This course will provide health insurance licensing candidates in Washington with the materials needed to successfully prepare for the health license examination. This 20-hour course covers all of the topics included within the Washington 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 General Insurance, which includes common terminology, concepts of coverage and additional associated information. The course continues with the basics of disability, accident and health insurance, and introduces the candidate to terms, definitions and concepts that are the foundation of health insurance coverage. Then, we’ll continue with information on individual health insurance policy provisions that are included within the policies, many of which are required to be included by law.
Individual and group 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 disability, accident and 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.
The course next dives into insurance coverage for specialized individuals and explores Medicare, Medicaid, Long-Term Care, Medicare Supplements and other policies.The lesson details the coverages, mandates, legal requirements, and protections offered to purchasers of these policies. The course begins to conclude with tax information related to health insurance for individual and group[ coverage, tax-favored plans such as Health Savings Account, Health Reimbursement Accounts and others.
The final lessons in this course will introduce the licensing candidate to laws and rules that apply to all license categories and those specific to disability, accident and health insurance.
The course includes material on everything necessary to successfully prepare for the exam:
- 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
- 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 Plans 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;
- Insurance Regulation: Licensing and purpose, maintenance and duration of license, including continuing education requirements and renewal procedures, state regulations, unfair trade practices,
- Federal laws and Regulations: Federal laws and rules related to the Fair Credit Reporting Act, Prohibited Persons in Insurance, the Affordable Care Act, Privacy issues through the Gramm-Leach-Bliley Act, the National Do Not Call list, and the CAN-SPAM Act.
- Laws and rules specific to health insurance, such as disclosures, marketing and advertising concerns, licensing requirements, and state rules that regulate provisions found in health insurance policies.
The course will also contain material on the laws and rules that are mandated in Washington for insurance producers, insurance companies, and others in the insurance business. In the lessons for laws and rules, the course covers insurance regulation in Washington, general insurance concepts, terms and definitions, and material specific to health insurance laws and rules.
Each lesson will include a practice examination with complete explanations and details to help the student retain information. There is a 125 question final examination designed to mimic the state examination, and must be successfully completed in order to receive credit for the course.
Course Format: Text
- Module 1
- Insurance Regulation [6 Activities]
- 01. Washington Insurance Laws, Rules, and Regulations
- 02. The Insurance Commissioner
- 03. Terms, Conditions, and Concepts
- 04. Licensing
- 05. Marketing Practices
- 06. Producer Responsibilities
- Incremental Quiz 1 (40 questions)
- Insurance Regulation [6 Activities]
- Module 2
- Federal Laws and Regulations [5 Activities]
- 01. Federal Laws and Regulations
- 02. Fair Credit Reporting Act; the ??FCRA?? and Purpose (Title VI of the Consumer Credit Protection Act)
- 03. Fraud and False Statements (18 USC ?? 1033 and ?? 1034)
- 04. National Do Not Call List (15 US Code 6151-6155)
- 05. Federal Laws and Regulations: Conclusion
- Incremental Quiz 2 (10 questions)
- Federal Laws and Regulations [5 Activities]
- Module 3
- General Insurance [5 Activities]
- 01. General Insurance Concepts
- 02. Concepts and Risk Management Key Terms
- 03. Elements of an Insurable Risk
- 04. Producers and the General Rule of Agency
- 05. Legal Interpretations Affecting Insurance Contracts
- Incremental Quiz 3 (8 questions)
- General Insurance [5 Activities]
- Module 4
- Accident and Health Insurance Basics [10 Activities]
- 01. Introduction to Accident and Health Insurance Basics
- 02. Definitions
- 03. Principal Types of Losses and Benefits
- 04. Types of Health Insurance Policies: Part One
- 05. Limited Coverage Policies
- 06. Types of Health Insurance Policies: Part Two
- 07. Underwriting
- 08. Field Underwriting: Varies by Insurer
- 09. Individual Underwriting by the Insurer
- 10. Conclusion
- Incremental Quiz 4 (20 questions)
- Accident and Health Insurance Basics [10 Activities]
- Module 5
- Individual Health Insurance Provisions, Options and Riders [7 Activities]
- 01. Health Policy Provisions, Options and Riders: General Provisions
- 02. Uniform Policy Provisions
- 03. Other General Provisions
- 04. Other General Provisions - Part 1
- 05. Deductibles and Other General Provisions
- 06. Riders
- 07. Conclusion
- Incremental Quiz 5 (14 questions)
- Individual Health Insurance Provisions, Options and Riders [7 Activities]
- Module 6
- Disability Income Insurance [18 Activities]
- 01. Introduction to Disability Income
- 02. Disability Income
- 03. Definitions and Concepts
- 04. Additional Definitions
- 05. Qualifying for Disability Benefits
- 06. Qualifying for Disability Benefits
- 07. Different Types of Disability Coverage
- 08. Different Types of Disability Coverage
- 09. Group and Individual Disability Income Insurance
- 10. Group and Individual Disability Income Insurance
- 11. Other Provisions Affecting Income Benefits
- 12. Group Disability Insurance
- 13. Unique Aspects of Disability Underwriting
- 14. Unique Aspects of Disability Underwriting
- 15. Social Security Disability
- 16. Social Security Disability Income (SSDI)
- 17. Business Disability Income Insurance Coverages
- 18. Conclusion
- Incremental Quiz 6 (15 questions)
- Disability Income Insurance [18 Activities]
- Module 7
- Medical Plans [13 Activities]
- 01. Introduction to Medical Plans
- 02. Medical Plan Concepts
- 03. Types of Providers and Plans
- 04. Types of Providers and Plans
- 05. Managed Care
- 06. Managed Care
- 07. Major Medical Insurance
- 08. Cost Containment in Health Care Delivery
- 09. Cost Containment in Health Care Delivery
- 10. Patient Protection and Affordable Care Act
- 11. Patient Protection and Affordable Care Act (PPACA)
- 12. Health Insurance Portability and Accountability Act: HIPAA
- 13. Conclusion
- Incremental Quiz 7 (20 questions)
- Medical Plans [13 Activities]
- Module 8
- Group Health Insurance [8 Activities]
- 01. Introduction to Group Health Insurance Policies
- 02. Group Insurance Concepts
- 03. Group Insurance Concepts Review
- 04. Group Plan Characteristics
- 05. Group Plan Characteristics
- 06. Eligibility, Enrollment and Continuation of Coverage
- 07. Group Conversion
- 08. Conclusion
- Incremental Quiz 8 (20 questions)
- Group Health Insurance [8 Activities]
- Module 9
- Specialized Plans for Qualified Individuals [18 Activities]
- 01. Introduction to Insurance for Special Needs Qualified Individuals: Medicare
- 02. Medicare: An Overview
- 03. Introduction to Medicare
- 04. Part C: Medicare Advantage (MA) Plans
- 05. Part D Prescription Drug Plan
- 06. Medicare Supplement/Medigap Plans
- 07. Medicare Conclusion
- 08. Introduction to Long-Term Care Insurance and Medicaid
- 09. Introduction to Long-Term Care Insurance (LTC)
- 10. Introduction to Long-Term Care Insurance, Levels of Care and Riders
- 11. Levels of Care and Optional Benefits and Riders
- 12. Other LTC Attributes
- 13. Marketing Rules and Policy Exclusions
- 14. Suitability
- 15. Levels of Care, Riders, Marketing and Options
- 16. Tax-Qualified, Long-Term Care Partnership Contracts, and Medicaid
- 17. Medicaid
- 18. Conclusion
- Incremental Quiz 9 (20 questions)
- Specialized Plans for Qualified Individuals [18 Activities]
- Module 10
- Federal Taxation Health Insurance [7 Activities]
- 01. Federal Tax Health
- 02. Health Insurance Taxes
- 03. Rule of Thumb
- 04. Health Insurance Taxation
- 05. Health Savings Accounts and Other Tax-Favored Health Plan Tax Features
- 06. Health Savings Accounts and Other Tax-Favored Health Plan Tax Features
- 07. Conclusion
- Incremental Quiz 10 (14 questions)
- Federal Taxation Health Insurance [7 Activities]
- Module 11
- Disability, Accident and Health Insurance Specific Law and Rule [8 Activities]
- 01. Washington Disability, Accident and Health Insurance Laws, Rules and Regulations: Introduction
- 02. Marketing Methods and Practices: Outline of Coverage/Disclosure (WAC 284-50-410 to 440)
- 03. Medicare Supplement Health Insurance Act (WAC 284-66-010, 020)
- 04. Long-Term Care Education Requirements (RCW 48.83.130, WAC 284-17-262, 264)
- 05. Health Care False Claims Act (RCW 48.80.010, 020, 030)
- 06. Policy Clauses, Exclusions and Provisions
- 07. Federal Laws: Fair Credit Reporting Act: The FCRA
- 08. Examples of Disclosure Statements
- Incremental Quiz 11 (15 questions)
- Disability, Accident and Health Insurance Specific Law and Rule [8 Activities]
- Module 12
- Final Exam (125 questions)
- Course Certificate

