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At what level is the insurance industry primarily regulated?

  1. State

  2. County

  3. Federal

  4. Insurers

The correct answer is: State

The insurance industry is primarily regulated at the state level due to the historical development of insurance regulation in the United States. Each state has its own regulatory framework, which includes the establishment of insurance departments responsible for overseeing various aspects of the industry, such as licensing insurers, approving policy forms, and monitoring the financial solvency of insurance companies. This state-based regulation allows local authorities to tailor their regulatory approaches according to the specific needs and conditions of their markets. While there is some federal oversight in specific areas, such as through the Health Insurance Portability and Accountability Act (HIPAA) and the Affordable Care Act (ACA), the foundational regulation of insurance remains within the purview of the states. This decentralized approach enables more direct consumer protection and allows states to address local market dynamics more effectively. The other levels mentioned, such as county and federal, do not have the same level of direct influence over the day-to-day operations of insurance companies. County regulations may exist but are not comprehensive or standardized across the industry, while federal regulation usually applies to specific sectors like health insurance rather than the entire industry.