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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.

Exam weight: 3 accident and sickness-only Georgia questions on the exam on the Georgia Life, Accident and Sickness agent exam. Updated 2026-11-05.

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).

CoverageFree look
Individual accident and sickness10 days from delivery (§ 33-29-11)
Medicare supplement30 days from delivery (§ 33-43-6)
Individual long-term care30 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).

Practice questions

  1. Lena pays the premium on her Georgia individual accident and sickness policy every quarter. Under O.C.G.A. § 33-29-3(b)(3), the grace period written into her policy must be at least:

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    Answer: C. Georgia's grace period provision leaves the number of days blank and requires the insurer to insert at least 7 for weekly premium policies, 10 for monthly premium policies and 30 for all other policies, such as quarterly or annual. So the Georgia figure for a quarterly policy is 30, not 31. Thirty-one days is the Georgia minimum for a group policyholder under § 33-30-4. If the insurer reserves the right to refuse renewal, the provision must say that renewal can be refused by written notice delivered or mailed at least 30 days before the premium due date.

    Source: Georgia outline XII.A: Individual accident and sickness insurance (33-29-1 to 22); O.C.G.A. § 33-29-3; O.C.G.A. § 33-30-4

  2. Marcus gives his Georgia insurer written notice of a hospital claim, but the insurer never sends claim forms. Under the claim forms provision of O.C.G.A. § 33-29-3(b)(6), once how much time has passed may he file his own written proof of the loss instead?

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    Answer: D. If the insurer does not furnish its claim forms within ten working days after notice is given, the claimant meets the proof-of-loss requirement by submitting written proof of the occurrence, character and extent of the loss within the time allowed for proof. Fifteen days is not the Georgia figure. Twenty days is the deadline for giving notice of claim. Proof of loss is due within 90 days, or as soon as reasonably possible but no later than one year unless the claimant lacks legal capacity.

    Source: Georgia outline XII.A: Individual accident and sickness insurance (33-29-1 to 22); O.C.G.A. § 33-29-3

  3. Ruth's Georgia individual accident and sickness policy lapses. When she sends the overdue premium, the insurer requires an application for reinstatement and gives her a conditional receipt. If the insurer neither approves the application nor sends written disapproval, under O.C.G.A. § 33-29-3(b)(4) the policy is reinstated:

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    Answer: C. If the insurer takes a late premium without asking for an application, the policy is reinstated at once. If it requires an application and issues a conditional receipt, the policy is reinstated on approval or, lacking approval, on the forty-fifth day after the receipt unless the insurer has disapproved in writing. The reinstated policy covers accidental injury sustained after reinstatement and sickness beginning more than 10 days after it. A premium accepted for reinstatement may not be applied to any period more than 60 days before the reinstatement date.

    Source: Georgia outline XII.A: Individual accident and sickness insurance (33-29-1 to 22); O.C.G.A. § 33-29-3

  4. Kofi's new individual accident and sickness policy is delivered to him in Georgia on September 4. Under O.C.G.A. § 33-29-11, which statement about his right to return it is correct?

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    Answer: B. Every individual accident and sickness policy, except a single premium nonrenewable policy, must carry a notice that the buyer may return it within ten days of delivery and have the premium refunded if not satisfied for any reason. Returning it to the insurer's home or branch office, or to the agent who sold it, makes it void from the beginning, as if no policy had been issued. Sending it by certified mail or statutory overnight delivery with a return receipt is prima facie evidence of the fact and date of return. The 30-day period applies to Medicare supplement and individual long-term care policies, not to ordinary accident and sickness coverage.

    Source: Georgia outline XII.A: Individual accident and sickness insurance (33-29-1 to 22); O.C.G.A. § 33-29-11

  5. A Georgia insurer plans to raise premiums on its individual accident and sickness policies effective July 1. Under O.C.G.A. § 33-29-22, notice of the increase must be mailed or delivered to each policyholder:

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    Answer: B. Section 33-29-22 requires notice of any premium increase to be mailed or delivered to each individual accident and sickness policyholder not less than 60 days before the increase takes effect. Group coverage has a parallel rule: § 33-30-13 requires notice of the maximum group premium increase to the group policyholder and to each employer group or subgroup at least 60 days ahead. For guaranteed renewable major medical coverage, § 33-29-9 lets an insured who switches to a comparable plan or a higher deductible during the 60-day period after the notice do so without any new preexisting condition exclusion.

    Source: Georgia outline XII.A: Individual and group accident and sickness insurance (33-29-1 to 22; 33-30-1 to 15); O.C.G.A. § 33-29-22; O.C.G.A. § 33-30-13; O.C.G.A. § 33-29-9

  6. Sam is totally disabled when his employer's group major medical policy is discontinued. Under Ga. Comp. R. & Regs. r. 120-2-10-.10(5)(d), a 'reasonable' extension of benefits for his disability must last at least:

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    Answer: A. Group plans in Georgia must extend benefits for people who are totally disabled when the group policy is discontinued. For major medical and comprehensive medical coverage, the extension is reasonable only if it lasts at least twelve months. Other hospital or medical expense coverage may instead give at least 90 days, or accrued liability for a disability or a 90-day period starting with an event such as an accident. Unless the cancellation is for nonpayment of premium, the insurer must mail or deliver notice of discontinuance at least 60 days before it takes effect. A succeeding carrier must credit deductible expenses incurred under the prior plan during the 90 days before its plan began.

    Source: Georgia outline XII.A: Group accident and sickness insurance (outline 'Reg. 100-2-10 through 12', i.e. Ga. Comp. R. & Regs. r. 120-2-10-.10 to .12); Ga. Comp. R. & Regs. r. 120-2-10-.10

  7. Dana leaves her job after 8 months under her employer's Georgia group major medical policy and wants an individual converted policy. Under Ga. Comp. R. & Regs. r. 120-2-10-.11, what must she do?

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    Answer: D. A person continuously insured for at least six months under a group hospital, surgical or major medical plan is entitled to a converted individual policy. The application and first premium are due within thirty-one days after termination, the policy is issued without evidence of insurability, and it takes effect the day after the group coverage ends. Conversion is not available if coverage ended because the person failed to pay a required contribution, or if the group plan was immediately replaced by similar group coverage. The converted policy may not exclude a preexisting condition the group policy did not exclude. Section 33-30-15 requires the insurer to offer conversion once creditable coverage ends, including after state continuation or COBRA.

    Source: Georgia outline XII.A: Group accident and sickness insurance, conversion (r. 120-2-10-.11; 33-30-15); Ga. Comp. R. & Regs. r. 120-2-10-.11; O.C.G.A. § 33-30-15

  8. Walter turns 65 on August 20, and his Medicare Part B coverage starts on August 1. Under Ga. Comp. R. & Regs. r. 120-2-8-.11, his Medicare supplement open enrollment period:

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    Answer: C. An issuer may not deny, condition or price a Medicare supplement policy differently because of health status, claims experience, receipt of care or medical condition if the application is made before or during the six months beginning with the first day of the first month the person is both 65 and enrolled in Part B. For Walter, that month is August. If he has at least six months of creditable coverage, no preexisting condition exclusion may apply, and a shorter period of creditable coverage reduces any exclusion. The seven months around the birthday month is Medicare's own initial enrollment period. The 63-day window belongs to guaranteed issue after losing other coverage (r. 120-2-8-.12).

    Source: Georgia outline XII.B: Medicare supplement (Reg. 120-2-8-.01 to .23; 33-43-1 to 8); Ga. Comp. R. & Regs. r. 120-2-8-.11; Ga. Comp. R. & Regs. r. 120-2-8-.12

  9. Jorge, age 52, is enrolled in Medicare Parts A and B because of a disability. Under O.C.G.A. § 33-43-3, a Georgia insurer that sells Medicare supplement policies to people 65 and older:

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    Answer: B. Insurers offering Medicare supplement policies to people 65 or older must also offer them to Georgians eligible for and enrolled in Medicare because of disability or end-stage renal disease, with the same benefits, protections and procedures unless the section says otherwise. A person under 65 may enroll within six months of enrolling in Part B, within six months of notice of a retroactive Part B enrollment, or at any time federal law allows. Premiums may differ between the two age groups, as long as the difference is actuarially sound and not excessive, inadequate or unfairly discriminatory. The section sets no waiting period before an under-65 enrollee may buy.

    Source: Georgia outline XII.B: Medicare supplement (33-43-1 to 8); O.C.G.A. § 33-43-3

  10. Grace buys a Medicare supplement policy in Georgia and, after reading it, decides she does not want it. Under O.C.G.A. § 33-43-6, what right does she have?

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    Answer: D. Every Medicare supplement policy or certificate must have a notice prominently printed on its first page saying the applicant may return it within 30 days of delivery and have the premium refunded if not satisfied for any reason. The statute also requires the issuer to pay any refund directly to the applicant in a timely manner, so the refund does not pass through the agent. The 10-day period applies to ordinary individual accident and sickness policies under § 33-29-11. Rule 120-2-8-.17 repeats the 30-day notice requirement.

    Source: Georgia outline XII.B: Medicare supplement, free look (33-43-6; r. 120-2-8-.17); O.C.G.A. § 33-43-6; Ga. Comp. R. & Regs. r. 120-2-8-.17

  11. A Georgia agent meets a Medicare beneficiary in person to take an application for a Medicare supplement policy. Under O.C.G.A. § 33-43-5 and Ga. Comp. R. & Regs. r. 120-2-8-.17, when must the applicant receive the outline of coverage?

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    Answer: C. No Medicare supplement policy may be delivered in Georgia unless an outline of coverage was delivered when the application was made. Under the rule, the issuer must provide it when the application is presented and, except for direct response sales, obtain the applicant's acknowledgment of receipt. If the policy is issued on a basis that changes the outline, a substitute outline must come with the policy, carrying a notice that it differs from the one given at application. The Guide to Health Insurance for People with Medicare is also delivered at application, with a signed acknowledgment, while direct response issuers send it on request and no later than policy delivery.

    Source: Georgia outline XII.B: Medicare supplement, disclosure (33-43-5; r. 120-2-8-.17; Appendix C); O.C.G.A. § 33-43-5; Ga. Comp. R. & Regs. r. 120-2-8-.17

  12. A Georgia insurer pays agents $150 in the second year of a Medicare supplement policy. Under Ga. Comp. R. & Regs. r. 120-2-8-.16, the highest first-year commission it may pay is:

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    Answer: D. First-year commission or other first-year compensation may be no more than 200 percent of what is paid for selling or servicing the policy in the second year, so $150 in year two allows at most $300 in year one. Renewal compensation must equal the second-year amount and be paid for at least five renewal years. When an existing policy is replaced, the agent may receive no more than the replacing issuer's renewal compensation. Compensation includes any pecuniary or non-pecuniary reward, such as bonuses, gifts, prizes, awards and finder's fees.

    Source: Georgia outline XII.B: Medicare supplement, compensation (Reg. 120-2-8-.16); Ga. Comp. R. & Regs. r. 120-2-8-.16

  13. Ben has owned a Medicare supplement policy for three years. His agent recommends replacing it with another insurer's Medicare supplement policy. Under Ga. Comp. R. & Regs. r. 120-2-8-.18 and .23, which statement is correct?

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    Answer: D. When a Medicare supplement policy replaces one that has been in effect for at least six months, the replacing policy may not provide any time period for preexisting conditions, waiting, elimination or probation. If the old policy was in force for less time, the new issuer must credit the time already served. Before the policy is issued or delivered, the agent must give a replacement notice signed by the applicant and the agent. The applicant keeps one copy and the issuer retains another signed copy. The notice tells the buyer not to drop the old policy until sure about the new one, and that the new policy carries a 30-day free look.

    Source: Georgia outline XII.B: Medicare supplement, replacement (Reg. 120-2-8-.18, .23); Ga. Comp. R. & Regs. r. 120-2-8-.23; Ga. Comp. R. & Regs. r. 120-2-8-.18

  14. Under O.C.G.A. § 33-42-6(c), how may a Georgia long-term care insurance policy treat preexisting conditions?

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    Answer: D. A long-term care policy may define a preexisting condition no more restrictively than symptoms that would lead an ordinarily prudent person to seek diagnosis or treatment, or a condition for which advice or treatment was recommended or received, within the six months before coverage took effect. It may exclude a loss or confinement caused by such a condition only if it begins within six months after the effective date. The insurer may still ask for a full health history and underwrite on the answers. It may not use waivers or riders to exclude named conditions beyond the six months. A policy also cannot be canceled or nonrenewed because of the insured's age or declining mental or physical health (§ 33-42-6(b)).

    Source: Georgia outline XII.C: Long-term care, preexisting conditions (33-42-1 to 6); O.C.G.A. § 33-42-6

  15. Helen's individual long-term care policy is delivered to her in Georgia on May 2. Under O.C.G.A. § 33-42-6(f), until when may she return it for a full refund?

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    Answer: D. Individual long-term care policyholders may return the policy within 30 days of its delivery and have the premium refunded if, after examining it, they are not satisfied for any reason. The policy must carry a notice of this right prominently on its first page, and direct response policies and certificates must carry the same 30-day notice. The outline of coverage must be delivered at the time of application, or for direct response sales no later than policy delivery (§ 33-42-6(g)). Ten days is the free look for ordinary individual accident and sickness policies (§ 33-29-11).

    Source: Georgia outline XII.C: Long-term care, free look (33-42-6); O.C.G.A. § 33-42-6

  16. When she applied for an individual long-term care policy, Mae named her daughter to receive lapse notices. Mae then misses a premium. Under Ga. Comp. R. & Regs. r. 120-2-16-.07, the policy cannot lapse for nonpayment unless the insurer:

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    Answer: B. An individual long-term care policy cannot be issued until the applicant either names at least one other person to receive lapse notices or signs a waiver declining to do so. Before a lapse for nonpayment, notice must go by first-class mail to the insured and every designee at least 30 days before the lapse date. It may not be sent until a premium has been due and unpaid for 30 days, and it counts as given 5 days after mailing. The insurer must remind the insured of the right to change the designee at least once every 2 years. If the insured was cognitively impaired or had lost functional capacity before the grace period ended, reinstatement must be available on request within 5 months after termination.

    Source: Georgia outline XII.C: Long-term care, unintentional lapse (Reg. 120-2-16-.07); Ga. Comp. R. & Regs. r. 120-2-16-.07

  17. Under Ga. Comp. R. & Regs. r. 120-2-16-.13, a Georgia individual long-term care policy will include 5% compound inflation protection unless:

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    Answer: A. At purchase, the insurer must offer inflation protection at least as favorable as one of three options: benefits rising at least 5% a year compounded annually, a guaranteed right to buy periodic increases without proof of insurability, or coverage of a percentage of actual or reasonable charges with no maximum dollar limit. The 5% compound design must be included unless the insurer obtains a rejection signed by the policyholder, which becomes part of the application. The outline of coverage must include a graph comparing benefits with and without inflation protection over at least 20 years. The offer is not required for life insurance policies or riders with accelerated long-term care benefits.

    Source: Georgia outline XII.C: Long-term care, inflation protection (Reg. 120-2-16-.13); Ga. Comp. R. & Regs. r. 120-2-16-.13

  18. Pat bought a Georgia long-term care policy at age 65 and declined the nonforfeiture benefit. Years later the insurer raises rates, and her annual premium reaches 50% more than her initial premium. Under Ga. Comp. R. & Regs. r. 120-2-16-.28, what protection does she have?

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    Answer: A. Every long-term care buyer must be offered a nonforfeiture benefit. A buyer who declines still gets a contingent benefit upon lapse when cumulative rate increases reach a set percentage of the initial premium based on issue age. The figure is 70% at issue age 60, 50% at 65 and 30% at 75, and the benefit applies if the policy then lapses within 120 days of the increased premium's due date. The insurer must notify policyholders at least 30 days before that premium is due. It must also offer to reduce benefits without new underwriting so the premium does not rise, or to convert to paid-up coverage with a shortened benefit period. A lapse during the 120 days counts as choosing the paid-up option.

    Source: Georgia outline XII.C: Long-term care, nonforfeiture (Reg. 120-2-16-.28); Ga. Comp. R. & Regs. r. 120-2-16-.28

  19. A Georgia agent is selling an individual long-term care policy. Under Ga. Comp. R. & Regs. r. 120-2-16-.24 and .32, which statement about suitability and disclosure is correct?

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    Answer: A. Issuers must develop suitability standards and train agents to use them. The agent presents the Long-Term Care Insurance Personal Worksheet at or before application, together with the disclosure form 'Things You Should Know Before You Buy Long-Term Care Insurance.' The completed worksheet must be returned to the issuer before it considers the applicant, except for employer group sales to employees and their spouses. If the applicant does not meet the financial standards or declines to give the information, the issuer may reject the application. Alternatively it sends a suitability letter, or may verify intent another way when information was declined. An agent must deliver the shopper's guide before presenting an application (r. 120-2-16-.32).

    Source: Georgia outline XII.C: Long-term care, suitability and shopper's guide (Reg. 120-2-16-.24, .32); Ga. Comp. R. & Regs. r. 120-2-16-.24; Ga. Comp. R. & Regs. r. 120-2-16-.32

  20. A 68-year-old Georgia resident buys a long-term care policy intended to qualify for the Georgia Long-Term Care Partnership. Under Ga. Comp. R. & Regs. r. 120-2-16-.34(2)(d), the policy:

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    Answer: A. A Partnership policy must provide compound annual inflation protection if the buyer has not reached age 61, some level of inflation protection from 61 until 76, and may omit it at 76 or older. It must also be a tax-qualified long-term care policy issued no earlier than January 1, 2007, covering someone who was a Georgia resident when coverage first took effect. The agent gives a Partnership Program Notice with the outline of coverage, and buying one does not automatically qualify anyone for Medicaid. An agent may sell Partnership policies only after 8 hours of initial training, with 4 hours of ongoing training every 24 months.

    Source: Georgia outline XII.D: Long-term care Partnership requirements (Reg. 120-2-16-.34); Ga. Comp. R. & Regs. r. 120-2-16-.34

Where these questions come from: Georgia content outline (Pearson VUE #121102, effective 22 Oct 2024), Life, Accident and Sickness agent, section XII.A–D: Georgia rules and codes pertinent to accident and sickness insurance only (individual and group accident and sickness, Medicare supplement, long-term care and the Long-Term Care Partnership). See how we write questions.