Under Missouri law, a person must hold a producer license with which line of authority before selling, soliciting, or negotiating individual or group health insurance in the state?
A. Accident and health/sickness
B. Property
C. Casualty only
D. No license is required for health insurance
Show answer and reasoning
Correct answer: A. Accident and health/sickness
Correct. Selling, soliciting, or negotiating health-related insurance in Missouri requires a producer license for the accident and health (sickness) line of authority under Mo. Rev. Stat. § 375.014.
- B: Property is a distinct line of authority covering real and personal property risks, not health/sickness coverage.
- C: Casualty alone does not authorize the sale of health insurance products; a separate accident and health line is required.
- D: Missouri requires licensure for the sale of health insurance just as it does for life insurance; there is no blanket exemption.
Source: Mo. Rev. Stat. § 375.014
How long is a Missouri resident producer license valid before renewal is required?
A. One year
B. Two years
C. Four years
D. It is valid for the producer's lifetime
Show answer and reasoning
Correct answer: B. Two years
Correct. Missouri issues resident producer licenses for a term of two years under Mo. Rev. Stat. §§ 375.014-.016.
- A: Missouri's license term is not one year.
- C: Four years overstates the Missouri license term, which is two years.
- D: The license must be actively renewed every two years; it is not a lifetime credential.
Source: Mo. Rev. Stat. § 375.016
How many total hours of continuing education must a Missouri health insurance producer complete every two years, and how many of those hours must specifically cover ethics, Missouri law, and producer duties?
A. 16 total hours, including 3 hours of ethics/law
B. 8 total hours, including 1 hour of ethics/law
C. 30 total hours, including 5 hours of ethics/law
D. 16 total hours, with no ethics/law requirement
Show answer and reasoning
Correct answer: A. 16 total hours, including 3 hours of ethics/law
Correct. Missouri requires 16 hours of continuing education every two years, and producers licensed under Mo. Rev. Stat. § 375.018.1(1)-(6) must include 3 of those hours on ethics, Missouri law, and producer duties to the department, per 20 CSR 700-3.200.
- B: 8 total hours understates Missouri's biennial CE requirement.
- C: 30 total hours overstates Missouri's biennial requirement.
- D: Missouri does require a dedicated ethics/law component within the 16-hour total; it is not CE without any ethics requirement.
Source: Mo. Rev. Stat. § 375.020; 20 CSR 700-3.200
Which of the following would be grounds for the Missouri Department of Commerce and Insurance to discipline a health insurance producer's license?
A. Misrepresenting the terms of a health policy to induce a sale
B. Recommending a lower-premium plan that meets the client's stated budget
C. Referring a client's question to the insurer's customer service line
D. Explaining a plan's deductible and coinsurance accurately
Show answer and reasoning
Correct answer: A. Misrepresenting the terms of a health policy to induce a sale
Correct. Misrepresenting policy terms to induce a purchase is a form of misrepresentation/unfair trade practice and is listed among the grounds for discipline under Mo. Rev. Stat. § 375.141.
- B: Recommending a plan that fits a client's stated budget, when accurately and honestly presented, is normal, appropriate producer conduct, not a violation.
- C: Referring a client to the insurer's own service line is a routine, appropriate practice, not misconduct.
- D: Accurately explaining plan features such as deductibles and coinsurance is exactly what a producer should do and is not disciplinary conduct.
Source: Mo. Rev. Stat. § 375.141
In a Health Maintenance Organization (HMO) plan, how does a member typically access specialist care?
A. The member must generally select a primary care physician (PCP) who coordinates care and provides referrals to in-network specialists
B. The member may see any specialist nationwide with no network restriction and no referral
C. HMOs do not cover specialist visits under any circumstance
D. The member must pay the specialist's full billed charge with no insurance benefit at all
Show answer and reasoning
Correct answer: A. The member must generally select a primary care physician (PCP) who coordinates care and provides referrals to in-network specialists
Correct. HMO plans typically require members to choose a primary care physician who manages and coordinates care, including referrals to specialists within the HMO's network, in exchange for lower out-of-pocket costs and a tighter network.
- B: Unrestricted, referral-free access to any specialist nationwide describes an out-of-network indemnity or broad PPO-style structure, not the typical HMO gatekeeper model.
- C: HMOs do cover specialist care; it is simply accessed through the PCP-referral and network structure rather than open access.
- D: HMO coverage does apply to in-network specialist visits obtained properly through the plan's referral process; the member is not left to pay full billed charges out of pocket for covered, in-network, referred care.
Source: General insurance product knowledge
