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Georgia Accident and Sickness, Medicare Supplement and Long-Term Care Law: Practice Questions
20 free practice questions with explanations. Pick an answer for each, then check your score.
Quick study guide
Section XII draws on O.C.G.A. Chapters 29, 30, 42 and 43 of Title 33 and Commissioner's rules 120-2-10 (group), 120-2-8 (Medicare supplement) and 120-2-16 (long-term care).
Individual and group accident and sickness
Three Georgia numbers in the standard provisions (§ 33-29-3) are easy to confuse with other states'. The grace period is at least 7 days for weekly premiums, 10 days for monthly and 30 days (not 31) for other modes. Claim forms are due within 10 working days of notice of claim. An insurer that reserves the right to refuse renewal must give 30 days' notice before the premium due date. A group policyholder gets a 31-day grace period (§ 33-30-4). Premium increases need 60 days' notice for both individual and group policies (§§ 33-29-22, 33-30-13).
| Coverage | Free look |
|---|---|
| Individual accident and sickness | 10 days from delivery (§ 33-29-11) |
| Medicare supplement | 30 days from delivery (§ 33-43-6) |
| Individual long-term care | 30 days from delivery (§ 33-42-6(f)) |
When a group plan ends, a disabled person's major medical benefits must be extended at least 12 months (r. 120-2-10-.10). A person insured for 6 months under a group hospital, surgical or major medical plan can convert without evidence of insurability. The application and first premium are due within 31 days (r. 120-2-10-.11).
Medicare supplement
Open enrollment is the 6 months starting on the first day of the month a person is both 65 and enrolled in Part B. Insurers selling to people 65 and older must also offer policies to people under 65 who are on Medicare because of disability or end-stage renal disease (§ 33-43-3). Preexisting conditions have a 6-month look-back and a 6-month limit. The outline of coverage and the Guide to Health Insurance for People with Medicare are given at application. First-year commission is capped at 200% of the second year's. A replacing policy may not restart waiting periods once the old one has been in force 6 months.
Long-term care and the Partnership
Long-term care policies also use a 6-month look-back and 6-month exclusion (§ 33-42-6). The applicant names someone to receive lapse notices, which go out at least 30 days before lapse. If cognitive impairment caused the lapse, reinstatement is available for 5 months after termination. Insurers must offer 5% compound inflation protection and a nonforfeiture benefit. Declining nonforfeiture still leaves a contingent benefit upon lapse after a substantial rate increase. A suitability worksheet is required, and the shopper's guide comes before the application. A Partnership policy must include compound inflation protection if the buyer is under 61 and some inflation protection from 61 to 75. It is optional at 76 or older (r. 120-2-16-.34).