Heath insurance

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If an insured pays a health insurance premium each month how long would the grace period be under the policy

10 days

The policy holder return the policy to be insure a week after it's delivered how much of the premium will be returning to the applicant

100%

To qualify for disability income benefits under Social Security and individuals disability must be expected to result in death or less for at least

12 months

Cours benefits are included in all Medicare supplement policy is what percentage of part B call insurance is required

20%

The affordable care act mandate that ensures provide coverage for adult children of the insured up to the age

26

A Medicare supplement policy must have a free look period of at least

30 days

To be acceptable to insurance companies what percentage of eligible employees must be in rolled under a contributory group health insurance plan

75%

According to the meadow level classification of health plans what percentage of healthcare cost will be covered under a gold plan

80%

Flexible Spending Account (FSA)

A form of cafeteria plan benefit funded by salary reduction and employer contributions employee is allowed to deposit a certain amount of their paycheck into the account before paying income taxes FSA benefits are subject to annual maximum and user lose rule/ Maybe use to pay medical and dental for employee

Benefits of group disability plans are based on

A percentage of the workers income

An individual is approaching a retirement age and he's concerned about having proper coverage should he have to be placed on a long-term care bacillary his agent told him that LTC policies will provide necessary coverage at all of the following levels except

Acute

usual, customary, and reasonable (UCR)

Amount paid for procedure based upon the average charge for that procedure in that specific geographic area

Which of the following writers paid a beneficiary the death benefit that is double or triple the face amount if the insurance death was caused by an accident as defined in the policy

An accidental death writer

Which action by and ensure or it's representatives is not considered an unfair Claims violation

An agent in size is a claimant to obtain the services of an attorney

All of the following could qualify as a group for the purpose of purchasing group health insurance except

And Association of 35 people

An underwriter is reviewing an application with an extensive medical history which of the following we get the underwriter a better understanding of how the applicant has been treated for various illnesses

Attending physician statement

Accidental death and dismemberment

Can be written as a writer or as a separate policy the (principal sum) is paid for accidental death in case of loss of sight or accidental dismemberment a percentage will be paid by (capital some). The policy will usually pay the full principle of loss in sight in both eyes or two limbs however it only pays 50% of the loss of one hand or foot meaning the policy will pay twice or three times the face amount in the event of accidental death/ 90 days

Conrad receives 50,000 from 800,000 accidental death and dismemberment policy as a result of the loss of his left arm in an accident Conrad has received the

Capital amount

Which of the following elements of an insurance contract requires payment premium

Consideration

What is the purpose of the gate keeper in an HMO

Control and cost

HMO members pay a small fee when they see their primary care physician the fee is called a

Copay

When filling out an application for insurance the applicant makes a mistake if a fresh application were not available what could the application due to park with the correct

Cross the incorrect answer out right the correct one beside it and initial the answer

Which of the following meets the insurance personal needs and is provided by non-medical personnel

Custodial care

Which of the following losses would likely be covered under the accidental death writer

Death caused by a head on collision

Which of the following is provided by skilled medical personnel to those who need occasional medical assistance for rehabilitative care

Intermediate care

Which underwriting information includes information on and applicants character general reputation personal habits and motive living

Investigative consumer report

Point of Service (POS)

Is a combination of HMO and PPO plans

How does insurance distribute the financial consequences of individual losses

It transfers the risk to all persons insured

Which of the following time. Is the general enrollment period for Medicare part B

January 1 through March 31 each year

If an insurance company issued a policy even though some questions on the application where I answered when can we ensure I get the answers to those questions

Never the insurer has Waze it's right answers by issuing the policy by excepting the application with unanswered questions

Hi deductible health plan in savings account

Often in coordination with medical savings account health savings account or health reimbursement account the high deductible health plan features higher in your deductibles and out-of-pocket limit than traditional plans giving lower premiums the deductible of HDHP may be paid with funds from coordinating account plan

In network provider equals less out-of-pocket cost

Out of network provider equals higher out-of-pocket cost

PPO

PPL is a group of physicians in hospitals that contract with employers insurers and third-party organizations to provide medical care services at a reduced fee

HMO Prepaid Basis - member selects pcp, pcp gives referral

PPO fee for service basis - no pcp or referrals/ in network out network provider

The insured purchased a health insurance policy with a renewability clause that states in the policy is guaranteed renewable this means that as long as they require premiums are paid the policy will continue until the insured

Reach his age 65

Health insurance rates may be based upon all of the following except

Religion

Which of the following is a daily nursing and rehabilitation of care that can only be provided by medical personnel and do the direction of a physician

Skilled care

To limit to the amount an employee and employer cannot contribute to MSA

The annual deductible limit: 65% and the annual income limit: 75%

Once the initial benefit limit in Medicare part D is reach how isThe beneficiary affected

The beneficiary is then responsible for a portion of the prescription drug costs

benefit schedule

specifically states exactly what is covered in the plan and for how much

Medicare is health insurance program for all of the following individuals except

those with low income and low assets

Health insurance must offer pediatric dental coverage for children 18 or younger as an essential health benefit

under a health plan or a standalone dental plan

Health Savings Account (HSA)

Designed to help individuals safe for qualified health expenses that they their spouse or their dependence in Kerr individual who is covered by a high deductible health plan can make a tax deductible contribution to an HSA and use it to pay for out-of-pocket medical expenses contributions by an employer are included in the individual taxable income a person may obtain coverage under a qualified health insurance plan with establish minimum deductible of 1400 for singles 2800 for families/ an HSA holder who uses the money for A non-health expert denture pays tax on it plus a 20% penalty after age 65 a withdrawal use for non-health purposes will be taxed but not penalized

What is the purpose of the agents report in the application process

Do you provide additional information about the applicant to the underwriter

All of the following are features of health insurance plan purchased on the health insurance marketplace except

Dollar limit on essential benefits

All of the following are ways to handle wrist except

Elimination

Which of the following is not a hazard

Exposure

The illumination. In a disability income policy is better known as

The period of time and insured most weight after the onset of illness or injury for the benefits begin

Which of the following is required in order for a plan to be qualified?

The plan must be formally written and communicated to the employees

HRA characteristics /all size

They are contribution healthcare plans not defined benefit plan, not a taxable employee benefit, employers contribution or tax deductible, employees can( roll over and his balances at the end of the year), employers do not need to advance claims payments to employees or healthcare providers during the months of the plan year, provided with employer dollars not employee salary reductions, permit the employer to reduce health plan caused by coupling the HRA with a high deductible health plan and balancing the group purchasing power

What is the purpose of a disability Byselle agreement

To allow the business buy out in case the owners disability

And employee is covered under cobraHis previous premium payment was 100 per month his employer now collect 102 per month why does the employer collect an extra two dollars

To cover the employers administration cost

Health Reimbursement Account (HRA)

Employer-funded plan that reimburses employees only for eligible and substantiated health-care expenses.

All of the following statements about agents are true except

Exclusive agents work for themselves

FSA exemption

Exempt to federal income taxes Social Security FICA taxes and in most cases state income taxes saving 1/3 or more on taxes

Which of the following statements is not true regarding HICAP

Exist to assist seniors who are not qualified to receive Social Security or Medicare

And insurance agents have authorization to represent the company and may exercise this relationship to

Express authority implied authority and apparent authority

The family deductible is written so there any claims filed by the family within a year apply to the deductible for the entire family

Family deductible's are usually written with a common accident provision

Principle Sum

Full face amount 100%

A 25 year old full-time student is living off a trust fun why would he not qualify for an IRA

He doesn't have earned income

There are two types of flexible spending accounts

Healthcare account for out-of-pocket healthcare expenses and a dependent care account to help pay for dependence care expenses

In an HMO a gatekeeper helps to control the cost of

Healthcare, by only making the necessary referrals

All of the following are features of the catastrophic plan except

Hi premiums

consumer-driven health plan (CDHP)

High deductible plans or patient directive plans or healthcare plans that are controlled by employer employer determines eligibility contribution the girls percent and exit rules funds are allowed to roll over from here to here at the discretion of the employer

Dependent care account

IRS women's annual contribution to a specified amount they get suggested angela The for Coast And leaving this is a family limit meaning that even if both parents have access to flexible care accounts their combined contributions cannot exceed the amount

Qualifying life event changes/only time you can make changes outside of open enrollment

Marital status, number of dependence, one of dependence become eligible for or no longer satisfies the coverage requirements under the medical reimbursement plan for unmarried dependence due to attained age student status for similar circumstances, family medical leave, change independent care provider, the insureds spouses or qualified dependent employment status that affects eligibility under the plan

Which of the following used to be called Medicare choice plans

Medicare advantage plans

Non-help with drawls before age 65 equals 20% penalty

Non-health withdrawal after age 65 equals no penalty

What does basic medical if expense cover

Non-surgical services a physician provides

Only the agent is involved in completing the agents report the agent statement is

Not included in the entire contract

PPOs versus HMOs

PPOs allow more flexibility between in networking out network providers in exchange for a higher premium

Which of the following Medicare parts provides prescription drug benefits

Part d

Who makes up the medical information Bureau

Insurers / Insurance company

Medical Savings Account (MSA)

Is an employer funded account linked to a high deductible medical insurance plan the employer raises the medical plan deductible and returns all or part of the previous savings to the employees to contribute to the MSA, if a distribution is made for a reason other than to pay for qualified expenses the amount withdrawn will be subject to an income tax and an additional 20% tax

Darryl is involved in an automobile accident with another motor is Darryl was at fault Darryl was injured and hospitalized For two months the other motor is suffered 15,000 of medical expenses as a result of the accident Deorro's disability income policy will pay

Darryl's loss of income

A representation in an insurance contract qualifies as an

Implied warranty

A qualifying retire he has access to all parts of the Social Security Medicare program which of these parts requires a monthly payment from the insured

Part b

Which of the following is consideration on the part of the insurer

Paying a claim

Policies written on a third-party ownership bases are usually written to cover which of the following

Policy owner is minor children are business associates

The frequency amount of the premium payment is known as what

Premium mode

In group insurance the primary purpose of the coordination of benefits provision is to

Prevent over insurance

The main Focus for an HMO is

Preventative care

On an accident death and dismemberment policy the death benefit payable is known as the

Principal some

Self-insured association plans are

Prohibited by the CIC

the purpose of the Fair Credit Reporting Act is to

Protect consumers against the circulation of inaccurate or obsolete personal or financial information

And insured was diagnosed two years ago with kidney cancer she was treated with surgeries and chemotherapy and is now in remission she also has a 30 year smoking history the insured is not healthy enough to work and has just started a full-time job which describes the health insurance that she will most likely receive

She would be covered under her employer's group health insurance plan without higher premiums

Under the family medical leave act what happened to an employee's insurance benefits while he or she is on leave

The benefits earned remain in effect for the duration of the employees leave

Which of the following reasons me a great coverage not be discontinued

The company stock value lowers

And insured is anxious to get treated for a health condition and he's convinced that a specialist is needed to cure the condition is the insured has a PPO plan which of the following issue

The insured can select any specialist but not in network specialist will have a how your out-of-pocket cost

When a health plan has both the aggregate deductible and embedded deductibles the annual contribution limit for an HSA is the lesser of

The maximum annual contribution limit, the aggregate deductible, or the embedded deductible multiplied by the number of family matters

Close Panel HMO

The medical caregiver provide services to only members or subscribers of the health organization and contractually is not allowed to treat every patient

What is the purpose of a benefit schedule

To state what and how much is covered in the plan

Insurance provides a means to

Transfer loss

Which of the following services will not be provided by an HMO

Unlimited coverage for a treatment for a drug rehabilitation

Open-panel HMO

When a medical caregiver contracts with a health organization to provide services to its members or subscribers but retains the right to treat patients who are not members or subscribers

A limited health insurance policy that will pay a lump sum to an insured diagnosed with a heart attack stroke or renal Failure is known as

critical illness insurance

Which of the following is an example of a physical hazard

diabetes

Medicare part B covers all of the following except

long term care services

Under the affordable care act when would pregnancy be considered a pre-existing condition

never


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