Utah Insurance Licensing Information Bulletin

UTAH Insurance Department

Licensing Information Bulletin Effective on and after January 1, 2020

Published by Prometric Providing License Examinations for the State of Utah

Revised 01032020

Contents

Introduction 4 Licensing fees ...... 24 A Message from the Utah Insurance Printing Your License ...... 25 Department ...... 4 Obtaining an appointment ...... 25 At a Glance ...... 4 Address, phone, or email changes ...... 25 License renewals ...... 25 Utah License Requirements 6 Exam Content Outlines 26 Overview of the Licensing Process ...... 6 Types of Licenses ...... 7 Producer’s Life Exam...... 26 License types that require no exam ...... 8 Series 17-01 ...... 26 Requirements Based on Residence ...... 8 Producer's Accident and Health Exam ...... 30 Resident licensing requirements ...... 8 Series 17-02 ...... 30 New resident licensing requirements ...... 9 Producer's Combined Life, Accident and Health Fingerprinting Process...... 10 Exam ...... 36 Series 17-03 ...... 36 Scheduling Your Exam 12 Producer's Combined Property and Casualty Registering and Scheduling Exams ...... 12 Exam ...... 44 If Absent or Late for Your Appointment ..... 12 Series 17-04 ...... 44 Holidays ...... 12 Consultant's Combined Life, Accident and Emergency Closings ...... 12 Health Exam ...... 50 On the Internet—register and schedule at Series 17-09 ...... 50 one time ...... 13 Consultant's Combined Property and Casualty By phone—a one-step process ...... 13 Exam ...... 58 By fax or mail—a two-step process ...... 13 Series 17-10 ...... 58 Test Center Locations ...... 14 Adjuster's Property and Casualty Exam ...... 64 Online ...... 14 Series 17-11 ...... 64 By Fax or Mail ...... 14 Adjuster's Accident and Health Exam ...... 69 By Phone ...... 15 Series 17-12 ...... 69 Rescheduling Your Appointment ...... 15 Producer’s Title Marketing Representative Exam ...... 74 Reschedule and Cancellation ...... 15 Series 17-13 ...... 74 If Absent or Late for Your Appointment ..... 15 Producer’s Title Examination Exam ...... 75 Holidays ...... 15 Series 17-14 ...... 75 Emergency Closings ...... 15 Producer's Title Escrow Exam ...... 78 Testing Accommodations ...... 16 Series 17-16 ...... 78 Preparing for Your Exam 17 Utah Laws and Regulations Exam ...... 80 Content Outlines Overview ...... 17 Series 17-19 ...... 80 Study Materials ...... 17 Producer’s Personal Lines Exam ...... 81 Practice Exams ...... 17 Series 17-20 ...... 81 Producer's Surplus Lines Exam ...... 85 Taking Your Exam 19 Series 17-21 ...... 85 The Testing Process ...... 19 Producer's Property Exam ...... 85 Test Center Regulations ...... 20 Series 17-22 ...... 85 Question Types ...... 21 Producer's Casualty Exam ...... 89 Experimental Questions ...... 22 Series 17-23 ...... 89 Your Exam Results ...... 22 Consultant's Life Exam ...... 93 Appeals Process ...... 23 Series 17-24 ...... 93 Apply for Your license 24 Consultant's Accident and Health Exam ...... 97 Series 17-25 ...... 97 Submit Your Application ...... 24

Adjuster's Crop Exam ...... 103 Consultant's Casualty Exam ...... 109 Series 17-26 ...... 103 Series 17-29 ...... 109 Adjuster's Workers Compensation Exam ..... 104 Exam Registration Form 115 Series 17-27 ...... 104 Consultant's Property Exam ...... 106 Credit Card Payment Form 116 Series 17-28 ...... 106

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Introduction

A Message This Bulletin provides you with information about the examination and application from the Utah process for becoming licensed to sell insurance or provide certain insurance services in Utah. Please read and study it carefully. Insurance Once the Utah Insurance Department (referred to in this Bulletin as “the Department Department”) is satisfied that you have met all requirements for a license, the appropriate license will be issued. Remember, however, after you have your license you cannot sell, solicit or negotiate insurance until you have been appointed to represent at least one company or designated to represent an organization.

The Department has contracted with Prometric to conduct its examination program. All questions and requests for information about examinations should be directed to Prometric. Questions regarding your license, after successfully completing an exam, should be directed to the Department.

The Department wishes you well in preparing for your examination and encourages you to continue your insurance education after becoming licensed. An insurance license can open up the world of insurance for you—a world filled with satisfying and rewarding opportunities. Remember, however, that a license is a privilege, not a right. You should commit yourself from the beginning to comply with the laws and rules set forth to regulate the insurance industry.

Sincerely,

Todd Kiser Insurance Commissioner

At a Glance Follow these main steps if you are interested in obtaining an insurance license. To obtain your insurance license  1 Review this bulletin thoroughly to: • Determine the exams needed and any other license requirements. • Understand exam registration, expiration and rescheduling provisions. 2 Contact Prometric to register, pay for, and schedule your exam and fingerprinting appointment. The easiest way to register is online at www.prometric.com/utah/insurance. Phone, fax and mail options are also available. 3 Prepare for your exam by using this bulletin and other materials. The content outlines in this guide are the basis for the exams. 4 Take the scheduled exam, bringing required identification to the test center. You will receive your results immediately after the exam. If you pass it, go on to step 5. If you do not pass, repeat steps 2 through 4 until you do. 5 Complete and submit your license application electronically with the Department via the kiosk in the test center. Pay all required nonrefundable fees by credit card. 6 If applying for an initial resident insurance license, have your fingerprints taken at the test center.

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To get answers not provided in this bulletin  Direct all questions and requests for information about exams to: Prometric 7941 Corporate Drive Nottingham, MD 21236 Phone: 888.226.8740 Fax: 800.347.9242 TDD User: 800.790.3926 Web site: www.prometric.com/utah/insurance Direct questions about licensure to: Utah Insurance Department Suite 3110 State Office Building PO Box 146901 Salt Lake City, UT 84114-6901 Phone: 801.538.3855; In-State Toll Free: 800.439.3805 Web site: www.insurance.utah.gov

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Utah License Requirements

The Utah Insurance Department issues several types of insurance licenses. Each license granted by the Department is valid only for the line of authority named on the license.

This section describes: • The licensing process. • The types of licenses offered. • Licensing requirements based on residence. • Fingerprinting requirements.

Overview of Chapters 23a and 26 of Title 31A, of the Utah Insurance Code empowers the the Licensing Department to qualify individuals who wish to operate as insurance producers, consultants or adjusters in the state of Utah. The legislature may change these laws Process annually and administrative procedures may be changed at any time. Licensees are expected to be aware of changes in the law that affect their occupational practice.

For some licenses, you must pass an exam to confirm that you have attained a minimum level of knowledge regarding the statutes and regulations affecting the insurance profession and the products and services you will sell or represent to the public. After you have passed your exam, you must apply to the Department and pay the appropriate licensing fee in order to receive your license.

Note Passing an exam does not guarantee that you will be issued a license. Issuance of a license depends on review and approval of all license application ✓✓ materials, including application questions regarding any prior civil or criminal proceedings. See Page 24 for more information on obtaining your license.

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Types of The Department licenses the following professionals: Licenses • Producer. A person appointed by an insurer to solicit applications for insurance or negotiate insurance on its behalf. • Consultant. A person who receives compensation (other than sales commissions) for giving advice, rendering an opinion or providing information about insurance. • Adjuster. A person licensed to adjust losses for or against authorized insurers. Utah law states that a “regular salaried employee of an insurer” does not require a license to adjust losses for that insurer.

The Department grants the types of licenses listed in the table below. The table also identifies which exam needs to be passed for each license type.

You may qualify for combination licenses (such as Life and Accident/Health or Property and Casualty) by taking a combined exam. The combined exam results in one final score. You must pass the complete exam to qualify for a license. Exam Code Exam Name 1701 Producer's Life Exam 1702 Producer’s Accident and Health Exam 1703 Producer’s Combined Life, Accident and Health Exam 1704 Producer’s Combined Property and Casualty Exam 1709 Consultant’s Combined Life, Accident and Health Exam 1710 Consultant’s Combined Property and Casualty Exam 1711 Adjuster’s Property and Casualty Exam 1712 Adjuster’s Accident and Health Exam 1713 Producer's Title Marketing Representative Exam 1714 Producer's Title Examination Exam 1716 Producer’s Title Escrow Exam 1719 Utah Laws and Regulations Exam 1720 Producer's Personal Lines Exam 1721 Surplus Lines Producer Exam 1722 Producer's Property Exam 1723 Producer's Casualty Exam 1724 Consultant’s Life Exam 1725 Consultant's Accident and Health Exam 1726 Adjuster's Crop Exam 1727 Adjuster's Workers Compensation Exam 1728 Consultant's Property Exam

1729 Consultant's Casualty Exam

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License types that require no exam

There are some license candidates who the state requires to be fingerprinted but who are not required to sit for an exam first. Some candidates must show proof of payment for the background check only. The exam requirement is waived for these candidates: • Limited Line Credit Insurance • Travel Insurance • Motor Club Insurance • Car Rental Related Insurance • Legal Expense Insurance • Bail Bond Producer • Reinsurance Intermediary • Managing General Agent • Third-Party Administrator • Producer License/Variable Contracts • Navigator License • Limited Line Producer Crop • Self-Service Storage • Portable Electronics • GAP (guaranteed asset protection) Waiver

Application can be made online from your home or office at www.sircon.com/utah or at www.nipr.com. For more information about these license types, visit the Department’s Web site at www.insurance.utah.gov. The Navigator license has no specific Utah exam, but there is HHS training, exam, and certification requirement prior to applying for the Navigator license in Utah. There is a fingerprinting requirement for all Navigator license.

Requirements This section describes licensing requirements for applicants who currently live in Based on Utah, for those who are moving to Utah and for nonresidents. Residence Resident licensing requirements Producer License. To qualify for a Utah Resident Producer license, you must: • Be at least 18 years old; • Be a resident of Utah; • Be of good character and competency; and • Pass the license examination(s) required by statute. To conduct insurance transactions as a producer, you must: • Hold a current license for the line of insurance being transacted; • Be appointed and/or designated by an authorized insurer or licensed insurance agency; and • Be under contract with that insurer or insurance agency.

Note If you are not contracted or affiliated with any insurer or insurance agency, ✓✓ your license remains active, but you cannot conduct insurance transactions. Adjuster License. To qualify for an adjuster license, you must meet the basic requirements for a license given above. Surplus Lines License. To qualify for surplus lines, you must have been a property/casualty insurance producer for at least three of the past four years. The “comparable preparation” provision does not apply to surplus lines. 8

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It is your responsibility to make sure you meet the minimum experience requirements prior to taking the exam. Consultant License. To qualify for a consultant license, you must have been acting in a capacity that would provide you with the preparation to act as an insurance consultant for an aggregate period of not less than three years during the four years immediately preceding the date of the application. Your qualifications must relate to the line of insurance for which you plan to consult. It is your responsibility to make sure you meet the minimum experience requirements prior to taking the exam. Variable Contracts License. To qualify for a variable contracts license, you must meet the following requirements: 1) either apply for a life license at the same time or already hold a life license; and 2) have evidence of a current FINRA qualification and registration with the Utah Securities Division (a current CRD showing Utah approval may be used as evidence). New resident licensing requirements Utah is reciprocal in its licensing of new Utah residents who were previously licensed in another state. To become a resident licensee without a requirement to pass an examination, a person moving to Utah who was licensed as an insurance producer in another state must meet the following requirements: • Submit a completed application and appropriate fees to the Department within 90 days of canceling the other state’s license that was in good standing at the time of cancellation, and within 90 days of becoming a legal resident of Utah (after 90 days a Laws and Regulations test will be required); • Submit proof of residency to the Department within the last 90 days (for example, a Utah driver’s license with an issue date, mortgage agreement or lease agreement); and • Have evidence of good standing of the other state’s license at the time it was cancelled, such as a Letter of Clearance dated within the previous 90 days or electronic verification through the Producer Database (PDB).

You may contact the Department for more information on new resident licensing requirements or visit the Department’s Web site at www.insurance.utah.gov.

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Fingerprinting The Department requires all individuals applying for a resident insurance license to Process be fingerprinted. Fingerprinting must be done at a Prometric test center, using “live scan” technology, which digitally captures and transmits the fingerprints to the Utah Department of Public Safety, Bureau of Criminal Identification (BCI), and the Federal Bureau of Investigation (FBI). Fingerprinting is not required for resident licensees adding a line of authority to an existing license; only for initial licensees.

If the license type you are applying for requires an examination (Resident Consultant, Resident Producer, Resident Surplus Lines Producer, Resident Independent Adjuster, Resident Public Adjuster), the process is as follows: 1 Immediately after passing the exam, use the kiosk at the test center to complete your license application online via Sircon or NIPR. The license application will include an FBI/BCI fingerprint fee ($13.25 FBI/$15.00 BCI) that must be paid by credit card during the online license application process. Print out your Sircon or NIPR confirmation page that you will need for showing to the test center supervisor as proof you have paid the FBI/BCI fees in order to be fingerprinted. 2 Pay the separate Prometric fingerprint processing fee ($6.00) by going online at www.prometric.com/utah/insurance or by calling 888.226.8740. (We recommend you do not pay Prometric's $6.00 fingerprint processing fee until after you have passed your licensing exam, as you will not be fingerprinted if you do not pass your exam, and all fees are nonrefundable.) 3 Show the test center supervisor your passing score report and your payment confirmation and your fingerprints will then be scanned. 4 Fingerprint results will be returned to the Department. The Department will evaluate the results and the license application prior to issuing any license.

Note If you pass the examination and leave the test center without having your fingerprints scanned, you must schedule an appointment to return to the test ✓✓ center to have your fingerprints taken. When you return, you must present the Sircon or NIPR application confirmation page to have your fingerprints taken. As well as your passing score report.

If the license type you are applying for does not require an Utah examination (Resident Limited Lines Producer, Bail Bond, Managing General Agent, Reinsurance Intermediary, Third Party Administrator, Navigator), the process is as follows: 1 Schedule a fingerprint appointment and pay Prometric’s $6 fingerprint processing fee online at www.prometric.com/utah/insurance or by calling 888.226.8740 before arriving at the test center for fingerprinting. Test centers are not able to accept this processing fee at the test site. 2 Apply for the license online from your home or office at www.sircon.com/utah or www.nipr.com before arriving at the test center for fingerprinting. You can also apply online using a kiosk at the test center if you arrive a few minutes before your fingerprinting appointment. Payment for both the license application fee and the FBI/BCI fingerprint fee ($13.25 FBI/$15.00 BCI) must be made by credit card during the online license application process. 3 Upon completing the online application, print out the Sircon confirmation page as proof you have paid the FBI/BCI fees. Show the test center supervisor your payment confirmation to have your fingerprints scanned.

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4 Fingerprint results will be returned to the Department. The Department will evaluate the results and the license application prior to issuing any license.

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Scheduling Your Exam

Before you can test, you must contact Prometric to: 1 Register for the exam you need to take using your legal name and supporting information. 2 Pay the exam fee. 3 Schedule an appointment.

Registering You are encouraged to complete all three steps at one time using the Prometric and Scheduling Internet registration and scheduling system. Registration and scheduling is also available by phone. If you prefer, you can register by fax or by mail, but be aware Exams that is a two-step process. Confidentiality. Be assured that Prometric treats your Social Security number as confidential. It is used only as an identification number in maintaining your record and reporting your score to the Department. As part of the fingerprinting process you are required to disclose your Social Security number. Accommodations. If you require ADA accommodation or ESL additional time, see “Reschedule and Cancellation

To reschedule your existing exam appointment, you must contact Prometric 24 hours prior to the exam appointment date in order to avoid forfeiting your exam fee. If you need to reschedule or confirm your appointment, please go to http://www.prometric.com/utah/insurance.

If Absent or Late for Your Appointment

If you miss your appointment or arrive more than 30 minutes late and are not allowed to test, you will forfeit your exam fee(s).

Holidays Testing generally does not occur on federal holidays. Additional state holidays may be observed in the state where your schedule the exam appointment.

Emergency Closings

Severe weather or an emergency could require canceling scheduled exams. If this occurs, Prometric will attempt to contact you by phone; however, you may check for testing site closures by checking our website at https://prometric.com/closures or

calling Prometric at (866) 370-3411. If the site is closed, the exam will be rescheduled without a rescheduling fee. If a test center is open for testing and you choose not to appear for the appointment, you will forfeit the exam fees and must reschedule and pay another exam fee.

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Holidays. Testing generally does not occur on federal holidays. Additional state holidays may be observed in the state where your schedule the exam appointment. Additional state holidays may be observed in the state where you schedule your exam appointment. On the Internet—register and schedule at one time  Register and schedule your exam online at any time using our Internet Registration Service. Just follow these steps.

1 Access www.prometric.com/utah/insurance. 2 Click on Schedule your test and follow the prompts. By phone—a one-step process You may register and schedule your examination by calling 888.226.8740 between 6 a.m. and 7 p.m. Monday through Friday and 6 a.m. to 3 p.m. Saturday and Sunday (Mountain Time). Please have your exam registration form and your Visa or MasterCard information available. At the end of the call, you will be given a number confirming your appointment. Record and keep this confirmation number for your records. By fax or mail—a two-step process You can register by fax or mail in two steps: (1) register and pay your exam fee and (2) schedule your exam appointment by phone.

You may fax your completed exam registration form to Prometric at 800.347.9242. You must include the Visa or MasterCard number and the cardholder’s signature on the fax. Faxed registrations are processed within 24 hours, or one business day, of receipt.

You may mail your completed exam registration form (Page 115) and the appropriate exam fee. Assume four to eight days for delivery of mailed registrations and then 48 hours for processing.

Once your registration has been processed, you can schedule an appointment by calling 800.697.8947. Please record and retain the number confirming your appointment.

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Test Center Locations You may take your exam at any Prometric test center in the United States.

Fingerprinting must be completed at a Prometric test center in Utah.

The chart below lists the current Utah test center locations. Test center locations are subject to change. Be sure to verify the address of and directions to your destination before you leave for your exam.

Utah Test Test Sites Centers Lindon, UT 350 South 400 West, Suite 250 Lindon, UT 84042 801.226.2095 Salt Lake City, UT 201 South 1460 East 490 Student Services Building Salt Lake City, UT 84112-9059 801.581.7310 St. George, UT Dixie State College 46 South 1000 East St. George, UT 84770 435-879-4360

Taylorsville, UT 5500 South Redwood Road Suite 201 Taylorsville, UT 84123 801.969.0831 A complete list of test center locations may be found by going to www.prometric.com/utah/insurance and clicking on the “Do More” button. Alternatively, you may call 800.853.5448. Online Register and Schedule Online—it saves time and it’s easy! You can easily schedule your exam online at any time using our Internet Registration Service by going to: 1 http://www.prometric.com/utah/insurance 2 Click on Schedule Your Test and follow the prompts.

By Fax or Mail You may fax the completed Exam Registration Form found at the end of this handbook to Prometric to (877) 341-9469. You must also include the completed Credit Card Payment Form (Visa, MasterCard or American Express). The cardholder’s signature must be on the Form. OR

You may mail the completed Exam Registration Form and the appropriate exam fee to the address on the form. When registering by mail, you may pay the exam fee by Visa, MasterCard or American Express, company check, cashier’s check or money order. Personal checks and cash are not accepted. If paying by credit card, you

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must also include the completed Credit Card Payment Form (Visa, MasterCard or American Express). The cardholder’s signature must be on the Form. By Phone If you are unable to schedule online, you may schedule the examination by calling 888-226-8740 between 8 a.m. and 9 p.m. (Eastern Time), Monday through Friday, and between 10 a.m. and 3 p.m. (Eastern Time), Saturday and Sunday. Please have your exam information and credit card information for payment available. Rescheduling Reschedule and Cancellation Your To reschedule your existing exam appointment, you must contact Prometric 24 Appointment hours prior to the exam appointment date in order to avoid forfeiting your exam fee. If you need to reschedule or confirm your appointment, please go to http://www.prometric.com/utah/insurance.

If you cancel your appointment less than 24 hours before your exam or fail to appear for your appointment, you will forfeit your examination fee(s). Exam registration fees are not refundable or transferable. If Absent or Late for Your Appointment If you miss your appointment or arrive more than 30 minutes late and are not allowed to test, you will forfeit your exam fee(s).

Holidays Testing generally does not occur on federal holidays. Additional state holidays may be observed in the state where your schedule the exam appointment. Emergency Closings Severe weather or an emergency could require canceling scheduled exams. If this occurs, Prometric will attempt to contact you by phone; however, you may check for testing site closures by checking our website at https://prometric.com/closures or

calling Prometric at (866) 370-3411. If the site is closed, the exam will be rescheduled without a rescheduling fee.

If a test center is open for testing and you choose not to appear for the appointment, you will forfeit the exam fees and must reschedule and pay another exam fee.

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Testing ADA Accommodation. Reasonable testing accommodations are provided to Accommodations allow candidates with documented disabilities recognized under the ADA an opportunity to demonstrate their skills and knowledge. Prometric makes every effort to provide reasonable testing accommodations that enable all test takers to take examinations. If you require testing accommodations under the Americans with Disabilities Act (ADA), please complete and submit a Testing Accommodation Request Form online at https://www.prometric.com/en-us/for-test-takers/prepare-for-test- day/pages/arrange-testing-accommodations.aspx, or contact Prometric at (888) 226-9406 to obtain an Accommodation Request Form.

Producer documentation of the disability must be submitted with the Accommodation Request Form to aid Prometric in determining the appropriate testing accommodations. Thirty days’ advance notice is required for all testing arrangements. There is no additional charge for these accommodations.

ESL Accommodation. All examinations are given in English. If English is not your primary language, you may qualify for additional time for the test by requesting an ESL Authorization from Prometric. To request an ESL authorization, please submit: A personal letter requesting the authorization; and a letter from the English instructor or sponsoring company (on company letterhead), certifying that English is not your primary language. Please fax documents to 800.347.9242 and allow three (3) days for processing. If your request is approved, Prometric may extend the time limit on your examination to time-and-one-half or 150% of the normal time limit. Prometric will inform you by mail whether your request for accommodation is approved. You should not schedule your exam until you have received the confirmation email. Exams scheduled before the ESL request has been approved will not include extra time.

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Preparing for Your Exam

Being well prepared can help you pass the exam and save time and possibly money spent retaking it. This section offers: • An overview of the exam content outlines. • Information about study materials. • An explanation of how to take a practice exam.

Content The license exam for each type of license consists of questions that test knowledge Outlines of topical areas listed in the content outline for that exam. An overview of each exam content outline appears at the end of this handbook. Overview Note: Do not schedule the exam until you are familiar with all subject areas in the applicable content outline.

Study The Department of Insurance does not provide study materials, cannot recommend Materials any supplier for study materials and does not evaluate the quality of any training course or study material. You are free to use the materials of your choice to prepare for the exam. Different publishers provide materials to assist you in preparing for insurance licensing exams. These materials take different approaches and you should choose one that meets your needs.

General recommendations. You may obtain recommendations for study materials and pre-licensing study courses from insurance companies, the company or agency you plan to work for, or local insurance and agents’ associations. Information is also available at the following link: http://www.prometric.com/utah/insurance

The Utah Insurance Department does not require you to complete a training course before you take a Utah insurance examination. Use materials or complete education of your own choosing that you believe will best prepare you for the examination. Various publishers have prepared a variety of study guides and manuals to help candidates prepare for license examinations. Neither the Department nor Prometric publishes, reviews, or approves study materials. However, a list of sources that you may choose to use as a starting point in your search for study materials can be found on the Department's website at https://insurance.utah.gov/agent/producers/exam/materials.php .

Utah statutes The exams contain sections on Utah statutes. In addition to other study materials, you may wish to consult a standard statute reference, such as those available at most public or law libraries in Utah. The Utah Insurance Code is available on the Department’s Web site at www.insurance.utah.gov. Practice exams are available at www.prometric.com/utah/insurance. While Practice Exams practice exams contain general, nonstate-specific insurance questions, they are created in the same format and use the same question types as the actual licensure exams. Practice exams will also help you become familiar with the computer-based testing process.

During the practice exam, you will get immediate feedback to correct and incorrect responses as well as overall feedback at the end of the session just as you would during the actual exam. Practice exams are available for: • (LIPA) Life Insurance Producer/Agent Practice Exam in English only

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• (HIPA) Health Insurance Producer/Agent Practice Exam in English only • (PIPA) Property & Casualty Insurance Producer Practice Exam in English only There is no cost to take Prometric Practice Exams!

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Taking Your Exam

Knowing what to expect when taking the exam may help you prepare for it. This section contains: • An overview of the testing process. • Regulations that will be enforced at the testing center. • Information about the types of questions on the exam. • A guide to understanding the exam results. • Information about appeals.

The Testing The exam will be administered by computer; you are not required to have any computer experience or typing skills to take the exam. Process Arrival. You should arrive at least 30 minutes before the scheduled exam appointment. This allows time for you to sign in and for staff to verify your identification and complete all security checks.

Identification Required. You must present a valid form of identification before taking the test. The identification document must: • Be government-issued (e.g., driver’s license, state-issued identification card, passport, or military identification card). • Contain both a current photo and signature (if not you must present two identification cards: one with your photo and one with your signature). • Exactly match the name used to register for the exam (including designations such as “Jr.” and “III”).

Important Failure to provide appropriate identification at the time of the exam is considered a missed appointment. As a result, you will be required to pay another full examination fee before making another appointment. If you cannot provide the identification listed above, contact Prometric before scheduling the appointment to arrange an alternative way to meet this requirement.

Calculators. No calculators are allowed on these exams.

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Test Center Copyrighted Questions. All test questions are the property of Prometric LLC and Regulations are protected by copyright. Federal law provides severe civil and criminal penalties for the unauthorized reproduction, distribution, or exhibition of copyrighted materials.

To ensure that all candidates are tested under similar conditions, the following regulations and procedures will be enforced at each test center. Failure to follow any of these security procedures may result disqualification from taking an examination.

1 While in the test center, you will be continuously monitored by video. During your examination, you will also be monitored by physical walk- throughs and through an observation window. All testing sessions are video and audio recorded. 2 You must present valid (unexpired) and acceptable ID(s) in order to take your test. (See “Identification required” in the previous section). 3 You will be scanned with a metal detector wand prior to every entry into the test room. If you refuse, you cannot test. 4 You will be required to raise your pants legs above your ankles, empty and turn all pockets inside-out and raise shirt sleeves above your wrists prior to every entry into the test room. 5 If you are wearing eyeglasses, you will be required to remove them for visual inspection to ensure they don’t contain a recording device. Large jewelry items must be stored in your locker due to concerns over concealed recording devices. 6 You must sign the test center roster each time you leave the test room. You must also sign back in and show your ID to the Test Center Administrator (TCA) in order to re-enter the test room. 7 You are prohibited from communicating, publishing, reproducing, or transmitting any part of your test, in any form or by any means, verbal or written, for any purpose. 8 You must not talk to other candidates or refer to their screens, testing materials, or written notes in the test room. 9 You must not use written notes, published materials, or other testing aids. 10 You are allowed to bring soft ear plugs or center-supplied tissues into the test room. 11 Light clothing items removed for comfort such as sweaters, suit jackets, scarves, etc., must be hung on the examinee’s chair, not placed in laps or on the workstation desktop. Outerwear such as heavy coats, parkas, rain coats, etc., is not permitted in the test room

12 You must not bring any personal/unauthorized items into the testing room. Such items include but are not limited to outerwear, hats, food, drinks, purses, briefcases, notebooks, pagers, watches, cellular telephones, recording devices, and photographic equipment. Weapons are not allowed at any Prometric test center. You will be asked to empty and turn your pockets inside out prior to every entry into the test room to confirm that you have no prohibited items. 13 You must return all materials issued to you by the test center administrator (“TCA”) at the end of your test. 14 You are not allowed to use any electronic device or phone during breaks.

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15 If you have a medical condition that may require you to access food or medicine during your exam session, you must store those items separately from other items you place in the test center locker. You must inform the TCA before you retrieve the food or medicine, and the TCA will observe you obtaining the item from the locker. You are not allowed to access any item other than food or medicine needed for a medical reason. 16 You must conduct yourself in a civil manner at all times when on the premises of the test center. Exhibiting abusive behavior towards the TCA or any other staff member of the test center may result in examination disqualification and criminal prosecution.

Note Failure to follow any of these security procedures may result in the disqualification of the examination. Prometric reserves the right to audio and videotape any examination session.

For more information on Prometric test center regulations, please visit: www.prometric.com/en-us/for-test-takers/prepare-for-test- day/documents/TestCenterRegulations.pdf

Please note: Test center administrators are not allowed to answer any questions pertaining to the exam content. If you do not understand a question on the examination, you should answer the question to the best of your ability. Question Types The examination contains four-option multiple-choice questions. These questions are designed to be as clear and concise as possible while testing knowledge and comprehension of insurance concepts as well as the application of the insurance concepts. The design of the exam ensures that those who possess the required knowledge of the specific insurance line of authority being tested should perform well on the examination for which they prepared.

Question Formats. Three different multiple-choice formats are used. Each format is shown in the following examples. An asterisk (*) indicates the correct answer in each sample question. Format 1— Direct Which one of the following is a type of health insurance policy designed to replace Question the wages of an insured that is unable to work due to an accident or sickness? * 1. Disability Income Insurance Policy 2. Employer-Sponsored Group Major Medical Policy 3. Hospital Expense Insurance Policy 4. Special Risk Policy

Format 2— Benefits under workers’ compensation insurance are payable: Incomplete 1. For bodily injury that is accidental or intentional Sentence * 2. Regardless of the liability of the employer 3. Unless safety rules are violated 4. Up to a maximum of 30 percent of weekly wages

Format 3—All of A life insurance policy may include provisions that do all of the following EXCEPT: the following 1. Restrict coverage if death is caused by suicide except 2. Require evidence of insurability to reinstate coverage * 3. Extend the contestable period beyond two years 4. Adjust proceeds if the insured’s age is misstated on the application

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Experimental The examination may include some experimental questions that will not be scored. If present, they are distributed throughout the examination and will not be identified Questions as such. These are used to gather statistical information on the questions before they are added to the examination as scored items. These experimental questions will not be counted for or against you in the final examination score.

You will be helping us help future test takers by completing 5 experimental test questions in your exam. We plan to use the experimental questions on future exams based on your performance.

The questions will:

• be randomly distributed within your test

• will not be counted in your final score

• time spent on the question will not be deducted from your test time

Your Exam At the end of your exam, your score will be shown on the screen and you will Results receive a printed score report. The report shows your overall score and grade, including the numerical percentage of questions answered correctly and whether you passed or failed.

The report also displays the correct percentage in each major section of the exam, as defined by the exam content outline. These section scores are shown to guide you, or your employer and/or trainer, about areas requiring additional preparation for retesting if you do not pass the exam. Even after you pass, you may want to focus on these areas as you begin to provide insurance products and services to the public.

Prometric electronically notifies the Department of Insurance of exam results within 48 hours of passing the exam. Note that exam scores are confidential and will be revealed only to you and the Department.

Duplicate score report. You may call or write to Prometric to request a duplicate of your score report for a period of one year after an exam with no fee. Direct any questions or comments about your exam to Prometric.

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Appeals Our goal is to provide a quality exam and a pleasant testing experience for every Process candidate. If you are dissatisfied with either and believe we can correct the problem, we would like to hear from you. We provide an opportunity for general comments at the end of your exam. Your comments will be reviewed by our personnel, but you will not receive a direct response.

If you would like to submit an appeal concerning examination content, registration, scheduling or test administration (testing site procedures, equipment, personnel, etc.), please submit an appeal by visiting http://www.prometric.com/contactus.

The Appeals Committee will review your concern and send you a written response within 20 business days of receipt.

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Apply for Your license

This section offers information about: • Applying for your license. • New procedures for printing a license. • License fees. • Continuing education. Submit Your After you pass your examination, complete and submit your application electronically via Sircon or NIPR by using the kiosk located in the test center and paying all fees with a credit Application card. Sircon or NIPR will electronically forward your application and all fees to the Department. You can also later apply electronically at www.sircon.com or www.nipr.com. Electronic application is the Department’s required filing method. Warning It is your responsibility to ensure that the application and any supporting documents have been properly completed and that the information is accurate. If you have ever been the subject of a civil or criminal proceeding, whether it be misdemeanor or felony, including disciplinary proceedings by an insurance department, you must disclose this information on the license application, and electronically submit supporting documents to the department. Applications that are found to contain inaccurate or untruthful information may be denied. Initial resident insurance license applicants must provide fingerprints to permit the Department to obtain a criminal history record report.

Licensing fees

• Fingerprint Submission Fee — $28.25* (+ $6 Prometric processing fee) • Individual License Fees (including Producer, Surplus Lines Producer, Title*, Adjuster, Consultant, Managing General Agent (MGA’s), Reinsurance Intermediary, Third-Party Administrator) — $75 • Limited Lines License (Credit, Bail Bond Agent, Legal, Car Rental, Motor Club, Crop, Self-Service Storage, GAP Waiver, Portable Electronics, and Travel) — $50 • Individual Navigator, Certified Application Counselor — $40 • Agency License Fees (including Producer, Surplus Lines Producer, Title, Consultant, TPA, Reinsurance Intermediary, Managing General Agency (MGA), Adjusters, and Limited Lines Agency) — $85 • Navigator or Certified Application Counselor Agency — $50

Non-Resident Licensing Fees

• Individual License Fees (including Producer, Surplus Lines Producer, Adjuster, Consultant, Managing General Agent (MGA), Reinsurance Intermediary, Third Party Administrator (TPA)) — $75 • Limited Lines License Credit, Bail Bond, Legal-Expense, Car Rental, Motor Club, Crop, Self-Service Storage, GAP Waiver, Portable Electronics, and Travel) — $50 • Individual Navigator, Certified Application Counselor — $40 • Adding a Line of Authority — $25

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• Organization License Fees (including Producer, Surplus Lines Producer, Consultant, Third Party Administrator (TPA), Reinsurance Intermediary, Managing General Agency (MGA), Adjuster, and Limited Lines) — $85 • Navigator or Certified Application Counselor Agency — $50

Important: YOUR APPLICATION AND FEE MUST BE SUBMITTED WITHIN 90 DAYS OF PASSING YOUR EXAM. AFTER 90 DAYS, THE EXAM MUST BE ✓✓ RETAKEN IN ORDER FOR A LICENSE TO BE ISSUED. For additional lines of insurance, you must take and pass the applicable examination and submit a completed license application form indicating an amended license. For example, to add the Life and Accident and Health line of authority to your Property and Casualty license, you would need to take the required exam for Life, Accident and Health and pay a transaction fee to add it to the license.

Printing Your The Department no longer prints and mails hard copies of new, renewal or duplicate License licenses. You may print a hard copy yourself by going to www.sircon.com/utah and clicking on the link titled "Print a license.” You may print your license as soon as it has been issued.

To see if a new or renewal license has been approved and issued, go to: • www.sircon.com/utah and click on “Check license application status” or “Check license renewal status;” or • the Department's Web site at www.insurance.utah.gov and click on the “Search for Company & Agent” link.

You may print as many copies of a new or renewal license as you would like at no cost if your license application is processed through Sircon. If you apply for your license through NIPR, then Sircon will charge a small fee to print your license. Obtaining an appointment After obtaining your license, you need an appointment with an insurer or a designation with an agency to conduct insurance transactions for an insurer. Contact your employing insurance company or agency organization in order to be properly appointed as its producer or designee. Address, phone, or email changes Section 31A-23a-412 of the Utah Insurance Code requires all licensees to notify the Commissioner in writing of any change of address, phone number, or business email address within 30 days. You must process your own changes electronically online at www.sircon.com/utah or at www.nipr.com. License renewals A renewal reminder letter is sent to every licensee’s business email address on file with the department about 90 days prior to the license expiration date. Renewals are required to be completed electronically at www.sircon.com/utah or www.nipr.com. More detailed information about renewing a license is available on the Department’s Web site at www.insurance.utah.gov.

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Exam Content Outlines

308(10)(a); 31A- Unfair discrimination 23a-111) (31A-23a-402(3)) Probation (31A-23a- Boycott, coercion or Utah Producer’s Life Exam 112) intimidation (31A- 23a-402(4)) Series 17-01 Monetary forfeiture (fines) (31A-2-308) Illegal inducement 100 questions (31A-23a-402.5, (plus 5 unscored items) 1.2 State regulation Reg R590-154-11)

Commissioner's general Examination of records 2-hour time limit duties and powers (31A- (31A-2-203–205; 31A-

2-201) 23a-412) Effective date: January 1, 2020 Company regulation Privacy of Consumer 1.0 Insurance Regulation 10% Solvency (31A-4-105, Information (Reg R590- (10 Items) 105.5) 206)

1.1 Licensing Rates (31A-19a-201– Insurance fraud regulation (31A-31-103–106) Purpose (31A-23a-101) 203) Policy forms (31A-21- Personal liability for unpaid Process (31A-23a-103– claims (31A-15-105) 105, 107, 302) 201–203) 1.3 Federal regulation Qualifications (31A-23a- Producer appointment 107, 108) (31A-23a-115; Reg Fair Credit Reporting Act R590-244-1–14) (15 USC 1681–1681d) Types of licensees (31A-1- 301, 31A-23a-106, 203, Termination of Fraud and False 401, 504) appointment (Reg Statements (18 USC R590-244-1–14) 1033, 1034) Producers Unfair claim Privacy (Gramm Leach Consultants settlement practices Bliley) (31A-26-303; Reg Adjusters R590-190–192) National Do Not Call List Nonresidents (31A- Producer regulation 2.0 General Insurance 10% (10 23a-109) Items) Fiduciary and trust Maintenance and duration account 2.1 Concepts responsibilities Renewal (31A-23a- Risk management key (31A-23a-409) 105; 31A-23a-111) terms Place of Continuing education Risk requirements (31A- business/records 23a-202; Reg R590- maintenance (31A- Exposure 142-1-10) 23a-412) Hazard Reinstatement (31A- Controlled business Peril 23a-111(2), 113) (31A-23a-502) Loss Assumed name (31A- Shared commissions (31A-23a-504) 23a-110(2)) Methods of handling risk Unfair marketing practices Change of address or Avoidance telephone number (Reg R590-154) Retention (31A-23a-412(1)(c)) Misrepresentation Reporting of actions (31A-21-105; 31A- Sharing (31A-23a- 23a-402(1)) Reduction 105(2)(b)) False advertising Transfer Disciplinary actions (31A-23a-402(1)) Elements of insurable risks License termination, Rebating (31A-23a- 402(2), 31A-1- suspension, or Adverse selection revocation (31A-2- 301(145)) Law of large numbers 26

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Reinsurance Ambiguities in a Ordinary versus industrial contract of adhesion (home service) 2.2 Insurers Reasonable Permanent versus term Types of insurers expectations Participating versus Stock companies Indemnity nonparticipating

Mutual companies Utmost good faith Fixed versus variable life insurance and annuities Fraternal benefit Representations/misre societies including regulation of presentations variable products (SEC, Reciprocals Warranties FINRA, and Utah) (31A- 5-217, 217.5; 31A-23a- Lloyd's associations Concealment 206) Risk retention groups Fraud 3.7 Premiums

Private versus government Waiver and estoppel Factors in premium insurers determination 3.0 Life Insurance Basics 20% Admitted versus (20 Items) Mortality nonadmitted insurers 3.1 Insurable interest (31A- Interest Domestic, foreign and alien 21-104) insurers Expense 3.2 Personal uses of life Financial status insurance Premium concepts (independent rating services) Survivor protection Net single premium

Marketing (distribution) Estate creation Gross annual premium systems Cash accumulation Premium payment mode 2.3 Producers and general Liquidity 3.8 Licensee rules of agency responsibilities Estate conservation Insurer as principal Solicitation and sales 3.3 Life settlements Producer/insurer presentations (Reg (including stranger relationship R590-79-1–8) originated life Authority and powers of insurance) Advertising (Reg producer R590-130-4–16) 3.4 Determining amount of Express personal life insurance Utah Life and Health Insurance Guaranty Implied Human life value approach Association (31A- 28-119(1-4) R590- Needs approach Apparent 155) Types of information Responsibilities to the Illustrations (31A-22- gathered applicant/insured 631; Reg R590-177- 2.4 Contracts Determining lump- 1–13) sum needs Elements of a legal Policy summary (31A- contract Planning for income 22-631; Reg R590- needs 79-4(F), 5) Offer and acceptance 3.5 Business uses of life Buyer's guide (Reg Consideration insurance R590-229-4(A), 5)

Competent parties Buy-sell funding Need for variable license to Legal purpose Key person recommend termination (R590- Distinct characteristics of Executive bonuses an insurance contract 133) Deferred compensation Suitability (R590- Contract of adhesion funding 230) Aleatory contract Split dollar plans Life insurance policy Personal contract Change of insured cost comparison provision methods Unilateral contract 3.6 Classes of life insurance Replacement (Reg Conditional contract policies R590-93-1–12) Legal interpretations Group versus individual affecting contracts

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Use and disclosure of Single premium Minors insurance information 4.3 Flexible premium Trusts policies Field underwriting Revocation at Divorce 75- Adjustable life 2-804 Notice of information practices Universal life Succession

Application procedures 4.4 Specialized policies Revocable versus irrevocable Delivery Joint life (first-to-die) Common disaster clause Policy review Juvenile life Spendthrift clause Effective date of 4.5 Group life insurance 5.3 Settlement options coverage Characteristics of group Premium collection plans Cash payment Statement of good Types of plan sponsors Interest only health Group underwriting Fixed-period installments requirements 3.9 Individual underwriting Fixed-amount installments by the insurer Conversion to individual Life income Information sources and policy (31A-22-517– regulation 519) Single life

Application 5.0 Life Insurance Policy Joint and survivor Provisions, Options and Licensee report Riders 18% (18 Items) 5.4 Nonforfeiture options Attending physician 5.1 Standard provisions Cash surrender value statement Ownership Extended term Investigative Assignment (31A-22-412) consumer Reduced paid-up insurance (inspection) report Entire contract (31A-22- 5.5 Policy loan and 424) Medical Information withdrawal options Bureau (MIB) Modifications Cash loans

Medical examinations Right to examine (free Automatic premium loans and lab tests look) (31A-22-423) (including HIV Withdrawals or partial consent) (Reg Payment of premiums surrenders R590-132-3) Grace period (31A-22- 5.6 Dividend options Selection criteria and 402) unfair discrimination Cash payment Reinstatement (31A-22- (31A-23a-402(3)) 407) Reduction of premium Classification of risks payments Incontestability (31A-22- Preferred 403) Accumulation at interest

Standard Misstatement of age and One-year term option gender (31A-22-405) Substandard Paid-up additions Exclusions 5.7 Disability riders 4.0 Life Insurance Policies 10% Suicide exclusion (31A- (10 Items) Waiver of premium 22-404) 4.1 Term life insurance Waiver of cost of insurance Medical examination; Level term autopsy (31A-22-417) Disability income benefit Annual renewable Prohibited provisions Payor benefit life/disability term including backdating (juvenile insurance) Level premium term (31A-22-401) 5.8 Accelerated (living) Decreasing term 5.2 Beneficiaries benefit provision/rider

4.2 Whole life insurance Designation options Qualifying events Continuous premium Individuals Disclosure (straight life) Classes Effect of benefit payment Limited payment Estates

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5.9 Riders covering Market value adjusted 7.4 Taxation of individual additional insureds annuities retirement annuities (IRAs) Spouse/other-insured term Guaranteed living benefit rider riders Traditional IRAs

Children's term rider Variable annuities Contributions and deductible amounts Family term rider 6.5 Uses of annuities Premature 5.10 Riders affecting the Lump-sum settlements distributions death benefit amount Qualified retirement plans (including taxation Accidental death including group versus issues) individual annuities Guaranteed insurability Annuity phase benefit Personal uses payments Cost of living Individual retirement Values included in the Return of premium annuities (IRAs) annuitant's estate

6.0 Annuities 18% (18 Items) Tax-deferred growth Amounts received by beneficiary 6.1 Annuity principles and Retirement income concepts Roth IRAs Education funds Accumulation period Contributions and versus annuity period 7.0 Federal Tax Considerations limits for Life Insurance and Owner, annuitant and Distributions beneficiary Annuities 9% (9 Items) 7.1 Taxation of personal life 7.5 Rollovers and transfers Insurance aspects of insurance (IRAs and qualified annuities plans) Amounts available to 6.2 Immediate versus policyowner 7.6 Section 1035 exchanges deferred annuities Cash value increases 8.0 Qualified Plans 5% (5 Single premium immediate Items) annuities (SPIAs) Dividends 8.1 General requirements Deferred annuities Policy loans 8.2 Federal tax Premium payment Surrenders considerations options Amounts received by Tax advantages for Nonforfeiture beneficiary employers and employees Surrender charges General rule and exceptions Taxation of distributions Death benefits (age-related) Settlement options 6.3 Annuity (benefit) 8.3 Plan types, payment options Values included in characteristics and insured's estate Life contingency options purchasers 7.2 Modified endowment Simplified employee Pure life versus life contracts (MECs) with guaranteed pensions (SEPs) minimum Modified endowment Self-employed plans (HR versus life insurance Single life versus 10 or Keogh plans) multiple life Seven-pay test Profit-sharing and 401(k) Annuities certain (types) Distributions plans

6.4 Annuity products 7.3 Taxation of non- SIMPLE plans qualified annuities Fixed annuities 403(b) tax-sheltered Individually-owned annuities (TSAs) General account assets Accumulation phase (tax issues related Interest rate to withdrawals) guarantees (minimum versus Annuity phase and the current) exclusion ratio Level benefit payment Distributions at death amount Corporate-owned Indexed annuities

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Utah Producer's Accident and Commissioner's general Privacy of Consumer Health Exam duties and powers (31A- Information (Reg R590- 2-201) 206) Series 17-02 Company regulation Insurance fraud regulation (31A-31-103–106) 100 questions (plus 5 unscored Solvency (31A-4-105, items) 105.5) Personal liability for unpaid claims (31A-15-105) 2-hour time limit Rates (31A-19a-201– 203) 1.3 Federal regulation Effective date: January 1, 2020 Policy forms (31A-21- Fair Credit Reporting Act 201–203) (15 USC 1681–1681d)

Producer appointment Fraud and false statements 1.0 Insurance Regulation 7% (31A-23a-115; Reg (18 USC 1033, 1034) (7 Items) R590-244-1–14) 1.1 Licensing Privacy (Gramm Leach Termination of Bliley) Purpose (31A-23a-101) appointment (Reg R590-244-1–14) National Do Not Call List Process (31A-23a-103– 105, 107, 302) Unfair claim Affordable Care Act settlement practices Qualifications (31A-23a- 2.0 General Insurance 5% (5 (31A-26-303; Reg 107, 108) Items) R590-190–192) Types of licensees (31A-1- 2.1 Concepts Producer regulation 301, 31A-23a-106, 203, Risk management key 401, 504) Fiduciary and trust terms account Producers responsibilities Risk (31A-23a-409) Consultants Exposure Place of Adjusters Hazard business/records Nonresidents (31A- maintenance (31A- Peril 23a-109) 23a-412) Loss Maintenance and duration Controlled business Methods of handling risk Renewal (31A-23a- (31A-23a-502) 105) Shared commissions Avoidance (31A-23a-504) Continuing education Retention requirements (31A- Unfair marketing practices Sharing 23a-202; Reg R590- (Reg R590-154) 142-1 through 10) Reduction Misrepresentation Reinstatement (31A- (31A-21-105; 31A- Transfer 23a-111(2), 113) 23a-402(1)) Elements of insurable risks Assumed name (31A- False advertising 23a-110(2)) (31A-23a-402(1)) Adverse selection

Change of address or Rebating (31A-23a- Law of large numbers telephone number 402(2), 31A-1- Reinsurance (31A-23a-412(1)(c)) 301(145)) 2.2 Insurers Reporting of actions Unfair discrimination (31A-23a- (31A-23a-402(3)) Types of insurers 105(2)(b)) Boycott, coercion or Stock companies Disciplinary actions intimidation (31A- Mutual companies License termination, 23a-402(4)) suspension, or Illegal inducement Fraternal benefit revocation (31A-2- (31A-23a-402.5, societies 308(10)(a); 31A- Reg R590-154-11) 23a-111) Reciprocals Examination of Lloyd's associations Probation (31A-23a- records (31A-2- 112) 203–205; 31A-23a- Risk retention groups 412) Monetary forfeiture Private versus government (fines) (31A-2-308) insurers 1.2 State regulation

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Admitted versus 3.0 Accident and Health Utah Life and Health nonadmitted insurers Insurance Basics 30% (30 Insurance Guaranty Items) Association (31A- Domestic, foreign and alien 28-119(1-4); R590- 3.1 Definitions of perils insurers 155) Accidental injury (R590- Financial status Sales presentations (independent rating 126, 233) services) Outline of coverage Sickness, medical (Reg R590-126-8, necessity and emergency Marketing (distribution) 233-8) systems (31A-22-627) Compensation 3.2 Principal types of losses 2.3 Producers and general disclosure (31A- and benefits rules of agency 23a-501) Loss of income from Insurer as principal Field underwriting disability (R590-126, Producer/insurer 233) Nature and purpose relationship Medical expense Employee waiver form Authority and powers of (31A-22-635; R590- Dental expense producer 247) Long-term care expense Express Disclosure of Implied 3.3 Classes of health information about insurance policies individuals (R590- Apparent 126, 233) Individual versus group Responsibilities to the Application procedures applicant/insured Private versus government Requirements at 2.4 Contracts Self-funded vs fully insured delivery of policy

Elements of a legal Limited versus Utah individual and contract comprehensive small employer health insurance Employer group versus Offer and acceptance application (R590- association group Consideration 247) 3.4 Limited policies (R590- Common situations for Competent parties 126) errors/omissions Legal purpose Limited perils and amounts 3.7 Individual underwriting Distinct characteristics of Required notice to insured by the insurer an insurance contract Types of limited policies Underwriting criteria Contract of adhesion Accident-only Sources of underwriting Aleatory contract information Specified (dread) Personal contract disease Application

Unilateral contract Hospital indemnity Licensee report (income) Conditional contract Attending physician Credit disability statement Legal interpretations affecting contracts Blanket insurance Investigative (teams, passengers, consumer Ambiguities in a other) (inspection) report contract of adhesion Prescription drugs Medical Information Reasonable Bureau (MIB) expectations Vision care Medical examinations Indemnity 3.5 Common exclusions and lab tests from coverage (R590- Utmost good faith (including HIV 126) consent) (Reg Representations/misre R590-132-3) 3.6 Licensee presentations responsibilities in Unfair discrimination Warranties individual health (31A-23a-402(3)) insurance Concealment Genetic Information Marketing requirements and Fraud Nondiscrimination Advertising (Reg Act of 2008 (GINA) Waiver and estoppel R590-130-4–16)

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Classification of risks Guaranteed renewable Relation of earnings to insurance Preferred Conditionally renewable Other cash benefits Standard Renewable at option Accidental death and Substandard of insurer dismemberment

3.8 Considerations in Nonrenewable Rehabilitation benefit replacing accident and (cancelable, term) health insurance (Reg Medical R590-126-9, 233) 4.0 Disability Income and reimbursement Related Insurance 2% (2 benefit Benefits, limitations and Items) (nondisabling injury) exclusions 4.1 Qualifying for disability Refund provisions Underwriting requirements benefits Return of premium Licensee liability for errors Inability to perform duties and omissions Cash surrender value Own occupation Required notification Exclusions Any occupation 3.9 Other required, uniform 4.3 Unique aspects of and general provisions Loss of income (income individual disability (R590-126, 233) replacement contracts) underwriting

Incontestability (31A-22- Definition of total disability Occupational 609) (R590-126-3) considerations

Grace period (31A-22- Presumptive disability Benefit limits 607) Requirement to be under Policy issuance alternatives Reinstatement (31A-22- physician care 608) 4.4 Group disability income 4.2 Individual disability insurance Claim procedures (31A- income insurance 21-312; 31A-22-614; Group versus individual Basic total disability plan 31A-26-301; Reg R590- plans 192-1–14) Income benefits Short-term disability (STD) (monthly indemnity) Change of occupation Long-term disability (LTD) (31A-22-613(1)) Elimination and benefit periods 4.5 Social Security Misstatement of age (31A- disability 22-613(2,3)) Waiver of premium feature Qualification for disability Coordination of benefits benefits (31A-22-619) Coordination with social insurance and workers Definition of disability Right to examine (free compensation benefits look) (31A-22-606) Waiting period Additional monthly Rights of spouse (31A-22- Disability income benefits benefit (AMB) 612) Social insurance 5.0 Medical Plans 18% (18 Insuring clause supplement (SIS) Items) Consideration clause 5.1 Medical plan concepts Occupational versus Entire contract; changes nonoccupational Fee-for-service basis coverage versus prepaid basis Physical examinations and autopsy At-work benefits Specified coverages versus comprehensive care Legal actions Partial disability benefit Benefit schedule versus Change of beneficiary usual/reasonable/custom Residual disability ary charges Unpaid premium benefit Any provider versus Conformity with state Other provisions affecting limited choice of statutes income benefits providers Illegal occupation Cost of living Insureds versus adjustment (COLA) Renewability clause (Reg subscribers/participants rider R590-126-5; Reg R590- 5.2 Types of providers and 233) Future increase option plans (FIO) rider Noncancelable

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Major medical insurance Dependent child age Certificate of coverage (indemnity plans) limit (31A-22- 610.5) Experience rating versus Characteristics community rating Court ordered Common limitations dependency 6.2 Types of eligible groups Exclusions from coverage (31A-22- Employment-related coverage 610.5) groups (31a-22-501.1)

Provisions affecting Eligibility of dependent Individual employer cost to insured children not based groups solely on residency Health maintenance (31A-22-718) Multiple-Employer organizations (HMOs) Trusts (METs) or Policy extension for Welfare General characteristics handicapped Arrangements children (31A-22- (MEWAs) Preventive care 611) services Associations (alumni, Adoptions (31A-22- professional, other) Primary care physician 610.1) versus referral (31a-22-701) (specialty) physician Federal health care Customer groups reform required Emergency care (depositors, creditor- dependent coverage debtor, other) (31a-22- Hospital services Benefit offers 501.1)

Other basic services Substance abuse Discretionary groups (31a-22-507) Preferred provider coverage (31A-22- organizations (PPOs) 715) 6.3 Marketing considerations General characteristics 5.5 HIPAA (Health Insurance Portability Advertising (R590-155) Limited health plans and Accountability (31A-8-101(6)) Act) requirements Unfair inducements (R590-154) Open panel or closed Eligibility panel Regulatory Guaranteed issue jurisdiction/place of Types of parties to the delivery provider contract Pre-existing conditions Creditable coverage 6.4 Employer group health Utah NetCare Plan insurance (31A-22-724) Renewability Insurer underwriting 5.3 Cost containment in 5.6 Health Savings criteria health care delivery Accounts (HSAs) and Characteristics of Cost-saving services Health Reimbursement Accounts (HRAs) group Preventive care Definition Plan design factors Hospital outpatient Persistency factors benefits Eligibility Contribution limits Administrative Alternatives to capability hospital services Portability Eligibility for insurance Maternity stay 5.7 Uniform health benefit minimum limits plan information card Annual open (31A-22-610.2) (31A-22-635) enrollment

Utilization management 5.8 Federal Health Care Employee eligibility Prospective review Reform (Patient Dependent eligibility Protection and (31a-22-601.1, 31a- Concurrent review Affordable Care Act) 22-610.5, 31a-22- 611, 31a-22-718) 5.4 Utah requirements 6.0 Group Accident and Health (individual and group) Insurance 21% (21 Coordination of benefits Items) Eligibility requirements provision (Reg R590- 6.1 Characteristics of group 131) Newborn child insurance (31a-22- Change of insurance coverage (31A-22- 501.1) 610) companies or loss of Group contract coverage

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Coinsurance and Permitted increases in Combination plans deductible carryover employee contributions Exclusions No-loss no-gain Requirements for Limitations Events that terminate medical expense coverage Predetermination of coverage benefits Extension of benefits Civil Rights Act/Pregnancy 7.3 Employer group dental Continuation of Discrimination Act expense coverage under Applicability COBRA and Utah Integrated deductibles Mini-COBRA (31A- Guidelines versus stand-alone plans 22-722) Relationship with Medicare Minimizing adverse Utah Net Care 31A- selection 22-724, R590-255 Medicare secondary rules 8.0 Medicare 6% (6 Items) Conversion rights 8.1 Medicare standard Medicare carve-outs (31A-22-723) policies and supplements Reinstatement of Nature, financing and Nondiscrimination rules coverage for military administration personnel (31A-22- (highly-compensated) Part A — Hospital 717) 6.7 Types of funding and Insurance 6.5 Small employer medical administration Individual eligibility plans Conventional fully-insured requirements Definition of small plans Enrollment employer (31A-1-301) Fully self-funded (self- Basic coverage (31A-22- administered) plans Coverages and cost- sharing amounts 613.5) Characteristics Part B — Medical Availability of coverage Conditions suitable for Insurance (31A-30-108) self-funding Individual eligibility Rating of small employer Benefits suitable for requirements plans (31A-30; Reg self-funding R590-167) Enrollment 7.0 Dental Insurance 2% (2 Pre-existing conditions Items) Coverages and cost- (31A-22-605.1) 7.1 Categories of dental sharing amounts Participation requirements treatment Exclusions (31A-30-112) Diagnostic and preventive Claims terminology Surcharge for charging and other key terms carriers (31A-30-106.7) Restorative Part C — Medicare Open enrollment (Reg Oral surgery Advantage R590-176) Endodontics Part D — Prescription Drug 6.6 Regulation of employer Periodontics Insurance group insurance plans Prosthodontics 8.2 Medicare supplement Employee Retirement Income Security Act Orthodontics Purpose (ERISA) 7.2 Indemnity plans Open enrollment (Reg Applicability R590-146-11) Choice of providers Fiduciary Standardized Medicare responsibilities Scheduled versus supplement plans nonscheduled plans Reporting and Core benefits (Reg disclosure Benefit categories R590-146-8(B))

Age Discrimination in Diagnostic/preventive Additional benefits Employment Act (ADEA) services (Reg R590-146- 8(C)) Applicability to Basic services employers and Major services Utah regulations and workers required provisions Deductibles and Permitted reductions coinsurance in insured benefits

UTAH INSURANCE DEPA RTMENT

Standards for 9.1 Long-term care (LTC) Inflation protection marketing (Reg policies (Reg R590-148-13) R590-146-20) Eligibility for benefits Pre-existing conditions Advertising (Reg (31A-22-1406; Reg R590-146-19) Federal reform - CLASS R590-148-6(3)) ACT Appropriateness of Protection against recommended Levels of care unintentional lapse purchase and Skilled care (Reg R590-148-11) excessive insurance (Reg R590-146-21) Intermediate care Prohibited provisions (31A-22-1405, Right to return (free Custodial care 1407) look) (31A-22- 620(6)) Home health care Rate disclosure form

Replacement (Reg Adult day care 10.0 Federal Tax Considerations for Accident and Health R590-146-18, 23) Respite care Insurance 2% (2 Items) Pre-existing conditions Benefit periods 10.1 Personally-owned (Reg R590-146-23) health insurance Benefit amounts Required disclosure Individual provisions (Reg Optional benefits mandate/penalties for R590-146-17) Guarantee of noncompliance Outline of coverage insurability Disability income insurance (Reg R590-146- Return of premium 17(C)) Medical expense insurance Qualified LTC plans Guide to Health Long-term care insurance Insurance for People Exclusions with Medicare (Reg 10.2 Employer group health R590-146- Underwriting insurance 17(A)(6)(a)) considerations Disability income (STD, Permitted Utah regulations and LTD) compensation (Reg required provisions Benefits subject to R590-146-16) Standards for FICA New plans effective marketing (Reg Medical and dental June 1, 2010 (Reg R590-148-18) expense R590-146) Advertising (Reg Long-term care insurance Medicare Advantage R590-148-20) Accidental death and 8.3 Other options for Shopper's guide (Reg dismemberment individuals with R590-148-16) Medicare 10.3 Medical expense Outline of coverage coverage for sole Employer group health (31A-22-1409; Reg proprietors and plans R590-148-15) partners Disabled employees Appropriateness of 10.4 Business disability recommended insurance Employees with purchase (Reg kidney failure (End R590-148-17) Key person disability Stage Renal income Disease) (ESRD) Right to return (free look) (31A-22- Buy-sell policy Individuals age 65 and 1408) older 10.5 Health Savings Replacement (Reg Accounts (HSAs) and Medicaid R590-148-6(6)) Health Reimbursement Accounts (HRAs) Eligibility Renewal provisions Benefits (Reg R590-148- 6(1)) 8.4 Medicare Improvements for Patients and Continuation or Providers Act of 2008 conversion (Reg (MIPPA) R590-148-10) Required disclosure 9.0 Long-Term Care Insurance provisions (Reg 7% (7 Items) R590-148-6)

UTAH INSURANCE DEPA RTMENT

Utah Producer's Combined Life, Commissioner's general Insurance fraud regulation Accident and Health Exam duties and powers (31A- (31A-31-103–106) 2-201) Series 17-03 Personal liability for unpaid Company regulation claims (31A-15-105)

150 questions (plus 5 unscored Solvency (31A-4-105, 1.3 Federal regulation items) 105.5) Fair Credit Reporting Act 2.5-hour time limit Rates (31A-19a-201– (15 USC 1681–1681d) 203) Fraud and false statements Effective date: January 1, 2020 Policy forms (31A-21- (18 USC 1033, 1034) 201–203) Privacy (Gramm Leach Producer appointment Bliley) 1.0 Insurance Regulation 7% (31A-23a-115; Reg (11 Items) R590-244-1–14) National Do Not Call List 1.1 Licensing Termination of Affordable Care Act Purpose (31A-23a-101) appointment (Reg 2.0 General Insurance 5% (8 R590-244-1–14) Qualifications (31A-23a- Items) 107, 108) Unfair claim 2.1 Concepts settlement practices Process (31A-23a-103– (31A-26-303; Reg Risk management key 105, 107, 302) R590-190–192) terms Types of licensees (31A-1- Producer regulation Risk 301, 31A-23a-106, 203, 401, 504) Fiduciary and trust Exposure account Producers Hazard responsibilities Consultants (31A-23a-409) Peril

Adjusters Place of Loss business/records Nonresidents (31A- maintenance (31A- Methods of handling risk 23a-109) 23a-412) Avoidance Maintenance and duration Controlled business Retention Renewal (31A-23a- (31A-23a-502) Sharing 105) Shared commissions Continuing education (31A-23a-504) Reduction requirements (31A- Unfair marketing practices Transfer 23a-202; Reg R590- (Reg R590-154) 142-1-10) Elements of insurable risks Misrepresentation Reinstatement (31A- (31A-21-105; 31A- Adverse selection 23a-111(2), 113) 23a-402(1)) Law of large numbers Assumed name (31A- False advertising Reinsurance 23a-110(2)) (31A-23a-402(1)) 2.2 Insurers Change of address or Rebating (31A-23a- telephone number 402(2), 31A-1- Types of insurers (31A-23a-412(1)(c)) 301(145)) Stock companies Reporting of actions Unfair discrimination (31A-23a- (31A-23a-402(3)) Mutual companies 105(2)(b)) Boycott, coercion or Fraternal benefit Disciplinary actions intimidation (31A- societies License termination, 23a-402(4)) Reciprocals suspension, or Illegal inducement Lloyd's associations revocation (31A-2- (31A-23a-402.5, 308(10)(a); 31A- Reg R590-154-11) Risk retention groups 23a-111) Examination of records Private versus government Probation (31A-23a- (31A-2-203–205; 31A- insurers 112) 23a-412) Admitted versus Monetary forfeiture Privacy of Consumer nonadmitted insurers (fines) (31A-2-308) Information (Reg R590- 206) Domestic, foreign and alien 1.2 State regulation insurers

UTAH INSURANCE DEPA RTMENT

Financial status 3.2 Personal uses of life Expense (independent rating insurance services) Premium concepts Survivor protection Marketing (distribution) Net single premium Estate creation systems Gross annual premium Cash accumulation 2.3 Producers and general Premium payment mode rules of agency Liquidity 3.8 Licensee Insurer as principal Estate conservation responsibilities

Producer/insurer 3.3 Life settlements Solicitation and sales relationship (including stranger presentations (Reg Authority and powers of originated life R590-79-1–8) insurance) producer Advertising (Reg Express 3.4 Determining amount of R590-130-4–16) personal life insurance Implied Utah Life and Health Human life value approach Insurance Guaranty Apparent Association (31A- Needs approach 28-119(1-4) R590- Responsibilities to the 155) applicant/insured Types of information gathered Illustrations (31A-22- 2.4 Contracts Determining lump- 631; Reg R590-177- Elements of a legal sum needs 1–13) contract Planning for income Policy summary (31A- Offer and acceptance needs 22-631; Reg R590- 79-4(F), 5) Consideration 3.5 Business uses of life insurance Buyer's guide (Reg Competent parties R590-79-4(A), 5) Buy-sell funding Legal purpose Life insurance policy Key person cost comparison Distinct characteristics of methods an insurance contract Executive bonuses Replacement (Reg Contract of adhesion Deferred compensation R590-93-1–12) funding Aleatory contract Use and disclosure of Split dollar plans Personal contract insurance Change of insured information Unilateral contract provision Field underwriting Conditional contract 3.6 Classes of life insurance Notice of information Legal interpretations policies practices affecting contracts Group versus individual Application procedures Ambiguities in a Ordinary versus industrial Delivery contract of adhesion (home service) Policy review Reasonable Permanent versus term expectations Effective date of Participating versus coverage Indemnity nonparticipating Premium collection Utmost good faith Fixed versus variable life Representations/misre insurance and annuities Statement of good presentations including regulation of health variable products (SEC, Warranties FINRA, and Utah) (31A- 3.9 Individual underwriting 5-217, 217.5; 31A-23a- by the insurer Concealment 206) Information sources and Fraud 3.7 Premiums regulation

Waiver and estoppel Factors in premium Application determination 3.0 Life Insurance Basics 7% Licensee report (11 Items) Mortality Attending physician 3.1 Insurable interest (31A- Interest statement 21-104)

UTAH INSURANCE DEPA RTMENT

Investigative Assignment (31A-22-412) Reduced paid-up insurance consumer (inspection) report Entire contract (31A-22- 5.5 Policy loan and 424) withdrawal options Medical Information Bureau (MIB) Modifications Cash loans

Medical examinations Right to examine (free Automatic premium loans look) (31A-22-423) and lab tests Withdrawals or partial (including HIV Payment of premiums surrenders consent) (Reg R590-132-3) Grace period (31A-22- 5.6 Dividend options 402) Selection criteria and Cash payment unfair discrimination Reinstatement (31A-22- (31A-23a-402(3)) 407) Reduction of premium payments Classification of risks Incontestability (31A-22- 403) Accumulation at interest Preferred Misstatement of age and One-year term option Standard gender (31A-22-405) Paid-up additions Substandard Exclusions 5.7 Disability riders 4.0 Life Insurance Policies 7% Suicide exclusion (31A- Waiver of premium (11 Items) 22-404) 4.1 Term life insurance Waiver of cost of insurance Medical examination; Level term autopsy (31A-22-417) Disability income benefit

Annual renewable Prohibited provisions Payor benefit life/disability term including backdating (juvenile insurance) (31A-22-401) Level premium term 5.8 Accelerated (living) 5.2 Beneficiaries benefit provision/rider Decreasing term Designation options Qualifying events 4.2 Whole life insurance Individuals Disclosure Continuous premium (straight life) Classes Effect of benefit payment

Limited payment Estates 5.9 Riders covering additional insureds Single premium Minors Spouse/other-insured term 4.3 Flexible premium Trusts rider policies Succession Children's term rider Adjustable life Revocable versus Family term rider Universal life irrevocable 5.10 Riders affecting the 4.4 Specialized policies Common disaster clause death benefit amount

Joint life (first-to-die) Spendthrift clause Accidental death

Juvenile life Revocation at divorce 75- Guaranteed insurability 2-804 4.5 Group life insurance Cost of living 5.3 Settlement options Characteristics of group Return of premium plans Cash payment 6.0 Annuities 9% (13 Items) Types of plan sponsors Interest only 6.1 Annuity principles and Group underwriting Fixed-period installments concepts requirements Fixed-amount installments Accumulation period Conversion to individual versus annuity period Life income policy (31A-22-517– Owner, annuitant and 519) Single life beneficiary 5.0 Life Insurance Policy Joint and survivor Insurance aspects of Provisions, Options and annuities Riders 9% (13 Items) 5.4 Nonforfeiture options 5.1 Standard provisions Cash surrender value 6.2 Immediate versus deferred annuities Ownership Extended term

UTAH INSURANCE DEPA RTMENT

Single premium immediate Policy loans 8.2 Federal tax annuities (SPIAs) considerations Surrenders Deferred annuities Tax advantages for Amounts received by employers and Premium payment beneficiary employees options General rule and Taxation of distributions Nonforfeiture exceptions (age-related)

Surrender charges Settlement options 8.3 Plan types, Death benefits Values included in characteristics and insured's estate purchasers 6.3 Annuity (benefit) payment options 7.2 Modified endowment Simplified employee contracts (MECs) pensions (SEPs) Life contingency options Modified endowment Self-employed plans (HR Pure life versus life versus life insurance 10 or Keogh plans) with guaranteed minimum Seven-pay test Profit-sharing and 401(k) plans Single life versus Distributions multiple life SIMPLE plans 7.3 Taxation of non- Annuities certain (types) qualified annuities 403(b) tax-sheltered annuities (TSAs) 6.4 Annuity products Individually-owned 9.0 Accident and Health Fixed annuities Accumulation phase Insurance Basics 12% (18 (tax issues related Items) General account to withdrawals) assets 9.1 Definitions of perils Annuity phase and the Accidental injury (R590- Interest rate exclusion ratio guarantees 126, 233) (minimum versus Distributions at death Sickness, medical current) Corporate-owned necessity and emergency Level benefit payment (31A-22-627) amount 7.4 Taxation of individual retirement annuities 9.2 Principal types of losses Indexed annuities (IRAs) and benefits

Market value adjusted Traditional IRAs Loss of income from annuities disability (R590-126, Contributions and 233) Variable annuities deductible amounts Medical expense 6.5 Uses of annuities Premature distributions Dental expense Lump-sum settlements (including taxation Long-term care expense Qualified retirement plans issues) 9.3 Classes of health including group versus Annuity phase benefit insurance policies individual annuities payments Individual versus group Personal uses Values included in the Individual retirement annuitant's estate Private versus government annuities (IRAs) Amounts received by Self-funded vs fully insured Tax-deferred growth beneficiary Limited versus Retirement income Roth IRAs comprehensive

Education funds Contributions and Employer group versus limits association group 7.0 Federal Tax Considerations Distributions for Life Insurance and 9.4 Limited policies (R590- 126) Annuities 7% (10 Items) 7.5 Rollovers and transfers 7.1 Taxation of personal life (IRAs and qualified Limited perils and amounts insurance plans) Required notice to insured Amounts available to 7.6 Section 1035 exchanges policyowner Types of limited policies 8.0 Qualified Plans 4% (6 Cash value increases Items) Accident-only Dividends 8.1 General requirements

UTAH INSURANCE DEPA RTMENT

Specified (dread) Sources of underwriting Coordination of benefits disease information (31A-22-619)

Hospital indemnity Application Right to examine (free (income) look) (31A-22-606) Licensee report Credit disability Rights of spouse (31A-22- Attending physician 612) Blanket insurance statement (teams, passengers, Insuring clause other) Investigative consumer Consideration clause Prescription drugs (inspection) report Entire contract; changes Vision care Medical Information Bureau (MIB) Physical examinations and 9.5 Common exclusions autopsy from coverage (R590- Medical examinations 126) and lab tests Legal actions (including HIV Change of beneficiary 9.6 Licensee consent) (Reg responsibilities in R590-132-3) Unpaid premium individual health insurance Unfair discrimination Conformity with state (31A-23a-402(3)) statutes Marketing requirements Genetic Information Illegal occupation Advertising (Reg and R590-130-4–16) Nondiscrimination Renewability clause (31A- Act of 2008 (GINA) 30-107; Reg R590-126- Utah Life and Health 5; Reg R590-233) Insurance Guaranty Classification of risks Association (31A- Noncancelable 28-119(1-4); R590- Preferred 155) Guaranteed renewable Standard Sales presentations Conditionally Substandard renewable Outline of coverage (Reg R590-126-8, 9.8 Considerations in Renewable at option 233-8) replacing accident and of insurer health insurance (Reg Compensation R590-126-9, 233) Nonrenewable disclosure (31A- (cancelable, term) 23a-501) Pre-existing conditions (31A-22-605.1) 10.0 Disability Income and Field underwriting Related Insurance 2% (3 Benefits, limitations and Items) Nature and purpose exclusions 10.1 Qualifying for Employee waiver form Underwriting requirements disability benefits (31A-22-635; R590- Inability to perform duties 247) Licensee liability for errors and omissions Own occupation Disclosure of Required notification information about Any occupation individuals (R590- 9.9 Other required, uniform Loss of income (income 126, 233) and general provisions replacement contracts) Application procedures (R590-126, 233) Definition of total disability Incontestability (31A-22- Requirements at (R590-126-3) delivery of policy 609) Presumptive disability Utah individual and Grace period (31A-22- small employer 607) Requirement to be under physician care health insurance Reinstatement (31A-22- application (R590- 608) 10.2 Individual disability 247) income insurance Claim procedures (31A- Common situations for 21-312; 31A-22-614; Basic total disability plan errors/omissions 31A-26-301; Reg R590- Income benefits 9.7 Individual underwriting 192-1–14) (monthly indemnity) by the insurer Change of occupation Elimination and Underwriting criteria (31A-22-613(1)) benefit periods Misstatement of age (31A- 22-613(2,3))

UTAH INSURANCE DEPA RTMENT

Waiver of premium Qualification for disability Maternity stay feature benefits minimum limits (31A-22-610.2) Coordination with social Definition of disability insurance and workers Utilization management compensation benefits Waiting period Prospective review Additional monthly Disability income benefits benefit (AMB) Concurrent review 11.0 Medical Plans 10% (15 Social insurance Items) 11.4 Utah requirements (individual and group) supplement (SIS) 11.1 Medical plan concepts Eligibility requirements Occupational versus Fee-for-service basis nonoccupational versus prepaid basis Newborn child coverage coverage (31A-22- Specified coverages versus 610) At-work benefits comprehensive care Dependent child age Partial disability Benefit schedule versus limit (31A-22- benefit usual/reasonable/custom 610.5) ary charges Residual disability Court ordered benefit Any provider versus dependency limited choice of Other provisions affecting coverage (31A-22- providers income benefits 610.5) Insureds versus Cost of living Eligibility of dependent subscribers/participants adjustment (COLA) children not based rider 11.2 Types of providers and solely on residency plans (31A-22-718) Future increase option (FIO) rider Major medical insurance Policy extension for (indemnity plans) handicapped Relation of earnings to children (31A-22- insurance Characteristics 611)

Other cash benefits Common limitations Adoptions (31A-22- 610.1) Accidental death and Exclusions from dismemberment coverage Federal health care reform required Rehabilitation benefit Provisions affecting dependent coverage cost to insured Medical Benefit offers reimbursement Health maintenance benefit organizations (HMOs) Substance abuse (nondisabling injury) coverage (31A-22- Preferred provider 715) Refund provisions organizations (PPOs) 11.5 HIPAA (Health Return of premium General characteristics Insurance Portability Cash surrender value Limited health plans and Accountability (31A-8-101(6)) Act) requirements Exclusions Open panel or closed Eligibility 10.3 Unique aspects of panel individual disability Guaranteed issue underwriting Types of parties to the Pre-existing conditions provider contract Occupational Creditable coverage considerations Utah Net Care Plan (31A-22-724) Benefit limits Renewability 11.3 Cost containment in Policy issuance alternatives 11.6 Health Savings health care delivery Accounts (HSAs) and 10.4 Group disability Health Reimbursement Cost-saving services income insurance Accounts (HRAs) Preventive care Group versus individual Definition plans Hospital outpatient Eligibility benefits Short-term disability (STD) Contribution limits Alternatives to Long-term disability (LTD) hospital services Portability 10.5 Social Security disability

UTAH INSURANCE DEPA RTMENT

11.7 Uniform health benefit Eligibility for insurance Open enrollment (Reg plan information card R590-176) (31A-22-636) Annual open enrollment Utah Health Exchange 11.8 Federal HealthCare Reform (Patient Employee eligibility 12.6 Regulation of Protection and employer group Dependent eligibility insurance plans Affordable Care Act) (31a-22-601.1, 31a- 22-610.5, 31a-22- Employee Retirement 12.0 Group Accident and Health 611, 31a-22-718) Income Security Act Insurance 10% (15 (ERISA) Items) Coordination of benefits 12.1 Characteristics of provision (Reg R590- Applicability group insurance (31a- 131) Fiduciary 22-501) Change of insurance responsibilities Group contract companies or loss of coverage Reporting and Certificate of coverage disclosure Coinsurance and Experience rating versus deductible carryover Age Discrimination in community rating Employment Act (ADEA) No-loss no-gain 12.2 Types of eligible Applicability to groups Events that terminate employers and coverage workers Employment-related groups (31a-22-501.1) Extension of benefits Permitted reductions in insured benefits Individual employer Continuation of groups coverage under Permitted increases in COBRA and Utah employee Multiple-Employer Mini-COBRA (31A- contributions Trusts (METs) or 22-722) Welfare Requirements for Arrangements Conversion rights medical expense (MEWAs) (31A-22-723) coverage

Associations (alumni, Utah Net Care (31A- Civil Rights Act/Pregnancy professional, other) 22-724; R590-255) Discrimination Act (31a-22-70) Reinstatement of Applicability Customer groups coverage for military Guidelines (depositors, creditor- personnel (31A-22- debtor, other) (31a-22- 717) Relationship with Medicare 506) 12.5 Small employer Medicare secondary Discretionary groups medical plans rules (31a-22-70) Definition of small Medicare carve-outs 12.3 Marketing employer (31A-1-301) and supplements considerations Basic coverage (31a-22- Nondiscrimination rules Advertising (R590-155) 613.5) (highly-compensated)

Unfair inducements Availability of coverage 12.7 Types of funding and (R590-154) (31A-30-108) administration

Regulatory Rating of small employer Conventional fully-insured jurisdiction/place of plans (31A-30; Reg plans delivery R590-167) Fully self-funded (self- 12.4 Employer group health Benefit choices (31A-30- administered) plans insurance 109) Characteristics Insurer underwriting Renewability of coverage criteria (31A-30-107) Conditions suitable for self-funding Characteristics of Pre-existing conditions group (31A-22-605.1) Benefits suitable for self-funding Plan design factors Participation requirements (31A-30-112) 13.0 Dental Insurance 1% (1 Persistency factors Item) Surcharge for charging Administrative carriers (31A-30-106.7) 13.1 Categories of dental capability treatment

UTAH INSURANCE DEPA RTMENT

Diagnostic and preventive Claims terminology Employer group health and other key terms plans Restorative Part C — Medicare Disabled employees Oral surgery Advantage Employees with Endodontics Part D — Prescription Drug kidney failure (End Periodontics Insurance Stage Renal Disease) (ESRD) Prosthodontics 14.2 Medicare supplement Individuals age 65 and Orthodontics Purpose older

13.2 Indemnity plans Open enrollment (Reg Medicaid R590-146-11) Choice of providers Eligibility Standardized Medicare Scheduled versus supplement plans Benefits nonscheduled plans Core benefits (Reg 14.4 Medicare Benefit categories R590-146-8(B)) Improvements for Patients and Providers Diagnostic/preventive Additional benefits Act of 2008 (MIPPA) services (Reg R590-146- 8(C)) 15.0 Long-Term Care Insurance Basic services 4% (6 Items) Utah regulations and Major services required provisions 15.1 Long-term care (LTC) policies Deductibles and Standards for coinsurance marketing (Reg Eligibility for benefits R590-146-20) Combination plans Federal reform — CLASS ACT Exclusions Advertising (Reg R590-146-19) Levels of care Limitations Appropriateness of Skilled care Predetermination of recommended benefits purchase and Intermediate care excessive insurance 13.3 Employer group dental (Reg R590-146-21) Custodial care expense Right to return (free Home health care Integrated deductibles look) (31A-22- Adult day care versus stand-alone plans 620(6)) Respite care Minimizing adverse Replacement (Reg selection R590-146-18, 23) Benefit periods

14.0 Medicare 4% (6 Items) Pre-existing conditions Benefit amounts 14.1 Medicare standard (Reg R590-146-23) policies Optional benefits Required disclosure Nature, financing and provisions (Reg Guarantee of administration R590-146-17) insurability

Part A — Hospital Outline of coverage Return of premium (Reg R590-146- Insurance Qualified LTC plans 17(C)) Individual eligibility Exclusions requirements Guide to Health Insurance for People Underwriting Enrollment with Medicare (Reg considerations R590-146- Coverages and cost- 17(A)(6)(a)) Utah regulations and sharing amounts required provisions Permitted Part B — Medical compensation (Reg Standards for Insurance R590-146-16) marketing (Reg Individual eligibility R590-148-18) New plans effective requirements June 1, 2010 (Reg Advertising (Reg Enrollment R590-146) R590-148-20)

Coverages and cost- Medicare Advantage Shopper's guide (Reg sharing amounts R590-148-16) 14.3 Other options for Exclusions individuals with Medicare

UTAH INSURANCE DEPA RTMENT

Outline of coverage 16.3 Medical expense Change of address or (31A-22-1409; Reg coverage for sole telephone number R590-148-15) proprietors and (31A-23a-412(1)(c)) partners Appropriateness of Reporting of actions recommended 16.4 Business disability (31A-23a- purchase (Reg insurance 105(2)(b)) R590-148-17) Key person disability Disciplinary actions Right to return (free income look) (31A-22- License termination, 1408) Buy-sell policy suspension, or revocation (31A-2- Replacement (Reg 16.5 Health Savings 308(10)(a); 31A- R590-148-6) Accounts (HSAs) and 23a-111) Health Reimbursement Renewal provisions Accounts (HRAs) Probation (31A-23a- (Reg R590-148-6) 112)

Continuation or Monetary forfeiture conversion (Reg (fines) (31A-2-308) R590-148-10) 1.2 State regulation Required disclosure provisions (Reg Utah Producer's Combined Commissioner's general R590-148-6) Property and Casualty Exam duties and powers (31A- 2-201) Inflation protection Series 17-04 (Reg R590-148-13) Company regulation 150 questions (plus 5 unscored Pre-existing conditions items) Solvency (31A-4-105, (31A-22-1406; Reg 105.5) R590-148-6) 2.5-hour time limit Rates (31A-19a-201– Protection against 203) Effective date: January 1, 2020 unintentional lapse Policy forms (31A-21-

(Reg R590-148-11) 201–203)

Prohibited provisions 1.0 Insurance Regulation 11% Producer appointment (31A-22-1405, (17 Items) (31A-23a-115; Reg 1407) R590-244-1–14) 1.1 Licensing Rate disclosure form Termination of Purpose (31A-23a-101) appointment (Reg 16.0 Federal Tax Considerations Process (31A-23a-103– R590-244-1–14) for Accident and Health 105, 107, 302) Insurance 2% (3 Items) Unfair claim 16.1 Personally-owned Qualifications (31A-23a- settlement practices health insurance 107, 108) (31A-26-303; Reg R590-190–192) Individual Types of licensees (31A-1- mandate/penalties for 301, 31A-23a-106, 203, Producer regulation noncompliance 401, 504) Fiduciary and trust Disability income insurance Producers account responsibilities Medical expense insurance Consultants (31A-23a-409)

Long-term care insurance Adjusters Place of business/records 16.2 Employer group health Nonresidents (31A- maintenance (31A- insurance 23a-109) 23a-412) Disability income (STD, Maintenance and duration Controlled business LTD) Renewal (31A-23a- (31A-23a-502) Benefits subject to 105; 31A-23a-111) Shared commissions FICA Continuing education (31A-23a-504) Medical and dental requirements (31A- Unfair marketing practices expense 23a-202; Reg R590- 142-1-10) (Reg R590-154) Long-term care insurance Reinstatement (31A- Misrepresentation Accidental death and 23a-111(2), 113) (31A-21-105; 31A- dismemberment 23a-402(1)) Assumed name (31A- 23a-110(2)) False advertising (31A-23a-402(1))

UTAH INSURANCE DEPA RTMENT

Rebating (31A-23a- Law of large numbers Legal interpretations 402(2)) affecting contracts Reinsurance Unfair discrimination Ambiguities in a (31A-23a-402(3)) 2.2 Insurers contract of adhesion

Boycott, coercion or Types of insurers Reasonable intimidation (31A- Stock companies expectations 23a-402(4)) Mutual companies Indemnity Illegal inducement (31A-23a-402.5, Fraternal benefit Utmost good faith Reg R590-154-11) societies Representations/misre Examination of records Reciprocals presentations (31A-2-203–205; 31A- Warranties 23a-412) Lloyd's associations Concealment Privacy of Consumer Risk retention groups Information (Reg R590- Private versus government Fraud 206) insurers Waiver and estoppel Insurance fraud regulation Admitted versus 3.0 Property and Casualty (31A-31-103–106) nonadmitted insurers Insurance Basics 12% (18 Personal liability for unpaid Domestic, foreign and alien Items) claims (31A-15-105) insurers 3.1 Principles and concepts 1.3 Federal regulation Financial status Insurable interest Fair Credit Reporting Act (independent rating Underwriting (15 USC 1681–1681d) services) Function Fraud and false statements Marketing (distribution) systems (18 USC 1033, 1034) Loss ratio 2.3 Producers and general Privacy (Gramm Leach Rates Bliley) rules of agency Types National Flood Insurance Insurer as principal Loss costs Program Producer/insurer Terrorism Risk Insurance relationship Components Act Authority and powers of Hazards Motor Carrier Act (MCS-90 producer Physical and others) Express Moral 2.0 General Insurance 10% (15 Implied Items) Morale Apparent 2.1 Concepts Negligence Responsibilities to the Risk management key applicant/insured Elements of a terms negligent act 2.4 Contracts Risk Defenses against Elements of a legal Exposure negligence contract Hazard Damages Offer and acceptance Peril Compensatory — Consideration special versus Loss general Competent parties Methods of handling risk Punitive Legal purpose Avoidance Absolute liability Distinct characteristics of Retention an insurance contract Strict liability

Sharing Contract of adhesion Vicarious liability

Reduction Aleatory contract Causes of loss (perils) Transfer Personal contract Named perils versus special (open) perils Elements of insurable risks Unilateral contract Direct loss Adverse selection Conditional contract

UTAH INSURANCE DEPA RTMENT

Consequential or indirect Restoration/nonreduction Coverage A — Dwelling loss of limits Coverage B — Other Blanket versus specific Coinsurance structures insurance Vacancy or unoccupancy Coverage C — Personal Basic types of construction property Named insured provisions Loss valuation Coverage D — Fair rental Duties after loss value Actual cash value Assignment Coverage E — Additional Replacement cost Abandonment living expense Functional Other coverages replacement cost Insurer provisions 4.4 General exclusions Market value Liberalization 4.5 Conditions Agreed value Subrogation 4.6 Selected endorsements Stated amount Salvage Special provisions — Utah Valued policy Claim settlement options (DP 01 43) 3.2 Policy structure Third-party provisions Automatic increase in Declarations insurance (DP 04 11) Standard mortgage Definitions clause Broad theft coverage (DP 04 72) Insuring agreement or Loss payable clause clause Dwelling under No benefit to the construction (DP 11 43) Additional/supplementary bailee coverage 4.7 Personal liability 3.4 Utah laws, regulations supplement Conditions and required provisions 5.0 Homeowners Policy 12% Exclusions (18 Items) Utah Property and 5.1 Coverage forms Endorsements Casualty Insurance 3.3 Common policy Guaranty Association HO-2 through HO-6 provisions (31A-28-202–210, 212– 215, 217–218, 220, 222) HO-8 Insureds — named, first 5.2 Definitions named and additional Cancellation, issuance and renewal (31A-21-303) 5.3 Section I — Property Policy period Binders (31A-21-102) coverages Policy territory Other insurance (31A-21- Coverage A — Dwelling Cancellation and 307) Coverage B — Other nonrenewal Suit against insurer (31A- structures Deductibles 21-313) Coverage C — Personal Other insurance Concealment or fraud (RL property 76-6-521) Nonconcurrency Coverage D — Loss of use Federal Terrorism Additional coverages Primary and excess Insurance Program (15 Limits of liability USC 6701; Public Law 5.4 Section II — Liability 107–297, 109–144, coverages Per occurrence 110–160) (accident) Coverage E — Personal 4.0 Dwelling Policy 4% (6 liability Per person Items) Coverage F — Medical Aggregate—general 4.1 Characteristics and payments to others versus products— purpose completed Additional coverages 4.2 Coverage forms — Perils operations insured against 5.5 Perils insured against Split Basic 5.6 Exclusions Combined single Broad 5.7 Conditions Policy limits Special 5.8 Selected endorsements

4.3 Property coverages

UTAH INSURANCE DEPA RTMENT

Special provisions — Utah 6.2 Personal auto policy Garagekeepers (HO 01 43) coverage Definitions Limited fungi, wet or dry Trailer interchange rot, or bacteria coverage Liability coverage coverage (HO 04 26, HO 04 27, Bodily injury and HO 04 28) Physical damage property damage coverage Permitted incidental Supplementary Exclusions occupancies — residence payments premises (HO 04 42) Conditions Exclusions Earthquake (HO 04 54) Definitions Medical payments Scheduled personal coverage Selected endorsements property (HO 04 61) Uninsured motorists Lessor — additional Personal property coverage insured and loss replacement cost (HO payee (CA 20 01) 04 90) Coverage for damage to your auto Mobile equipment (CA Home day care (HO 04 20 15) 97) Collision Auto medical Business pursuits (HO 24 Other than collision payments coverage 71) Deductibles (CA 99 03) Personal injury (HO 24 Drive other car 82) Transportation expenses coverage (CA 99 10) 6.0 Auto Insurance 13% (20 Exclusions Items) Individual named 6.1 Laws Duties after an accident or insured (CA 99 17) loss Utah Financial Commercial carrier Responsibility of Motor General provisions regulations Vehicle Owners and Selected endorsements The Motor Carrier Act Operators Act (RL 41- of 1980 12a-101–104) Amendment of policy provisions — Utah Endorsement for Required motor vehicle (PP 01 93) motor carrier limits of liability (31A- policies of insurance 22-301–304) Towing and labor for public liability costs (PP 03 03) Personal injury protection (MCS-90) (31A-22-306–309) Extended non-owned 7.0 Commercial Package Policy coverage — vehicles Medical (CPP) 11% (16 Items) furnished or Loss of income available for regular 7.1 Components of a use (PP 03 06) commercial policy Special damages allowance Miscellaneous type Common policy vehicle (PP 03 23) declarations Funeral Joint ownership Common policy conditions Death coverage (PP 03 Interline endorsements 34) Uninsured/underinsured One or more coverage motorist (31A-22-305– 6.3 Commercial auto 305.3) parts Commercial auto coverage 7.2 Commercial general Definitions forms liability Bodily injury Business auto Commercial general Property damage Garage liability coverage forms (31A-22-305.5) Business auto physical Bodily injury and UM/UIM rejection damage property damage liability Required limits Truckers Personal and Utah Assigned Risk Motor carrier advertising injury Insurance Plan (31A-22- liability 310) Coverage form sections Medical payments Aftermarket Crash Parts Covered autos Act (31A-22-316–319) Liability coverage

UTAH INSURANCE DEPA RTMENT

Supplementary Value reporting form Installation floater payments (CP 13 10) Signs Who is an insured 7.4 Commercial crime Valuable papers and Limits of insurance General definitions records

Conditions Burglary Transportation coverages

Definitions Theft Motor truck cargo forms Exclusions Robbery Transit coverage Occurrence versus claims- Crime coverage forms forms made Commercial crime 7.6 Equipment breakdown Claims-made features coverage forms (discovery/loss Equipment breakdown Trigger sustained) protection coverage form (EB 00 20) Retroactive date Government crime Extended reporting coverage forms Selected endorsement periods — basic (discovery/loss sustained) Actual cash value (EB versus supplemental 99 59) Coverages Claim information 7.7 Farm coverage Employee theft Premises and operations Farm property coverage Products and completed Forgery or alteration form operations Inside the premises — Coverage A — Insured contract theft of money and Dwellings securities Pollution liability coverage Coverage B — Other form (CG 00 39) Inside the premises — private structures robbery or safe 7.3 Commercial property burglary of other Coverage C — property Household personal Commercial property property conditions form Outside the premises Coverage D — Loss of Coverage forms Computer fraud use

Building and personal Funds transfer fraud Coverage E — property Scheduled personal Money orders and property Condominium counterfeit money association Coverage F — Other crime coverages Unscheduled farm Condominium personal property commercial unit- Extortion — owners commercial entities Coverage G — Other (CR 04 03) farm structures Builders risk Guests' property (CR Farm liability coverage Business income 04 11) form

Legal liability 7.5 Commercial inland Coverage H — Bodily marine Extra expense injury and property Nationwide marine damage liability Causes of loss forms definition Coverage I — Personal Basic Commercial inland marine and advertising injury liability Broad conditions form Coverage J — Medical Special Inland marine coverage forms payments Selected endorsements Accounts receivable Mobile agricultural Ordinance or law (CP machinery and 04 05) Bailee's customer equipment coverage form Spoilage (CP 04 40) Commercial articles Livestock coverage form Peak season limit of Contractors insurance (CP 12 equipment floater Definitions 30) Electronic data Causes of loss (basic, processing broad and special)

UTAH INSURANCE DEPA RTMENT

Conditions Exclusive remedy (RL Workers' Compensation 34A-2-105) Fund (31A-22-1001; Exclusions 31A-33-101–118) Employment covered Limits (required, Self-insured employers Additional coverages voluntary) (RL 34A- (RR R612-400-3) 2-103, 104) 9.5 Rating organization 8.0 Businessowners Policy 8% Covered injuries (RL (31A-19a-301–309) (12 Items) 34A-2-401, 402) 8.1 Characteristics and 10.0 Other Coverages and purpose Occupational disease Options 8% (12 Items) (RL 34A-3-101–112) 8.2 Businessowners Section 10.1 Umbrella/excess I — Property Benefits provided (RL liability policies 34A-2-401, 408– Personal (DL 98 01) Coverages 418) Commercial (CU 00 01) Exclusions Employers' Reinsurance Fund Limits 10.2 Specialty liability (RL 34A-2-702, 703) insurance Deductibles Uninsured Employers' Errors and omissions Loss conditions Fund (RL 34A-2- 704) Professional liability General conditions 9.2 Workers compensation Directors and officers Optional coverages and employers liability liability insurance policy Definitions Fiduciary liability General section 8.3 Businessowners Section Liquor liability II — Liability Part One — Workers Employment practices compensation insurance Coverages liability Part Two — Employers Exclusions 10.3 Surplus lines (31A-15- liability insurance 103) Who is an insured Part Three — Other states Definitions and markets Limits of insurance insurance Licensing requirements General conditions Part Four — Your duties if injury occurs 10.4 Surety bonds Definitions Part Five — Premium Principal, obligee and 8.4 Businessowners Section surety III — Common Policy Part Six — Conditions Conditions Contract bonds Selected endorsements 8.5 Selected endorsements License and permit bonds Voluntary Hired auto and non-owned compensation Judicial bonds auto liability (BP 04 04) Anniversary rating 10.5 Aviation insurance Protective safeguards (BP date 04 30) Aircraft liability Other states Utility services — direct 10.6 Ocean marine Sole proprietors, damage (BP 04 56) insurance partners, officers Utility services — time and others coverage Major coverages element (BP 04 57) 9.3 Premium computations Protection and indemnity 9.0 Workers Compensation Job classification Insurance 11% (16 10.7 Other policies Items) Rates Boatowners (31A-22- 9.1 Workers compensation Payroll 1501–1504) laws Adjustment upon audit Type of law Experience modification Monopolistic versus factor competitive Premium discounts Compulsory versus elective 9.4 Other sources of coverage Utah Workers' Compensation Law

UTAH INSURANCE DEPA RTMENT

Utah Consultant's Combined Life, Commissioner's general Insurance fraud regulation Accident and Health Exam duties and powers (31A- (31A-31-103–106) 2-201) Series 17-09 Personal liability for unpaid Company regulation claims (31A-15-105)

150 questions (plus 5 unscored Solvency (31A-4-105, 1.3 Federal regulation items) 105.5) Fair Credit Reporting Act 2.5-hour time limit Rates (31A-19a-201– (15 USC 1681–1681d) 203) Fraud and false statements Effective date: January 1, 2020 Policy forms (31A-21- (18 USC 1033, 1034) 201–203) Privacy (Gramm Leach Producer appointment Bliley) 1.0 Insurance Regulation 7% (31A-23a-115; Reg (11 Items) R590-244-1–14) National Do Not Call List 1.1 Licensing Termination of Affordable Care Act Purpose (31A-23a-101) appointment (Reg 2.0 General Insurance 5% (8 R590-244-1–14) Process (31A-23a-103– Items) 105, 107, 302) Unfair claim 2.1 Concepts settlement practices Qualifications (31A-23a- (31A-26-303; Reg Risk management key 107, 108) R590-190–192) terms Types of licensees 31A-1- Producer regulation Risk 301, 31A-23a-106, 203, 401, 504) Fiduciary and trust Exposure account Producers Hazard responsibilities Consultants (31A-23a-409) Peril

Adjusters Place of Loss business/records Nonresidents (31A- maintenance (31A- Methods of handling risk 23a-109) 23a-412) Avoidance Maintenance and duration Controlled business Retention Renewal (31A-23a- (31A-23a-502) Sharing 105; 31A-23a-111) Shared commissions Continuing education (31A-23a-504) Reduction requirements (31A- Unfair marketing practices Transfer 23a-202; Reg R590- (Reg R590-154) 142-1-10) Elements of insurable risks Misrepresentation Reinstatement (31A- (31A-21-105; 31A- Adverse selection 23a-111(2), 113) 23a-402(1)) Law of large numbers Assumed name (31A- False advertising Reinsurance 23a-110(2)) (31A-23a-402(1)) 2.2 Insurers Change of address or Rebating (31A-23a- telephone number 402(2), 31A-1- Types of insurers (31A-23a-412(1)(c)) 301(145)) Stock companies Reporting of actions Unfair discrimination (31A-23a- (31A-23a-402(3)) Mutual companies 105(2)(b)) Boycott, coercion or Fraternal benefit Disciplinary actions intimidation (31A- societies License termination, 23a-402(4)) Reciprocals suspension, or Illegal inducement Lloyd's associations revocation (31A-2- (31A-23a-402.5, 308(10)(a); 31A- Reg R590-154-11) Risk retention groups 23a-111) Examination of records Private versus government Probation (31A-23a- (31A-2-203–205; 31A- insurers 112) 23a-412) Admitted versus Monetary forfeiture Privacy of Consumer nonadmitted insurers (fines) (31A-2-308) Information (Reg R590- 206) Domestic, foreign and alien 1.2 State regulation insurers

UTAH INSURANCE DEPA RTMENT

Producer/insurer 3.3 Life settlements Solicitation and sales relationship (including stranger presentations (Reg Authority and powers of originated life R590-79-1–8) insurance) producer Advertising (Reg Express 3.4 Determining amount of R590-130-4–16) personal life insurance Implied Utah Life and Health Human life value approach Insurance Guaranty Apparent Association (31A- Needs approach 28-119(1–4); Reg Responsibilities to the R590-155) applicant/insured Types of information gathered Illustrations (31A-22- 2.4 Contracts Determining lump- 631; Reg R590-177- Elements of a legal sum needs 1–13) contract Planning for income Policy summary (31A- Offer and acceptance needs 22-631; Reg R590- 79-4(F), 5) Consideration 3.5 Business uses of life insurance Buyer's guide (Reg Competent parties R590-79-4(A), 5) Buy-sell funding Legal purpose Life insurance policy Key person cost comparison Distinct characteristics of methods an insurance contract Executive bonuses Suitability (R590- Contract of adhesion Deferred compensation 230) funding Aleatory contract Need for variable Split dollar plans Personal contract license to Change of insured recommend Unilateral contract provision termination of a variable product Conditional contract 3.6 Classes of life insurance (R590-133) policies Legal interpretations Replacement (Reg affecting contracts Group versus individual R590-93-1–12)

Ambiguities in a Ordinary versus industrial Use and disclosure of contract of adhesion (home service) insurance information Reasonable Permanent versus term expectations Field underwriting Participating versus Indemnity nonparticipating Notice of information practices Utmost good faith Fixed versus variable life Representations/misre insurance and annuities Application procedures presentations including regulation of variable products (SEC, Delivery Warranties FINRA, and Utah) (31A- Policy review 5-217, 217.5; 31A-23a- Concealment 206) Effective date of coverage Fraud 3.7 Premiums Premium collection Waiver and estoppel Factors in premium determination Statement of good 3.0 Life Insurance Basics 7% health (11 Items) Mortality 3.1 Insurable interest (31A- 3.9 Individual underwriting Interest 21-104) by the insurer

UTAH INSURANCE DEPA RTMENT

Information sources and Conversion to individual Life income regulation policy (31A-22-517– 519) Single life Application Joint and survivor 5.0 Life Insurance Policy Licensee report Provisions, Options and 5.4 Nonforfeiture options Attending physician Riders 5% (7 Items) Cash surrender value statement 5.1 Standard provisions Extended term Investigative Ownership consumer Reduced paid-up insurance (inspection) report Assignment (31A-22-412) 5.5 Policy loan and Entire contract (31A-22- Medical Information withdrawal options Bureau (MIB) 424) Cash loans Medical examinations Modifications and lab tests Automatic premium loans Right to examine (free (including HIV look) (31A-22-423) consent) (Reg Withdrawals or partial surrenders R590-132-3) Payment of premiums 5.6 Dividend options Selection criteria and Grace period (31A-22- unfair discrimination 402) Cash payment (31A-23a-402(3)) Reinstatement (31A-22- Reduction of premium Classification of risks 407) payments

Preferred Incontestability (31A-22- Accumulation at interest 403) Standard One-year term option Misstatement of age and Substandard gender (31A-22-405) Paid-up additions

4.0 Life Insurance Policies 7% Exclusions 5.7 Disability riders (11 Items) Waiver of premium 4.1 Term life insurance Suicide exclusion (31A- 22-404) Waiver of cost of insurance Level term Medical examination; Disability income benefit Annual renewable autopsy (31A-22-417) term Payor benefit life/disability Prohibited provisions (juvenile insurance) Level premium term including backdating (31A-22-401) 5.8 Accelerated (living) Decreasing term benefit provision/rider 5.2 Beneficiaries 4.2 Whole life insurance Qualifying events Designation options Continuous premium Disclosure (straight life) Individuals Effect of benefit payment Limited payment Classes 5.9 Riders covering Single premium Estates additional insureds 4.3 Flexible premium Minors Spouse/other-insured term policies Trusts rider Adjustable life Succession Children's term rider Universal life Revocable versus Family term rider 4.4 Specialized policies irrevocable 5.10 Riders affecting the Joint life (first-to-die) Common disaster clause death benefit amount

Juvenile life Spendthrift clause Accidental death

4.5 Group life insurance Revocation at divorce 30- Guaranteed insurability 3-5 Characteristics of group Cost of living plans 5.3 Settlement options Return of premium Types of plan sponsors Cash payment 6.0 Annuities 9% (13 Items) Group underwriting Interest only 6.1 Annuity principles and requirements Fixed-period installments concepts

Fixed-amount installments

UTAH INSURANCE DEPA RTMENT

Accumulation period Education funds Contributions and versus annuity period limits 7.0 Federal Tax Considerations Owner, annuitant and for Life Insurance and Distributions beneficiary Annuities 9% (13 Items) 7.5 Rollovers and transfers Insurance aspects of 7.1 Taxation of personal life (IRAs and qualified annuities insurance plans)

6.2 Immediate versus Amounts available to 7.6 Section 1035 exchanges deferred annuities policyowner 8.0 Qualified Plans 6% (9 Single premium immediate Cash value increases Items) annuities (SPIAs) Dividends 8.1 General requirements Deferred annuities Policy loans 8.2 Federal tax Premium payment considerations Surrenders options Tax advantages for Amounts received by Nonforfeiture employers and beneficiary employees Surrender charges General rule and Taxation of distributions Death benefits exceptions (age-related)

6.3 Annuity (benefit) Settlement options 8.3 Plan types, payment options Values included in characteristics and purchasers Life contingency options insured's estate Simplified employee Pure life versus life 7.2 Modified endowment pensions (SEPs) with guaranteed contracts (MECs) minimum Modified endowment Self-employed plans (HR 10 or Keogh plans) Single life versus versus life insurance multiple life Seven-pay test Profit-sharing and 401(k) plans Annuities certain (types) Distributions SIMPLE plans 6.4 Annuity products 7.3 Taxation of non- Pension plans Fixed annuities qualified annuities Section 457 deferred General account Individually-owned compensation assets Accumulation phase 403(b) tax-sheltered Interest rate (tax issues related annuities (TSAs) guarantees to withdrawals) (minimum versus Annuity phase and the 8.4 Special rules for life current) exclusion ratio insurance Level benefit payment Distributions at death Incidental limitation amount Corporate-owned Taxation of economic Indexed annuities benefit 7.4 Taxation of individual Market value adjusted retirement annuities Taxation of life insurance annuities (IRAs) distributions Guaranteed living benefit Traditional IRAs 9.0 Accident and Health riders Insurance Basics 12% (18 Contributions and Variable annuities Items) deductible amounts 9.1 Definitions of perils 6.5 Uses of annuities Premature Accidental injury (R590- distributions Lump-sum settlements 126, 233) (including taxation Qualified retirement plans issues) Sickness, medical including group versus necessity and emergency Annuity phase benefit individual annuities (31A-22-627) payments Personal uses 9.2 Principal types of losses Values included in the and benefits Individual retirement annuitant's estate annuities (IRAs) Loss of income from Amounts received by disability (R590-126, Tax-deferred growth beneficiary 233) Retirement income Roth IRAs Medical expense

UTAH INSURANCE DEPA RTMENT

Dental expense Employee waiver form Licensee liability for errors (31A-22-635; R590- and omissions Long-term care expense 247) Required notification 9.3 Classes of health Disclosure of insurance policies information about 9.9 Other required, uniform and general provisions Individual versus group individuals (R590- 126, 233) (R590-126, 133) Private versus government Application procedures Incontestability (31A-22- Self-funded vs fully insured 609) Requirements at Limited versus delivery of policy Grace period (31A-22- comprehensive 607) Utah individual and Employer group versus small employer Reinstatement (31A-22- association group health insurance 608) application (R590- Claim procedures (31A- 9.4 Limited policies (R590- 247) 126) 21-312; 31A-22-614; Common situations for 31A-26-301; Reg R590- Limited perils and amounts errors/omissions 192-1–14)

Required notice to insured 9.7 Individual underwriting Change of occupation (31A-22-613(1)) Types of limited policies by the insurer Underwriting criteria Misstatement of age (31A- Accident-only 22-613(2,3)) Specified (dread) Sources of underwriting information Coordination of benefits disease (31A-22-619) Application Hospital indemnity Right to examine (free (income) Licensee report look) (31A-22-606)

Credit disability Attending physician Rights of spouse (31A-22- Blanket insurance statement 612) (teams, passengers, Investigative Insuring clause other) consumer Consideration clause Prescription drugs (inspection) report Entire contract; changes Vision care Medical Information Bureau (MIB) Physical examinations and 9.5 Common exclusions autopsy from coverage (R590- Medical examinations 126) and lab tests Legal actions (including HIV 9.6 Licensee consent) (Reg Change of beneficiary responsibilities in R590-132-3) individual health Unpaid premium insurance Unfair discrimination (31A-23a-402(3)) Conformity with state Marketing requirements statutes Genetic Information Advertising (Reg and Illegal occupation R590-130-4–16) Nondiscrimination Renewability clause (31A- Act of 2008 (GINA) Utah Life and Health 30-107; Reg R590-126- Insurance Guaranty Classification of risks 5; Reg R590-233) Association (31A- Noncancelable 28-119(1-4); R590- Preferred 155) Standard Guaranteed renewable

Sales presentations Substandard Conditionally renewable Outline of coverage 9.8 Considerations in (Reg R590-126-8, replacing accident and Renewable at option 233-8) health insurance (Reg of insurer Compensation R590-126-9, 233) Nonrenewable disclosure (31A- Pre-existing conditions (cancelable, term) 23a-501) (31A-22-605.1) 9.10 Federal Health Reform Field underwriting Benefits, limitations and (Patient Protection exclusions and Affordability Care Nature and purpose Act) Underwriting requirements 9.11 Utah Health Exchange

UTAH INSURANCE DEPA RTMENT

10.0 Disability Income and Medical Provisions affecting Related Insurance 2% (3 reimbursement cost to insured Items) benefit (nondisabling injury) Health maintenance 10.1 Qualifying for organizations (HMOs) disability benefits Refund provisions General characteristics Inability to perform duties Return of premium Preventive care Own occupation Cash surrender value services

Any occupation Exclusions Primary care physician versus referral Loss of income (income 10.3 Unique aspects of (specialty) physician replacement contracts) individual disability underwriting Emergency care Definition of total disability (R590-126-3) Occupational Hospital services considerations Presumptive disability Other basic services Benefit limits Requirement to be under Preferred provider physician care Policy issuance alternatives organizations (PPOs)

10.2 Individual disability 10.4 Group disability General characteristics income insurance income insurance Limited health plans Basic total disability plan Group versus individual (31A-8-101(6)) plans Income benefits Open panel or closed (monthly indemnity) Short-term disability (STD) panel

Elimination and Long-term disability (LTD) Types of parties to the benefit periods provider contract 10.5 Social Security Waiver of premium disability Utah Net Care Plan feature (31A-22-724) Qualification for disability Coordination with social benefits Point-of-service (POS) insurance and workers plans compensation benefits Definition of disability Nature and purpose Additional monthly Waiting period benefit (AMB) Out-of-network Disability income benefits provider access Social insurance (open-ended HMO) supplement (SIS) 11.0 Medical Plans 10% (15 Items) PCP referral Occupational versus 11.1 Medical plan concepts (gatekeeper PPO) nonoccupational coverage Fee-for-service basis Indemnity plan versus prepaid basis features At-work benefits Specified coverages versus 11.3 Cost containment in Partial disability comprehensive care health care delivery benefit Benefit schedule versus Cost-saving services Residual disability usual/reasonable/custom Preventive care benefit ary charges Hospital outpatient Other provisions affecting Any provider versus benefits income benefits limited choice of Cost of living providers Alternatives to hospital services adjustment (COLA) Insureds versus rider subscribers/participants Maternity stay minimum limits Future increase option 11.2 Types of providers and (31A-22-610.2) (FIO) rider plans Utilization management Relation of earnings to Major medical insurance insurance (indemnity plans) Prospective review Other cash benefits Characteristics Concurrent review Accidental death and Common limitations 11.4 Utah requirements dismemberment (individual and group) Exclusions from Rehabilitation benefit coverage Eligibility requirements

UTAH INSURANCE DEPA RTMENT

Newborn child Group contract Change of insurance coverage (31A-22- companies or loss of 610) Certificate of coverage coverage

Dependent child age Experience rating versus Coinsurance and limit (31A-22- community rating deductible carryover 610.5) 12.2 Types of eligible No-loss no-gain Court ordered groups dependency Events that terminate Employment-related coverage coverage (31A-22- groups (31a-22-501.1) 610.5) Extension of benefits Individual employer Eligibility of dependent groups (31a-22- Continuation of children not based 501.1) coverage under solely on residency COBRA and Utah (31A-22-718) Multiple-Employer Mini-COBRA (31A- Trusts (METs) or 22-722) Policy extension for Welfare handicapped Arrangements Conversion rights children (31A-22- (MEWAs) (31A-22-723) 611) Associations (alumni, Reinstatement of Adoptions (31A-22- professional, other) coverage for military 610.1) (31a-22-701) personnel (31A-22- 717) Federal health care Customer groups reform required (depositors, creditor- 12.5 Small employer dependent coverage debtor, other) (31a-22- medical plans 506) Benefit offers Definition of small Substance abuse Discretionary groups employer (31A-1-301) (31a-22-701) coverage (31A-22- Basic coverage (31A-22- 715) 12.3 Marketing 613.5) considerations 11.5 HIPAA (Health Availability of coverage Insurance Portability Advertising (R590-155) (31A-30-108) and Accountability Act) requirements Unfair inducements Benefit choices (31A-30- (R590-154) 109) Eligibility Regulatory Renewability of coverage Guaranteed issue jurisdiction/place of (31A-30-107) delivery Creditable coverage Pre-existing conditions Renewability 12.4 Employer group health (31A-22-605.1) insurance 11.6 Health Savings Participation requirements Accounts (HSAs) and Insurer underwriting (31A-30-112) criteria Health Reimbursement Surcharge for charging Accounts (HRAs) Characteristics of carriers (31A-30-106.7) group Definition Open enrollment (Reg Eligibility Plan design factors R590-176)

Contribution limits Persistency factors Rating of small employer plans (31A-30; Reg Portability Administrative R590-167) capability 11.7 Uniform health benefit 12.6 Regulation of plan information card Eligibility for insurance employer group (31A-22-635) Annual open insurance plans 11.8 Federal Health Care enrollment Employee Retirement Reform (Patient Employee eligibility Income Security Act Protection and (ERISA) Affordable Care Act) Dependent eligibility (31a-22-610, 31a- Applicability 12.0 Group Accident and Health 22-610.5, 31a-22- Fiduciary Insurance 10% (15 718, 31a-22-610.1, responsibilities Items) 31a-22-611) 12.1 Characteristics of Reporting and Coordination of benefits group insurance (31a- disclosure provision (Reg R590- 22-501) 131)

UTAH INSURANCE DEPA RTMENT

Age Discrimination in Diagnostic/preventive Additional benefits Employment Act (ADEA) services (Reg R590-146- 8(C)) Applicability to Basic services employers and Utah regulations and workers Major services required provisions

Permitted reductions Deductibles and Standards for in insured benefits coinsurance marketing (Reg R590-146-20) Permitted increases in Combination plans employee Exclusions/Limitations Advertising (Reg contributions R590-126 R590-146-19)

Requirements for Predetermination of Appropriateness of medical expense benefits recommended coverage purchase and 13.3 Employer group dental excessive insurance Civil Rights Act/Pregnancy expense (Reg R590-146-21) Discrimination Act Integrated deductibles Right to return (free Applicability versus stand-alone plans look) (31A-22- 620(6)) Guidelines Minimizing adverse Relationship with Medicare selection Replacement (Reg R590-146-18, 23) Medicare secondary 14.0 Medicare 4% (6 Items) Pre-existing conditions rules 14.1 Medicare standard (Reg R590-146-23) policies Medicare carve-outs Required disclosure and supplements Nature, financing and provisions (Reg administration Nondiscrimination rules R590-146-17) (highly-compensated) Part A — Hospital Outline of coverage Insurance 12.7 Types of funding and (Reg R590-146- administration Individual eligibility 17(C)) requirements Conventional fully-insured Guide to Health plans Enrollment Insurance for People with Medicare (Reg Fully self-funded (self- Coverages and cost- R590-146- administered) plans sharing amounts 17(A)(6)(a))

Characteristics Part B — Medical Permitted Insurance Conditions suitable for compensation (Reg R590-146-16) self-funding Individual eligibility requirements Benefits suitable for New plans effective June 1, 2010 (Reg self-funding Enrollment R590-146) 13.0 Dental Insurance 1% (1 Coverages and cost- Medicare Advantage Item) sharing amounts 14.3 Other options for 13.1 Categories of dental Exclusions treatment individuals with Claims terminology Medicare Diagnostic and preventive and other key terms Employer group health Restorative Part C — Medicare plans Advantage Oral surgery Disabled employees Part D — Prescription Drug Endodontics Employees with Insurance kidney failure (End Periodontics 14.2 Medicare supplement Stage Renal Prosthodontics Disease) (ESRD) Purpose Orthodontics Individuals age 65 and Open enrollment (Reg older 13.2 Indemnity plans R590-146-11) Medicaid Choice of providers Standardized Medicare supplement plans Eligibility Scheduled versus nonscheduled plans Core benefits (Reg Benefits R590-146-8(B)) Benefit categories 14.4 Medicare Improvements for

UTAH INSURANCE DEPA RTMENT

Patients and Providers Required disclosure Utah Consultant's Combined Act of 2008 (MIPPA) provisions (Reg Property and Casualty Exam R590-148-6) 15.0 Long-Term Care Insurance Series 17-10 4% (6 Items) Inflation protection (Reg R590-148-13) 15.1 Long-term care (LTC) 150 questions (plus 5 unscored policies Pre-existing conditions items) (31A-22-1406; Reg Eligibility for benefits R590-148-6) 2.5-hour time limit Levels of care Protection against Effective date: January 1, 2020 unintentional lapse Skilled care (Reg R590-148-11) Intermediate care Prohibited provisions 1.0 Insurance Regulation 11% Custodial care (31A-22-1405, (17 Items) 1407) Home health care 1.1 Licensing Rate disclosure form Adult day care Purpose (31A-23a-101)

Respite care 16.0 Federal Tax Considerations Process (31A-23a-103– for Accident and Health 105, 107, 302) Federal reform — CLASS Insurance 2% (3 Items) ACT 16.1 Personally-owned Qualifications (31A-23a- 107, 108) Benefit periods health insurance Individual Types of licensees (31A-1- Benefit amounts 301, 31A-23a-106, 203, mandate/penalties for 401, 504) Optional benefits noncompliance Producers Guarantee of Disability income insurance insurability Medical expense insurance Consultants Return of premium Long-term care insurance Adjusters Qualified LTC plans 16.2 Employer group health Nonresidents (31A- Exclusions insurance 23a-109)

Underwriting Disability income (STD, Maintenance and duration considerations LTD) Renewal (31A-23a- Utah regulations and Benefits subject to 105; 31A-23a-111) required provisions FICA Continuing education Standards for Medical and dental requirements (31A- marketing (Reg expense 23a-202; Reg R590- R590-148-18) 142-1-10) Long-term care insurance Advertising (Reg Reinstatement (31A- R590-148-20) Accidental death and 23a-111(2), 113) dismemberment Shopper's guide (Reg Assumed name (31A- R590-148-16) 16.3 Medical expense 23a-110(2)) coverage for sole Outline of coverage proprietors and Change of address or (31A-22-1409; Reg partners telephone number R590-148-15) (31A-23a-412(1)(c)) 16.4 Business disability Appropriateness of insurance Reporting of actions recommended (31A-23a- purchase (Reg Key person disability 105(2)(b)) income R590-148-17) Disciplinary actions Buy-sell policy Right to return (free License termination, look) (31A-22- 16.5 Health Savings suspension, or 1408) Accounts (HSAs) and revocation (31A-2- Replacement (Reg Health Reimbursement 308(10)(a); 31A- R590-148-6) Accounts (HRAs) 23a-111) Renewal provisions Probation (31A-23a- 112) (Reg R590-148-6) Monetary forfeiture Continuation or conversion (Reg (fines) (31A-2-308) R590-148-10) 1.2 State regulation

UTAH INSURANCE DEPA RTMENT

Commissioner's general Insurance fraud regulation Admitted versus duties and powers (31A- (31A-31-103–106) nonadmitted insurers 2-201) Personal liability for unpaid Domestic, foreign and alien Company regulation claims (31A-15-105) insurers

Solvency (31A-4-105, 1.3 Federal regulation Financial status 105.5) (independent rating Fair Credit Reporting Act services) Rates (31A-19a-201– (15 USC 1681–1681d) 203) Marketing (distribution) Fraud and false statements systems Policy forms (31A-21- (18 USC 1033, 1034) 201–203) 2.3 Producers and general Privacy (Gramm Leach rules of agency Producer appointment Bliley) (31A-23a-115; Reg Insurer as principal R590-244-1–14) National Flood Insurance Program Producer/insurer Termination of relationship appointment (Reg Terrorism Risk Insurance R590-244-1–14) Act Authority and powers of producer Unfair claim Motor Carrier Act (MCS-90 settlement practices and others) Express (31A-26-303; Reg 2.0 General Insurance 10% (15 Implied R590-190–192) Items) Apparent Producer regulation 2.1 Concepts Responsibilities to the Fiduciary and trust Risk management key applicant/insured account terms responsibilities 2.4 Contracts (31A-23a-409) Risk Elements of a legal Place of Exposure contract business/records Hazard maintenance (31A- Offer and acceptance 23a-412) Peril Consideration

Controlled business Loss Competent parties (31A-23a-502) Methods of handling risk Legal purpose Shared commissions (31A-23a-504) Avoidance Distinct characteristics of an insurance contract Unfair marketing practices Retention (Reg R590-154) Contract of adhesion Sharing Misrepresentation Aleatory contract Reduction (31A-21-105; 31A- Personal contract 23a-402(1)) Transfer Unilateral contract False advertising Elements of insurable risks (31A-23a-402(1)) Conditional contract Adverse selection Rebating (31A-23a- Legal interpretations Law of large numbers 402(2), 31A-1- affecting contracts 301(145)) Reinsurance Ambiguities in a Unfair discrimination 2.2 Insurers contract of adhesion (31A-23a-402(3)) Types of insurers Reasonable Boycott, coercion or expectations intimidation (31A- Stock companies 23a-402(4)) Indemnity Mutual companies Illegal inducement Utmost good faith (31A-23a-402.5, Fraternal benefit Representations/misre Reg R590-154-11) societies presentations Examination of records Reciprocals Warranties (31A-2-203–205; 31A- Lloyd's associations 23a-412) Concealment Risk retention groups Privacy of Consumer Fraud Information (Reg R590- Private versus government 206) insurers Waiver and estoppel

UTAH INSURANCE DEPA RTMENT

3.0 Property and Casualty 3.2 Policy structure Duty to defend Insurance Basics 12% (18 Declarations Third-party provisions Items) 3.1 Principles and concepts Definitions Standard mortgage clause Insurable interest Insuring agreement or clause Loss payable clause Underwriting Additional/supplementary No benefit to the Function coverage bailee

Loss ratio Conditions 3.4 Utah laws, regulations and required Rates Exclusions provisions Types Endorsements Utah Property and Loss costs 3.3 Common policy Casualty Insurance provisions Guaranty Association Components (31A-28-202–210, 212– Insureds — named, first 215, 217–218, 220, 222) Hazards named and additional Cancellation, issuance and Physical Policy period renewal (31A-21-303) Moral Policy territory Binders (31A-21-102) Morale Cancellation and Other insurance (31A-21- Negligence nonrenewal 307)

Elements of a Deductibles Suit against insurer (31A- negligent act 21-313) Other insurance Defenses against Concealment or fraud (RL Nonconcurrency negligence 76-6-521) Primary and excess Damages Federal Terrorism Limits of liability Insurance Program (15 Compensatory — USC 6701; Public Law special versus Per occurrence 107–297, 109–144, general (accident) 110–160)

Punitive Per person 4.0 Dwelling Policy 4% (6 Items) Absolute liability Aggregate—general versus products— 4.1 Characteristics and Strict liability completed purpose operations Vicarious liability 4.2 Coverage forms — Perils Causes of loss (perils) Split insured against

Named perils versus Combined single Basic special (open) perils Policy limits Broad Direct loss Restoration/nonreduction Special of limits Consequential or indirect 4.3 Property coverages loss Coinsurance Coverage A — Dwelling Blanket versus specific Vacancy or unoccupancy insurance Coverage B — Other Named insured provisions structures Basic types of construction Duties after loss Coverage C — Personal Loss valuation property Assignment Actual cash value Coverage D — Fair rental Abandonment Replacement cost value Insurer provisions Functional Coverage E — Additional living expense replacement cost Liberalization Other coverages Market value Subrogation 4.4 General exclusions Agreed value Salvage 4.5 Conditions Stated amount Claim settlement options Valued policy 4.6 Selected endorsements

UTAH INSURANCE DEPA RTMENT

Special provisions — Utah Business pursuits (HO 24 Other than collision (DP 01 43) 71) Deductibles Automatic increase in Personal injury (HO 24 insurance (DP 04 11) 82) Transportation expenses Broad theft coverage (DP 6.0 Auto Insurance 13% (20 Exclusions 04 72) Items) Dwelling under 6.1 Laws Duties after an accident or construction (DP 11 43) loss Utah Financial 4.7 Personal liability Responsibility of Motor General provisions Vehicle Owners and supplement Selected endorsements Operators Act (RL 41- 5.0 Homeowners Policy 12% 12a-101–104) Amendment of policy (18 Items) provisions — Utah Required motor vehicle (PP 01 93) 5.1 Coverage forms limits of liability (31A- HO-2 through HO-6 22-301–304) Towing and labor costs (PP 03 03) HO-8 Personal injury protection (31A-22-306–309) Extended non-owned 5.2 Definitions coverage — vehicles Medical furnished or 5.3 Section I — Property available for regular coverages Loss of income use (PP 03 06) Coverage A — Dwelling Special damages allowance Miscellaneous type Coverage B — Other vehicle (PP 03 23) structures Funeral Joint ownership Coverage C — Personal Death coverage (PP 03 34) property Uninsured/underinsured Coverage D — Loss of use motorist (31A-22-305– 6.3 Commercial auto 305.3) Additional coverages Commercial auto coverage Definitions forms 5.4 Section II — Liability coverages Bodily injury Business auto

Coverage E — Personal Property damage Garage liability (31A-22-305.5) Business auto physical Coverage F — Medical UM/UIM rejection damage payments to others Required limits Truckers Additional coverages Utah Assigned Risk Motor carrier 5.5 Perils insured against Insurance Plan (31A-22- 310) Coverage form sections 5.6 Exclusions Aftermarket Crash Parts Covered autos 5.7 Conditions Act (31A-22-316–319) Liability coverage 5.8 Selected endorsements 6.2 Personal auto policy Garagekeepers Special provisions — Utah Definitions coverage (HO 01 43) Liability coverage Trailer interchange Limited fungi, wet or dry coverage rot, or bacteria coverage Bodily injury and Physical damage (HO 04 26, HO 04 27) property damage coverage Permitted incidental Supplementary Exclusions occupancies — residence payments premises (HO 04 42) Exclusions Conditions

Earthquake (HO 04 54) Medical payments Definitions coverage Scheduled personal Selected endorsements property (HO 04 61) Uninsured motorists Lessor — additional coverage Personal property insured and loss replacement cost (HO Coverage for damage to payee (CA 20 01) 04 90) your auto Mobile equipment (CA Home day care (HO 04 Collision 20 15) 97)

UTAH INSURANCE DEPA RTMENT

Auto medical Claim information Employee theft payments coverage (CA 99 03) Premises and operations Forgery or alteration

Drive other car Products and completed Inside the premises — coverage (CA 99 operations theft of money and securities 10) Insured contract Inside the premises — Individual named Pollution liability coverage insured (CA 99 17) robbery or safe form (CG 00 39) burglary of other Commercial carrier 7.3 Commercial property property regulations Commercial property Outside the premises The Motor Carrier Act conditions form of 1980 Computer fraud Coverage forms Endorsement for Funds transfer fraud motor carrier Building and personal Money orders and policies of insurance property counterfeit money for public liability (MCS-90) Condominium Other crime coverages association 7.0 Commercial Package Policy Extortion — Condominium (CPP) 11% (16 Items) commercial entities commercial unit- (CR 04 03) 7.1 Components of a owners commercial policy Guests' property (CR Builders risk 04 11) Common policy declarations Business income 7.5 Commercial inland marine Common policy conditions Legal liability Nationwide marine Interline endorsements Extra expense definition One or more coverage Causes of loss forms Commercial inland marine parts Basic conditions form 7.2 Commercial general Broad Inland marine coverage liability forms Special Commercial general Accounts receivable liability coverage forms Selected endorsements Bailee's customer Bodily injury and Ordinance or law (CP property damage 04 05) Commercial articles liability Spoilage (CP 04 40) Contractors Personal and equipment floater advertising injury Peak season limit of liability insurance (CP 12 Electronic data 30) processing Medical payments Value reporting form Installation floater Supplementary (CP 13 10) payments Signs 7.4 Commercial crime Who is an insured Valuable papers and General definitions records Limits of insurance Burglary Transportation coverages Conditions Theft Motor truck cargo Definitions forms Robbery Exclusions Transit coverage Crime coverage forms forms Occurrence versus claims- made Commercial crime 7.6 Equipment breakdown coverage forms Claims-made features (discovery/loss Equipment breakdown sustained) protection coverage form Trigger (EB 00 20) Government crime Retroactive date coverage forms Selected endorsement Extended reporting (discovery/loss Actual cash value (EB periods — basic sustained) 99 59) versus supplemental Coverages

UTAH INSURANCE DEPA RTMENT

7.7 Farm coverage General conditions Uninsured Employers' Fund (RL 34A-2- Farm property coverage Optional coverages 704) form Definitions 9.2 Workers compensation Coverage A — and employers liability Dwellings 8.3 Businessowners Section II — Liability insurance policy Coverage B — Other General section private structures Coverages Exclusions Part One — Workers Coverage C — compensation insurance Household personal Who is an insured property Part Two — Employers Limits of insurance liability insurance Coverage D — Loss of use General conditions Part Three — Other states insurance Coverage E — Definitions Scheduled personal Part Four — Your duties if property 8.4 Businessowners Section injury occurs III — Common Policy Coverage F — Conditions Part Five — Premium Unscheduled farm personal property 8.5 Selected endorsements Part Six — Conditions

Coverage G — Other Hired auto and non-owned Selected endorsements auto liability (BP 04 04) farm structures Voluntary Farm liability coverage Protective safeguards (BP compensation 04 30) form Anniversary rating Coverage H — Bodily Utility services — direct date damage (BP 04 56) injury and property Other states damage liability Utility services — time element (BP 04 57) Sole proprietors, Coverage I — Personal partners, officers and advertising 9.0 Workers Compensation and others coverage injury liability Insurance 11% (16 9.3 Premium computations Coverage J — Medical Items) payments 9.1 Workers compensation Job classification laws Mobile agricultural Rates machinery and Type of law equipment coverage Payroll Monopolistic versus form Adjustment upon audit competitive Livestock coverage form Experience modification Compulsory versus factor Definitions elective Premium discounts Causes of loss (basic, Utah Workers' broad and special) Compensation Law 9.4 Other sources of coverage Conditions Exclusive remedy (RL 34A-2-105) Exclusions Workers' Compensation Fund (31A-22-1001; Employment covered Limits 31A-33-101–118) (required, Additional coverages voluntary) (RL 34A- Self-insured employers 2-103, 104) (RR R612-3-1–7) 8.0 Businessowners Policy 8% (12 Items) Covered injuries (RL 9.5 Rating organization 34A-2-401, 402) (31A-19a-401–407) 8.1 Characteristics and purpose Occupational disease 10.0 Other Coverages and (RL 34A-3-101–112) 8.2 Businessowners Section Options 8% (12 Items) I — Property Benefits provided (RL 10.1 Umbrella/excess 34A-2-401, 408– liability policies Coverages 418) Personal (DL 98 01) Exclusions Employers' Commercial (CU 00 01) Limits Reinsurance Fund (RL 34A-2-702, 703) 10.2 Specialty liability Deductibles insurance

Loss conditions Errors and omissions

UTAH INSURANCE DEPA RTMENT

Professional liability 10.9 Residual markets 206; Reg. R590-142-1 including Joint through 10) Directors and officers Underwriting liability Association (31A-2- Reinstatement (31A-26- 214) 214.5 (2); Reg. R590- Fiduciary liability 244-8) Liquor liability 10.10 Alternative funding mechanisms Assumed name (31A-26- Employment practices 209(2)) Self-insured liability Records (31A-26-306(2– 10.3 Surplus lines (31A-15- Pooling 4)) 103) Risk retention groups Change of address or Definitions and markets telephone number (31A- Captives 26-306(1)(b)) Licensing requirements Reporting of actions (31A- 10.4 Surety bonds 26-203) Principal, obligee and 1.3 Disciplinary actions surety Utah Adjuster's Property and License Termination, Contract bonds Casualty Exam suspension, revocation, refusal to issue or renew License and permit bonds Series 17-11 (31A-26-213)

Judicial bonds 150 questions (plus 5 unscored Probation (31A-26-214) 10.5 Aviation insurance items) Monetary forfeiture (fines) (31A-2-308) Aircraft hull 2.5-hour time limit Aircraft liability 1.4 Unfair claim settlement Effective date: January 1, 2020 laws and regulations Airport liability (31A-26-301, 303; Reg R590-190-1–14) Hangarkeepers liability 1.0 Insurance Regulation 8% Place of business/records 10.6 Ocean marine (12 Items) maintenance (31A-26- insurance 1.1 Licensing requirements 102) Major coverages Definitions (31A-26-102) 2.0 Insurance Basics 23% (35 Hull insurance Items) Qualifications (31A-26- 2.1 Contracts Cargo insurance 203, 205) Elements of a legal Freight insurance Purpose (31A-26-202) contract Protection and Process (31A-26-202) Offer and acceptance indemnity Classifications of licenses Consideration Implied warranties (31A-26-204) Competent parties Perils License/character requirements (31A-26- Legal purpose General and particular 204 & 205) average Distinct characteristics of Licensing exceptions an insurance contract 10.7 National Flood (31A-26-201(2)) Insurance Program Contract of adhesion Adjusters (31A-26-102, "Write your own" versus 201, 204 (1)(c)) Aleatory contract government Nonresident adjuster Personal contract Eligibility (31A-26-208) Unilateral contract Coverage Emergency adjuster license (31A-26-212) Conditional contract Limits 1.2 Maintenance and Legal interpretations Deductibles duration affecting contracts 10.8 Other policies Renewal (31A-26-213; Ambiguities in a contract of adhesion Boatowners (31A-22- 31A-26-214.5; Reg. 1501–1504) R590-244-7 though 9) Reasonable expectations Difference in conditions Continuing education requirements (31A-26- Indemnity

UTAH INSURANCE DEPA RTMENT

Utmost good faith Insuring agreement or Duties and responsibilities clause (31A-26-304–311) Representations/misre presentations Additional/supplementary Staff and independent coverage adjuster versus public Warranties adjuster Conditions Concealment Relationship to legal Exclusions Fraud profession Endorsements Waiver and estoppel 3.2 Claim reporting 2.4 Common policy Claim investigation 2.2 Principles and concepts provisions Insurable interest Claim file documentation of Insureds — named, first events Hazards named and additional Types of reports Physical Policy period Initial or first field Moral Policy territory Interim or status Morale Cancellation and nonrenewal Full formal Negligence Deductibles 3.3 Property losses Elements of a negligent act Other insurance Duties of insured after a loss Defenses against Nonconcurrency Notice to insurer negligence Primary and excess Minimizing the loss Damages Pro rata Proof of loss Compensatory — Contribution by equal special versus shares Special requirements general Limits of liability Production of books Punitive and records Per occurrence Absolute liability (accident) Abandonment

Strict liability Per person Determining value and loss

Vicarious liability Aggregate — general Burden of proof of Causes of loss (perils) versus products — value and loss completed Named perils versus operations Estimates special (open) perils Split Depreciation Direct loss Combined single Salvage Consequential or indirect Claim settlement options loss Restoration/nonreduction of limits Payment and discharge Blanket versus specific insurance Coinsurance 3.4 Liability losses

Basic types of construction Vacancy or unoccupancy Investigation procedures

Loss valuation Assignment Verify coverages Actual cash value Insurer provisions Determine liability

Replacement cost Liberalization Gathering evidence

Functional Duty to defend Physical evidence replacement cost Third-party provisions Witness statements Market value Standard mortgage Determining value of Agreed value clause intangible damages

Stated amount Loss payable clause 3.5 Coverage problems

Valued policy No benefit to the Dealing with coverage bailee disputes 2.3 Policy structure 3.0 Adjusting Losses 24% (36 Reservation of rights Declarations Items) letter Definitions 3.1 Role of the adjuster

UTAH INSURANCE DEPA RTMENT

Nonwaiver agreement 4.7 Personal liability Utah Financial supplement Responsibility of Motor Declaratory judgment Vehicle Owners and action 5.0 Homeowners Policy 9% (13 Operators Act (RL 41- Items) 3.6 Claims adjustment 12a-101–104) 5.1 Coverage forms procedures Required motor vehicle Settlement procedures HO-2 through HO-6 limits of liability (31A- 22-301–304) Advance payments HO-8 Personal injury protection Draft authority 5.2 Definitions (31A-22-306–309)

Execution of releases 5.3 Section I — Property Medical coverages Subrogation procedures Loss of income Coverage A — Dwelling Alternative dispute Special damages resolution Coverage B — Other allowance structures Appraisal Funeral Coverage C — Personal Arbitration property Death

Competitive estimates Coverage D — Loss of use Uninsured/underinsured motorist (31A-22-305– Mediation Additional coverages 305.3)

Negotiation 5.4 Section II — Liability Definitions coverages 4.0 Dwelling Policy 4% (6 Bodily injury Items) Coverage E — Personal Property damage 4.1 Characteristics and liability (31A-22-305.5) purpose Coverage F — Medical UM/UIM rejection 4.2 Coverage forms — Perils payments to others insured against Additional coverages Required limits Basic 5.5 Perils insured against Utah Assigned Risk Insurance Plan (31A-22- Broad 5.6 Exclusions 310) Special 5.7 Conditions Aftermarket Crash Parts Act (31A-22-316–319) 4.3 Property coverages 5.8 Selected endorsements 6.2 Personal auto policy Coverage A — Dwelling Special provisions — Utah Coverage B — Other (HO 01 43) Definitions structures Limited fungi, wet or dry Liability coverage Coverage C — Personal rot, or bacteria coverage Bodily injury and property (HO 04 26, HO 04 27, HO 04 28) property damage Coverage D — Fair rental Supplementary value Permitted incidental occupancies — residence payments Coverage E — Additional premises (HO 04 42) Exclusions living expense Earthquake (HO 04 54) Medical payments Other coverages Scheduled personal coverage 4.4 General exclusions property (HO 04 61) Uninsured motorists 4.5 Conditions Personal property coverage replacement cost (HO Coverage for damage to 4.6 Selected endorsements 04 90) your auto Special provisions — Utah Home day care (HO 04 Collision (DP 01 43) 97) Other than collision Automatic increase in Business pursuits (HO 24 insurance (DP 04 11) 71) Deductibles Broad theft coverage (DP Personal injury (HO 24 Transportation 04 72) 82) expenses Dwelling under 6.0 Auto Insurance 9% (13 Exclusions construction (DP 11 43) Items) 6.1 Laws

UTAH INSURANCE DEPA RTMENT

Duties after an accident or False pretense Definitions loss coverage (CA 25 03) Exclusions General provisions Auto medical Occurrence versus claims- Selected endorsements payments coverage made Amendment of policy (CA 99 03) Claims-made features provisions — Utah Drive other car Trigger (PP 01 93) coverage (CA 99 Towing and labor 10) Retroactive date costs (PP 03 03) Hired autos specified Extended reporting Extended non-owned as covered autos periods — basic coverage — vehicles you own (CA 99 16) versus supplemental furnished or Individual named Claim information available for regular insured (CA 99 17) use (PP 03 06) Premises and operations Employees as insureds Miscellaneous type (CA 99 33) Products and completed vehicle (PP 03 23) operations Pollution liability — Joint ownership broadened coverage Insured contract coverage (PP 03 (CA 99 48; CA 99 34) Owners and contractors 55) protective liability 6.3 Commercial auto Commercial carrier coverage form Commercial auto coverage regulations Pollution liability forms The Motor Carrier Act Pollution liability Business auto of 1980 coverage form (CG 00 39) Garage Endorsement for motor carrier Pollution liability Business auto physical policies of insurance limited coverage damage for public liability form (CG 00 40) (MCS-90) Truckers Pollution liability 7.0 Commercial Package Policy Motor carrier coverage extension (CPP) 8% (12 Items) endorsement (CG Coverage form sections 7.1 Components of a 04 22) commercial policy Covered autos 7.3 Commercial property Common policy Liability coverage Commercial property declarations conditions form Garagekeepers Common policy conditions coverage Coverage forms Interline endorsements Trailer interchange Building and personal coverage One or more coverage property parts Physical damage Condominium coverage 7.2 Commercial general association liability Exclusions Condominium Commercial general commercial unit- Conditions liability coverage forms owners Definitions Bodily injury and Builders risk property damage Selected endorsements Business income liability Deductible liability Legal liability (CA 03 01) Personal and advertising injury Extra expense Lessor — additional liability insured and loss Causes of loss forms payee (CA 20 01) Medical payments Basic Mobile equipment (CA Supplementary 20 15) payments Broad

Broad form products Who is an insured Special (CA 25 01) Limits of insurance Selected endorsements

Conditions Ordinance or law (CP 04 05)

UTAH INSURANCE DEPA RTMENT

Spoilage (CP 04 40) Commercial inland marine Farm liability coverage conditions form form Peak season limit of insurance (CP 12 Inland marine coverage Coverage H — Bodily 30) forms injury and property damage liability Value reporting form Accounts receivable (CP 13 10) Coverage I — Personal Bailee's customer and advertising 7.4 Commercial crime Commercial articles injury liability General definitions Contractors Coverage J — Medical Burglary equipment floater payments

Theft Electronic data Mobile agricultural processing machinery and Robbery equipment coverage Equipment dealers form Crime coverage forms Installation floater Livestock coverage form Commercial crime coverage forms Jewelers block Definitions (discovery/loss sustained) Signs Causes of loss (basic, broad and special) Government crime Valuable papers and coverage forms records Conditions (discovery/loss Transportation coverages Exclusions sustained) Common carrier cargo Limits Coverages liability Additional coverages Employee theft Motor truck cargo 8.0 Businessowners Policy 7% Forgery or alteration forms (11 Items) Transit coverage Inside the premises — 8.1 Characteristics and forms theft of money and purpose securities 7.6 Equipment breakdown 8.2 Businessowners Section Inside the premises — Equipment breakdown I — Property robbery or safe protection coverage form Coverages burglary of other (EB 00 20) property Exclusions Selected endorsement Outside the premises Limits Actual cash value (EB Computer fraud 99 59) Deductibles Funds transfer fraud 7.7 Farm coverage Loss conditions Money orders and Farm property coverage General conditions counterfeit money form Optional coverages Other crime coverages Coverage A — Definitions Extortion — Dwellings commercial entities Coverage B — Other 8.3 Businessowners Section (CR 04 03) private structures II — Liability

Lessees of safe Coverage C — Coverages deposit boxes (CR Household personal Exclusions 04 09) property Who is an insured Securities deposited Coverage D — Loss of with others (CR 04 use Limits of insurance 10) Coverage E — General conditions Guests' property (CR Scheduled personal 04 11) property Definitions

Safe depository (CR Coverage F — 8.4 Businessowners Section 04 12) Unscheduled farm III — Common Policy Conditions 7.5 Commercial inland personal property marine Coverage G — Other 8.5 Selected endorsements farm structures Nationwide marine Hired auto and non-owned definition auto liability (BP 04 04)

UTAH INSURANCE DEPA RTMENT

Protective safeguards (BP Part Four — Your duties if Assumed name (31A-26- 04 30) injury occurs 209(2))

Utility services — direct Part Five — Premium Records (31A-26-306(2– damage (BP 04 56) 4)) Part Six — Conditions Utility services — time Change of address or element (BP 04 57) Selected endorsements telephone number (31A- Voluntary 26-306(1)(b)) 9.0 Workers Compensation compensation Insurance 8% (12 Items) 1.3 Disciplinary actions 9.1 Workers compensation Foreign coverage License Termination, laws Anniversary rating suspension, revocation, refusal to issue or renew Type of law date (31A-26-213) Monopolistic versus Other states Probation (31A-26-214) competitive Sole proprietors, Monetary forfeiture (fines) Compulsory versus partners, officers (31A-2-308) elective and others coverage 1.4 Unfair claim settlement Utah Workers' laws and regulations Compensation Law (31A-26-301, 301.5, Exclusive remedy (RL 303; Reg R590-192-1– 34A-2-105) Utah Adjuster's Accident and 14) Health Exam Employment covered 1.5 Federal regulation (required, Series 17-12 Fraud and false statements voluntary) (RL 34A- (18 USC 1033-1034) 2-103, 104) 100 questions (5 unscored items)

2.0 Accident and Health Covered injuries (RL 2-hour time limit 34A-2-401, 402) Insurance Basics 17% (17 Items) Effective date: January 1, 2020 Occupational disease 2.1 Definition of potential (RL 34A-3-101–112) claims Benefits provided (RL 1.0 Insurance Regulation 10% Accidental injury 34A-2-401, 408– (10 Items) 418) Sickness 1.1 Licensing requirements Employers' 2.2 Principal types of claims Reinsurance Fund Qualifications (31A-26- and benefits (RL 34A-2-702, 703) 203, 205) Loss of income from Uninsured Employers' Process (31A-26-202) disability Fund (RL 34A-2- Classifications of licenses 704) Medical expense (31A-26-204) Federal workers Dental expense Adjusters (31A-26-102, compensation laws 201, 204 (1)(c)) Long-term care expense U.S. Longshore and Licensing exemptions 2.3 Classes of health Harbor Workers' (31A-26-201(2)) insurance policies Compensation Act (33 USC 904) Nonresident adjuster Individual versus group (31A-26-208) The Jones Act (46 Private versus government USC 688) Emergency adjuster Limited versus license (31A-26-212) 9.2 Workers compensation comprehensive and employers liability 1.2 Maintenance and 2.4 Limited policies insurance policy duration Limited benefits and General section Renewal (31A-23a-105; amounts 31A-23a-111) Part One — Workers Required notice to insured compensation insurance Continuing education (31A-26-206; Reg R590- Part Two — Employers Types of limited policies 142) liability insurance Accident-only Reinstatement (31A-26- Part Three — Other states 214.5 (2); Reg. R590- Specified (dread) insurance 244-8) disease

UTAH INSURANCE DEPA RTMENT

Hospital indemnity Strains and sprains 31A-26-301; Reg R590- (income) 192-1–14) Dislocations Credit disability 4.2 Optional provisions Fractures Blanket insurance Change of occupation (teams, passengers, Soft tissue injuries (31A-22-613(1)) other) Brain injuries Misstatement of age (31A- Prescription drugs Burn classifications 22-613(2, 3))

Vision care Cumulative trauma Other insurance (31A-22- 619) 2.5 Common exclusions Repetitive motion injuries from coverage Coordination of benefits Lung disease (Reg R590-131-1–9) 2.6 Considerations in replacing accident and Diabetes mellitus 4.3 Other general health insurance (Reg provisions R590-126-9, 233) Glaucoma Right to examine (free Benefits, limitations and Hypertension look) (31A-22-606) exclusions Osteoarthritis Insuring clause Underwriting requirements Osteomyelitis Consideration clause 2.7 Accident and health Osteoporosis insurance claims Entire contract; changes Stroke Insured's notice Physical examinations and Tachycardia autopsy Standard claim forms Atherosclerosis Legal actions Insurer's provision of claim forms Coronary thrombosis Rights of spouse (31A-22- 612) Insured's submission of 3.4 Medical tests proof of loss Change of beneficiary Laboratory Insurer's Unpaid premium Radiography (X-ray) investigation/verification Conformity with state of loss Magnetic resonance statutes imaging (MRI) Insurer's payment of claim Illegal occupation Physical examination and Computerized tomography (CT or CAT) Renewability clause (31A- autopsy 30-107; Reg R590-126- Legal actions Electromyography (EMG) 5, 233) Nerve conduction studies Noncancelable 3.0 Understanding the Language of Medical Reports 10% Myelography Guaranteed renewable (10 Items) Arthroscopy Conditionally 3.1 Medical terminology renewable and abbreviations Electrocardiogram (EKG or ECG) Renewable at option Location terms of insurer Electroencephalography Movement terms (EEG) Nonrenewable Prefixes, suffixes and root (cancelable, term) words 4.0 Accident and Health Insurance Policy General 5.0 Disability Income and Abbreviations used in Provisions 13% (13 Related Insurance 10% medical reports items) (10 Items)

Medical specialties 4.1 Required provisions 5.1 Qualifying for disability benefits 3.2 Basic human anatomy Incontestability (31A-22- 609) Inability to perform duties Skeletal structure Grace period (31A-22- Own occupation Nervous system 607) Any occupation Respiratory system Reinstatement (31A-22- 608) Loss of income (income Cardiovascular system replacement contracts) Claim procedures (31A- Abdominal organs 21-312; 31A-22-614; Presumptive disability 3.3 Injuries and diseases

UTAH INSURANCE DEPA RTMENT

Requirement to be under Policy issuance alternatives Primary care physician physician care versus referral 5.4 Group disability income (specialty) physician 5.2 Individual disability insurance income insurance Emergency care Group versus individual Basic total disability plan plans Hospital services

Income benefits Short-term disability (STD) Other basic services (monthly indemnity) Long-term disability (LTD) Preferred provider Elimination and organizations (PPOs) benefit periods 5.5 Business disability insurance General characteristics Waiver of premium feature Key employee (partner) Limited health plans disability income (31A-8-101(6)) Coordination with social insurance and workers Disability buy-sell policy Open panel or closed panel compensation benefits 5.6 Social Security Additional monthly disability Types of parties to the provider contract benefit (AMB) Qualification for disability Social insurance benefits Point-of-service (POS) plans supplement (SIS) Definition of disability Nature and purpose Occupational versus Waiting period nonoccupational Out-of-network coverage Disability income benefits provider access At-work benefits 5.7 Workers compensation (open-ended HMO)

Partial disability Eligibility PCP referral benefit (gatekeeper PPO) 6.0 Medical Plans 10% (10 Indemnity plan Residual disability Items) benefit features 6.1 Medical plan concepts Other provisions affecting 6.3 Cost containment in Fee-for-service basis income benefits health care delivery versus prepaid basis Cost of living Cost-saving services Specified coverages versus adjustment (COLA) comprehensive care Preventive care rider Benefit schedule versus Hospital outpatient Future increase option usual/reasonable/custom benefits (FIO) rider ary charges Alternatives to Relation of earnings to Any provider versus hospital services insurance limited choice of Utilization management Other cash benefits providers Prospective review Accidental death and Insureds versus dismemberment subscribers/participants Concurrent review

Rehabilitation benefit 6.2 Types of providers and 6.4 Utah requirements plans (individual and group) Medical reimbursement Major medical insurance Eligibility requirements benefit (indemnity plans) (nondisabling injury) Newborn child Characteristics coverage (31A-22- Refund provisions 610) Common limitations Return of premium Dependent child age Exclusions from limit (31A-22- coverage Cash surrender value 610.5) Provisions affecting Exclusions Eligibility of dependent cost to insured 5.3 Unique aspects of children not based individual disability Health maintenance solely on residency underwriting organizations (HMOs) (31A-22-718)

Occupational General characteristics Policy extension for considerations handicapped Preventive care children (31A-22- Benefit limits services 611)

UTAH INSURANCE DEPA RTMENT

Benefit offers 7.4 Employer group health Participation requirements insurance (31A-30-112) Substance abuse coverage (31A-22- Insurer underwriting Open enrollment (Reg 715) criteria R590-176-1–11)

6.5 HIPAA (Health Characteristics of 7.6 Regulation of employer Insurance Portability group group insurance plans and Accountability Act) requirements Plan design factors Employee Retirement Income Security Act Eligibility Persistency factors (ERISA)

Guaranteed issue Administrative Applicability capability Creditable coverage Fiduciary Eligibility for insurance responsibilities Renewability Annual open Reporting and 6.6 Medical savings enrollment disclosure accounts (MSAs) and Health savings Employee eligibility Age Discrimination in accounts (HSAs) Dependent eligibility Employment Act (ADEA) Definition (31a-22-601.1, 31a- Applicability to 22-610.5, 31a-22- employers and Eligibility 611, 31a-22-718) workers

Contribution limits Coordination of benefits Permitted reductions provision (Reg R590- in insured benefits Portability 131-1–9) Permitted increases in 7.0 Group Accident and Health Change of insurance employee Insurance 10% (10 companies or loss of contributions Items) coverage 7.1 Characteristics of group Requirements for Coinsurance and insurance (31a-22-501) medical expense deductible carryover coverage Group contract No-loss no-gain Civil Rights Act/Pregnancy Certificate of coverage Events that terminate Discrimination Act Experience rating versus coverage Applicability community rating Extension of benefits Guidelines 7.2 Types of eligible groups Continuation of Relationship with Medicare Employment-related coverage under groups (31a-22-501.1) COBRA and Utah Medicare secondary specific rules (31A- rules Individual employer 22-722) groups (31a-22- Medicare carve-outs 501.1) Conversion rights and supplements (31A-22-723) Multiple-Employer Nondiscrimination rules Trusts (METs) or Conversion rights for (highly-compensated) Welfare former spouse 7.7 Types of funding and Arrangements (31A-22-612) administration (MEWAs) Reinstatement of Conventional fully-insured Associations (alumni, coverage for military plans professional, other) personnel (31A-22- (31a-22-701 717) Fully self-funded (self- administered) plans Customer groups 7.5 Small employer medical (depositors, creditor- plans Characteristics debtor, other) (31a-22- Definition of small 506) Conditions suitable for employer (31A-1-301) self-funding 7.3 Marketing Basic coverage (31A-22- considerations Benefits suitable for 613.5) self-funding Advertising (R590-155) Availability of coverage 8.0 Dental Insurance 7% (7 (31A-30-108) Regulatory Items) jurisdiction/place of Pre-existing conditions delivery 8.1 Categories of dental (31A-22-605.1) treatment

UTAH INSURANCE DEPA RTMENT

Diagnostic and preventive Exclusions Employer group health plans Restorative Claims terminology and other key terms Disabled employees Oral surgery Part C — Medicare Employees with Endodontics Advantage kidney failure

Periodontics Part D — Prescription Drug Individuals age 65 and Prosthodontics Insurance older

Orthodontics 9.2 Medicare supplements Medicaid

8.2 Indemnity plans Purpose Eligibility

Choice of providers Open enrollment (Reg Benefits R590-146-11) Scheduled versus 9.4 Long-term care (LTC) nonscheduled plans Standardized Medicare policies supplement plans Benefit categories LTC, Medicare and Core benefits (Reg Medicaid compared Diagnostic/preventive R590-146-8(B)) services Eligibility for benefits Additional benefits Basic services (Reg R590-146- Levels of care 8(C)) Major services Skilled care Utah regulations and Intermediate care Deductibles and required provisions coinsurance Custodial care Standards for Combination plans marketing (Reg Home health care R590-146-20) Exclusions Adult day care Limitations Advertising (Reg R590-146-19) Respite care Predetermination of Benefit periods benefits Appropriateness of recommended Benefit amounts 8.3 Employer group dental purchase and expense excessive insurance Optional benefits (Reg R590-146-21) Integrated deductibles Guarantee of versus stand-alone plans Right to return (free insurability look) (31A-22- Minimizing adverse 620(6)) Return of premium selection Replacement (Reg Qualified LTC plans 9.0 Insurance for Senior Citizens R590-146-18, 22 & Exclusions and Special Needs 23) Individuals 10% (10 Underwriting Items) Pre-existing conditions considerations (Reg R590-146-23) 9.1 Medicare Utah regulations and Required disclosure Nature, financing and required provisions provisions (Reg administration R590-146-17) Standards for Part A — Hospital marketing (Reg Outline of coverage Insurance R590-148-18) (Reg R590-146- Individual eligibility 17(C)) Advertising (Reg requirements R590-148-20) Guide to Health Enrollment Insurance for People Shopper's guide (Reg with Medicare (Reg R590-148-16) Coverages and cost- R590-146- Outline of coverage sharing amounts 17(A)(6)(a)) (31A-22-1409; Reg Part B — Medical Permitted R590-148-15) Insurance compensation (Reg Appropriateness of R590-146-16) Individual eligibility recommended requirements Medicare Select (Reg purchase (Reg R590-146-10) R590-148-17) Enrollment Right to return (free Coverages and cost- 9.3 Other options for look) (31A-22- sharing amounts individuals with Medicare 1408)

UTAH INSURANCE DEPA RTMENT

Replacement (Reg proprietors and 412(1)(c); R590- R590-148-6) partners 258)

Renewal provisions 10.4 Business disability Reporting of actions (Reg R590-148-6) insurance (31A-23a- 105(2)(b)) Continuation or Key person disability conversion (Reg income Disciplinary actions R590-148-10) Buy-sell policy License termination, Required disclosure suspension or provisions (Reg 10.5 Medical savings revocation (31A-2- R590-148-6) accounts (MSAs) and 308(11)(a); 31A- Health savings 23a-111) Inflation protection accounts (HSAs) (Reg R590-148-13) Probation (31A-23a- 112) Pre-existing conditions (31A-22-1406; Reg Monetary forfeiture R590-148-6) (fines) (31A-2-308; R592-2) Protection against unintentional lapse 1.2 State regulation (Reg R590-148-11) Utah Producer’s Title Marketing Representative Exam Commissioner's general Prohibited provisions duties and powers (31A- (31A-22-1405, Series 17-13 2-201) 1407) 50 questions (plus 5 unscored Title and Escrow 9.5 Utah Comprehensive items) Commission Act (31A-2- Health Insurance Pool 401) 1-hour time limit Eligibility (31A-29-111) Definitions (31A-2- 402) Coverages and limits Effective date: January 1, 2020 (31A-29-113) Appointments and terms (31A-2-403) Exclusions (31A-29-113) 1.0 Insurance Regulation 10% Duties of commission Deductibles and (5 Items) (31A-2-404) coinsurance (31A-29- 1.1 Licensing 114) Title company provisions Purpose (31A-23a-101; Solvency (31A-4-105, 10.0 Federal Tax Considerations R592-1) for Accident and Health 105.5) Insurance 3% (3 Items) Qualifications (31A-23a- Insurance rates and 107) 10.1 Personally-owned escrow changes health insurance Persons to be licensed (31A-19a-201–203, 209; R592-15) Individual General requirements mandate/penalties for (31A-23a-105–108) Termination of noncompliance appointment (Reg Title insurance R590-244-1–14) Disability income insurance producer additional Unfair claim Medical expense insurance requirements (31A- 23a-204) settlement practices Long-term care insurance (31A-26-303; Maintenance and duration Admin. Rule R590- 10.2 Employer group health 190-1–14; R592-6; insurance Renewal (31A-23a- 105) R592-14) Disability income (STD, Records maintenance LTD) Continuing education requirements (31A- (31A-23a-102, 412, 31A-20-110; R592- Benefits subject to 23a-202; Reg R590- 11) FICA 142-4; R592-7) Controlled business Medical and dental Reinstatement (31A- (31A-23a-503; expense 23a-111(2), 113) R592-11) Long-term care insurance Assumed name (31A- 23a-110(2)) Commissions (31A- Accidental death and 23a-501, 504) dismemberment Change of address, telephone number Contract with insurer 10.3 Medical expense or business email (31A-23a-405, 408) coverage for sole address (31A-23a-

UTAH INSURANCE DEPA RTMENT

Insurance fraud regulation Hidden off-record title risks Discrimination (31A-31-103–106; R592-14) Risk of omission and Unfair inducements and commission by producer marketing practices in 2.0 General Insurance 5% (3 obtaining title insurance 3.2 Entities that can be Items) business insured; need for 2.1 Producers and general insurance Unfair or deceptive rules of agency practices Types of entities Insurer as principal 4.2 Commissions (31A-23a- Individual 501, 504) Producer/insurer relationship Corporations

Authority and powers of Partnerships producers Limited Liability Express Companies Utah Producer’s Title Examination Implied Trusts (trustee of) Exam Apparent Title insurance needs Series 17-14 Responsibilities to the Residential applicant/insured 100 questions (plus 5 unscored Commercial Items) 2.2 Contracts 3.3 Interests that can be Elements of a legal insured 2-hour time limit contract Estates Effective date: January 1, 2020 Offer and acceptance Fee simple Consideration Leasehold 1.0 Insurance Regulation 10% Competent parties Life (10 Items) Legal purpose 1.1 Licensing Easements Distinct characteristics of Purpose (31A-23a-101) 3.4 Title insurance forms an insurance contract Qualifications (31A-23a- Commitments Contract of adhesion 107) Owner's policy Personal contract Persons to be licensed Loan policy Unilateral contract General requirements Leasehold policies (31A-23a-105–108) Conditional contract Endorsements Title insurance Legal interpretations producer additional affecting contracts 3.5 Title insurance policy requirements (31A- structure and Ambiguities in a 23a-204; provisions contract of adhesion R592-1) Covered risks Reasonable Maintenance and duration expectations Schedule A Renewal (31A-23a- Indemnity Schedule B — Exceptions 105) from coverage Utmost good faith Continuing education Exclusions from coverage Representations/misre requirements (31A- 23a-202; Admin. presentations Conditions Rule R590-142-4; Warranties 3.6 Rates and premiums R592-7)

Concealment 4.0 Marketing Title Insurance Reinstatement (31A- 23a-111(2), 113) Fraud 45% (22 Items) 4.1 Unfair marketing Assumed name (31A- Waiver and estoppel practices (31A-23a- 23a-110(2)) 402; Admin. Rule R590- 3.0 Title Insurance 40% (20 154-1–18 & R592-6-1–7) Change of address, Items) telephone number 3.1 Risks covered by title Rebating or business email insurance address (31A-23a- Misrepresentations 412(1)(c); R590- Risk of error in public Defamation of insurer 258) records

UTAH INSURANCE DEPA RTMENT

Reporting of actions Contract with insurer Conditional contract (31A-23a- (31A-23a-405, 408) 105(2)(b)) Legal interpretations Insurance fraud regulation affecting contracts Disciplinary actions (31A-31-103–106) Ambiguities in a License termination, 1.3 Utah marketing contract of adhesion suspension or practices revocation (31A-2- Reasonable 308(11)(a); 31A- Unfair marketing practices expectations 23a-111) (31A-23a-402; Admin. Rule R590-154-1–18, Indemnity Probation (31A-23a- Admin. Rule R592-6-1– Utmost good faith 112) 7, R592-14) Representations/misre Monetary forfeiture Rebating (31A-1- presentations (fines) (31A-2-308; 301(145)) R592-2) Warranties False advertising 1.2 State regulation (31A-23a-402(1)) Concealment

Commissioner's general Misrepresentation Fraud duties and powers (31A- 2-201) Defamation of insurer Waiver and estoppel

Title and Escrow Discrimination 3.0 Real Property 35% (35 Items) Commission Act (31A-2- Unfair inducements 401) and marketing 3.1 Concepts, principles and practices Definitions (31A-2- practices in obtaining title 402) Definition of real property insurance business Appointments and Types of real property terms (31A-2-403) Unfair or deceptive practices (Admin. Title to real property Duties of commission Rule R590-99-4) (31A-2-404) 3.2 Acquisition and transfer 2.0 General Insurance 5% (5 of real property Title company provisions Items) Conveyances Solvency (31A-4-105, 2.1 Producers and general 105.5) rules of agency Encumbrances

Insurance rates and Insurer as principal Adverse possession escrow changes Producer/insurer Condemnation (31A-19a-201–203, relationship 209; R592-15) Accession Authority and powers of Termination of producers Dedication appointment (Reg R590-244-1–14) Express Escheats

Unfair claim Implied Involuntary alienation settlement practices Abandonment (31A-26-303; Apparent Admin. Rule R590- Responsibilities to the Foreclosures 190-1–14; R592-6) applicant/insured Judicial sales Producer regulation 2.2 Contracts Trusts Place of Elements of a legal business/records Types of joint ownership contract maintenance (31A- Tenants in common 23a-412) Offer and acceptance Joint tenancy Record retention and Consideration annual reports 31A- Acknowledgments 23a-413; Admin. Competent parties Rule R592-11; Legal capacity of parties Legal purpose Admin. Rule R590- Individuals 136-1-6, R592-11) Distinct characteristics of an insurance contract Corporations Controlled business (31A-23a-503; Contract of adhesion General partnerships R592-11) Personal contract Limited partnerships Commissions (31A- 23a-501, 504) Unilateral contract Trust agreements

UTAH INSURANCE DEPA RTMENT

Limited Liability Covered risks Forfeiture Company (LLC) Schedule A Claims against the title 3.3 Legal descriptions Schedule B — Lis pendens Types of legal descriptions Exceptions from coverage 5.3 Principles of clearing Types of measurements title used Exclusions from coverage Releases Language of legal descriptions Conditions Assignments

Structure and format Rates and premiums Collateral assignments

Interpretation 4.2 Title searching Subordinations techniques Affidavits 4.0 Title Insurance 18% (18 Items) Hard copy index Reconveyances 4.1 Title insurance Computer index principles 6.0 Real Estate Transactions Chain sheet 10% (10 Items) Risks covered by title 6.1 Document preparation insurance 5.0 Title Exceptions and regulations and Procedures for Clearing requirements Risk of error in public Title 22% (22 Items) records 5.1 Principles and concepts Deeds Hidden off-record title Trust deeds risks General exceptions Mortgages Risk of omission and Voluntary and involuntary commission by liens Notes producer Federal liens Releases Entities that can be Deed of trust insured; need for Reconveyances insurance Deeds Acknowledgment forms Types of entities Judgments 6.2 Title insurance policy Individual Taxes and assessments preparation instructions Corporations Surveys Contract vendee Partnerships Condominiums Coverages Limited Liability Planned unit developments Companies Endorsements Water rights Trusts (trustee of) Exclusions Mineral rights Title insurance needs Liabilities Equitable interests Residential 6.3 Recording Attachments Commercial Types of records Executions Interests that can be Requirements to record insured Easements (R592-14)

Fee simple estate Covenants Acknowledgments

Leasehold estate Conditions Presumptions

Life estate Restrictions 6.4 Search Principles and Techniques Title insurance forms 5.2 Special problem areas and concerns Types of available records Commitments Acknowledgments Records to Search Owner's policy Mechanic's lien County recorder Loan policy (geographical index) Bankruptcy Leasehold policies County treasurer Probate Endorsements County assessor Good faith Title insurance policy Utah Court records structure and provisions Foreclosure (xchange)

UTAH INSURANCE DEPA RTMENT

Federal bankruptcy Reinstatement (31A- Record retention and records 23a-111(2), 113) annual reports (31A-23a-413; State construction Assumed name (31A- Admin. Rule R592- registry 23a-110(2)) 11; Admin. Rule Special improvement Change of address or R590-136-1-6, districts telephone number R592-11) (31A-23a-412(1)(c); Marketable Title Act Controlled business R590-258) (31A-23a-503; Title Examination Principles Reporting of actions R592-11) Ownership (31A-23a- Commissions (31A- 105(2)(b)) 23a-501, 504) Legal description problems – closure, gaps & Disciplinary actions Contract with insurer overlaps License termination, (31A-23a-405, 408) Inderloper/wild suspension or Insurance fraud regulation documents revocation (31A-2- (31A-31-103–106) 308(11)(a); 31A- Priority 23a-111) 1.3 Utah marketing practices Subdivision Plats Probation (31A-23a- 112) Unfair marketing (31A- Ownership Plats 23a-402; Admin. Rule Monetary forfeiture Mineral rights R590-154-1–18, Admin. (fines) (31A-2-308; Rule R592-6-1–7, R592- Water rights R592-2) 14)

1.2 State regulation Rebating (31A-1- 301(145)) Commissioner's general duties and powers (31A- False advertising Utah Producer's Title Escrow 2-201) (31A-23a-402(1)) Exam Title and Escrow Misrepresentation Series 17-16 Commission Act (31A-2- 401) Defamation of insurer 100 questions (plus 5 unscored Definitions (31A-2- Discrimination items) 402) Unfair inducements 2-hour time limit Appointments and and marketing terms (31A-2-403) practices in Effective date: January 1, 2020 obtaining title Duties of commission insurance business (31A-2-404) Unfair or deceptive 1.0 Insurance Regulation 10% Title company provisions practices (Admin. (10 Items) Solvency (31A-4-105, Rule R590-99-4) 1.1 Licensing 105.5) 2.0 General Insurance 5% (5 Purpose (31A-23a-101) Insurance rates and Items) escrow changes 2.1 Producers and general Qualifications (31A-23a- (31A-19a-201–203, rules of agency 107) 209; R592-15) Insurer as principal Persons to be licensed Unfair claim Producer/insurer General requirements settlement practices relationship (31A-23a-105–108) (31A-26-303; Admin. Rule R590- Authority and powers of Title insurance 190-1–14; R592- producers producer additional 6,14) requirements (31A- Express 23a-204; R592-1) Termination of appointment (Reg Implied Maintenance and duration R590-244-1–14) Apparent Renewal (31A-23a- Producer regulation 105) Responsibilities to the Place of applicant/insured Continuing education business/records requirements (31A- maintenance (31A- 2.2 Contracts 23a-202; Admin. 23a-412) Elements of a legal Rule R590-142-4, contract R592-7)

UTAH INSURANCE DEPA RTMENT

Offer and acceptance Tenants in common Leasehold estate

Consideration Joint tenancy Life estate

Competent parties Acknowledgments Easement estate

Legal purpose Legal capacity of parties Title insurance forms

Distinct characteristics of Individuals Commitments an insurance contract Corporations Owner's policy Contract of adhesion General partnerships Loan policy Personal contract Limited partnerships Homeowner's policy Unilateral contract Trustee rights and Leasehold policies Conditional contract obligations Endorsements Legal interpretations Limited Liability affecting contracts Company (LLC) Title insurance policy structure and provisions Ambiguities in a 3.3 Legal descriptions contract of adhesion Covered risks Types of legal descriptions Reasonable Schedule A expectations Types of measurements used Schedule B — Indemnity Exceptions from Language of legal coverage Utmost good faith descriptions Exclusions from Representations/misre Structure and format coverage presentations Interpretation Conditions Warranties 4.0 Title Insurance 15% (15 Rates and premiums Concealment Items) 4.2 Title searching and Fraud 4.1 Title insurance examination principles techniques Waiver and estoppel Risks covered by title Hard copy index 3.0 Real Property 15% (15 insurance Items) Computer index Risk of error in public 3.1 Concepts, principles and records Chain sheet practices Hidden off-record title 5.0 Title Exceptions and Definition of real property risks Procedures for Clearing Title 20% (20 Items) Types of real property Risk of omission and 5.1 Principles and concepts Title to real property commission by producer General exceptions 3.2 Acquisition and transfer of real property Entities that can be Voluntary and involuntary insured; need for liens Conveyances insurance Federal liens Encumbrances Types of entities Deed of trust Adverse possession Individual Deeds Condemnation Corporations Judgments Accession Partnerships Taxes and assessments Dedication Limited Liability Companies Surveys Escheats Trusts (trustee of) Condominiums Involuntary alienation Title insurance needs Planned unit developments Abandonment Residential Water rights Foreclosures Commercial Mineral rights Judicial sales Interests that can be Equitable interests Trusts insured Attachments Types of joint ownership Fee simple estate Executions

UTAH INSURANCE DEPA RTMENT

Easements Settlement statement, Producers lender and government Covenants entity requirements Consultants

Conditions Contract sales Adjusters

Restrictions All-inclusive trust deed Nonresidents (31A- 23a-109) 5.2 Special problem areas Lot sales and concerns Maintenance and duration Loan closings Acknowledgments Renewal (31A-23a- Exchanges (including 105; 31A-23a-111) Mechanic's lien 1031) Continuing education Bankruptcy Short sale closings requirements (31A- 23a-202; Reg R590- Probate/order to 6.3 Recording determining heirs 142-1 through 10) Types of records Foreclosure Reinstatement (31A- Constructive notice 23a-111(2), 113) Forfeiture Requirements to record Assumed name (31A- Claims against the title (R592-14) 23a-110(2))

Lis pendens Acknowledgments Change of address or telephone number 5.3 Principles of clearing Presumptions (31A-23a-412(1)(c)) title 6.4 Document preparation Reporting of actions Releases regulations and (31A-23a- Assignments requirements 105(2)(b))

Collateral assignments Deeds Disciplinary actions

Subordinations Trust deeds License termination, suspension, or Affidavits Mortgages revocation (31A-2- Notes 308(10)(a); 31A- Reconveyances 23a-111) Releases 6.0 Real Estate Transactions Probation (31A-23a- 35% (35 Items) Reconveyances 112) 6.1 Escrow principles (31A- Acknowledgment forms Monetary forfeiture 23a-406, 409; Reg R590- (fines) (31A-2-308) 170-4–6) 1.2 State regulation Escrow terminology Commissioner's general Types of escrows Utah Laws and Regulations Exam duties and powers (31A- Escrow contracts 2-201) Series 17-19 Fiduciary responsibilities of Company regulation escrow producers 50 questions (plus 5 unscored items) Solvency (31A-4-105, Good funds 105.5) 6.2 Settlement/closing 1-hour time limit Rates (31A-19a-201– procedures for all 203) types of closings Effective date: January 1, 2020 Policy forms (31A-21-

Types of documents used 201–203)

FHA requirements 1.0 Insurance Regulation 60% Producer appointment (30 Items) (31A-23a-115; Reg VA requirements 1.1 Licensing R590-244-1–14) Real Estate Settlement Purpose (31A-23a-101) Termination of Procedures Act (RESPA) appointment (Reg R590-244-1–14) Good Faith Estimate Process (31A-23a-103– 105, 107, 302) Unfair claim Insured closing protection Qualifications (31A-23a- settlement practices Recording and 107, 108) (31A-26-303; Reg disbursement procedures R590-190–192) Types of licensees (31A-1- 301, 31A-23a-106, 203, Producer regulation 401, 504)

UTAH INSURANCE DEPA RTMENT

Fiduciary and trust Methods of handling risk Legal purpose account responsibilities Avoidance Distinct characteristics of an insurance contract (31A-23a-409) Retention Contract of adhesion Place of Sharing business/records Aleatory contract maintenance (31A- Reduction 23a-412) Personal contract Transfer Controlled business Unilateral contract (31A-23a-502) Elements of insurable risks Conditional contract Shared commissions Adverse selection (31A-23a-504) Legal interpretations Law of large numbers affecting contracts Unfair marketing practices Reinsurance (Reg R590-154) Ambiguities in a 2.2 Insurers contract of adhesion Misrepresentation (31A-21-105; 31A- Types of insurers Reasonable 23a-402(1)) expectations Stock companies False advertising Indemnity Mutual companies (31A-23a-402(1)) Utmost good faith Rebating (31A-23a- Fraternal benefit societies Representations/misre 402(2), 31A-1- presentations 301(145)) Reciprocals Warranties Unfair discrimination Lloyd's associations (31A-23a-402(3)) Concealment Risk retention groups Boycott, coercion or Fraud intimidation (31A- Private versus government 23a-402(4)) insurers Waiver and estoppel

Illegal inducement Admitted versus (31A-23a-402.5, nonadmitted insurers Reg R590-154-11) Domestic, foreign and alien Examination of records insurers Utah Producer’s Personal Lines (31A-2-203–205; 31A- Exam Financial status 23a-412) (independent rating Series 17-20 Privacy of Consumer services) 100 questions (plus 5 unscored Information (Reg R590- Marketing (distribution) items) 206) systems Insurance fraud regulation 2-hour time limit (31A-31-103–106) 2.3 Producers and general rules of agency Personal liability for unpaid Effective date: January 1, 2020 claims (31A-15-105) Insurer as principal

1.3 Federal regulation Producer/insurer relationship 1.0 Insurance Regulation 10% Fair Credit Reporting Act (10 Items) Authority and powers of (15 USC 1681–1681d) 1.1 Licensing producer Fraud and false statements Purpose (31A-23a-101) Express (18 USC 1033, 1034) Process (31A-23a-103– Implied 2.0 General Insurance 40% (20 105, 107, 302) Items) Apparent Qualifications (31A-23a- 2.1 Concepts Responsibilities to the 107, 108) applicant/insured Risk management key Types of licensees (31A-1- terms 2.4 Contracts 301, 31A-23a-106, 203, 401, 504) Risk Elements of a legal Producers Exposure contract Consultants Hazard Offer and acceptance Adjusters Peril Consideration

Loss Competent parties

UTAH INSURANCE DEPA RTMENT

Nonresidents (31A- Place of Loss 23a-109) business/records maintenance (31A- Methods of handling risk Maintenance and duration 23a-412) Avoidance Renewal (31A-23a- Controlled business Retention 105; 31A-23a-111) (31A-23a-502) Sharing Continuing education Shared commissions requirements (31A- (31A-23a-504) Reduction 23a-202; Reg R590- 142-1 through 10) Unfair marketing practices Transfer (Reg R590-154) Reinstatement (31A- Elements of insurable risks 23a-111(2), 113) Misrepresentation (31A-21-105; 31A- Adverse selection Assumed name (31A- 23a-402(1)) 23a-110(2)) Law of large numbers False advertising Reinsurance Change of address or (31A-23a-402(1)) telephone number 2.2 Insurers (31A-23a-412(1)(c)) Rebating (31A-23a- 402(2), 31A-1- Types of insurers Reporting of actions 301(145)) (31A-23a- Stock companies 105(2)(b)) Unfair discrimination (31A-23a-402(3)) Mutual companies Disciplinary actions Boycott, coercion or Fraternal benefit License termination, intimidation (31A- societies suspension, or 23a-402(4)) revocation (31A-2- Reciprocals 308(10)(a); 31A- Illegal inducement Lloyd's associations 23a-111) (31A-23a-402.5, Reg R590-154-11) Risk retention groups Probation (31A-23a- 112) Examination of records Private versus government (31A-2-203–205; 31A- insurers Monetary forfeiture 23a-412) (fines) (31A-2-308) Admitted versus Privacy of Consumer nonadmitted insurers 1.2 State regulation Information (Reg R590- Domestic, foreign and alien 206) Commissioner's general insurers duties and powers (31A- Insurance fraud regulation Financial status 2-201) (31A-31-103–106) (independent rating Company regulation Personal liability for unpaid services) claims (31A-15-105) Solvency (31A-4-105, Marketing (distribution) 105.5) 1.3 Federal regulation systems

Rates (31A-19a-201– Fair Credit Reporting Act 2.3 Producers and general 203) (15 USC 1681–1681d) rules of agency

Policy forms (31A-21- Fraud and false statements Insurer as principal 201–203) (18 USC 1033, 1034) Producer/insurer Producer appointment Privacy (Gramm Leach relationship (31A-23a-115; Reg Bliley) R590-244-1–14) Authority and powers of National Flood Insurance producer Termination of Program appointment (Reg Express R590-244-1–14) 2.0 General Insurance 10% (10 Implied Items) Unfair claim Apparent settlement practices 2.1 Concepts (31A-26-303; Reg Risk management key Responsibilities to the R590-190–192) terms applicant/insured Producer regulation Risk 2.4 Contracts Fiduciary and trust Exposure Elements of a legal account contract responsibilities Hazard (31A-23a-409) Offer and acceptance Peril Consideration

UTAH INSURANCE DEPA RTMENT

Competent parties Punitive Per person

Legal purpose Absolute liability Split

Distinct characteristics of Strict liability Combined single an insurance contract Vicarious liability Policy limits Contract of adhesion Causes of loss (perils) Restoration/nonreduction Aleatory contract of limits Named perils versus Personal contract special (open) perils Coinsurance

Unilateral contract Direct loss Vacancy or unoccupancy

Conditional contract Consequential or indirect Named insured provisions loss Legal interpretations Duties after loss affecting contracts Blanket versus specific insurance Assignment Ambiguities in a contract of adhesion Basic types of construction Abandonment

Reasonable Loss valuation Insurer provisions expectations Actual cash value Liberalization Indemnity Replacement cost Subrogation Utmost good faith Functional Salvage Representations/misre replacement cost Claim settlement presentations Market value options Warranties Agreed value Duty to defend Concealment Stated amount Third-party provisions Fraud Valued policy Standard mortgage Waiver and estoppel clause 3.2 Policy structure Loss payable clause 3.0 Property and Casualty Declarations Insurance Basics 26% (26 No benefit to the Items) Definitions bailee 3.1 Principles and concepts Insuring agreement or 3.4 Utah laws, regulations Insurable interest clause and required provisions Underwriting Additional/supplementary coverage Utah Property and Function Casualty Insurance Conditions Guaranty Association Loss ratio Exclusions (31A-28-202–210, 212– Rates 215, 217–218, 220, 222) Endorsements Types Cancellation, issuance and 3.3 Common policy renewal (31A-21-303) Loss costs provisions Binders (31A-21-102) Components Insureds — named, first named and additional Other insurance (31A-21- Hazards 307) Policy period Physical Suit against insurer (31A- Policy territory 21-313) Moral Cancellation and Concealment or fraud (RL Morale nonrenewal 76-6-521) Negligence Deductibles Federal Terrorism Elements of a Insurance Program (15 Other insurance negligent act USC 6701; Public Law Nonconcurrency 107–297, 109–144, Defenses against 110–160) negligence Primary and excess 4.0 Dwelling Policy 10% (10 Damages Limits of liability Items) Compensatory — Per occurrence 4.1 Characteristics and special versus (accident) purpose general

UTAH INSURANCE DEPA RTMENT

4.2 Coverage forms — Perils Additional coverages Required limits insured against 5.5 Perils insured against Utah Assigned Risk Basic Insurance Plan (31A-22- 5.6 Exclusions 310) Broad 5.7 Conditions Aftermarket Crash Parts Special 5.8 Selected endorsements Act (31A-22-316–319) 4.3 Property coverages Special provisions — Utah 6.2 Personal auto policy Coverage A — Dwelling (HO 01 43) Definitions

Coverage B — Other Limited fungi, wet or dry Liability coverage structures rot, or bacteria coverage (HO 04 26, HO 04 27, Bodily injury and Coverage C — Personal HO 04 28) property damage property Permitted incidental Supplementary Coverage D — Fair rental occupancies — residence payments value premises (HO 04 42) Exclusions Coverage E — Additional Earthquake (HO 04 54) living expense Medical payments Scheduled personal coverage Other coverages property (HO 04 61) Uninsured motorists 4.4 General exclusions Personal property coverage 4.5 Conditions replacement cost (HO 04 90) Coverage for damage to 4.6 Selected endorsements your auto Home day care (HO 04 Special provisions — Utah 97) Collision (DP 01 43) Business pursuits (HO 24 Other than collision Automatic increase in 71) Deductibles insurance (DP 04 11) Personal injury (HO 24 Transportation Broad theft coverage (DP 82) expenses 04 72) 6.0 Auto Insurance 19% (19 Exclusions Dwelling under Items) construction (DP 11 43) Duties after an accident or 6.1 Laws loss 4.7 Personal liability Utah Financial supplement General provisions Responsibility of Motor 5.0 Homeowners Policy 19% Vehicle Owners and Selected endorsements (19 Items) Operators Act (RL 41- 12a-101–104) Amendment of policy 5.1 Coverage forms provisions — Utah Required motor vehicle (PP 01 93) HO-2 through HO-6 limits of liability (31A- Towing and labor HO-8 22-301–304) costs (PP 03 03) 5.2 Definitions Personal injury protection (31A-22-306–309) Extended non-owned 5.3 Section I — Property coverage — vehicles coverages Medical furnished or available for regular Loss of income Coverage A — Dwelling use (PP 03 06) Special damages Coverage B — Other Miscellaneous type allowance structures vehicle (PP 03 23) Funeral Coverage C — Personal Joint ownership property Death coverage (PP 03 34) Coverage D — Loss of use Uninsured/underinsured Additional coverages motorist (31A-22-305– 7.0 Other Coverages and Options 305.3) 6% (6 items) 5.4 Section II — Liability Definitions 7.1 Personal umbrella coverages policies (DL 98 01) Bodily injury Coverage E — Personal 7.2 National Flood liability Property damage Insurance Program (31A-22-305.5) Coverage F — Medical "Write your own" versus payments to others UM/UIM rejection government

UTAH INSURANCE DEPA RTMENT

Eligibility Requirements Functions (Reg R590-171- 1–10) Coverage List of admitted surplus lines insurers Limits Withdrawal of admitted Deductibles status Utah Producer's Property Exam 7.3 Other policies Service of process (31A-2- Boatowners 309) Series 17-22

7.4 Residual markets 1.5 Surplus lines coverages 100 questions (plus 5 unscored including Joint Characteristics and uses items) Underwriting Association (31A-2- Types of coverages 2-hour time limit 214) available (Reg R590- 171-5) Effective date: January 1, 2020 1.6 Requirements for placement of surplus lines insurance 1.0 Insurance Regulation 13% Utah Producer's Surplus Lines (13 Items) Exam Export list (Reg R590- 171-5) 1.1 Licensing Series 17-21 Good faith effort (Reg Purpose (31A-23a-101) 60 questions (plus 5 unscored R590-171-6) Process (31A-23a-103– items) 105, 107, 302) Conditions for marketing (Reg R590-171-7) 1-hour time limit Qualifications (31A-23a- Notice to insured (31A- 107, 108) 15-103(8), (9)) Effective date: January 1, 2020 Types of licensees (31A-1-

Assisting unauthorized 301, 31A-23a-106, 203, insurers 401, 504) 1.0 Surplus Lines Markets and Practices 100% Unauthorized insurers Producers (31A-15-103) (60 Items) Consultants 1.7 Records of surplus lines 1.1 United States Adjusters broker nonadmitted market Nonresidents (31A- Content of records (31A- Insurance exchanges 23a-109) 15-103(7), 109) Foreign nonadmitted Maintenance and duration Maintenance (31A-15- market 103(7)) Renewal (31A-23a- 1.2 Alien insurers 105; 31A-23a-111) Reporting (Reg R590-157- London market 6; R590-171-8) Continuing education requirements (31A- Monthly statement (Reg Lloyd's of London 23a-202; Reg R590- R590-157-6) Other London 142-1 through 10) Penalties - violation of companies Reinstatement (31A- chapter (31A-15-105) Other alien markets 23a-111(2), 113) 1.8 Surplus lines tax (31A- Assumed name (31A- United States trust funds 3-301–303; Reg R590- 23a-110(2)) 1.3 Alternative markets 157-1–8) Change of address or Amount Captive insurers (31A-3- telephone number 304; 31A-37-101–604) Policy fees and service (31A-23a-412(1)(c)) charges Risk retention groups Reporting of actions (31A-15-201–205, 211– Collection (31A-23a- 213) 105(2)(b)) Remittance Purchasing groups (31A- Disciplinary actions 15-207–212) 1.9 Surplus lines advisory organization (31A-15- License termination, Independently procured 111, Reg R590-171-4) suspension, or insurance (31A-15-104) revocation (31A-2- Surplus lines stamping fee 308(10)(a); 31A- 1.4 Non-Admitted surplus (31A-15-103(11); Reg 23a-111) lines insurers (31A-15- R590-157-4) 103)

UTAH INSURANCE DEPA RTMENT

Probation (31A-23a- Examination of records Risk retention groups 112) (31A-2-203–205; 31A- 23a-412) Private versus government Monetary forfeiture insurers (fines) (31A-2-308) Privacy of Consumer Information (Reg R590- Admitted versus 1.2 State regulation 206) nonadmitted insurers

Commissioner's general Insurance fraud regulation Domestic, foreign and alien duties and powers (31A- (31A-31-103–106) insurers 2-201) Personal liability for unpaid Financial status Company regulation claims (31A-15-105) (independent rating services) Solvency (31A-4-105, 1.3 Federal regulation 105.5) Marketing (distribution) Fair Credit Reporting Act systems Rates (31A-19a-201– (15 USC 1681–1681d) 203) 2.3 Producers and general Fraud and false statements rules of agency Policy forms (31A-21- (18 USC 1033, 1034) 201–203) Insurer as principal Privacy (Gramm Leach Producer appointment Bliley) Producer/insurer (31A-23a-115; Reg relationship R590-244-1–14) National Flood Insurance Program Authority and powers of Termination of producer appointment (Reg Terrorism Risk Insurance R590-244-1–14) Act Express Implied Unfair claim 2.0 General Insurance 13% (13 settlement practices Items) Apparent (31A-26-303; Reg 2.1 Concepts R590-190–192) Responsibilities to the Risk management key applicant/insured Producer regulation terms 2.4 Contracts Fiduciary and trust Risk account Elements of a legal responsibilities Exposure contract (31A-23a-409) Hazard Offer and acceptance Place of business/records Peril Consideration maintenance (31A- Loss Competent parties 23a-412) Methods of handling risk Legal purpose Controlled business (31A-23a-502) Avoidance Distinct characteristics of an insurance contract Shared commissions Retention (31A-23a-504) Contract of adhesion Sharing Unfair marketing practices Aleatory contract (Reg R590-154) Reduction Personal contract Misrepresentation Transfer (31A-21-105; 31A- Unilateral contract Elements of insurable risks 23a-402(1)) Conditional contract Adverse selection False advertising Legal interpretations (31A-23a-402(1)) Law of large numbers affecting contracts

Rebating (31A-23a- Reinsurance Ambiguities in a 402(2), 31A-1- contract of adhesion 301(145)) 2.2 Insurers Reasonable Types of insurers Unfair discrimination expectations (31A-23a-402(3)) Stock companies Indemnity Boycott, coercion or Mutual companies intimidation (31A- Utmost good faith 23a-402(4)) Fraternal benefit Representations/misre societies Illegal inducement presentations (31A-23a-402.5, Reciprocals Warranties Reg R590-154-11) Lloyd's associations

UTAH INSURANCE DEPA RTMENT

Concealment Endorsements Suit against insurer (31A- 21-313) Fraud 3.3 Common policy provisions Concealment or fraud (RL Waiver and estoppel 76-6-521) Insureds — named, first 3.0 Property and Casualty named and additional Federal Terrorism Insurance Basics 16% (16 Insurance Program (15 Items) Policy period USC 6701; Public Law 3.1 Principles and concepts Policy territory 107–297, 109–144, 110–160) Insurable interest Cancellation and nonrenewal 4.0 Dwelling Policy 8% (8 Underwriting Items) Deductibles Function 4.1 Characteristics and Other insurance purpose Loss ratio Nonconcurrency 4.2 Coverage forms — Perils Rates insured against Primary and excess Types Basic Limits of liability Loss costs Broad Policy limits Components Special Restoration/nonreduction Hazards of limits 4.3 Property coverages Physical Coinsurance Coverage A — Dwelling Moral Vacancy or unoccupancy Coverage B — Other Morale structures Named insured provisions Causes of loss (perils) Coverage C — Personal Duties after loss property Named perils versus Assignment special (open) perils Coverage D — Fair rental value Abandonment Direct loss Coverage E — Additional Insurer provisions Consequential or indirect living expense loss Liberalization Other coverages Blanket versus specific Subrogation insurance 4.4 General exclusions Salvage Basic types of construction 4.5 Conditions Claim settlement 4.6 Selected endorsements Loss valuation options Special provisions — Utah Actual cash value Third-party provisions (DP 01 43) Replacement cost Standard mortgage Automatic increase in clause Functional insurance (DP 04 11) replacement cost Loss payable clause Broad theft coverage (DP Market value No benefit to the 04 72) bailee Agreed value Dwelling under 3.4 Utah laws, regulations construction (DP 11 43) Stated amount and required 4.7 Personal liability provisions Valued policy supplement 3.2 Policy structure Utah Property and Casualty Insurance 5.0 Homeowners Policy 17% Declarations Guaranty Association (17 Items) (31A-28-202–210, 212– 5.1 Coverage forms Definitions 215, 217–218, 220, 222) HO-2 through HO-6 Insuring agreement or Cancellation, issuance and clause renewal (31A-21-303) HO-8 Additional/supplementary Binders (31A-21-102) 5.2 Definitions coverage Other insurance (31A-21- 5.3 Section I — Property Conditions 307) coverages Exclusions Coverage A — Dwelling

UTAH INSURANCE DEPA RTMENT

Coverage B — Other Causes of loss forms Coverage C — structures Household personal Basic property Coverage C — Personal property Broad Coverage D — Loss of use Coverage D — Loss of use Special Selected endorsements Coverage E — Additional coverages Scheduled personal 5.4 Perils insured against Ordinance or law (CP property 04 05) 5.5 Exclusions Coverage F — Spoilage (CP 04 40) Unscheduled farm 5.6 Conditions personal property Peak season limit of 5.7 Selected endorsements insurance (CP 12 Coverage G — Other 30) farm structures Special provisions — Utah (HO 01 43) Value reporting form Mobile agricultural (CP 13 10) machinery and Limited fungi, wet or dry equipment coverage rot, or bacteria coverage 6.3 Commercial inland form (HO 04 26, HO 04 27) marine Livestock coverage form Permitted incidental Nationwide marine occupancies — residence definition Definitions premises (HO 04 42) Commercial inland marine Causes of loss (basic, Earthquake (HO 04 54) conditions form broad and special)

Scheduled personal Inland marine coverage Conditions property (HO 04 61) forms Exclusions Personal property Accounts receivable replacement cost (HO Limits Bailee's customer 04 90) Additional coverages Home day care (HO 04 Commercial articles 7.0 Businessowners Policy 15% 97) Contractors (15 Items) equipment floater 6.0 Commercial Package Policy 7.1 Characteristics and (CPP) 14% (14 Items) Electronic data purpose processing 6.1 Components of a 7.2 Businessowners Section commercial policy Installation floater I — Property Common policy Signs Coverages declarations Valuable papers and Exclusions Common policy conditions records Limits Interline endorsements Transportation coverages Deductibles One or more coverage Motor truck cargo parts Loss conditions forms 6.2 Commercial property General conditions Transit coverage Commercial property forms Optional coverages conditions form 6.4 Equipment breakdown Definitions Coverage forms Equipment breakdown 7.3 Businessowners Section Building and personal protection coverage form III — Common Policy property (EB 00 20) Conditions

Condominium Selected endorsement 7.4 Selected endorsements association Actual cash value (EB Protective safeguards (BP Condominium 99 59) 04 30) commercial unit- 6.5 Farm coverage owners Utility services — direct damage (BP 04 56) Farm property coverage Builders risk form Utility services — time Business income element (BP 04 57) Coverage A — Legal liability Dwellings 8.0 Other Coverages and Options 4% (4 Items) Extra expense Coverage B — Other private structures 8.1 Aviation insurance

UTAH INSURANCE DEPA RTMENT

Aircraft Liability License termination, Boycott, coercion or suspension, or intimidation (31A- 8.2 Ocean marine insurance revocation (31A-2- 23a-402(4)) Major coverages 308(10)(a); 31A- 23a-111) Illegal inducement Protection and indemnity (31A-23a-402.5, Probation (31A-23a- Reg R590-154-11) 8.3 Other policies 112) Examination of Boatowners Monetary forfeiture records (31A-2- (fines) (31A-2-308) 203–205; 31A-23a- 412) 1.2 State regulation Privacy of Consumer Commissioner's general Information (Reg R590- Utah Producer's Casualty Exam duties and powers (31A- 206) 2-201) Series 17-23 Insurance fraud regulation Company regulation (31A-31-103–106) 100 questions (plus 5 unscored items) Solvency (31A-4-105, Personal liability for unpaid 105.5) claims (31A-15-105) 2-hour time limit Rates (31A-19a-201– 1.3 Federal regulation 203) Effective date: January 1, 2020 Fair Credit Reporting Act Policy forms (31A-21- (15 USC 1681–1681d) 201–203) Fraud and false statements 1.0 Insurance Regulation 11% Producer appointment (18 USC 1033, 1034) (11 Items) (31A-23a-115; Reg 1.1 Licensing R590-244-1–14) Privacy (Gramm Leach Bliley) Purpose (31A-23a-101) Termination of appointment (Reg Motor Carrier Act (MCS-90 Process (31A-23a-103– R590-244-1–14) and others) 105, 107, 302) Unfair claim 2.0 General Insurance 11% (11 Qualifications (31A-23a- settlement practices Items) 107, 108) (31A-26-303; Reg 2.1 Concepts R590-190–192) Types of licensees (31A-1- Risk management key 301, 31A-23a-106, 203, Producer regulation terms 401, 504) Fiduciary and trust Risk Producers account responsibilities Exposure Consultants (31A-23a-409) Hazard Adjusters Place of Peril Nonresidents (31A- business/records maintenance (31A- 23a-109) Loss 23a-412) Maintenance and duration Methods of handling risk Controlled business Renewal (31A-23a- (31A-23a-502) Avoidance 105; 31A-23a-111) Shared commissions Retention Continuing education (31A-23a-504) requirements (31A- Sharing Unfair marketing practices 23a-202; Reg R590- Reduction 142-1 through 10) (Reg R590-154) Transfer Reinstatement (31A- Misrepresentation (31A-21-105; 31A- 23a-111(2), 113) Elements of insurable risks 23a-402(1)) Assumed name (31A- Adverse selection 23a-110(2)) False advertising (31A-23a-402(1)) Law of large numbers Change of address or telephone number Rebating (31A-23a- Reinsurance (31A-23a-412(1)(c)) 402(2), 31A-1- 301(145)) 2.2 Insurers Reporting of actions Types of insurers (31A-23a- Unfair discrimination 105(2)(b)) (31A-23a-402(3)) Stock companies

Disciplinary actions Mutual companies

UTAH INSURANCE DEPA RTMENT

Fraternal benefit Utmost good faith 3.3 Common policy societies provisions Representations/misre Reciprocals presentations Insureds — named, first named and additional Lloyd's associations Warranties Policy period Risk retention groups Concealment Policy territory Private versus government Fraud insurers Cancellation and Waiver and estoppel nonrenewal Admitted versus nonadmitted insurers 3.0 Property and Casualty Deductibles Insurance Basics 13% (13 Domestic, foreign and alien Items) Other insurance insurers 3.1 Principles and concepts Nonconcurrency Financial status Insurable interest (independent rating Primary and excess services) Underwriting Limits of liability

Marketing (distribution) Function Per occurrence systems (accident) Loss ratio 2.3 Producers and general Per person rules of agency Rates Aggregate—general Types Insurer as principal versus products— Producer/insurer Loss costs completed relationship operations Components Authority and powers of Split Hazards producer Combined single Physical Express Policy limits Moral Implied Named insured provisions Morale Apparent Duties after loss Negligence Responsibilities to the Assignment applicant/insured Elements of a negligent act Insurer provisions 2.4 Contracts Defenses against Liberalization Elements of a legal negligence contract Subrogation Damages Offer and acceptance 3.4 Utah laws, regulations Compensatory — and required Consideration special versus provisions general Competent parties Utah Property and Legal purpose Punitive Casualty Insurance Guaranty Association Distinct characteristics of Absolute liability (31A-28-202–210, 212– an insurance contract 215, 217–218, 220, 222) Strict liability Contract of adhesion Cancellation, issuance and Vicarious liability renewal (31A-21-303) Aleatory contract 3.2 Policy structure Binders (31A-21-102) Personal contract Declarations Other insurance (31A-21- Unilateral contract Definitions 307) Conditional contract Insuring agreement or Suit against insurer (31A- Legal interpretations clause 21-313) affecting contracts Additional/supplementary Concealment or fraud (RL Ambiguities in a coverage 76-6-521) contract of adhesion Conditions Federal Terrorism Reasonable Insurance Program (15 Exclusions expectations USC 6701; Public Law 107–297, 109–144, Endorsements Indemnity 110–160)

UTAH INSURANCE DEPA RTMENT

4.0 Homeowners Policy 14% Definitions Commercial auto coverage (14 Items) forms Bodily injury 4.1 Coverage forms Business auto Property damage HO-2 through HO-6 (31A-22-305.5) Garage

HO-8 UM/UIM rejection Business auto physical damage 4.2 Definitions Required limits Truckers 4.3 Section II — Liability Utah Assigned Risk coverages Insurance Plan (31A-22- Motor carrier 310) Coverage E — Personal Coverage form sections liability Aftermarket Crash Parts Act (31A-22-316–319) Covered autos Coverage F — Medical payments to others 5.2 Personal auto policy Liability coverage Additional coverages Definitions Garagekeepers coverage 4.4 Exclusions Liability coverage Trailer interchange 4.5 Conditions Bodily injury and coverage property damage 4.6 Selected endorsements Physical damage Supplementary coverage Special provisions — Utah payments (HO 01 43) Exclusions Exclusions Limited fungi, wet or dry Conditions rot, or bacteria coverage Medical payments (HO 04 26, HO 04 27, coverage Definitions HO 04 28) Uninsured motorists Selected endorsements Permitted incidental coverage Lessor — additional occupancies — residence insured and loss premises (HO 04 42) Coverage for damage to your auto payee (CA 20 01) Home day care (HO 04 Mobile equipment (CA 97) Collision 20 15) Business pursuits (HO 24 Other than collision Auto medical 71) Deductibles payments coverage Personal injury (HO 24 (CA 99 03) Transportation 82) expenses Drive other car coverage (CA 99 5.0 Auto Insurance 14% (14 Exclusions Items) 10) 5.1 Laws Duties after an accident or Individual named loss insured (CA 99 17) Utah Financial Responsibility of Motor General provisions Commercial carrier Vehicle Owners and Selected endorsements regulations Operators Act (RL 41- 12a-101–104) Amendment of policy The Motor Carrier Act provisions — Utah of 1980 Required motor vehicle (PP 01 93) limits of liability (31A- Endorsement for 22-301–304) Towing and labor motor carrier costs (PP 03 03) policies of insurance Personal injury protection for public liability (31A-22-306–309) Extended non-owned (MCS-90) coverage — vehicles Medical furnished or 6.0 Commercial Package Policy (CPP) 10% (10 Items) Loss of income available for regular use (PP 03 06) 6.1 Components of a Special damages commercial policy allowance Miscellaneous type vehicle (PP 03 23) Common policy Funeral declarations Joint ownership Death coverage (PP 03 Common policy conditions 34) Uninsured/underinsured Interline endorsements motorist (31A-22-305– 5.3 Commercial auto 305.3)

UTAH INSURANCE DEPA RTMENT

One or more coverage Forgery or alteration Hired auto and non-owned parts auto liability (BP 04 04) Inside the premises — 6.2 Commercial general theft of money and 8.0 Workers Compensation liability securities Insurance 9% (9 Items) Commercial general Inside the premises — 8.1 Workers compensation liability coverage forms robbery or safe laws burglary of other Type of law Bodily injury and property property damage Monopolistic versus liability Outside the premises competitive Personal and Computer fraud Compulsory versus advertising injury elective liability Funds transfer fraud Utah Workers' Medical payments Money orders and counterfeit money Compensation Law Supplementary Exclusive remedy (RL payments Other crime coverages 34A-2-105) Who is an insured Extortion — commercial entities Employment covered Limits of insurance (CR 04 03) (required, voluntary) (RL 34A- Conditions Guests' property (CR 2-103, 104) 04 11) Definitions Covered injuries (RL 6.4 Farm coverage 34A-2-401, 402) Exclusions Farm liability coverage Occupational disease Occurrence versus claims- form (RL 34A-3-101–112) made Coverage H — Bodily Benefits provided (RL Claims-made features injury and property 34A-2-401, 408– Trigger damage liability 418)

Retroactive date Coverage I — Personal Employers' and advertising Reinsurance Fund Extended reporting injury liability (RL 34A-2-702, 703) periods — basic versus supplemental Coverage J — Medical Uninsured Employers' payments Fund (RL 34A-2- Claim information 704) Definitions Premises and operations 8.2 Workers compensation Conditions and employers liability Products and completed insurance policy operations Exclusions General section Insured contract Limits Part One — Workers Pollution liability coverage Additional coverages compensation insurance form (CG 00 39) 7.0 Businessowners Policy 10% Part Two — Employers 6.3 Commercial crime (10 Items) liability insurance 7.1 Characteristics and General definitions purpose Part Three — Other states Burglary insurance 7.2 Businessowners Section Theft II — Liability Part Four — Your duties if injury occurs Robbery Coverages Part Five — Premium Crime coverage forms Exclusions Part Six — Conditions Commercial crime Who is an insured coverage forms Selected endorsements Limits of insurance (discovery/loss Voluntary sustained) General conditions compensation Government crime Definitions Anniversary rating coverage forms date (discovery/loss 7.3 Businessowners Section sustained) III — Common Policy Other states Conditions Coverages 7.4 Selected endorsement Employee theft

UTAH INSURANCE DEPA RTMENT

Sole proprietors, Major coverages License termination, partners, officers suspension, or and others coverage Protection and revocation (31A-2- indemnity 308(10)(a); 31A- 8.3 Premium computations 9.7 Other policies 23a-111) Job classification Boatowners (31A-22- Probation (31A-23a- Rates 1501–1504) 112)

Payroll Monetary forfeiture (fines) (31A-2-308) Adjustment upon audit 1.2 State regulation Experience modification factor Commissioner's general Utah Consultant's Life Exam duties and powers (31A- Premium discounts 2-201) Series 17-24 8.4 Other sources of Company regulation coverage 100 questions (plus 5 unscored Solvency (31A-4-105, items) Workers' Compensation 105.5) Fund (31A-22-1001; 31A-33-101–118) 2-hour time limit Rates (31A-19a-201– 203) Self-insured employers Effective date: January 1, 2020 (RR R612-400-3) Policy forms (31A-21- 201–203) 8.5 Rating organization (31A-301-309) 1.0 Insurance Regulation 10% Producer appointment (31A-23a-115; Reg (10 Items) 9.0 Other Coverages and Options R590-244-1–14) 8% (8 Items) 1.1 Licensing Termination of 9.1 Umbrella/excess Purpose (31A-23a-101) appointment (Reg liability policies Process (31A-23a-103– R590-244-1–14) Personal (DL 98 01) 105, 107, 302) Unfair claim settlement practices Commercial (CU 00 01) Qualifications (31A-23a- 107, 108) (31A-26-303; Reg 9.2 Specialty liability R590-190–192) insurance Types of licensees (31A-1- 301, 31A-23a-106, 203, Producer regulation Errors and omissions 401, 504) Fiduciary and trust Professional liability Producers account responsibilities Directors and officers Consultants (31A-23a-409) liability Adjusters Place of Fiduciary liability business/records Nonresidents (31A- maintenance (31A- Liquor liability 23a-109) 23a-412) Employment practices Maintenance and duration Controlled business liability Renewal (31A-23a- (31A-23a-502) 9.3 Surplus lines (31A-15- 105; 31A-23a- Shared commissions 103) 111)Continuing (31A-23a-504) Definitions and markets education requirements (31A- Unfair marketing practices Licensing requirements 23a-202; Reg R590- (Reg R590-154) 142-1 through 10) 9.4 Surety bonds Misrepresentation Reinstatement (31A- (31A-21-105; 31A- Principal, obligee and 23a-111(2), 113) 23a-402(1)) surety Assumed name (31A- False advertising Contract bonds 23a-110(2)) (31A-23a-402(1))

License and permit bonds Change of address or Rebating (31A-23a- 402(2), 31A-1- Judicial bonds telephone number (31A-23a-412(1)(c)) 301(145)) 9.5 Aviation insurance Reporting of actions Unfair discrimination Aircraft liability (31A-23a- (31A-23a-402(3)) 105(2)(b)) 9.6 Ocean marine insurance Disciplinary actions

UTAH INSURANCE DEPA RTMENT

Boycott, coercion or Reciprocals Representations/misre intimidation (31A- presentations 23a-402(4)) Lloyd's associations Warranties Illegal inducement Risk retention groups Concealment (31A-23a-402.5, Private versus government Reg R590-154-11) insurers Fraud

Examination of records Admitted versus Waiver and estoppel (31A-2-203–205; 31A- nonadmitted insurers 23a-412) 3.0 Life Insurance Basics 15% Domestic, foreign and alien (15 Items) Privacy of Consumer insurers Information (Reg R590- 3.1 Insurable interest (31A- 206) Financial status 21-104) (independent rating 3.2 Personal uses of life Insurance fraud regulation services) (31A-31-103–106) insurance Marketing (distribution) Survivor protection Personal liability for unpaid systems claims (31A-15-105) Estate creation 2.3 Producers and general 1.3 Federal regulation rules of agency Cash accumulation Fair Credit Reporting Act Insurer as principal Liquidity (15 USC 1681–1681d) Producer/insurer Estate conservation Fraud and false statements relationship (18 USC 1033, 1034) 3.3 Life settlements Authority and powers of (including stranger Privacy (Gramm Leach producer originated life Bliley) insurance) Express National Do Not Call List 3.4 Determining amount of Implied 2.0 General Insurance 10% (10 personal life insurance Apparent Items) Human life value approach 2.1 Concepts Responsibilities to the Needs approach applicant/insured Risk management key Types of information terms 2.4 Contracts gathered Risk Elements of a legal Determining lump- contract Exposure sum needs Offer and acceptance Hazard Planning for income Consideration needs Peril Competent parties 3.5 Business uses of life Loss insurance Legal purpose Methods of handling risk Buy-sell funding Distinct characteristics of Avoidance an insurance contract Key person Retention Contract of adhesion Executive bonuses Sharing Aleatory contract Deferred compensation Reduction funding Personal contract Transfer Split dollar plans Unilateral contract Elements of insurable risks Change of insured Conditional contract provision Adverse selection Legal interpretations 3.6 Classes of life insurance Law of large numbers affecting contracts policies

Reinsurance Ambiguities in a Group versus individual contract of adhesion 2.2 Insurers Ordinary versus industrial Reasonable (home service) Types of insurers expectations Permanent versus term Stock companies Indemnity Participating versus Mutual companies Utmost good faith nonparticipating Fraternal benefit societies

UTAH INSURANCE DEPA RTMENT

Fixed versus variable life 3.9 Individual underwriting Group underwriting insurance and annuities by the insurer requirements including regulation of variable products (SEC, Information sources and Conversion to individual FINRA, and Utah) (31A- regulation policy (31A-22-517– 519) 5-217, 217.5; 31A-23a- Application 206) 5.0 Life Insurance Policy Licensee report 3.7 Premiums Provisions, Options and Attending physician Riders 16% (16 Items) Factors in premium statement 5.1 Standard provisions determination Investigative Ownership Mortality consumer Assignment (31A-22-412) Interest (inspection) report Entire contract (31A-22- Expense Medical Information Bureau (MIB) 424) Premium concepts Medical examinations Modifications Net single premium and lab tests Right to examine (free (including HIV look) (31A-22-423) Gross annual premium consent) (Reg Premium payment mode R590-132-3) Payment of premiums

3.8 Licensee Selection criteria and Grace period (31A-22- responsibilities unfair discrimination 402) (31A-23a-402(3)) Solicitation and sales Reinstatement (31A-22- presentations (Reg Classification of risks 407) R590-79-1–8) Preferred Incontestability (31A-22- 403) Advertising (Reg Standard R590-130-4–16) Misstatement of age and Substandard Utah Life and Health gender (31A-22-405) Insurance Guaranty 4.0 Life Insurance Policies 10% Exclusions Association (31A- (10 Items) 28-119(1-4) R590- 4.1 Term life insurance Suicide exclusion (31A- 155 22-404) Level term Illustrations (31A-22- Medical examination; 631; Reg R590-177- Annual renewable autopsy (31A-22-417) 1–13) term Prohibited provisions Policy summary (31A- Level premium term including backdating 22-631; Reg R590- (31A-22-401) 79-4(F), 5) Decreasing term 5.2 Beneficiaries Buyer's guide (Reg 4.2 Whole life insurance R590-79-4(A), 5) Designation options Continuous premium Replacement (Reg (straight life) Individuals R590-93-1–12) Limited payment Classes Use and disclosure of Single premium Estates insurance information 4.3 Flexible premium Minors policies Field underwriting Trusts Adjustable life Notice of information Revocation at Divorce 30- practices Universal life 3-5

Application procedures 4.4 Specialized policies Succession

Delivery Joint life (first-to-die) Revocable versus irrevocable Policy review Juvenile life Common disaster clause Effective date of 4.5 Group life insurance coverage Spendthrift clause Characteristics of group Premium collection plans 5.3 Settlement options Statement of good Types of plan sponsors Cash payment health Interest only

UTAH INSURANCE DEPA RTMENT

Fixed-period installments 6.1 Annuity principles and Tax-deferred growth concepts Fixed-amount installments Retirement income Accumulation period Life income versus annuity period Education funds

Single life Owner, annuitant and 7.0 Federal Tax Considerations for Life Insurance and Joint and survivor beneficiary Annuities 13% (13 Items) Insurance aspects of 5.4 Nonforfeiture options 7.1 Taxation of personal life annuities insurance Cash surrender value 6.2 Immediate versus Amounts available to Extended term deferred annuities policyowner Reduced paid-up insurance Single premium immediate Cash value increases annuities (SPIAs) 5.5 Policy loan and Dividends withdrawal options Deferred annuities Policy loans Cash loans Premium payment options Surrenders Automatic premium loans Nonforfeiture Amounts received by Withdrawals or partial beneficiary surrenders Surrender charges General rule and 5.6 Dividend options Death benefits exceptions Cash payment 6.3 Annuity (benefit) Settlement options payment options Reduction of premium Values included in payments Life contingency options insured's estate Accumulation at interest Pure life versus life 7.2 Modified endowment with guaranteed contracts (MECs) One-year term option minimum Modified endowment Paid-up additions Single life versus versus life insurance 5.7 Disability riders multiple life Seven-pay test Waiver of premium Annuities certain (types) Distributions Waiver of cost of insurance 6.4 Annuity products 7.3 Taxation of non- Fixed annuities Disability income benefit qualified annuities General account Payor benefit life/disability Individually-owned (juvenile insurance) assets Accumulation phase Interest rate 5.8 Accelerated (living) (tax issues related guarantees benefit provision/rider to withdrawals) (minimum versus Qualifying events current) Annuity phase and the exclusion ratio Disclosure Level benefit payment amount Distributions at death Effect of benefit payment Indexed annuities Corporate-owned 5.9 Riders covering additional insureds Market value adjusted 7.4 Taxation of individual annuities retirement annuities Spouse/other-insured term (IRAs) rider Guaranteed living benefit riders Traditional IRAs Children's term rider Variable annuities Contributions and Family term rider deductible amounts 6.5 Uses of annuities 5.10 Riders affecting the Premature death benefit amount Lump-sum settlements distributions Accidental death Qualified retirement plans (including taxation including group versus issues) Guaranteed insurability individual annuities Annuity phase benefit Cost of living Personal uses payments Return of premium Individual retirement Values included in the annuities (IRAs) annuitant's estate 6.0 Annuities 16% (16 Items)

UTAH INSURANCE DEPA RTMENT

Amounts received by Utah Consultant's Accident and Commissioner's general beneficiary Health Exam duties and powers (31A- 2-201) Roth IRAs Series 17-25 Company regulation Contributions and limits 100 questions (plus 5 unscored Solvency (31A-4-105, items) 105.5) Distributions 2-hour time limit Rates (31A-19a-201– 7.5 Rollovers and transfers 203) (IRAs and qualified plans) Effective date: January 1, 2020 Policy forms (31A-21- 201–203) 7.6 Section 1035 exchanges Producer appointment 1.0 Insurance Regulation 7% (7 8.0 Qualified Plans 10% (10 (31A-23a-115; Reg Items) Items) R590-244-1–14) 8.1 General requirements 1.1 Licensing Termination of 8.2 Federal tax Purpose (31A-23a-101) appointment (Reg R590-244-1–14) considerations Process (31A-23a-103– Tax advantages for 105, 107, 302) Unfair claim settlement practices employers and Qualifications (31A-23a- (31A-26-303; Reg employees 107, 108) R590-190–192) Taxation of distributions Types of licensees (31A-1- Producer regulation (age-related) 301, 31A-23a-106, 203, 8.3 Plan types, 401, 504) Fiduciary and trust account characteristics and Producers purchasers responsibilities Consultants (31A-23a-409) Simplified employee pensions (SEPs) Adjusters Place of business/records Self-employed plans (HR Nonresidents (31A- maintenance (31A- 10 or Keogh plans) 23a-109) 23a-412)

Profit-sharing and 401(k) Maintenance and duration Controlled business plans Renewal (31A-23a- (31A-23a-502) SIMPLE plans 105; 31A-23a-111) Shared commissions (31A-23a-504) Pension Plans Continuing education requirements (31A- Unfair marketing practices 403(b) tax-sheltered 23a-202; Reg R590- (Reg R590-154) annuities (TSAs) 142-1 through 10) Misrepresentation Section 457 deferred Reinstatement (31A- (31A-21-105; 31A- compensation 23a-111(2), 113) 23a-402(1)) 8.4 Special rules for life Assumed name (31A- False advertising insurance 23a-110(2)) (31A-23a-402(1)) Incidental limitation Change of address or Rebating (31A-23a- Taxation of economic telephone number 402(2), 31A-1- benefit (31A-23a-412(1)(c)) 301(145))

Taxation of life insurance Reporting of actions Unfair discrimination distributions (31A-23a- (31A-23a-402(3)) 105(2)(b)) Boycott, coercion or Disciplinary actions intimidation (31A- License termination, 23a-402(4)) suspension, or Illegal inducement revocation (31A-2- (31A-23a-402.5, 308(10)(a); 31A- Reg R590-154-11) 23a-111) Examination of records Probation (31A-23a- (31A-2-203–205; 31A- 112) 23a-412) Monetary forfeiture Privacy of Consumer (fines) (31A-2-308) Information (Reg R590- 1.2 State regulation 206)

UTAH INSURANCE DEPA RTMENT

Insurance fraud regulation Financial status Accidental injury (R590- (31A-31-103–106) (independent rating 126, 233) services) Personal liability for unpaid Sickness, medical claims (31A-15-105) Marketing (distribution) necessity and emergency systems (31A-22-627) 1.3 Federal regulation 2.3 Producers and general 3.2 Principal types of losses Fair Credit Reporting Act rules of agency and benefits (15 USC 1681–1681d) Insurer as principal Loss of income from Fraud and false statements disability (R590-126, (18 USC 1033, 1034) Producer/insurer 233) relationship Privacy (Gramm Leach Medical expense Bliley) Authority and powers of producer Dental expense National Do Not Call List Express Long-term care expense Affordable Care Act Implied 3.3 Classes of health 2.0 General Insurance 5% (5 insurance policies Items) Apparent Individual versus group 2.1 Concepts Responsibilities to the applicant/insured Private versus government Risk management key terms 2.4 Contracts Self-funded vs fully insured

Risk Elements of a legal Limited versus contract comprehensive Exposure Offer and acceptance Employer group versus Hazard association group Consideration Peril 3.4 Limited policies (R590- Competent parties Loss 126) Legal purpose Methods of handling risk Limited perils and amounts Distinct characteristics of Avoidance Required notice to insured an insurance contract Retention Types of limited policies Contract of adhesion Sharing Accident-only Aleatory contract Reduction Specified (dread) Personal contract disease Transfer Unilateral contract Hospital indemnity Elements of insurable risks Conditional contract (income) Adverse selection Legal interpretations Credit disability Law of large numbers affecting contracts Blanket insurance (teams, passengers, Reinsurance Ambiguities in a contract of adhesion other) 2.2 Insurers Reasonable Prescription drugs Types of insurers expectations Vision care Stock companies Indemnity 3.5 Common exclusions Mutual companies Utmost good faith from coverage (R590- 126) Fraternal benefit Representations/misre societies presentations 3.6 Licensee responsibilities in Reciprocals Warranties individual health insurance Lloyd's associations Concealment Marketing requirements Risk retention groups Fraud Advertising (Reg Private versus government Waiver and estoppel R590-130-4–16) insurers 3.0 Accident and Health Utah Life and Health Admitted versus Insurance Basics 30% (30 Insurance Guaranty nonadmitted insurers Items) Association (31A- Domestic, foreign and alien 3.1 Definitions of perils 28-119(1-4); R590- insurers 155)

UTAH INSURANCE DEPA RTMENT

Sales presentations 3.8 Considerations in Nonrenewable replacing accident and (cancelable, term) Outline of coverage health insurance (Reg (Reg R590-126-8, R590-126-9, 233) 4.0 Disability Income and 233-8) Related Insurance 2% (2 Benefits, limitations and Items) Compensation exclusions disclosure (31A- 4.1 Qualifying for disability 23a-501) Underwriting requirements benefits

Field underwriting Licensee liability for errors Inability to perform duties and omissions Nature and purpose Own occupation Required notification Employee waiver form Any occupation (31A-22-635; R590- 3.9 Other required, uniform Loss of income (income 247) and general provisions replacement contracts) (R590-126, 133) Disclosure of Definition of total disability information about Incontestability (31A-22- (R590-126-3) individuals (R590- 609) 126, 233) Presumptive disability Grace period (31A-22- Application procedures 607) Requirement to be under physician care Requirements at Reinstatement (31A-22- delivery of policy 608) 4.2 Individual disability income insurance Utah individual and Claim procedures (31A- small employer 21-312; 31A-22-614; Basic total disability plan health insurance 31A-26-301; Reg R590- application (R590- 192-1–14) Income benefits 247) (monthly indemnity) Change of occupation Common situations for (31A-22-613(1)) Elimination and errors/omissions benefit periods Misstatement of age (31A- 3.7 Individual underwriting 22-613(2,3)) Waiver of premium by the insurer feature Coordination of benefits Underwriting criteria (31A-22-619) Coordination with social insurance and workers Sources of underwriting Right to examine (free compensation benefits information look) (31A-22-606) Additional monthly Application Rights of spouse (31A-22- benefit (AMB) 612) Licensee report Social insurance Insuring clause supplement (SIS) Attending physician statement Consideration clause Occupational versus nonoccupational Investigative Entire contract; changes coverage consumer Physical examinations and (inspection) report At-work benefits autopsy Medical Information Partial disability Legal actions Bureau (MIB) benefit Change of beneficiary Medical examinations Residual disability and lab tests Unpaid premium benefit (including HIV consent) (Reg Conformity with state Other provisions affecting R590-132-3) statutes income benefits

Unfair discrimination Illegal occupation Cost of living (31A-23a-402(3)) adjustment (COLA) Renewability clause (31A- rider Genetic Information 30-107; Reg R590-126- and 5; Reg R590-233) Future increase option Nondiscrimination (FIO) rider Act of 2008 (GINA) Noncancelable Relation of earnings to Classification of risks Guaranteed renewable insurance

Preferred Conditionally Other cash benefits renewable Standard Accidental death and Renewable at option dismemberment Substandard of insurer

UTAH INSURANCE DEPA RTMENT

Rehabilitation benefit Provisions affecting Newborn child cost to insured coverage (31A-22- Medical 610) reimbursement Health maintenance benefit organizations (HMOs) Dependent child age (nondisabling injury) limit (31A-22- General characteristics 610.5) Refund provisions Preventive care Court ordered Return of premium services dependency Cash surrender value Primary care physician coverage (31A-22- versus referral 610.5) Exclusions (specialty) physician Eligibility of dependent 4.3 Unique aspects of Emergency care children not based individual disability solely on residency underwriting Hospital services (31A-22-718)

Occupational Other basic services Policy extension for considerations handicapped Preferred provider children (31A-22- Benefit limits organizations (PPOs) 611)

Policy issuance alternatives General characteristics Adoptions (31A-22- 4.4 Group disability income Limited health plans 610.1) insurance (31A-8-101(6)) Federal health care Group versus individual Open panel or closed reform required plans panel dependent coverage

Short-term disability (STD) Types of parties to the Benefit offers provider contract Long-term disability (LTD) Substance abuse Utah NetCare Plan coverage (31A-22- 4.5 Social Security (31A-22-724) 715) disability Point-of-Service (POS) 5.5 HIPAA (Health Qualification for disability plans Insurance Portability benefits and Accountability Nature and Purpose Act) requirements Definition of disability Out-of-network Eligibility Waiting period provider access Guaranteed issue Disability income benefits (open-ended HMO) PCP referral Pre-existing conditions 5.0 Medical Plans 18% (18 (gatekeeper PPO) Items) Creditable coverage 5.1 Medical plan concepts Indemnity plan features Renewability Fee-for-service basis 5.3 Cost containment in 5.6 Health Savings versus prepaid basis health care delivery Accounts (HSAs) and Health Reimbursement Specified coverages versus Cost-saving services Accounts (HRAs) comprehensive care Preventive care Definition Benefit schedule versus Hospital outpatient usual/reasonable/custom benefits Eligibility ary charges Alternatives to Contribution limits Any provider versus hospital services limited choice of Portability providers Maternity stay minimum limits Insureds versus (31A-22-610.2) 5.7 Uniform health benefit subscribers/participants plan information card Utilization management 5.2 Types of providers and (31A-22-635) plans Prospective review 5.8 Federal Health Care Major medical insurance Concurrent review Reform (Patient (indemnity plans) Protection and 5.4 Utah requirements Affordable Care Act) Characteristics (individual and group) 6.0 Group Accident and Health Common limitations Eligibility requirements Insurance 21% (21 Exclusions from Items) coverage

100

UTAH INSURANCE DEPA RTMENT

6.1 Characteristics of group Coordination of benefits Applicability to insurance (31a-22- provision (Reg R590- employers and 501.1) 131) workers

Group contract Change of insurance Permitted reductions companies or loss of in insured benefits Certificate of coverage coverage Permitted increases in Experience rating versus Coinsurance and employee community rating deductible carryover contributions

6.2 Types of eligible groups No-loss no-gain Requirements for Employment-related medical expense Events that terminate coverage groups (31a-22-501.1) coverage Civil Rights Act/Pregnancy Individual employer Extension of benefits groups (31a-22- Discrimination Act 501.1) Continuation of Applicability coverage under Multiple-Employer COBRA and Utah Guidelines Trusts (METs) or Mini-COBRA (31A- Welfare 22-722) Relationship with Medicare Arrangements (MEWAs) Conversion rights Medicare secondary (31A-22-723) rules Associations (alumni, professional, other) Reinstatement of Medicare carve-outs (31a-22-701) coverage for military and supplements personnel (31A-22- Nondiscrimination rules Customer groups 717) (depositors, creditor- (highly-compensated) debtor, other) (31a-22- 6.5 Small employer medical 6.7 Types of funding and 506) plans administration

Discretionary groups Definition of small Conventional fully-insured (31a-22-701) employer (31A-1-301) plans

6.3 Marketing Basic coverage (31A-22- Fully self-funded (self- considerations 613.5) administered) plans

Advertising (R590-155) Availability of coverage Characteristics (31A-30-108) Unfair inducements Conditions suitable for (R590-154) Rating of small employer self-funding plans (31A-30; Reg Regulatory R590-167) Benefits suitable for jurisdiction/place of self-funding delivery Pre-existing conditions (31A-22-605.1) 7.0 Dental Insurance 2% (2 6.4 Employer group health Items) insurance Participation requirements (31A-30-112) 7.1 Categories of dental Insurer underwriting treatment criteria Surcharge for charging carriers (31A-30-106.7) Diagnostic and preventive Characteristics of group Open enrollment (Reg Restorative R590-176) Plan design factors Oral surgery 6.6 Regulation of employer Endodontics Persistency factors group insurance plans Periodontics Administrative Employee Retirement capability Income Security Act Prosthodontics Eligibility for insurance (ERISA) Orthodontics Annual open Applicability 7.2 Indemnity plans enrollment Fiduciary Choice of providers Employee eligibility responsibilities Scheduled versus Dependent eligibility Reporting and nonscheduled plans (31a-22-610, 31a- disclosure 22-610.5, 31a-22- Age Discrimination in Benefit categories 718, 31a-22-610.1, Employment Act (ADEA) 31a-22-611) Diagnostic/preventive services

101

UTAH INSURANCE DEPA RTMENT

Basic services Utah regulations and 9.0 Long-Term Care Insurance required provisions 7% (7 Items) Major services Standards for 9.1 Long-term care (LTC) Deductibles and marketing (Reg policies coinsurance R590-146-20) Eligibility for benefits Combination plans Advertising (Reg Federal reform - CLASS R590-146-19) Exclusions ACT Appropriateness of Limitations R590-126 Levels of care recommended Predetermination of purchase and Skilled care benefits excessive insurance (Reg R590-146-21) Intermediate care 7.3 Employer group dental expense Right to return (free Custodial care look) (31A-22- Home health care Integrated deductibles 620(6)) versus stand-alone plans Adult day care Replacement (Reg Minimizing adverse R590-146-18, 23) Respite care selection Pre-existing conditions Benefit periods 8.0 Medicare 6% (6 Items) (Reg R590-146-23) 8.1 Medicare standard Benefit amounts Required disclosure policies provisions (Reg Optional benefits R590-146-17) Nature, financing and Guarantee of administration Outline of coverage insurability (Reg R590-146- Part A — Hospital Return of premium Insurance 17(C)) Qualified LTC plans Individual eligibility Guide to Health requirements Insurance for People Exclusions with Medicare (Reg Enrollment R590-146- Underwriting 17(A)(6)(a)) considerations Coverages and cost- sharing amounts Permitted Utah regulations and compensation (Reg required provisions Part B — Medical R590-146-16) Insurance Standards for New plans effective marketing (Reg Individual eligibility June 1, 2010 (Reg R590-148-18) requirements R590-146) Advertising (Reg Enrollment Medicare Advantage R590-148-20) Coverages and cost- 8.3 Other options for Shopper's guide (Reg sharing amounts individuals with R590-148-16) Medicare Exclusions Outline of coverage Claims terminology Employer group health (31A-22-1409; Reg and other key terms plans R590-148-15)

Part C — Medicare Disabled employees Appropriateness of Advantage recommended Employees with purchase (Reg Part D — Prescription Drug kidney failure (End R590-148-17) Insurance Stage Renal Disease) (ESRD) Right to return (free 8.2 Medicare supplement look) (31A-22- Individuals age 65 and 1408) Purpose older Replacement (Reg Open enrollment (Reg Medicaid R590-148-6) R590-146-11) Eligibility Renewal provisions Standardized Medicare (Reg R590-148-6) supplement plans Benefits Continuation or 8.4 Medicare Improvements Core benefits (Reg conversion (Reg for Patients and R590-146-8(B)) R590-148-10) Providers Act of 2008 Additional benefits (MIPPA) (Reg R590-146- 8(C))

102

UTAH INSURANCE DEPA RTMENT

Required disclosure Utah Adjuster's Crop Exam Probation (31A-26-214) provisions (Reg R590-148-6) Series 17-26 License termination, suspension, nonrenewal, Inflation protection 60 questions (plus 5 unscored or revocation (31A-26- (Reg R590-148-13) items) 213) Pre-existing conditions Monetary forfeiture (fines) (31A-22-1406; Reg 1-hour time limit (31A-2-308) R590-148-6) Effective date: January 1, 2020 1.4 Claim settlement laws Protection against and regulations

unintentional lapse (Reg R590-148-11) 2.0 Crop Insurance 25% (15 1.0 Insurance Regulation 15% Items) Prohibited provisions (9 Items) 2.1 Eligibility (31A-22-1405, 1.1 Licensing requirements 1407) Insureds Purpose (31A-26-101) Rate disclosure form Insurable crops Definitions (31A-26-102) 10.0 Federal Tax Considerations 2.2 Application for Accident and Health Qualifications (31A-26- Insurance 2% (2 Items) 203, 205) Binder 10.1 Personally-owned Purpose (31A-26-202) Declarations section health insurance Process (31A-26-202) Required signatures Individual mandate/penalties for Classifications of licenses Required information noncompliance (31A-26-204) 2.3 Term of coverage

Disability income insurance Adjuster (31A-26- Effective date 102, 201, 204 Medical expense insurance (1)(c)) Inception of coverage

Long-term care insurance Nonresident adjuster Expiration (31A-26-208) 10.2 Employer group health Cancellation insurance Emergency adjuster (31A- 2.4 Perils insured against Disability income (STD, 26-212) LTD) License/character 2.5 Exclusions Benefits subject to requirements (31A-26- 2.6 Limits of coverage FICA 204 & 205) Insurable value Medical and dental Licensing exceptions expense (31A-26-201 (2)) Percentage plan

Long-term care insurance 1.2 Maintenance and Deductibles duration Accidental death and Reduction of insurance dismemberment Renewal (31A-26-213; 31A-26-214.5; Reg. 2.7 Other provisions 10.3 Medical expense R590-244-7 though 9) Replanting clause coverage for sole proprietors and Change of name, address, Acreage variation partners telephone number (31A- 26-306 (1)(b)) Transit coverage 10.4 Business disability Fire department service insurance Assumed names (31A-26- 209 (2)) charge Key person disability Pro rata liability clause income Records (31A-26-306 (2- 4)) Fire and lightning coverage Buy-sell policy Continuing education Assignment 10.5 Health Savings requirements (31A-26- Accounts (HSAs) and 206; Reg. R590-142- Subrogation Health Reimbursement 1through 10) Accounts (HRAs) 2.8 Claim settlement Reinstatement (31A-26- practices 214.5 (2); Reg. R590- 244-8) Notice of loss

Reporting of actions (31A- Insured's duties after loss 26-203) Appraisal/arbitration 1.3 Disciplinary actions

103

UTAH INSURANCE DEPA RTMENT

2.9 Mandatory Subrogation Utah Adjuster's Workers endorsements 3.3 Other provisions Compensation Exam NCIS — 444 Tomatoes, Series 17-27 Truck and Vine Crops Individual crop

NCIS — 578 Tree Fruits Small grain 60 questions (plus 5 unscored items) Coarse grain 3.0 Federal Multi-peril Crop Insurance Programs 30% Priorities of conflicts 1-hour time limit (18 Items) between provisions 3.1 Basic catastrophic crop Effective date: January 1, 2020 Duties after loss insurance (CAT) Insured Eligibility 1.0 Insurance Regulation 8% (5 Insurer Insureds Items) 3.4 Additional programs Insurable crops 1.1 Licensing requirements Group Risk Plan (GRP) Actuarial document books Definitions (31A-26-102) County expected yield Yield guarantee Qualifications (31A-26- 203, 205) County average yield Actual production Purpose (31A-26-202) history (APH) Eligible crops Process (31A-26-202) Assigned yield 4.0 Plant Physiology 10% (6 Transitional yield Items) Classifications of licenses 4.1 Basic plant functions (31A-26-204) Coverage level 4.2 Structure of the stem Adjusters (31A-26- Market price percentage and leaf 102, 201, 204 (1)(c)) Covered causes of loss 4.3 Stages of growth Non-resident adjuster Application 4.4 Main classification of (31A-26-208) plants Basic unit License/character Administrative fee Grassy plants requirements (31A-26- 204 & 205) Production records Broadleaf plants Licensing exceptions Acreage reporting 5.0 Loss Adjusting Procedures (31A-26-201 (2)) 20% (12 Items) Late planting agreement Change in name or 5.1 Settling the claim option address or phone Other insurance number (31A-26-306 Disqualification of producer (1)(b)) Subrogation Life of policy Emergency adjuster Field inspections and Continuous license (31A-26-212) counts Cancellation 1.2 Maintenance and Closing the claim duration Termination Deferments Renewal (31A-26-213; 3.2 Multiple peril policy 31A-26-214.5; Reg. Unsettled claims (snags) options R590-244-7though 9)

Levels of coverage Change in name, address, telephone number (31A- Price election 26-306 (1)(b)) Optional units Records (31A-26-306 (2- High-risk land exclusion 4))

Hail/fire exclusion Reinstatement (31A-26- 214.5 (2); Reg. R590- Replant payments 244-8)

Late planting coverage Assumed name (31A-26- 209(2) Prevented planting coverage Continuing education requirements (31A-26- Transfer of coverage 206; Reg. R590-142-1 Assignment of indemnity through 10)

104

UTAH INSURANCE DEPA RTMENT

Reporting of actions (31A- Compensation Distinct characteristics of 26-203) agreements and an insurance contract disputed claims 1.3 Disciplinary actions Contract of adhesion Second injury fund Probation (31A-26-214) Aleatory contract Federal workers Termination, suspension, compensation laws Personal contract revocation, refusal to issue or renew (31A-26- Federal Employers Unilateral contract 213) Liability Act (FELA) Conditional contract (45 USC 51–60) Monetary forfeiture (fines) Utmost good faith (31A-2-308) U.S. Longshore and Harbor Workers Representations/misre 1.4 Claim settlement laws Compensation Act presentations and regulations (33 USC 904) Warranties Unfair claim settlement The Jones Act (46 practices (31A-26-303; USC 688) Concealment Reg R590-190–192) 2.2 Workers compensation Fraud Producer regulation and employers liability 3.3 Negligence Place of business/records insurance policy Elements of a negligent act maintenance (31A-26- General section 102) Defenses against Part One — Workers negligence 2.0 Workers Compensation compensation insurance Insurance 44% (26 Absolute liability Items) Part Two — Employers liability insurance Strict liability 2.1 Workers compensation laws Part Three — Other states Vicarious liability insurance Types of laws 3.4 Controlling medical Part Four — Your duties if costs Monopolistic versus injury occurs competitive Managed care Part Five — Premium Compulsory versus Utilization review elective Part Six — Conditions Inpatient services Utah's Workers Selected endorsements Compensation Law (UT Outpatient services Labor Code Chp. 2, 3, Voluntary Hospital bill auditing 8a; 31A-33-101-105, compensation 111-118; 31A-19a-401- Foreign coverage Designated provider 408; 31A-22-1001- endorsement 1010,1012,1013; 78B-4- 3.5 Investigation and 603; R602-6-3; Bulletin Other states evaluation 92-7 (Amended)) Anniversary date Compensability Exclusive remedy Sole proprietor, Employee/non- Employment covered partners, officers employee (required, and others coverage Arising out of voluntary) employment 3.0 Workers Compensation Claim Covered injuries Principles 38% (23 Items) Arising in the course Occupational disease 3.1 Role of the adjuster of employment

Benefits provided Duties and responsibilities Documentation

Subrogation Relationship to the legal First report of injury profession Bars to recovery Claimant statement 3.2 Contract basics Average weekly wage Insured's records Elements of a legal Witness statements Notice of injury and contract claim Current activity Offer and acceptance Medical examination reports Consideration Managed care Medical determination Competent parties Medical authorization Legal purpose Diagnosis

105

UTAH INSURANCE DEPA RTMENT

Prognosis Brain injuries Renewal (31A-23a- 105; 31A-23a-111) Independent Medical Burn classifications Examinations (IMEs) Continuing education Cumulative trauma requirements (31A- 3.6 Claim reserves Repetitive motion injuries 23a-202; Reg R590- Components 142-1 through 10) Lung diseases Indemnity Reinstatement (31A- 4.4 Medical tests 23a-111(2), 113) Medical Laboratory Assumed name (31A- Expense 23a-110(2)) Radiography (X-ray) Factors affecting reserves Change of address or Magnetic resonance telephone number Reserving techniques imaging (MRI) (31A-23a-412(1)(c))

Individual case Computerized tomography Reporting of actions method (CT or CAT) (31A-23a- Formula method Electromyography (EMG) 105(2)(b))

Round-table technique Nerve conduction studies Disciplinary actions

3.7 Claims management Myelography License termination, suspension, or Analysis Arthroscopy revocation (31A-2- 308(10)(a); 31A- On-site inspections Electrocardiogram (EKG or 23a-111) ECG) Selecting an Probation (31A-23a- evaluating physician Electroencephalography 112) (EEG) Physician evaluation Monetary forfeiture (fines) (31A-2-308) Disposition Litigation management 1.2 State regulation Utah Consultant's Property Exam Settlement negotiation Commissioner's general Series 17-28 duties and powers (31A- 4.0 Understanding the Language 2-201) of Medical Reports 10% (6 100 questions (plus 5 unscored Company regulation Items) items)

4.1 Medical terminology Solvency (31A-4-105, and abbreviations 2-hour time limit 105.5)

Location terms Effective date: January 1, 2020 Rates (31A-19a-201– 203) Movement terms Policy forms (31A-21- Prefixes, suffixes and root 1.0 Insurance Regulation 13% 201–203) words (13 Items) Producer appointment Abbreviations used in 1.1 Licensing (31A-23a-115; Reg medical reports Purpose (31A-23a-101) R590-244-1–14) Medical specialties Process (31A-23a-103– Termination of appointment (Reg 4.2 Basic human anatomy 105, 107, 302) R590-244-1–14) Skeletal structure Qualifications (31A-23a- 107, 108) Unfair claim Nervous system settlement practices Types of licensees (31A-1- (31A-26-303; Reg Respiratory system 301, 31A-23a-106, 203, R590-190–192) 401, 504) Cardiovascular system Producer regulation Producers Abdominal organs Fiduciary and trust 4.3 Common occupational Consultants account injuries and disease responsibilities Adjusters (31A-23a-409) Strains and sprains Nonresidents (31A- Place of Dislocations 23a-109) business/records Maintenance and duration maintenance (31A- Fractures 23a-412) Soft tissue injuries

106

UTAH INSURANCE DEPA RTMENT

Controlled business Methods of handling risk Legal purpose (31A-23a-502) Avoidance Distinct characteristics of Shared commissions an insurance contract (31A-23a-504) Retention Contract of adhesion Unfair marketing practices Sharing Aleatory contract (Reg R590-154) Reduction Personal contract Misrepresentation Transfer (31A-21-105; 31A- Unilateral contract 23a-402(1)) Elements of insurable risks Conditional contract False advertising Adverse selection (31A-23a-402(1)) Legal interpretations Law of large numbers affecting contracts Rebating (31A-23a- 402(2), 31A-1- Reinsurance Ambiguities in a 301(145)) 2.2 Insurers contract of adhesion

Unfair discrimination Types of insurers Reasonable (31A-23a-402(3)) expectations Stock companies Boycott, coercion or Indemnity intimidation (31A- Mutual companies 23a-402(4)) Utmost good faith Fraternal benefit Illegal inducement societies Representations/misre (31A-23a-402.5, presentations Reciprocals Reg R590-154-11) Warranties Lloyd's associations Examination of records Concealment (31A-2-203–205; 31A- Risk retention groups 23a-412) Fraud Private versus government Privacy of Consumer insurers Waiver and estoppel Information (Reg R590- 206) Admitted versus 3.0 Property and Casualty nonadmitted insurers Insurance Basics 16% (16 Insurance fraud regulation Items) (31A-31-103–106) Domestic, foreign and alien 3.1 Principles and concepts insurers Personal liability for unpaid Insurable interest claims (31A-15-105) Financial status (independent rating Underwriting 1.3 Federal regulation services) Function Fair Credit Reporting Act Marketing (distribution) (15 USC 1681–1681d) systems Loss ratio

Fraud and false statements 2.3 Producers and general Rates (18 USC 1033, 1034) rules of agency Types Privacy (Gramm Leach Insurer as principal Bliley) Loss costs Producer/insurer Components National Flood Insurance relationship Program Hazards Authority and powers of Terrorism Risk Insurance producer Physical Act Express Moral 2.0 General Insurance 13% (13 Items) Implied Morale 2.1 Concepts Apparent Causes of loss (perils)

Risk management key Responsibilities to the Named perils versus terms applicant/insured special (open) perils

Risk 2.4 Contracts Direct loss

Exposure Elements of a legal Consequential or indirect contract Hazard loss Offer and acceptance Peril Blanket versus specific insurance Consideration Loss Basic types of construction Competent parties

107

UTAH INSURANCE DEPA RTMENT

Loss valuation Claim settlement Special provisions — Utah options (DP 01 43) Actual cash value Third-party provisions Automatic increase in Replacement cost insurance (DP 04 11) Standard mortgage Functional clause Broad theft coverage (DP replacement cost 04 72) Loss payable clause Market value Dwelling under No benefit to the construction (DP 11 43) Agreed value bailee Stated amount 4.7 Personal liability 3.4 Utah laws, regulations supplement Valued policy and required provisions 5.0 Homeowners Policy 17% 3.2 Policy structure (17 Items) Utah Property and Declarations Casualty Insurance 5.1 Coverage forms Guaranty Association HO-2 through HO-6 Definitions (31A-28-202–210, 212– Insuring agreement or 215, 217–218, 220, 222) HO-8 clause Cancellation, issuance and 5.2 Definitions Additional/supplementary renewal (31A-21-303) 5.3 Section I — Property coverage Binders (31A-21-102) coverages Conditions Other insurance (31A-21- Coverage A — Dwelling Exclusions 307) Coverage B — Other Endorsements Suit against insurer (31A- structures 21-313) 3.3 Common policy Coverage C — Personal provisions Concealment or fraud (RL property 76-6-521) Insureds — named, first Coverage D — Loss of use named and additional Federal Terrorism Insurance Program (15 Additional coverages Policy period USC 6701; Public Law 5.4 Perils insured against 107–297, 109–144, Policy territory 110–160) 5.5 Exclusions Cancellation and 4.0 Dwelling Policy 8% (8 5.6 Conditions nonrenewal Items) 5.7 Selected endorsements Deductibles 4.1 Characteristics and purpose Special provisions — Utah Other insurance (HO 01 43) 4.2 Coverage forms — Perils Nonconcurrency insured against Limited fungi, wet or dry Primary and excess rot, or bacteria coverage Basic (HO 04 26, HO 04 27) Limits of liability Broad Permitted incidental Policy limits Special occupancies — residence premises (HO 04 42) Restoration/nonreduction 4.3 Property coverages of limits Earthquake (HO 04 54) Coverage A — Dwelling Coinsurance Scheduled personal Coverage B — Other property (HO 04 61) Vacancy or unoccupancy structures Personal property Named insured provisions Coverage C — Personal replacement cost (HO Duties after loss property 04 90)

Assignment Coverage D — Fair rental Home day care (HO 04 value 97) Abandonment Coverage E — Additional 6.0 Commercial Package Policy Insurer provisions living expense (CPP) 14% (14 Items) Liberalization Other coverages 6.1 Components of a commercial policy Subrogation 4.4 General exclusions Common policy Salvage 4.5 Conditions declarations

4.6 Selected endorsements Common policy conditions

108

UTAH INSURANCE DEPA RTMENT

Interline endorsements Transportation coverages Limits

One or more coverage Motor truck cargo Deductibles parts forms Loss conditions 6.2 Commercial property Transit coverage forms General conditions Commercial property conditions form 6.4 Equipment breakdown Optional coverages

Coverage forms Equipment breakdown Definitions protection coverage form 7.3 Businessowners Section Building and personal (EB 00 20) property III — Common Policy Selected endorsement Conditions Condominium association Actual cash value (EB 7.4 Selected endorsements 99 59) Condominium Protective safeguards (BP commercial unit- 6.5 Farm coverage 04 30) owners Farm property coverage Utility services — direct Builders risk form damage (BP 04 56)

Business income Coverage A — Utility services — time Dwellings element (BP 04 57) Legal liability Coverage B — Other 8.0 Other Coverages and Options Extra expense private structures 4% (4 Items) 8.1 Aviation insurance Causes of loss forms Coverage C — Basic Household personal Aircraft Liability property Broad 8.2 Ocean marine insurance Coverage D — Loss of Special use Major coverages

Selected endorsements Coverage E — Protection and indemnity Scheduled personal 8.3 Other policies Ordinance or law (CP property 04 05) Boatowners Coverage F — Spoilage (CP 04 40) Unscheduled farm Peak season limit of personal property insurance (CP 12 Coverage G — Other 30) farm structures Utah Consultant's Casualty Exam Value reporting form Mobile agricultural (CP 13 10) machinery and Series 17-29 6.3 Commercial inland equipment coverage marine form 100 questions (plus 5 unscored items) Livestock coverage form Nationwide marine definition Definitions 2-hour time limit

Commercial inland marine Causes of loss (basic, Effective date: January 1, 2020 conditions form broad and special)

Inland marine coverage Conditions forms 1.0 Insurance Regulation 11% Exclusions Accounts receivable (11 Items) Limits Bailee's customer 1.1 Licensing Additional coverages Commercial articles Purpose (31A-23a-101) 7.0 Businessowners Policy 15% Contractors Process (31A-23a-103– (15 Items) equipment floater 105, 107, 302) 7.1 Characteristics and Qualifications (31A-23a- Electronic data purpose processing 107, 108) 7.2 Businessowners Section Installation floater Types of licensees (31A-1- I — Property 301, 31A-23a-106, 203, Signs Coverages 401, 504)

Valuable papers and Exclusions Producers records

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UTAH INSURANCE DEPA RTMENT

Consultants responsibilities Hazard (31A-23a-409) Adjusters Peril Place of Nonresidents (31A- business/records Loss 23a-109) maintenance (31A- Methods of handling risk Maintenance and duration 23a-412) Avoidance Renewal (31A-23a- Controlled business 105; 31A-23a-111) (31A-23a-502) Retention

Continuing education Shared commissions Sharing (31A-23a-504) requirements (31A- Reduction 23a-202; Reg R590- Unfair marketing practices 142-1 through 10) (Reg R590-154) Transfer Reinstatement (31A- Misrepresentation Elements of insurable risks 23a-111(2), 113) (31A-21-105; 31A- Adverse selection Assumed name (31A- 23a-402(1)) Law of large numbers 23a-110(2)) False advertising Change of address or (31A-23a-402(1)) Reinsurance telephone number Rebating (31A-23a- 2.2 Insurers (31A-23a-412(1)(c)) 402(2), 31A-1- Types of insurers Reporting of actions 301(145)) (31A-23a- Unfair discrimination Stock companies 105(2)(b)) (31A-23a-402(3)) Mutual companies Disciplinary actions Boycott, coercion or Fraternal benefit License termination, intimidation (31A- societies suspension, or 23a-402(4)) Reciprocals revocation (31A-2- Illegal inducement 308(10)(a); 31A- (31A-23a-402.5, Lloyd's associations 23a-111) Reg R590-154-11) Risk retention groups Probation (31A-23a- Examination of Private versus government 112) records (31A-2- insurers Monetary forfeiture 203–205; 31A-23a- (fines) (31A-2-308) 412) Admitted versus nonadmitted insurers 1.2 State regulation Privacy of Consumer Information (Reg R590- Domestic, foreign and alien Commissioner's general 206) insurers duties and powers (31A- 2-201) Insurance fraud regulation Financial status (31A-31-103–106) (independent rating Company regulation Personal liability for unpaid services) Solvency (31A-4-105, claims (31A-15-105) Marketing (distribution) 105.5) 1.3 Federal regulation systems Rates (31A-19a-201– 2.3 Producers and general 203) Fair Credit Reporting Act (15 USC 1681–1681d) rules of agency Policy forms (31A-21- Insurer as principal 201–203) Fraud and false statements (18 USC 1033, 1034) Producer/insurer Producer appointment relationship (31A-23a-115; Reg Privacy (Gramm Leach R590-244-1–14) Bliley) Authority and powers of producer Termination of Motor Carrier Act (MCS-90 appointment (Reg and others) Express R590-244-1–14) 2.0 General Insurance 11% (11 Implied Unfair claim Items) Apparent settlement practices 2.1 Concepts (31A-26-303; Reg Responsibilities to the R590-190–192) Risk management key applicant/insured terms Producer regulation 2.4 Contracts Risk Fiduciary and trust Elements of a legal account Exposure contract

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UTAH INSURANCE DEPA RTMENT

Offer and acceptance Compensatory — 3.4 Utah laws, regulations special versus and required Consideration general provisions

Competent parties Punitive Utah Property and Legal purpose Casualty Insurance Absolute liability Guaranty Association Distinct characteristics of Strict liability (31A-28-202–210, 212– an insurance contract 215, 217–218, 220, 222) Vicarious liability Contract of adhesion Cancellation, issuance and 3.2 Policy structure renewal (31A-21-303) Aleatory contract Declarations Binders (31A-21-102) Personal contract Definitions Other insurance (31A-21- Unilateral contract 307) Insuring agreement or Conditional contract clause Suit against insurer (31A- 21-313) Legal interpretations Additional/supplementary affecting contracts coverage Concealment or fraud (RL 76-6-521) Ambiguities in a Conditions contract of adhesion Federal Terrorism Exclusions Reasonable Insurance Program (15 expectations Endorsements USC 6701; Public Law 107–297, 109–144, Indemnity 3.3 Common policy 110–160) provisions Utmost good faith 4.0 Homeowners Policy 14% Insureds — named, first (14 Items) Representations/misre named and additional presentations 4.1 Coverage forms Policy period Warranties HO-2 through HO-6 Policy territory Concealment HO-8 Cancellation and 4.2 Definitions Fraud nonrenewal 4.3 Section II — Liability Waiver and estoppel Deductibles coverages 3.0 Property and Casualty Other insurance Insurance Basics 13% (13 Coverage E — Personal Items) Nonconcurrency liability 3.1 Principles and concepts Primary and excess Coverage F — Medical payments to others Insurable interest Limits of liability Additional coverages Underwriting Per occurrence (accident) 4.4 Exclusions Function Per person 4.5 Conditions Loss ratio Aggregate—general 4.6 Selected endorsements Rates versus products— Special provisions — Utah completed Types (HO 01 43) operations Loss costs Limited fungi, wet or dry Split Components rot, or bacteria coverage Combined single (HO 04 26, HO 04 27, Hazards HO 04 28) Policy limits Physical Permitted incidental Named insured provisions occupancies — residence Moral premises (HO 04 42) Duties after loss Morale Home day care (HO 04 Assignment Negligence 97) Insurer provisions Elements of a Business pursuits (HO 24 negligent act Liberalization 71) Defenses against Subrogation Personal injury (HO 24 negligence 82)

Damages

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UTAH INSURANCE DEPA RTMENT

5.0 Auto Insurance 14% (14 Exclusions Drive other car Items) coverage (CA 99 Duties after an accident or 10) 5.1 Laws loss Individual named Utah Financial General provisions insured (CA 99 17) Responsibility of Motor Vehicle Owners and Selected endorsements Commercial carrier Operators Act (RL 41- Amendment of policy regulations 12a-101–104) provisions — Utah The Motor Carrier Act Required motor vehicle (PP 01 93) of 1980 limits of liability (31A- Towing and labor 22-301–304) Endorsement for costs (PP 03 03) motor carrier Personal injury protection Extended non-owned policies of insurance (31A-22-306–309) coverage — vehicles for public liability (MCS-90) Medical furnished or available for regular 6.0 Commercial Package Policy Loss of income use (PP 03 06) (CPP) 10% (10 Items) Special damages Miscellaneous type 6.1 Components of a allowance vehicle (PP 03 23) commercial policy

Funeral Joint ownership Common policy coverage (PP 03 Death declarations 34) Uninsured/underinsured Common policy conditions 5.3 Commercial auto motorist (31A-22-305– Interline endorsements 305.3) Commercial auto coverage forms One or more coverage Definitions parts Business auto Bodily injury 6.2 Commercial general Garage Property damage liability (31A-22-305.5) Business auto physical Commercial general damage UM/UIM rejection liability coverage forms Truckers Required limits Bodily injury and property damage Motor carrier Utah Assigned Risk liability Insurance Plan (31A-22- Coverage form sections 310) Personal and Covered autos advertising injury Aftermarket Crash Parts liability Act (31A-22-316–319) Liability coverage Medical payments 5.2 Personal auto policy Garagekeepers coverage Supplementary Definitions payments Trailer interchange Liability coverage coverage Who is an insured Bodily injury and Physical damage Limits of insurance property damage coverage Conditions Supplementary Exclusions payments Definitions Conditions Exclusions Exclusions Definitions Medical payments Occurrence versus claims- coverage Selected endorsements made

Uninsured motorists Lessor — additional Claims-made features insured and loss coverage Trigger payee (CA 20 01) Coverage for damage to Retroactive date your auto Mobile equipment (CA 20 15) Extended reporting Collision periods — basic Auto medical versus supplemental Other than collision payments coverage (CA 99 03) Deductibles Claim information

Transportation Premises and operations expenses

112

UTAH INSURANCE DEPA RTMENT

Products and completed Conditions 8.2 Workers compensation operations and employers liability Exclusions insurance policy Insured contract Limits General section Pollution liability coverage form (CG 00 39) Additional coverages Part One — Workers compensation insurance 6.3 Commercial crime 7.0 Businessowners Policy 10% (10 Items) Part Two — Employers General definitions 7.1 Characteristics and liability insurance purpose Burglary Part Three — Other states Theft 7.2 Businessowners Section insurance II — Liability Robbery Part Four — Your duties if Coverages injury occurs Crime coverage forms Exclusions Part Five — Premium Commercial crime coverage forms Who is an insured Part Six — Conditions (discovery/loss Limits of insurance Selected endorsements sustained) General conditions Voluntary Government crime compensation coverage forms Definitions (discovery/loss Anniversary rating sustained) 7.3 Businessowners Section date III — Common Policy Coverages Conditions Other states

Employee theft 7.4 Selected endorsement Sole proprietors, partners, officers Forgery or alteration Hired auto and non-owned and others coverage auto liability (BP 04 04) Inside the premises — 8.3 Premium computations theft of money and 8.0 Workers Compensation securities Insurance 9% (9 Items) Job classification Inside the premises — 8.1 Workers compensation Rates robbery or safe laws burglary of other Payroll Type of law property Adjustment upon audit Outside the premises Monopolistic versus competitive Experience modification Computer fraud factor Compulsory versus Funds transfer fraud elective Premium discounts

Money orders and Utah Workers' 8.4 Other sources of counterfeit money Compensation Law coverage

Other crime coverages Exclusive remedy (RL Workers' Compensation 34A-2-105) Fund (31A-22-1001; Extortion — 31A-33-101–118) commercial entities Employment covered (CR 04 03) (required, Self-insured employers voluntary) (RL 34A- (RR R612-400-3) Guests' property (CR 2-103, 104) 04 11) 8.5 Rating organization Covered injuries (RL (31A-301-309) 6.4 Farm coverage 34A-2-401, 402) 9.0 Other Coverages and Options Farm liability coverage Occupational disease 8% (8 Items) form (RL 34A-3-101–112) 9.1 Umbrella/excess liability policies Coverage H — Bodily Benefits provided (RL injury and property 34A-2-401, 408– Personal (DL 98 01) damage liability 418) Commercial (CU 00 01) Coverage I — Personal Employers' and advertising Reinsurance Fund 9.2 Specialty liability injury liability (RL 34A-2-702, 703) insurance

Coverage J — Medical Uninsured Employers' Errors and omissions payments Fund (RL 34A-2- Professional liability Definitions 704)

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UTAH INSURANCE DEPA RTMENT

Directors and officers 9.7 Other policies liability Boatowners (31A-22- Fiduciary liability 1501–1504) Liquor liability

Employment practices liability

9.3 Surplus lines (31A-15- 103)

Definitions and markets Licensing requirements

9.4 Surety bonds

Principal, obligee and surety Contract bonds

License and permit bonds

Judicial bonds

9.5 Aviation insurance Aircraft liability

9.6 Ocean marine insurance

Major coverages Protection and indemnity

114

Exam Registration Form for Utah Insurance Examinations

Print or type clearly and neatly. Incomplete or illegible forms will not be processed.

Last Name First Name Middle Name Social Security Number

Residence Address (Your address of legal residence is required) Date of Birth

City State ZIP Code Daytime Phone Number (including area code) ( ) Employer (insurance company, if known) Evening Phone Number (including area code) ( ) E-mail address (applications without an email address may experience delays) Fax Number (including area code) ( ) You must notify the Department, in writing, within 30 days when you have established a business address and phone number. All future changes in business and residence addresses and/or phone numbers must likewise be reported. Series Exam Title Exam Fee Total 17-01 Producer's Life Exam $32 $ 17-02 Producer's Accident and Health Exam $32 $ 17-03 Producer's Combined Life, Accident and Health Exam $44 $ 17-04 Producer's Combined Property and Casualty Exam $44 $ 17-09 Consultant's Combined Life, Accident and Health Exam $44 $ 17-10 Consultant's Combined Property and Casualty Exam $44 $ 17-11 Adjuster's Property and Casualty Exam $32 $ 17-12 Adjuster's Accident and Health Exam $32 $ 17-13 Producer’s Title Marketing Representative Exam $32 $ 17-14 Producer’s Title Examination Exam $32 $ 17-16 Producer's Title Escrow Exam $32 $ 17-19 Utah Laws and Regulations Exam $32 $ 17-20 Producer’s Personal Lines Exam $32 $ 17-21 Producer's Surplus Lines Exam $32 $ 17-22 Producer's Property Exam $32 $ 17-23 Producer's Casualty Exam $32 $ 17-24 Consultant’s Life Exam $32 $ 17-25 Consultant's Accident and Health Exam $32 $ 17-26 Adjuster’s Crop Exam $32 $ 17-27 Adjuster's Workers Compensation Exam $32 $ 17-28 Consultant’s Property Exam $32 $ 17-29 Consultant’s Casualty Exam $32 $ Fingerprint Processing Fee $6 $ By filing this registration, you assume full responsibility for exam selection. Fees for these exams are not refundable and not transferable. If you are unsure which exam is needed for Total Fee $ the license you are seeking, resolve this question before you register. Exam fees are valid for 90 days from receipt at Prometric. Fee may be paid by cashier’s check, company check, money order, MasterCard or Visa. Make checks payable to Prometric. Please put your Social Security number on the check. Personal checks and cash are not accepted. Registration fees are not refundable. Testing fees are determined by the State of Utah and are subject to contractual change without notice. To pay by credit card, please complete the information below. To register, visit our Web site at www.prometric.com/utah, call 800.697.8947 or fax this completed form to 800.347.9242. To register by mail, send this completed form along with the appropriate fee to: Prometric ATTN: UT Insurance Program, 7941 Corporate Drive Nottingham, MD 21236

115

Credit Card Payment Form

Print or type clearly. Incomplete or illegible forms will not be processed.

Card Type (Check One) MasterCard Visa American Express

Card Number Expiration Date

Amount

$ ______. __ __

Name of Cardholder (Print)

Signature of Cardholder

116