12- Health and Accident Insurance

If an employee contributes 50% toward the disability plan premium provided by an employer, what would be considered the taxable income of a $1,000 monthly disability benefit? $100 $250 $500 $1,000

$500

How many employees must an employer have for a terminated employee to be eligible for COBRA? 20 30 40 50

20

Under a disability income policy, which provision would be payable if the cause of an injury is unexpected and accidental? Presumptive disability provision Absolute accidental provision Accidental death benefit provision Accidental bodily injury provision

Accidental bodily injury provision

Which of the following does Coordination of Benefits allow? Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid Allows both a group health plan and individual health plan to coordinate their benefit payments Allows the deductible to be spread out between all the health providers Allows each health provider to pay 100% of the claim

Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid

Which type of business insurance is meant to cover the costs of continuing to do business while the owner is disabled? Disability overhead policy Business continuation policy Disability buy-sell policy Business overhead expense policy

Business overhead expense policy

What is issued to each employee of an employer health plan? Provision Receipt Policy Certificate

Certificate

Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n) crossover conversion exchange extension of benefits

Conversion

Under which criteria may a group health plan exclude participation? Member's claims history Member's current age Member's pre-existing condition Member's part-time employment status

Member's part-time employment status

Under the subrogation clause, legal action can be taken by the insurer against the responsible third party beneficiary policyowner State

Responsible Third Party

Health insurance involves two perils, accident and ____. death sickness disability liability

Sickness

Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the employee's benefits still owed can be claimed employee cannot be excluded from the new employer's health plan employee's waiting period for coverage of a preexisting condition can be reduced under the new employer's health plan new health insurance carrier will have a clear record of any chronic conditions that exist

employee's waiting period for coverage of a preexisting condition can be reduced under the new employer's health plan

According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual is eligible for coverage upon hire must wait 360 days to be eligible for coverage must continue coverage with the previous employer is eligible for only health insurance, not life or dental insurance

is eligible for coverage upon hire

What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 allow an employee to do? In the event of employment termination, group health insurance can be kept if the employee pays the premiums Receive a tax credit to help offset the cost of health insurance Remain on their current coverage for 30 months In the event of employment termination, group health insurance can be kept if the employer pays the premiums

In the event of employment termination, group health insurance can be kept if the employee pays the premiums

A person covered with an individual health plan is issued a policy is issued a certificate of medical costs does not contract directly with the insurance company is not subject to medical underwriting

Is Issued A Policy

Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA? It would be considered taxable income to the employee The employee would not be allowed to an HSA The employer would pay payroll tax and FICA on the contribution amount The employer would not be allowed to deduct the contribution from the employee's pay

It would be considered taxable income to the employee

Which of the following is typically NOT eligible for coverage in a group health policy? Full-time employee Temporary employee Business owner Partner in a partnership

Temporary employee

Which of the following is NOT a decision that can be made by an individual with a Health Savings Account (HSA)? The amount of his/her employer's contribution The amount of his/her contribution The type of investments used in the HSA The medical expenses the HSA will pay

The amount of his/her employer's contribution

When are group disability benefits considered to be tax-free to the insured? When the recipient pays the premiums When the employer pays the premiums When both the employer and recipient pay the premiums When benefits paid are equal to or lower than the recipient's salary

When the recipient pays the premiums

Which of the following is INELIGIBLE to participate in a Section 125 Plan? Key Employee in a C-Corp Highly Compensated Employee in an S-Corp A C-Corp Owner with a greater than 2% share An S-Corp Owner with a greater than 2% share

An S-Corp Owner with a greater than 2% share

A master contract and certificate of coverage can be found in which type of policy? Long-term Medicaid Group Medicare

Group