free look, and grace period
Master policy Used in Group life insurance rules
Misstatement of age Used in Individual life policy provisions, free look, and grace period
Nonforfeiture Used in Nonforfeiture law
Nonguaranteed elements Used in Life insurance marketing, advertising, and the buyer's guide
Paid-up nonforfeiture benefit Used in Nonforfeiture law
Policy Summary Used in Life insurance marketing, advertising, and the buyer's guide
Policyholder Used in Group life insurance rules
Reduced paid-up insurance Used in Nonforfeiture law
Reinstatement Used in Individual life policy provisions, free look, and grace period
Replacement Used in Replacement duties for life insurance
Replacement notice Used in Replacement duties for life insurance
Right to return the policy Used in Life insurance marketing, advertising, and the buyer's guide
Table of guaranteed values Used in Nonforfeiture law
Total impression standard Used in Life insurance marketing, advertising, and the buyer's guide
Twisting Used in Replacement duties for life insurance

Texas statutes for accident and health insurance

Texas statutes for HMOs

Basic health care services Used in HMO definitions and evidence of coverage
Cancellation Used in HMO nonrenewal, cancellation, and enrollment
Certificate of authority Used in HMO definitions and evidence of coverage
Clean claim Used in HMO out-of-network claims
Complaint and appeal system Used in HMO nonrenewal, cancellation, and enrollment
Continuity of care Used in HMO out-of-network claims
Cost sharing Used in HMO out-of-network claims
Emergency care Used in HMO out-of-network claims
Enrollee Used in HMO definitions and evidence of coverage
Evidence of coverage Used in HMO definitions and evidence of coverage
Grace period Used in HMO nonrenewal, cancellation, and enrollment
Group contract termination Used in HMO nonrenewal, cancellation, and enrollment
Health care plan Used in HMO definitions and evidence of coverage
Health maintenance organization (HMO) Used in HMO definitions and evidence of coverage
Limited health care service Used in HMO definitions and evidence of coverage
Loss of eligibility Used in HMO nonrenewal, cancellation, and enrollment
Material misuse Used in HMO nonrenewal, cancellation, and enrollment
Nonrenewal Used in HMO nonrenewal, cancellation, and enrollment
Participating provider Used in HMO out-of-network claims
Preauthorization Used in HMO out-of-network claims
Prompt-pay law Used in HMO out-of-network claims
Service area Used in HMO definitions and evidence of coverage
Single health care service plan Used in HMO definitions and evidence of coverage

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