Chapter 23: health
An Insured has a $500 deductible with a 20% coinsurance provision. If the Insured has a $10,000 accident claim, the Insured will be responsible for how much of the claim?
2,400
Which of the following is most likely to be the grace period for a Health Insurance policy?
31 days
New point not in the text - be sure to read the explanation. Mika has a $100 health insurance deductible. Her only claim for this year was a $75 claim in November. Her policy has a "90-day carryover deductible." In February of the next year, she suffered a fall resulting in $8,000 worth of medical care. After applying the carryover deductible and the 80% coinsurance provision, her health insurer will pay:
80%x$7,975
New point not in text - be sure to read the explanation. Under the Affordable Care Act (Obamacare), the health policy choices are referred to as:
Bronze, silver, gold, platinum a
Which feature of a Health policy requires the Insured to pay a specified amount of money prior to the policy paying benefits?
Deductible
Which policy provision requires the Insured to pay a specified dollar amount of the loss?
Deductible
New point not in text - be sure to read the explanation. "Out-of-pocket limits" refer to the maximum that the Insured will have to pay on an annual basis for:
Deductibles, copayment, and coinsurance
Which of the following statements regarding a Probationary Period under a Group Policy is TRUE?
During the Probationary Period, the Insurer may deny coverage.
If the deductible goes down, the premium:
Goes up
When an Insurer has no choice regarding renewal but may raise the premium, the policy is:
Guaranteed renewable
The deductible results in each of the following EXCEPT:
Indemnified the insured
Increasing the deductible
Lowers the premium
A policy that provides both renewability and a price guarantee is called?
Noncancelable
Which of the following Health Insurance renewability provisions guarantees the amount of future premiums?
Noncancelable
A deductible accomplishes all of the following EXCEPT:
Reduces fraudulent health claims
Each of the following policy characteristics help prevent overuse of Health Insurance policy benefits EXCEPT:
Stop loss limit
Which of the following is NOT a purpose of the Coinsurance Clause?
The correct answer is: To reduce fraudulent claims.
Which renewability provision is worst for the Insured?
cancelable
Deductibles
eliminate small claims and reduce administrative expenses.
The purpose of the Coinsurance Clause is to prevent overuse of the policy by requiring the Insured to pay a:
stated percentage of each Health claim.
