LOMA 280
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LOMA 280
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LOMA 280
Chapter 1 Introduction to Risk and Insurance
Risk
Speculative Risk
Pure Risk
loss or no loss
Manage Financial Risk
Avoiding the risk
Controlling the risk
Transferring the risk
Purchase insurance coverage
Accepting the risk
Type of risks
Personal Risk
Property damage risk
Liability risk
Type of Life Insurance Product
Term life insurance
Cash value life insurace
Endowment insurace
Type of Health Insurance Product
Medical expense insurance
Disability income coverage
Long-term care insurace
Characteristics of Insurable Risk
The loss must occur by chance
The loss must be definite
The loss must be significant
The loss rate must be predictable
mortality tables
morbidity tables
The loss must not be catastrophic to the insurer
Antiselection
Underwriting
Identifying risks
Classifying Risks
Risk Class
standard risks
preferred risks
substandard risks
declined risks
Insurable Interest
Chapter 2 The Life and Hleath Insurance Industry
Types of business organization
Sole proprietorship
Partnership
Corporation
Types of Insurance Company Organizations
Stock Insurance Companies
Mutual Insurance Companies
Owned by its police owner
Fraternal Benefit Societies
Financial Instituions
Insurance Companies
Depository institutions
Finance companies
Securities firms
Mutual fund companies
Evolution of the Financial Services Industry
Convergence
Consolidation
merger
acquistition
Globalization
Role of Government in Insurance
Social Insurance Program
US
Medicare
for elderly and people with qualifying disabilities
Medicaregap
supplement for Medicare
Regulation of Insurance
NAIC
Two Primary Goals of Insurance
Solvency Regulation
Assets = Liabilities + Owner's Equity
Owner's Equity = Capital + Surplus
Market Conduct Regulation
Taxation
Chapter 3 The Insurance Contract
Types of Contracts
Formal or informal Contracts
life and health insurance contracts are informal contracts
Bilateral or unilateral contracts
Life and health insurance are unilateral contracts
Commutative or aleatory contracts
Life and health insurance policies are aleatory contracts
Bargaining contracts or contracts of adhesion
Life and health contract are contracts of adhesion
General Requirements of Contract
The parties to the contract mush have contractual capacity
The parties to the contract mush exchange legally adequate consideration
The contract mush be for a lawful purpose
legal status of a contract
Valid
Void
Voidable
Chapter 4 Life Insurance Premiums
The legal Reserve System
Establishing Premium Rates
Ensure the premium rate are
Adequate
Equitable
Not excessive
Factors
The cost of benefits
Operating expenses
Investment earning
The Level Premium System
Chapter 5 Term life Insurance
Needs met b Life Insurance
Personal Needs
Dependents' Support
Debts and Final Expenses
Business Needs
Business Continuation Insurance
Key Person Life Insurance
Buy-Sell Agreements
Employee Benefits
Term Life Insurance
the death benefit is payable only if
the insured dies during the policy term
Plans of term life insurance coverage
level term life insurance
Decreasing term life insurance
Mortgage Life Insurance
Joint mortgage life insurance
Credit Life Insurance
Family Income Coverage
Increasing Term Life Insurance
Features of term life insurance policies
Renewable term insurance
without evidence of insurability
attained age
yearly renewable term(YRT) insurance
Convertible Term Insurance
Convert to cash value life insurance without evidence of insurability
Conversion Types
attained age conversion
original age conversion
Return of premium(ROP) term insurance
Chapter 6 Cash Value Life Insurance and Endowment Insurance
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Premium payment periods
Continuous-Premium policies
Limited-Payment policies
paid-up policy
no further premium payment but continues to provide coverage
Single-Premium Policies
Modified Whole Life Insurance
Modified Premium
Modified Coverage
Whole Life Insurance Covering more than one Insured
Joint Whole Life Insurance
Last Survivor Life Insurance
two people obtain insurance and cost is less than the Joint whole life Insurance
Family Policies
Universal Life Insurance
Separation of Policy Elements
Mortality Charges
Interest Rate
Expenses
Death Benefit
Option A Plan
the amount of the death benefit is level equal to the face amount
Option B Plan
The amount of the death benefit is equal to the policy face amount plus the amount of the cash value
Premiums
Flexible-premium
Fixed-premium
Indexed Universal Life Insurance
offer the possibility of additional earnings based on changes in a published index
fixed account & index account
Variable Life Insurance
Variable Universal Life Insurance
Compare above life insurance
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Endowment Insurance
maturity date
Chapter 7 Supplemental Benefits
Supplemental Disability Benefits
The waiver of premium for disability benefit
The waiver of premium for payor benefit
The disability income benefit
Accident Benefits
Accidental Death Benefit
Accidental Death and Dismemberment Benefit
Accelerated Death Benefits
Terminal illness Benefit
Dread Disease Benefit
Long-Term Care Insurance Benefit
Benefits for Additional Insureds
Spouse Insurance Rider
Children's Insurance Rider
Second Insured Rider
Insurability Benefits
Guaranteed Insurability Benefit
Paid-Up Additions Option Benefit
Chapter 8 Individual Life Insurance Policy Provisions
Standard Policy Provisions
Free-Look Provision
Entire Contract Provision
Closed contract
Most individual life insurance policies are close contract
open contract
Incontestability Provision
Material Misrepresentation
Grace Period Provision
Reinstatement Provision
Misstatement of Age or Sex Provision
Provision Unique to Cash Value Policies
Policy Loans and Policy Withdrawals
Nonforfeiture Provision
Cash Payment Nonforfeiture Option
surrender charge
net cash surrender value
Continued Insurance Coverage nonforfeiture Options
Reduced Paid-Up Insurance
Extended Term Insurance
Automatic Premium Loan Option
Life Insurance Policy Exclusions
suicide exclusion provision
war exclusion clause
hazardous activities exclusion provision
aviation exclusion provision
Chapter 9 Life Insurance PolicyOwnership Rights
Naming the Beneficiary
Primary and Contingent Beneficiaries
Changing the Beneficiary
right of revocation
Revocable Beneficiary
vested interest
Irrevocable Beneficiary
Mode of Premium Payment
Policy Dividends
participating policy
dividend options
cash
premium reduction
policy loan repayment
accumulation at interest
paid-up additional insurance
additional term insurance
nonparticipating policy
Transfer of Policy Ownership
assignment
Absolute Assignment
Collateral Assignment
Assignment Provision
Transfer of Ownership by Endorsement
Death of the policyowner
Right to Receive Policy Proceeds
Identifying who is entitled to policy proceeds
No Surviving Beneficiary
Insured and Beneficiary Die in a Common Disaster
simultaneous death act: Insured is deemed to have survived the beneficiary
survivorship clause
Beneficiary Wrongfully kills the insured
Calculating the Amount of the Policy Proceeds
+death benefit payable
+accidental death benefits payable
+declared but unpaid policy dividends
+accumulated policy dividends
+paid-up additions
+unearned premiums paid in advance
-outstanding policy lands
-premium due and unpaid
Paying Policy Proceeds under a Settlement Option
Interest Option
Fixed Period Option
Fixed Amount Option
Life Income Option
Chapter 10 Introduction to Annuities
Term
Individual annuity
Group annuity
annuitant
payee
beneficiary
annuity start date
payout period
annuity period
Types of Annuity Contracts
Immediate and Deferred Annuities
Single-Premium and Flexible-Premium Annuities
Fixed and Variable Annuities
fixed
guaranteed minimum interest-crediting rate
current interest-crediting rate
variable
subaccounts and fixed accounts for variable deferred annuities
Accumulation Units for variable deferred annuities
Other Types of Fixed Anunuities
Deferred Income Annuities and longevity annuity
Fixed Indexed Annuities
Annuity Contract Provision
Standard Annuity Contract Provisions
entire contract provision
free-look provision
incontestability provision
misstatement of age or sex provision
dividends provision
Standard deferred Annuity Contract Provisions
withdrawal provision
market-value-adjusted annuity
death benefit
Chapter 11 Annuities and IndividualRetirement Arrangements
Annuity Options
Lump-Sum Distribution
Fixed Period Annuity
Fixed Amount Annuity
Life Annuities
life only annuity
joint and survivor annuity
life income with period certain annuity
life income with refund annuity
Annuity Guarantee Riders
Guaranteed Minimum Death Benefit Riders
Guaranteed Living Benefit Riders
Guaranteed lifetime withdrawal benefit
Guaranteed minimum income benefit
Guaranteed minimum withdrawal benefit
Guaranteed minimum accumulation benefit
Financial Aspects of Annuities
Determining Annuity Payment Amounts
Determining Annuity Payment for Fixed single premium immediate annuity
angle premium/ 1000 * payout factor
Determining Annuity payments for Fixed Deferred annuity
accumulated value / 1000 * payout factor
Determining Annuity Payments for variable annuities
Fees and Charges for Annuities
Contract fee and contract maintenance fee
Front-end load
Surrender charge or contingent deferred sales charge
service fee
Mortality and expense risks charge
Fund operating expense charge
Taxation of Annuities
A qualified annuity
tax-advantaged retirement plan or IRA
taxed in accordance with the tax law that apply to these plan or IRA
A non qualified annuity
Individual Retirement Arragement
individual retirement account/individual retirement annuity
traditional individual retirement arrangement(traditional IRA) / Roth individual retirement arrangement (Roth IRA)
Chapter 12 Health Insurance Product
Medical Expense Coverage
traditional medical expense insurance policies
basic medical expense coverage
first-dollar coverage
major medical expense coverage
expense participation Requirement
deductible
coinsurance
maximum out-of-pocket provision
Exclusion
Cosmetic surgery/Military/self-inflicted injuries/treatment paid by government/dental/eye/corrective lense
other medical expense coverage
Dental expense coverage
Prescription drug coverage
Vision care coverage
government-sponsored medical expense coverage
to people age 65 and older and those with certain disabilities
frequently purchase supplemental Medicare coverage
Medicard
to low-income individuals and to certain elderly and disable individuals
managed care plan
Managing Access to Health care services
Primary care provider
Managing the Cost of Health care Services
copayment
Types of managed care plan
Health maintenance organization
preferred provider organization
point-of-service plan
consumer-driven health plans
key component
financial incentives
information
some are accompanied by a High-deductible health plan
Forms
health savings accounts
tax advantaged
Both employee and the employer can contribute
health reimbursement arrangements
employer-sponsored
health care flexible spending accounts
employer0sonsored
Compare
The patient Protection and Affordable Care Act
health insurance exchange
Disability Income Coverage
Types
Short-term individual disability income coverage
Long-term individual disability income coverage
short-term group disability income coverage
long-term group disability income coverage
Total Disablility
Any occupation
Current Usual Definition
Own previous occupation
Presumptive Disablities
Elimination Period
Benefit Amounts
Income Benefit Formula
Flat benefit amount
Supplemental Disability Benefit
Partial Diability Benfefits
Future purchase Option Benefit
Cost-of-living-adjustment Benefit
Specialized Types of Disability Coverage
Long-Term care coverage
Important Features
Benefit Triggers
Chapter 13 Principles of Group Insurance
Contracts
Certificate of Insurance
Eligibility Provision
probationary period
eligibility period
underwriting
Group type
single-employer group
labor union group
multiple-employer group
Association group
Trade Association
Professional assoiation
Public employee association
Common interest association
Debtor-creditor group
Credit union group
Discretionary group
Risk characteristics
the reason for the group's existence
the size of the group
the flow of new members into the group
the stability of the group
Participation Levels
Determination of Benefit Levels
Nature of the business
Group Insurance Premiums
Method of setting premium rates
Manual rating
Experience Rating
Blended Rating
Premium amount
Premium Refund
Chapter 14 Group Life Insurance andGroup Retirement Plans
Group Life Insurance
Provision
Beneficiary Designation
Portability Provision
Misstatement of Age
Settlement Options
Plans mainly are yearly renewable term(YRT)
Group Term Life Insurance
Accidental Death and Dismemberment Insurance
Group Cash Value Life Insurance
Level Premium Whole Life Plans
Group Universal Life and Group Variable Universal Life Plans
Group Creditor Life Insurance
Group Retirement Plans
Components
Plan
Benefit Formulas
Defined benefit formula
defined contribution formula
Plan administration
Method for administering
The funding vehicle
Types of Plans
Pension Plans
employee contribute
401(K) Plans
employer and employee contribute
Profit sharing plans
Employee stock ownership plans(ESOPs)
Government-Sponsored Retirement Plan
the policy is in force when the insured dies
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