HEALTH ONLY_Chapter 6- Group Accident and Health Insurance

What is the purpose of COBRA? A. To provide continuation of coverage for terminated employees B. To provide coverage for the dependents C. To provide health coverage for people with low income D. To protect the insureds against insolvent insurers

A. To provide continuation of coverage for terminated employees

What is the benefit of experience rating? A. It allows employers with high claims experience to obtain insurance B. It allows employers with low claims experience to get lower premiums C. It helps employers with high claims experience to get group coverage D. It helps employees with low claims experience to become exempt form group premiums

B. It allows employers with low claims experience to get lower premiums

In a group policy, the contract is between A. The employer and the union B. The employee and the employer C. The employer and the insurance company D. The individual and the insurance company

C. The employer and the insurance company

In a non contributory health insurance plan, what percentage of eligible employees must participate in the plan before the plan can become effective? A. 100% B. 75% C. 50% D. 25%

A. 100%

A small employer can have a maximum of A. 50 employees B. 15 employees C. 20 employees D. 35 employees

A. 50 employees

All of the following are differences between individual and group health insurance EXCEPT A. Individual insurance does not require medical examinations, while group insurance does require medical examinations B. In individual policies, the individual selects coverage options, while in a group plan all employees are covered for the same coverage which is chosen by the employer C. Individual coverage can be written on an occupational or non occupational basis, while group plans cover only nonoccupational D. Individual policies are renewable at the option of the insured, while group usually terminates when the individual leaves the group

A. Individual insurance does not require medical examinations, while group insurance does require medical examinations

Can a group that is formed for the sole purpose of obtaining group insurance qualify for group coverage? A. No, the group must be formed for a purpose other than obtaining group insurance B. No, a group of individuals cannot apply for group coverage unless represented by an association or trust C. Yes, any group can apply for group coverage D. Yes, but only if the group is over 35 people

A. No, the group must be formed for a purpose other than obtaining group insurance

An employee insured under a group health plan has been paying $25 monthly premium for his group health coverage. The employer has been contributing $75, for the total monthly cost of $100. If the employee leaves the company, what would be his maximum monthly premium for COBRA coverage? A. $100 B. $102 C. $25 C. $25.50

B. $102

Every small employer carrier must actively offer to small employers at least how many health benefit plans? A. One plan B. 2 plans C. 3 plans D. There is no minimum

B. 2 plans

If an employer provides health insurance for its employees, which of the following is true regarding pregnancy coverage? A. It can be grounds for requiring the employee to take leave B. It must be covered to the same extent as any other medical condition D. It can be excluded D. It must be considered a disability

B. It must be covered to the same extent as any other medical condition

Which of the following would be a qualifying event as it relates to COBRA? A. Eligibility for Medicare B. Termination of employment due to downsizing C. Termination of employment for stealing D. Eligibility for coverage under another group plan

B. Termination of employment due to downsizingq

Which of the following statements concerning group health insurance is CORRECT? A. Under group insurance, the insurer may reject certain individuals from coverage B. The employer is the policyholder C. Only the employer receives a certificate of insurance D. Each employee receives a policy

B. The employer is the policyholder

Who is the beneficiary in a credit health policy? A. The federal government B. The lending institution C. The insurer D. The estate of the borrower

B. The lending instiution

All of the following cases show when a Small Employer Medical plan cannot be renewable EXCEPT A. When the small employer carrier elects to nonrenew all of its health benefit plans delivered or issued for delivery to small employers B. When the employer chooses to renew the plan C. For nonpayment of required premiums D. When the Commissioner/Director finds that the continuation of the coverage would not be in the best interests of the policyholders or certificate holders or may impair the carrier's ability to meet its contractual obligations

B. When the employer chooses to renew the plan

Which statement best defines a Multiple Employer Welfare Arrangement (MEWA)? A. A government health plan that provides health care for the unemployed B. A group health plan that covers medical expenses arising from work related injuries C. A joining together by employers to provide health benefits for employees D. A plan that provides hospice care for terminally ill patients

C. A joining together by employers to provide health benefits for employees

The main purpose of ERISA is to ensure that A. Uniform policy terms and provisions are established for all insurers in all states B. High quality care is available to all insured C. Employees receive the pension and other benefits promised by their employers D. Employees are able to extend group health coverage after termination of employment

C. Employees receive the pension and other benefits promised by their employers

Who guarantees a conventional fully-insured group plan? A. The annuitant B. The employer C. The insurer D. The insured

C. The insurer

Why do group health providers usually require a certain amount of participation in the plan by eligible employees? A. To ensure a higher profit for the insurer B. The ensure the employer is being fair to employees C. To guard against adverse selection and reduce cost D. To promote preventive care

C. To guard against adverse selection and reduce cost

How many eligible employees must be included in a contributory plan? A. 90% B. 100% C. 50% D. 75%

D. 75%

Which of the following are unlawful with regard to the ADEA? A. Refusing to hire any individual because of the individual's age B. Classifying employees in any way which would deprive any individual of employment opportunities or otherwise adversely affect his status as an employee because of the individual's age C. Reduce the wage rate of any employee in order to comply with the ADEA D. All of the above are unlawful

D. All of the above are unlawful