Life and Health Insurance Licensing Curriculum

Here is a summary that is consistent in all states regarding the licensing exam curriculum.

1. General Insurance Knowledge

  • Insurance Concepts and Principles
    • Risk management: Types of risk (pure vs. speculative), methods of handling risk
    • Insurable interest: Definition and importance
    • Contract law: Elements of a valid insurance contract (offer, acceptance, consideration, etc.)
  • Insurance Markets
    • Private vs. government insurers
    • Mutual vs. stock companies
    • Admitted vs. non-admitted carriers
    • Reinsurance: Function and importance
  • Regulatory Framework
    • State regulation and the role of the Department of Insurance (DOI)
    • Federal laws impacting insurance (e.g., Affordable Care Act for health, ERISA)
    • Unfair trade practices and market conduct

2. Life Insurance

  • Types of Policies
    • Term life
    • Whole life
    • Universal life
    • Variable life
    • Group life
  • Policy Provisions, Riders, and Options
    • Standard provisions (e.g., grace period, incontestability)
    • Beneficiary designations
    • Riders (e.g., waiver of premium, accidental death)
    • Settlement options
  • Policy Applications and Underwriting
    • Application process
    • Medical vs. non-medical underwriting
    • Risk classification: Preferred, standard, substandard
  • Life Insurance Taxation
    • Tax treatment of premiums, death benefits, and cash values
    • Modified Endowment Contracts (MECs)

3. Health Insurance

  • Types of Policies
    • Medical expense insurance
    • Disability income insurance
    • Long-term care insurance
    • Medicare supplements
    • Group health plans
  • Policy Provisions and Clauses
    • Coordination of benefits
    • Deductibles, co-pays, coinsurance
    • Grace periods and reinstatement
  • Managed Care and Networks
    • HMOs, PPOs, EPOs, POS plans
    • Pre-authorization and case management
  • Health Insurance Taxation
    • Employer-paid premiums
    • Benefits and their tax treatment
  • Federal and State Health Insurance Programs
    • Medicare: Parts A, B, C, D
    • Medicaid and CHIP
    • Affordable Care Act provisions

4. Ethics and Market Conduct

  • Ethical sales practices
  • Suitability requirements (e.g., NAIC model regulations)
  • Advertising standards
  • Consumer protections and complaint resolution

5. State-Specific Laws and Regulations

  • Licensing requirements: Pre-licensing education, application, and exams
  • Continuing education requirements
  • State-specific policy requirements (e.g., free look periods, mandated benefits)
  • Complaint procedures and DOI oversight

6. Exam Preparation

  • Practice exams and study techniques
  • Test-taking strategies
  • Time management during the exam

Implementation Notes

  1. Pre-Licensing Hours: States often specify a minimum number of pre-licensing hours (e.g., 20–40 hours per line).
  2. Exam Format: Includes multiple-choice questions divided between general insurance knowledge and state-specific regulations.
  3. Study Materials: Should align with NAIC model curriculum standards and include updated federal and state regulations for 2025.
  4. State-Specific Customization: This framework can be tailored with state-specific details such as DOI requirements, mandated benefits, and unique insurance laws.

Key Differences in Life and Health Insurance by State

  1. Pre-Licensing Education Requirements
    • States vary in the number of hours required (e.g., 20–40 hours per line).
    • Some states have separate hours for ethics training.
  2. Licensing Exam
    • Varying number of questions and pass scores (e.g., 70% vs. 75% passing).
    • State-specific sections on health mandates or rules (e.g., Medicaid, mandated coverages).
  3. State-Mandated Health Coverages
    • Requirements for specific benefits (e.g., infertility treatment, mental health parity, chiropractic care).
    • Medicaid expansion under the Affordable Care Act varies by state.
    • Mandates for short-term health insurance policies.
  4. Policy Free-Look Period
    • Free-look periods for life insurance policies can vary (e.g., 10–30 days).
  5. Continuing Education (CE)
    • CE requirements differ (e.g., 24 hours every two years, including ethics training).
    • Specific CE courses mandated for health (e.g., long-term care or annuity suitability training).
  6. Taxation of Insurance Benefits
    • Variations in how state tax laws treat cash value withdrawals or premiums.
  7. State-Specific Licensing Types
    • Some states issue limited lines licenses for certain products (e.g., travel, credit, funeral insurance).