Oregon Health Insurance Pre-License Course (20 Hr)

This course will provide health insurance licensing candidates in Oregon with the materials needed to successfully prepare for the health license examination. This 20-hour course covers all of the topics included within the Oregon Candidate Information Bulletin, and will give the student a solid base of knowledge and understanding for the license examination.

This updated course includes many illustrations, examples, and quizzes associated with the state test, and provides a well-rounded approach to test preparation. The topics covered in the course begin with the basics of Health insurance, and introduce the candidate to terms, definitions and concepts that are the foundation of health insurance coverage. The course continues with information on individual health insurance policy provisions that are included within the policies. Disability Income contracts are discussed, with an emphasis on coverage and associated benefits and provisions. The medical plans that are available in the state are detailed, along with terms and concepts related to health insurance contracts. Group insurance is deeply explored and contains information on group policyowners, how employees are insured, the requirements of group insurance compared to individual policies, and how groups may be legally formed, among other pieces of information.

Dental insurance is covered, including how the Affordable Care Act mandates coverage for children. The course next dives into insurance coverage for senior citizens, and the lessons explain the coverages, mandates, legal requirements, and protections offered to senior citizens. The course begins to conclude with tax information related to health insurance.The course includes material on everything necessary to successfully prepare for the exam:

• Health Insurance Basics, including types of products and benefits, types of policies, exclusions and producer responsibilities and individual underwriting.
• Individual Health Insurance Policy General Provisions: Uniform required and optional provisions and other general provisions.
• Disability Income Insurance, including qualifying for benefits, individual disability underwriting/unique aspects, occupational and nonoccupational considerations, and riders and other cash benefits.
• Medical plans include medical plan concepts, types of providers and medical plans, health care reform: Patient Protection and Affordable Care Act (PPACA), the Health Insurance Exchange and SHOP Marketplace and Health Insurance Portability and Accountability Act (HIPAA).
• Group Health insurance. This lesson includes the purpose of group insurance,types of eligible groups, marketing considerations, employer group health insurance, the coordination of benefits provision, and small employer medical plans.
• Specialized Health Insurance for Qualified Individuals: This lesson includes material on Medicare and Medicaid, Medicare Supplements/Medigap plans, other options for people with Medicare, Long-term care insurance policies, Qualified long-term care plans, and exclusions and conditions.
• Federal Tax Considerations for Health Insurance: Personally-owned health insurance, employer group health insurance, medical expense for sole proprietors and partners, Health Savings Accounts and Health Reimbursement Accounts and business disability insurance.
• General Insurance includes material on concepts, methods of handling risk including elements of an insurable risk, adverse selection and the Law of Large Numbers, Producers and general rules of agency, contracts and required elements, the distinct characteristics of insurance contracts and more.

The course will also contain material on the laws and rules that are mandated in Oregon for insurance producers, insurance companies, and others in the insurance business. In the lessons for laws and rules, the course covers insurance regulation in Oregon, general insurance concepts, terms and definitions, and material specific to health insurance laws and rules.

• Oregon Insurance Regulation: Licensing and purpose, maintenance and duration of license, including continuing education requirements and renewal procedures, state regulations, unfair trade practices and more,
• Federal regulation, including the Fair Credit Reporting Act, Fraud and False Statements U.S. Civil Code Sections 1033 and 1034, Privacy and the Gramm-Leach-bliley Act, the Affordable Care Act, the National Do-Not-Call Registry and the CAN-SPAM Act.
• Laws and rules specific to health insurance, such as disclosures, marketing and advertising concerns, licensing requirements, state rules that regulate provisions found in health insurance policies and more.

Each lesson will include a practice examination with complete explanations and details to help the student retain information. There is a 100 question final examination designed to mimic the state examination, and must be successfully completed in order to receive credit for the course.

Credit Type: Health

Course ID(s): 10015026 (PL)

Approved By: Oregon Higher Education Coordinating Commission (HECC)