Health Insurance
critical illness
A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is known as
full benefits
Alden is involved in a small plane accident that renders him permanently deaf, although he does not sustain any other major injuries. Alden is still able to perform his current job. To what extent will he receive Presumptive Disability benefits?
the capital amount in a lump sum
An insured loses her left arm in an accident that is covered by her Accidental Death and Dismemberment policy. What kind of benefit will she most likely receive from this policy?
revocable
An insured wants to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have her husband named as what type of beneficiary?
the gatekeeper of an HMO helps
Control specialist costs
6 months to 2 years
Health: Individual short-term policies provide benefits for _____months to ______ years.
5 days
If a consumer requests additional information concerning an Investigative Consumer Report, how long does the insurer or reporting agency have to comply?
guaranteed renewable disability insurance policy
Is renewable at the insureds option to a specified age
guaranteed renewabilitiy
Most LTC plans have what feature
90 days
Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within
what is the purpose of COBRA
To provide continuation of coverage for terminated employees
3 days
Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained?
hospital indemnity policy
a benefit for each day that the insured is in the hospital
Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
a statement that is sufficiently clear to identify the insured and the nature of the claim
Dread Disease Policy
an example of a limited accident and health insurance policy.
No coverage will apply, since the injury could have been foreseen
an insured jumps down from a bus.
what is the maximum period of time in which an insurer may contest fraudulent misstatements made in a health insurance application
as long as the policy is in force
Inpatient Hospital Care for HMO members
can be provided outside of the service area
90 days or as soon as reasonably possible
how soon following an occurrence of a covered loss must an insured submit written proof?
the probationary period of a group health insurance policy is intended for people who
join after the effective date
Short Term Disability
no more than 2 years
Insurer
the entity that can legally bind coverage
Medicade
the government insurance program for low-income individuals & familys that is funded both by the federal government & each individual state
which of the following is Not a feature of a noncancellable policy
the insurer may terminate the contract only at renewal for certain conditions
Material Misrepresentation
A statement that, if discovered, would alter the underwriting decision of the insurance company.
$102
An employee insured under a group health plan has been paying $25 monthly premium for his group health coverage. The employer has been contributing $75, for the total monthly cost of $100. If the employee leaves the company, what would be his maximum monthly premium for COBRA coverage?
36 months
What is the period of coverage for events such as death or divorce under COBRA?
the insurer can increase the premium on an individual bass
what is not a feature of guaranteed renewable provision
