Group Health Insurance

Association groups applying for group health insurance must have a minimum of:

100 members

How long is the annual open enrollment period for employer-sponsored group health plans?

30 days

What is outlined in the certificate of coverage for a group health insurance policy? Select one: a. Benefits b. Claim procedures c. Conversion rights d. All of the above

All of the above

Which of the following would be considered unfair advertising for group health insurance? Select one: a. Using insurance jargon b. Contrived testimonials c. Incomplete comparisons of other insurers_ group health insurance products d. All of the above

All of the above

All of the following groups may purchase group health insurance coverage, EXCEPT: Select one: a. Sally's Flower Shop with 15 employees b. Judy's Handmade Card Shop with 5 employees c. Maggie's Piano Studio with 1 employee d. Fran's Furniture Land with 50 employees

Maggie's Piano Studio with 1 employee

All of the followings statements regarding group health insurance are true, EXCEPT: Select one: a. The policyholder is the employer, union, or other association, not the insured members. b. Each member is issued a certificate of coverage. c. Maternity does not need to be covered. d. Enrollees typically do not need to undergo a medical exam.

Maternity does not need to be covered.

The coordination of benefits provision specifies that the primary insurer:

Pays benefits as if secondary coverage does not exist

All of the following statements are true regarding creditor group health insurance, EXCEPT: Select one: a. Premiums are typically paid by the lender. b. The lender is the policy's beneficiary. c. Creditor group health insurance protects lenders for losses resulting from disability or death of borrower. d. Creditor group health insurance provides specialized insurance for lenders to protect against nonpayment of a loan when a borrower becomes disabled or dies, and cannot repay the loan.

Premiums are typically paid by the lender.

Will has a physically disabled child, who is in high school, and is incapable of self-sustaining employment. Which of the following statements accurately describes the child's coverage under Will's health insurance?

The child may continue to receive coverage under Will's plan as long as the child continues to be disabled and financially dependent on Will.

Blain's Spa and Salon has a group health plan for his employees. Blain pays for the entire cost of coverage. Which of the following is true?

The plan is noncontributory and all eligible employees must participate in the plan.

What does the coordination of benefits provision specify?

The primary insurer pays benefits as if the secondary coverage does not exist.

What is the purpose of the coordination of benefits clause in group health plans?

To prevent duplicate benefit payments to employees who are insured under multiple coverages

Xavier is enrolled in his employer's group health plan. When he reaches the age of 65, he will no longer be eligible for group coverage. Which of the following is true?

Xavier must be permitted to convert his group coverage to individual coverage within 31 days of his ineligibility under the group plan.

Jacob has a group health insurance policy and pays the same premium as all other insureds under the policy. What rating was used?

community rating

The master contract for a group health plan is issued to the:

employer

Most group health plans are sponsored by:

employers

Group health insurance policy rates are usually based on:

experience rating

What term describes the situation where an employer changes group plan coverage to another insurer, and all employees eligible for coverage by the old plan are automatically covered under the new plan without any probationary period?

no loss no gain

A group health insurance plan that pays the entire cost of premiums is termed:

noncontributory

Which of the following terms describes a situation where an employer keeps the same group health plan for many years?

persistency