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New York Life, Accident & Health Study Guide

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Section 1 Apply ownership, assignment, beneficiary, premium, grace, reinstatement, incontestability, exclusion, and misstatement provisions Preview

Preview: Life Insurance Policy Provisions, Options, and Riders (10%)

Preview includes
  • 4 of 5 lesson topics
  • 1 overview segment
  • 3 core concepts
  • 2 exam tips

Lesson Topics

  • Ownership, assignment and entire contract
  • Premium, grace, reinstatement and incontestability
  • Misstatement, exclusions and applicant statements
  • Beneficiary forms and succession

Overview

This card focuses on: Apply ownership, assignment, beneficiary, premium, grace, reinstatement, incontestability, exclusion, and misstatement provisions.

Core Concepts

  • The policyowner—not necessarily the insured—holds contractual ownership rights, including beneficiary changes (subject to irrevocable rights), assignment, loans, and surrender where the policy permits.
  • Assignment transfers specified policy rights. Absolute assignment transfers all assignable ownership rights; collateral assignment gives a creditor a limited priority interest.
  • Under New York §3204, the policy plus an attached application and properly incorporated documents form the entire contract; an oral promise does not unilaterally rewrite the policy.

Exam Tips

  • For every provision, memorize trigger → right → consequence.
  • For nonforfeiture, ask: cash now, full face temporarily, or smaller permanent coverage?
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Section 2 Determine personal or business life-insurance needs and identify the controlling insurable-interest or underwriting fact Pro
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Section 3 Match term, whole, universal, indexed, joint, survivorship, group, or credit life coverage to the stated need Pro
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Section 4 Apply New York life, accident and health producer licensing, appointment, maintenance, and disciplinary requirements Pro
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Section 5 Distinguish immediate, deferred, fixed, indexed, and variable annuities by accumulation, payout, guarantees, and investment risk Pro
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Section 6 Apply own-occupation, any-occupation, presumptive, total, partial, residual, elimination-period, and benefit-period terms Pro
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Section 7 Distinguish indemnity, HMO, PPO, POS, and EPO plans by network, referral, emergency, and cost-sharing rules Pro
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Section 8 Apply Marketplace eligibility, enrollment, premium-tax-credit, cost-sharing-reduction, metal-level, and catastrophic-plan facts Pro
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Section 9 Distinguish skilled, intermediate, custodial, home, adult-day, respite, nursing-facility, and assisted-living care Pro
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Section 10 Apply New York Medicare supplement standardization, eligibility, enrollment, marketing, replacement, renewability, and suitability rules Pro
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Section 11 Distinguish accidental injury, sickness, disability income, medical expense, long-term care, and limited-benefit coverage Pro
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Section 12 Determine eligible group, employee, dependent, certificate, experience-rating, community-rating, and plan-funding facts Pro
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Section 13 Distinguish Workers’ Compensation, Social Security disability, and New York Disability Benefits Law eligibility and benefits Pro
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Section 14 Distinguish risk, peril, hazard, loss, indemnity, reinsurance, and insurer classifications in a transaction Pro
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Section 15 Apply New York individual health entire-contract, grace, reinstatement, claim, legal-action, beneficiary, and conformity provisions Pro
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Section 16 Select the correct settlement, nonforfeiture, dividend, loan, withdrawal, disability, accelerated-benefit, or additional-insured option Pro
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Section 17 Apply New York life-settlement licensing, disclosure, privacy, advertising, and prohibited-transaction requirements Pro
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Section 18 Apply New York life solicitation, illustration, suitability, replacement, delivery, and field-underwriting duties Pro
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Section 19 Distinguish premium, cash-value, conversion, participation, investment-risk, and death-benefit characteristics Pro
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Section 20 Apply the stated basis, withdrawal, surrender, loan, death-benefit, rollover, or exchange facts without inventing tax advice Pro
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Section 21 Apply New York producer conduct, compensation, privacy, fraud, advertising, and prohibited-practice rules Pro
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Section 22 Select an annuity payout, surrender, withdrawal, death-benefit, or life-contingency option from the stated objective Pro
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Section 23 Distinguish defined-benefit and defined-contribution arrangements and common qualified-plan distribution forms Pro
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Section 24 Match individual, group, key-person, buy-sell, business-overhead, statutory, or Social Security disability coverage to the need Pro
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Section 25 Apply deductibles, copayments, coinsurance, utilization review, mandated benefits, exclusions, and provider-access facts Pro
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Section 26 Apply essential-benefit, preventive-care, preexisting-condition, annual-limit, medical-loss-ratio, and employer-responsibility concepts Pro
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Section 27 Apply ADL triggers, benefit periods, reimbursement or indemnity design, inflation, nonforfeiture, replacement, suitability, and Partnership facts Pro
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Section 28 Distinguish Original Medicare, Medicare Advantage, Part D, employer coverage, Medicare secondary rules, Medigap, and other senior options Pro
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Section 29 Match individual, group, private, government, limited, or comprehensive coverage to the stated loss exposure Pro
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Section 30 Apply ERISA, FMLA, COBRA or New York continuation, conversion, coordination, termination, FSA, and HSA concepts Pro
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Section 31 Distinguish Medicare, Medicaid, and Child Health Plus administration, eligibility, enrollment, coverage, and coordination roles Pro
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Section 33 Apply renewability, cancellation, coordination, unpaid-premium, occupation, earnings, intoxicant, and free-look facts Pro
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Section 34 Evaluate a life settlement from the owner’s interests, alternatives, compensation, rescission, creditor, tax, and public-benefit facts Pro
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Section 35 Distinguish tax deferral from tax-free treatment and identify when qualified tax guidance is required Pro
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Section 36 Apply participant, beneficiary, spousal-annuity, rollover, and plan-document facts to a retirement-plan scenario Pro
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