Xcel ch 15 medical expense insurance

an insured has a stop-loss limit of $5,000, a deductible of $500, and an 80/20 insurance. The insured incurs $25,000 of covered losses. How much will the insured have to pay?

$5,000 the insured will pay the stop-loss limit of $5,000

all of the following plans allow for employee contributions to be taken on a pre-tax basis EXCEPT

Health reimbursement Arrangement plan CORRECT: section 125 plan, premium only plan, cafeteria plan

which of the following is NOT included under health benefit plan?

Hospital Indemnity plan CORRECT: major medical policy, basic Hospital policy, surgical expense policy

an insured has a health plan that pays established amounts in accordance with the list of injuries, surgical procedures, or other losses. This list is called a

benefit schedule

all of these are characteristics of a major medical expense policy EXCEPT

elimination periods CORRECT: large benefit maximum, deductibles, coinsurance elimination period is the period of time between the onset of a disability and the time you're eligible for benefits. and is typically a characteristic of disability policies, not major medical expense policies.

all of the following are qualifications for establishing a health savings account (HSA) EXCEPT

enrolled in a health plan with the prescription drug benefit CORRECT: enrolled in a high-deductible health plan, be under the age of 65 and not enrolled in Medicare, enrolled in a health plan that limits out-of-pocket expenses

which of the following types of deductibles would apply a single deductible to both medical and dental insurance coverage?

integrated deductible

low-frequency diseases can be exclusively covered by what kind of health insurance policies?

limited policies

the focus of major medical insurance is providing coverage for

medical and hospitalization expenses

when an insured has a major medical plan with first dollar coverage, how does this impact the benefits paid?

no deductible payment is required

what is the tax liability for employer contributions and Health Savings Account (HSA's)?

no tax payment needed

an Indemnity plan

provides the insured a specific dollar amount for services

a fee-for-service health insurance plan will normally cover

the disease

the elimination period under a hospital Indemnity plan is

the specified number of days in insured must wait before becoming eligible to receive benefits for each hospitalization