pt 2

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NOT a feature of a noncancellable policy?

The insurer may terminate the contract only at renewal for certain conditions.

An insured has a major medical policy with a $500 deductible and a coinsurance clause of 80/20. If he incurs medical expenses of $4,000, the insurer would pay

The insurer would pay 80% of covered expenses after the $500 deductible is satisfied.

Which of the following is NOT the purpose of HIPAA?

a) To prohibit discrimination against employees based on their health status b) To limit exclusions for pre-existing conditions c) To provide immediate coverage to new employees who had been previously covered for 18 months. d) To guarantee the right to buy individual policies to eligible individuals

A Health insurance policy lapses but is reinstated within an acceptable timeframe. How soon from the reinstatement date will coverage for accidents become effective?

immediately

60 days after proof of loss is known as

legal actions

Any person or organization willfully violating any provision of rate-making provisions of the law will be punished by a fine of

500 $ each

A hospital indemnity policy will pay

A benefit for each day the insured is in a hospital.

Which of the following is NOT true of basic medical expense plans?

Coverage for catastrophic medical expenses

As it pertains to group health insurance, COBRA stipulates that

Group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense.

When an employee is still employed upon reaching age 65 and eligibility for Medicare, which of the following is the employee's option?

Remain on the group health insurance plan and defer eligibility for Medicare until retirement

NOT a goal of risk retention?

To minimize the insured's level of liability in the event of loss

When an insurer offers services like preadmission testing, second opinions regarding surgery, and preventative care, which term would best apply?

case management

must be included on the first page of a Medicare supplement policy

continuation provision

taxation of long-term care insurance?

excess benefits might be taxed

NOT a feature of a guaranteed renewable provision

he insurer can increase the policy premium on an individual basis.

Which of the following is NOT provided by an HMO?

reimbursement

What types of services may NOT be provided under the long-term care's assisted living care?

visits by registered nurse


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