Are COVID-19 Losses Covered by Insurance?

Coronavirus surgical mask doctor wearing face protective mask against corona virus banner panoramic medical professional preventive gear.

Along with the obvious public health concerns, the COVID-19 pandemic raises several questions about insurance. Will my health insurer cover testing? Can my business make a claim for lost income?

Although the answers from carriers, regulators and courts might change as the situation evolves, here’s how some of the most common insurance products are expected to respond to coronavirus-related losses.

Health Insurance

Federal and state governments will pay for lab tests associated with COVID-19. However, hospitals might charge their own fees for collecting specimens and can pass those expenses along to consumers. For health plans regulated by the Illinois Department of Insurance, emergency care from an out-of-network provider (including ambulatory services and hospital care) must be billed as if it were from an in-network provider. Similarly, patients at an in-network facility who are treated by an out-of-network provider can’t be charged higher copayments (assuming no qualified in-network provider is available at the facility). In an effort to promote social distancing, telehealth services from medical providers must be covered as if they were part of an in-office visit.

Life Insurance

Purchasers of life insurance may have been asked to disclose recent travel to other countries. If a consumer misrepresented this information on an application and contracted a terminal case of COVID-19 while in a high-risk area, the insurer might be able to deny death benefits. Otherwise, life insurance policies generally don’t have exclusions that would pertain to the present crisis. Policies with a cash-value component might decrease in value due to the pandemic’s impact on the economy but are usually subject to a minimum guarantee.

Workers Compensation

Workers compensation insurance pays for medical care and a portion of lost wages when an employee becomes injured or ill as a result of his or her job duties. Although eligibility differs by state, compensation for illnesses generally only applies when job duties or work environments made employees significantly more susceptible to illness than the general population. Historically, for example, ill workers have received benefits after being exposed to hazardous chemicals but not when catching the flu from a co-worker. Whereas most workers are unlikely to qualify for workers compensation due to COVID-19, hospital workers (and perhaps grocery store employees) might qualify due to their elevated exposure. Time will tell.

Commercial General Liability Insurance

This insurance is intended to respond when a member of the public is harmed by a business’s work or by unsafe conditions at an insured location. Although some coverage might exist if a customer were to contract the virus from someone at a business, it’s possible that the insurance would only respond in cases of negligence (such as a business continuing to remain open to the public after being ordered to close). Although some policies might provide benefits regardless of fault, those amounts are generally limited to no more than a few thousand dollars.

Business Interruption Insurance

This insurance compensates businesses for lost income and extra expenses when they’re forced to shut down through no fault of their own (including by emergency order of the government). Unfortunately for policyholders, coverage is typically dependent on “direct physical loss” or damage to property, such as a fire at either the insured’s business or a neighboring building. Interruptions that result in lost income but aren’t caused by a “direct physical loss” or property damage are generally excluded. Although COVID-19-related lawsuits have already been filed against insurers based on this language, carriers might still be able to deny claims based on other parts of the policy. For example, since the early 2000s, most business interruption policies specifically exempt losses due to viruses and bacteria.

As in all cases regarding claims, policy language can differ from product to product and carrier to carrier. Insurance professionals should carefully read the applicable coverage forms before advising the public about a specific loss.

Real Estate institute offers insurance continuing education approved by the Illinois Department of Insurance. Thousands of Illinois insurance producers complete our webinar, classroom and self-study continuing education courses each year. 

Insurance Ethics Webinars Now Approved and Available

business hand typing on a laptop keyboard with Webinar homepage on the computer screen learning internet website web page concept.After nearly a decade of asking, Illinois insurance producers can finally complete their 3-hour ethics continuing education requirement via webinar. The bill allowing for ethics webinars was signed into law by Gov. Bruce Rauner on August 14, 2018, and the Department of Insurance began approving webinars from course providers (including Real Estate Institute) a few weeks ago.

Although the new law provides a new method of ethics course delivery for insurance producers, the change is not applicable to public adjusters. According to the DOI, licensed Illinois public adjusters must still earn 3 hours of ethics credit by attending a live, in-person class.

The law also creates an education advisory council that will be charged with making recommendations to the state about insurance courses, curriculum and instructor qualifications.

To view Real Estate Institute’s extensive schedule of ethics webinars and in-person classes, click here.

Illinois Doubles “Credit Reporting Fee” for Insurance CE Hours

Up-Arrow-BlueEffective March 2, the state-mandated fee for reporting Illinois insurance continuing education credit hours to the appropriate licensing authorities has increased from 50 cents per hour to $1 per hour. The fee is intended, in part, to fund online licensing services available through the National Association of Insurance Commissioners’ “State Based Systems” website, Producers can use the site to review their licensing information, monitor their remaining CE requirements, find approved education providers and more.

Real Estate institute offers insurance education approved by the Illinois Department of Insurance. Thousands of Illinois insurance producers complete our classroom and self-study continuing education courses each year. All state-mandated fees are required upon enrollment. State fees are subject to change without notice. We encourage students to complete courses promptly to avoid further fee increases.

Renewing Your Illinois Insurance Producer License? Better Check Your Email

Business-woman-running-with-clockIf you’re like most insurance producers in Illinois, you probably don’t give your continuing education requirements much thought until you receive a license renewal notice from the state. For years, notifications have gone out in the mail and have given insurance professionals a helpful reminder regarding when to complete CE and how to renew their license.

Well, not anymore.

Effective Nov. 5 of last year, the Department of Insurance stopped sending hard-copy renewal notices to licensees. Instead of a mailed reminder, renewal notices will be emailed to whatever email address a producer has on file with the DOI.

Don’t let this change in departmental procedures impact your ability to do business! Consider taking the following steps to make your next renewal as simple as possible:

  1. Complete your continuing education sooner rather than later. As a reminder, producers in Illinois must complete 24 hours of continuing education (including 3 hours of in-class ethics training) in order to renew their license. (Additional requirements exist for producers who sell long-term care insurance.)
  2. Verify that your email address is correct. Producers can confirm, add or change their email address by visiting the National Insurance Producer Registry online at

If you’ve completed the entire 24-credit-hour CE requirement on or before your license expiration date, follow these on-time renewal instructions.

If you’re renewing your license after your expiration date, follow this link for details about reinstating your license.

Real Estate Institute is an Illinois-approved insurance continuing education provider that offers a wide range of self-study courses and thought-provoking ethics classes. Our team of knowledgeable customer service representatives is here to assist you with all of your CE needs. Contact us to enroll today!

7 Facts Insurance Producers Need To Know About Annuity Training

Before they can sell, solicit or recommend annuity products to the public, Illinois insurance producers must complete a state-approved annuity training course. However, we continue to hear from students who were unaware of this important state rule. Keep reading to learn more about how to stay in compliance with this requirement.

  1. What kind of course do I need?
    The course must be at least 4 hours in length and can be completed in any format (classroom, self-study, etc.) that is acceptable to the Department of Insurance. Real Estate Institute’s 4-Hour NAIC Annuity Suitability Training course contains all the state-mandated topics and has been approved to help producers satisfy this requirement. Students who complete our course will also receive 4 hours of continuing education credit.
  2. Is there an exemption for people who have already been selling annuities for several years?
    The Illinois rules don’t have any “grandfather” exemption. The requirement applies equally to all producers regardless of when they first became licensed.
  3. I only sell fixed/variable/indexed annuities? Does the rule apply to me?
    The training must be completed regardless of whether a producer sells fixed, variable or indexed annuities. Although there are exemptions for producers who only sell certain types of annuity products, those exemptions are for a very small segment of the annuity market. Most Illinois producers won’t qualify for them.
  4. I’m new to the annuity business. Is this course all I need in order to start selling annuity products?
    In addition to completing a 4-hour training course, individuals who want to sell annuities in Illinois must have a life insurance license.In the case of variable annuities, an individual must also be licensed to sell “variable products.” In order to earn the variable-product licensing designation, a producer must complete all necessary securities licensing procedures and become registered with a national organization called the Financial Industry Regulatory Authority (FINRA).
  5. Do I need to complete annuity training every 2 years before renewing my license?
    Although some states require continuous training, the rule in Illinois is only a one-time requirement. Once this training has been completed, no additional annuity-specific coursework is required in order to renew a producer’s license. However, producers who sell variable products might be required to take special courses through FINRA in order to renew their securities license.
  6. I have a non-resident Illinois license and completed annuity training for my home state. Do I need an Illinois annuity course?
    In general, non-resident producers are exempt from the Illinois requirement if they satisfy the annuity training requirements in their home state. However, the topics covered in their training must be substantially similar to those required by Illinois.
  7. What will happen if I don’t complete the training?
    Insurance companies are required to verify completion of the training before letting anyone sell annuities on their behalf. Most carriers take this responsibility very seriously and won’t let you do business with them unless they obtain proof of your completion.Some insurers go beyond the Illinois requirement and want producers to take specific courses from specific education providers. If you have not completed your training and are asked to do so by a particular insurance carrier, you might want to ask about any company-specific rules.Be aware that the Department of Insurance will not keep a permanent record of your course completion. In order to prove that you have completed the mandatory training, you should keep a certificate of completion in a safe place. This document will be provided to you by your course provider.

Producer Alert: Illinois Makes Changes to LTC Training Requirement

New rules published last week by the Illinois Department of Insurance have made subtle yet significant changes to the training requirements for producers who sell long-term care coverage. Those same rules also provide some long-awaited guidance for insurance carriers who are interested in offering LTC policies in conjunction with the state’s somewhat mysterious Long Term Care Partnership Program.

Are There Changes to Licensing Requirements?
For producers wanting to sell LTC products, the basics of the licensing and training requirements remain the same: An individual who wishes to sell LTC insurance in the state must first have a health insurance license and complete an 8-hour “Long Term Care (Partnership)” training course. Then, in order to continue selling the insurance, the licensee must complete an additional 4 hours of LTC training every 2 years.

What’s The New LTC Training Deadline?
Until now, the 2-year deadline for completing the 4 hours of additional training was tied to the date of the producer’s most recent LTC course completion and not to the producer’s license expiration date. As a result, producers could only ensure compliance with their 4-hour requirement if they could remember the completion date of their initial 8-hour course and all of their subsequent 4-hour completion dates.
Effective immediately, the deadline for completing the additional 4 hours of training is identical to a producer’s license expiration date.

What If I Miss The Deadline?
In another change to the training requirements, the department has implemented a 12-month grace period for producers who fail to complete 4 hours of additional training. Producers who miss their 4-hour deadline will be able to complete their training during the grace period without having to repeat an 8-hour training course again. Be aware, however, that this grace period doesn’t exempt producers from having to complete 24 hours of continuing education (LTC training or otherwise) prior to renewing their license. Selling LTC insurance without the proper license or prior to completing the required 8-hour or 4-hour training continues to be a licensing violation.

What’s New With LTC Partnership Policies?
Besides the changes to producer training, the department’s new rules contain a list of requirements for Long Term Care Partnership policies. Already popular in other states, Partnership policies might allow beneficiaries to qualify for Medicaid without having to “spend down” practically all of their savings. For each dollar received in benefits from an Illinois Partnership policy, the recipient can shield one dollar of assets. Changes to the Illinois rules reflect model language from the National Association of Insurance Commissioners.

For help with any of your Illinois insurance CE needs, visit us online or call (800) 289-4310.

Health Insurance Exchanges: 10 Key Questions for Consumers

medical doctor

Implementation of the Affordable Care Act (commonly referred to as “Obamacare”) is accelerating and will result in several important changes to the U.S. health care system over the coming months. One significant change is the opening of new insurance marketplaces, known as “exchanges,” in many states on October 1. But what exactly are these exchanges, and how do they relate to the law’s other major pieces? This Q&A factsheet addresses those crucial questions and prepares consumers for what’s to come.

1. What’s an exchange?

A health insurance exchange is a government-overseen marketplace in which individuals and small businesses can shop for health insurance coverage. Individuals and small businesses who shop in an exchange will be able to closely compare their insurance options, determine their eligibility for new federal tax credits and apply for a health plan of their choice. Although several insurance companies will be offering plans for sale on the exchanges, all plans must meet certain federal and/or state standards.

Even though consumers will still be allowed to purchase insurance outside of an exchange, there are several important reasons why consumers might shop in one. Most importantly, individuals and small businesses must purchase their insurance through an exchange if they wish to receive tax credits and government subsidies that are available under the Affordable Care Act.

2. What’s the difference between an exchange and a marketplace?

In news items or discussions about the new health care law, you may have heard people use terms like “health insurance exchange” and “health insurance marketplace.” These terms mean the same thing. Although the law itself uses the term “exchange,” the general consensus is that the term “marketplace” is easier for consumers to understand.

3. What kind of insurance will be available in an exchange?

All insurance in an exchange must provide “essential health benefits,” including (but not limited to) coverage for hospitalization, emergency services, rehabilitation services, prescription drugs, preventive care, mental health care and maternity/newborn/pediatric services. However, consumers can still be held responsible for deductibles, copayments and coinsurance fees. These out-of-pocket expenses must have an annual cap (approximately $6,300 for individuals and $12,700 for families).

In order to give consumers a general sense of their potential out-of-pocket expenses, plans in the exchanges will be put into one of several metal-based categories. For example, plans that are estimated to pay for roughly 90 percent of covered services will be categorized as “platinum” plans. Conversely, plans that are estimated to pay for roughly 60 percent of covered services will be categorized as “bronze” plans. Be aware that these metal-named designations are merely estimates that are based on a broad base of consumers. The amount actually paid by an insurer for a specific kind of care might be higher or lower than these percentages.

4. Will plans in an exchange charge me more if I’m in bad health?

Plans in an exchange are prohibited from discriminating against consumers on the basis of health. They can’t refuse to insure someone because of health and can’t charge a sick person more than a healthy person.  Similarly, the cost of group insurance can’t be based on the collective health of the group’s members.

Although there may be some differences from state to state, the cost of coverage for a consumer will depend on the chosen plan and the following factors:

  • Age. (The cost for any one age group can’t be more than three times the cost of any other age group.)
  • Tobacco use. (The cost for smokers can’t exceed 150 percent of the cost for non-smokers. People in group plans can receive non-smoker rates by participating in a smoking cessation program.)
  • Geography. (For employer group plans, this will be based on the location of the employer, not the location of the individual employee.)
  • Whether the coverage is for an individual or family.

5. Will I receive tax credits or subsidies if I purchase insurance through an exchange?

U.S. citizens and legal residents with low or moderate incomes might have some of their insurance premiums paid for by the federal government if they shop in an exchange. This assistance is provided as a tax credit and is provided on a sliding scale to households whose income is below 400 percent of the poverty line. (The poverty line is adjusted each year and is dependent on family size. For 2013, 400 percent of the poverty line is roughly $46,000 for a one-person household and $94,200 for a family of four.)

The amount of an individual’s potential tax credit will be calculated by the exchange when the person shops there. Consumers who are eligible for the credit will have the choice of either receiving it in the form of an annual tax refund or having it applied automatically to their insurance premiums and sent directly to an insurer upon enrollment. Married couples who wish to receive the credit must file their income taxes jointly.

Households with an income below 250 percent of poverty will receive additional financial assistance in order to reduce their deductibles, copayments and co-insurance fees.

Credits and subsidies can be estimated via an online tool from the non-partisan Kaiser Family Foundation.

6. I get health insurance through my job. Can I buy my own insurance in the exchange and get the tax credit/subsidies?

Workers who are offered insurance through their employer can decline it and purchase their own insurance in an exchange. However, they usually won’t be eligible for the tax credit or other subsidies.

In general, an individual who is offered group health insurance will only be eligible for the aforementioned financial assistance if the group plan provides insufficient benefits (by covering less than 60 percent of treatment-related costs) or is unaffordable (more than 9.5 percent of the person’s income for self-only coverage.)

7. When can an individual enroll in a plan in the exchange?

Eligible individuals can’t be denied health insurance in an exchange as long as they enroll during an open enrollment period. The first chance to enroll will occur from October 1, 2013 to March 31, 2014. In order to have coverage in place by January 1, 2014, individuals must enroll by December 15 of this year. In subsequent years, enrollment will open on an annual basis from October 15 to December 7. Individuals will also be allowed to enroll at any point during the year in special circumstances. Special circumstances might include the loss of other coverage, the birth or adoption of a child or a marriage.

8. What is the enrollment process like for individuals in an exchange?

Individuals who wish to purchase insurance through an exchange will complete a single application that will determine their eligibility for all plans in the exchange as well as their eligibility for other health insurance, such as Medicaid or other federal insurance programs. Once eligibility has been determined, the applicant will be contacted by the exchange and can begin shopping. The applicant will enroll in a chosen plan through the exchange, and the exchange will notify the person’s chosen insurer. Although most applications and enrollments are likely to be done online at and other websites, phone and mail options will also be available. Individuals in Illinois can enroll and learn more by going to or by calling (800) 318-2596.

9. Can an employer’s group plan charge employees different amounts based on their age?

Unless prohibited by their state, group plans in an exchange can charge employees different amounts for health insurance based on age. However, employers will retain the option of charging a flat amount for each employee regardless of age.

10. Why are group plans being allowed to charge different amounts based on an employee’s age?

In order for an employer to purchase insurance through an exchange, at least 70 percent of eligible employees must participate in it. (There is an exemption for employees who are already covered by different health insurance.) Research has shown that younger (and presumably healthier) employees are more likely to decline health insurance from their employer. The age-based pricing is designed to encourage greater participation among this demographic.

To learn how insurance agents and brokers will be impacted by the exchanges, keep reading Real Estate Institute’s blog. Important information will be posted here.

What Illinois Insurance Producers Need to Know About the New Health Insurance Exchanges

Throughout the rollout of the Affordable Care Act, insurance sales professionals have been particularly curious about the new health insurance “exchanges.” Beginning this week, millions of consumers will utilize these marketplaces in order to compare their coverage options and purchase their own insurance. But where does this leave agents and brokers? Can they continue to be a source of counsel and expertise for their health insurance customers? What do new terms like “navigator” and “exchange” really mean?

Those questions, as well as others that are especially relevant to insurance licensees, will be addressed here. More general information about the exchanges can be found elsewhere on this blog.

What’s an exchange?

A health insurance exchange is a government-overseen marketplace in which individuals and small businesses can shop for health insurance coverage. Individuals and small businesses who shop in an exchange will be able to closely compare their insurance options, determine their eligibility for new federal tax credits and apply for a health plan of their choice. Although several insurance companies will be offering plans for sale on the exchanges, all plans must meet certain federal and/or state standards.

Even though consumers will still be allowed to purchase insurance outside of an exchange, there are several important reasons why consumers might shop in one. Most importantly, individuals and small businesses must purchase their insurance through an exchange if they wish to receive tax credits and government subsidies that are available under the Affordable Care Act.

What’s the difference between an exchange, a marketplace and a SHOP?

In news items or discussions about the new health care law, you may have heard people use terms like “health insurance exchange” and “health insurance marketplace.” These terms mean the same thing. Although the law itself uses the term “exchange,” the general consensus is that the term “marketplace” is easier for consumers to understand.

You might also read or hear about SHOP, which stands for “Small Business Health Options Program.” A SHOP is a health insurance exchange in which small businesses can purchase group coverage. Most states will have at least two exchanges: one exchange for small businesses (a SHOP) and one exchange for individuals.

How do health insurance producers (agents and brokers) fit into the exchanges?

Health insurance producers are a valuable component to the new health insurance exchanges. Agents and brokers can be compensated for helping individuals and small businesses choose and enroll in a plan from an exchange. In fact, insurance companies can’t have separate compensation methods for producers who sell plans in the exchange and producers who sell other health plans.

Do health insurance producers need to complete additional training in order to help consumers in the exchange?

Training requirements depend on whether the exchange is for individuals or small businesses. Before helping Illinois consumers in an exchange for individuals, licensed health insurance producers must complete an online training program through the Center for Medicare and Medicaid Services. Producers must score at least 70 percent on a final exam and must supply a certificate of completion to each health insurer that they work with.

This training is not required for producers who will only be working in a SHOP exchange, but it is highly recommended. Regardless of the kind of exchange, producers must complete a registration process and sign certain documents.

For more on the training and the role of producers, contact the Illinois Department of Insurance or click here. Note that requirements for producers may differ from state to state.

I keep hearing about so-called “navigators.” Are they insurance producers?

Navigators are specially trained entities and staff who help facilitate enrollment in the exchange’s health plans and provide information about the Affordable Care Act. From the government’s perspective, the hope is that navigators will cater to communities that might be underserved by producers. For example, navigators might be stationed in low-income community centers where visitors are likely to be eligible for a newly expanded version of Medicaid.

Although it is technically possible for a licensed insurance producer to be a navigator, this overlap is unlikely to occur at the same time in the same transaction. Unlike a producer, a navigator in Illinois can’t make recommendations and can’t be compensated, directly or indirectly, by insurance companies. In general, navigators are compensated through federal and state grants. Also, training requirements for navigators are different from the training requirements for producers. Specifics may differ from state to state.

Although Illinois has passed a law that puts certain restrictions on navigators, additional rules are still being finalized by the Department of Insurance. For more about navigators in Illinois, click here.

For important insurance producer and ACA news, please subscribe to this blog.

Obama Administration Announces Delay in Key Health Care Requirement

Under pressure from business groups, the Obama administration announced Tuesday that it is postponing the implementation of a major piece of its signature health care law. A requirement that would have required large and medium-sized businesses to offer health insurance to employees next year or pay a fine will be delayed until 2015.

Under the Patient Protection and Affordable Care Act, most businesses with at least 50 full-time employees will need to have a health plan. The number of full-time employees at a business will be based on the number of people working 30 hours per week.

Businesses that are required to offer insurance and don’t do it will face an annual fine of $2,000 per employee but will be allowed an exemption for their first 30 workers. For example, an employer with exactly 50 full-time employees will be fined $40,000.

The employer mandate to have a health plan won’t apply to businesses with fewer than 50 full-time employees. Businesses are also allowed to ignore it if none of their employees purchases their own insurance and qualifies for a government subsidy. In effect, this generally means that if a business with at least 50 employees wants to avoid having a health plan, it must pay all its employees enough so that their household income is above 400 percent of the poverty line.

Despite this postponement for businesses, the requirement for most individuals to have health insurance in 2014 remains intact.  Government subsidies for citizens and legal residents with household incomes below 400 percent of the poverty line will be available at that time.

More details about the requirement to cover employees are expected to be announced in the next few months. A comprehensive review of the Patient Protection and Affordable Care Act will be part of Real Estate Institute’s insurance continuing education self-study package for 2014.

What Every Illinois Long Term Care Insurance Agent Needs to Know

Due in large part to their experiences with elderly family members, consumers are becoming more aware of long-term care (LTC) insurance. Depending on a person’s assets and financial goals, this insurance can be a valuable way of covering bills from nursing homes, assisted-living facilities or at-home nursing providers. But the rules for agents who want to sell LTC insurance in Illinois have confused many licensees. We’ve contacted high-ranking officials at the Illinois Department of Insurance in order to clear up some common misunderstandings.

An individual who wishes to sell LTC insurance in Illinois must first have a health insurance license and complete an 8-hour “Long Term Care (Partnership)” training course. Then, in order to continue selling the insurance, the licensee must complete an additional 4 hours of LTC training every 2 years. If a producer misses the deadline for completing 4 hours of additional training, the 8-hour “Long Term Care (Partnership)” course must be repeated.

Unfortunately, several LTC producers—and even some insurance schools—don’t understand how the deadline for the 4-hour requirement is calculated. Many mistakenly believe that the due date for the additional training is the same as their license renewal date. Others assume that the deadline is forever tied to the date when they completed the 8-hour “Long Term Care (Partnership)” course. This, too, is incorrect.

If you sell LTC insurance in Illinois, your deadline for completing your next 4 hours of LTC training is 2 years from the date of your most recent LTC course completion. Let’s illustrate how this works with a hypothetical example.

Paul Producer took the 8-hour “Long Term Care (Partnership)” course on April 1, 2009. Paul had until April 1, 2011, to complete 4 hours of additional LTC training, but he chose to complete it a bit earlier on March 25, 2011. Based on his most recent LTC course completion date, Paul’s next 4 hours of LTC training must be completed by March 25, 2013.

Be aware that the deadline mentioned here applies only to LTC training requirements. The deadline for completing 24 hours of continuing education (including 3 hours of live ethics training) continues to be tied to a producer’s license expiration date. Also, deadlines are dependent on state rules and departmental interpretations. If we become aware of any changes, we’ll report about them on this blog.

Real Estate Institute offers insurance education approved by the Illinois Department of Insurance..Approved provider #102877.  To learn about our LTC courses, click the following: 8-hr LTC (Partnership) and 4-hr LTC.