Life Insurance and Health Individual vs Group Contracts

What is the period of coverage for events such as death or divorce under COBRA?

36 months

Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within

90 days

Which of the following long- term care benefits would provide coverage for care for functionally impaired adults on less than 24-hour basis?

Adult day care

How can a new physician be added to the PPO's approved list?

Agree to follow the PPO standards and charge the appropriate fees

Long-term care insurance policies must cover which of the following?

Alzheimer's disease

Occasional visits by which of the following medical professionals will NOT be covered under LTC's home health care?

Attending physician

All of the following can be insures EXCEPT

Bankers

In comparison to a policy that uses the accidental means definition, a policy that uses the accidental bodily injury definition would provide a coverage that is

Broader in general

A small company offers group health insurance to its employees, nut recently has decided to terminate the health insurance contract, leaving the workers without insurance. What can the employees do regarding their insurance?

Convert to an individual health policy

Who can provide skilled nursing case

Doctor

In disability income insurance, the time between the onset of an injury or sickness and when benefits begin is known as the

Elimination period

An association could buy group insurance for its members if it meets all of the following requirements EXCEPT

Has at least 50 members.

What are the three basic coverages for medical expense insurance?

Hospital, surgical and medical

All of the following are differences between individual and group health insurance EXCEPT

Individual insurance does not require medical examinations, while group insurance does require medical examinations.

Underwriting a group health insurance plan that is paid for by the employer requires all of the following EXCEPT

Individual members of the group may select the level of benefits for their own coverage.

The type of dental plan which is incorporated into a major medical expense plan is a/an

Integrated dental plan.

What is NOT a benefit of a POS plan?

It allows guaranteed acceptance of all applicants.

Which of the following would NOT be considered a limited coverage policy?

Major medical expense insurance

An insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive Presumptive Disability benefits

No benefits

Can a group that is formed for the sole purpose of obtaining group insurance qualify for group insurance?

No, the group must be formed for a purpose other than obtaining insurance

All of the following are the most common variations in a Long-Term Care policy EXCEPT

Number of family dependents

The primary purpose of disability income insurance is to

Replace income lost due to a disability

Which of the following is true regarding optional benefits with long-term care policies?

They are available for an additional premium

Which is NOT a characteristic of group health insurance?

a policy is issued to each insured individual

Which of the following is NOT covered under a long-term care policy?

acute care hospital

A typical Accidental Death & Dismemberment policy covers all of the following losses EXCEPT

income

In long term care (LTC) policies, as the benefit period lengthens, the premium

increases

Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital?

indemnity

Which of the following is NOT covered under Basic Hospital Expense Coverage?

surgeon's fees

Which of the following is NOT true regarding Basic Surgical Expense coverage?

Coverage is unlimited

All of the following statements concerning Accidental Death and Dismemberment coverage are correct EXCEPT

Death benefits are paid only if death occurs within 24 hours of an accident

Which statement is NOT true reguarding underwriting group health insurance

The group is assessed individually for insurability

Which statement id not true regarding underwriting group health insurance?

The group is assessed individually for insurability.

Which of the following best describes the "first-dollar coverage" principle in basic medical insurance?

The insured is not required to pay the deductible

An insured makes regular contributions to his Health Savings Account. How are those contributions treated in regards to taxation?

They are tax deductible

If an insured is not required to pay a deductible, what kind of coverage does he/she have?

first dollar

Regarding long-term care coverage, as the elimination period gets shorter, the premium

gets higher

Which of the following types of LTC is NOT provided in an institutional setting?

home health care

What is the typical deductible for basic surgical expense insurance?

$0

In long-term car insurance, what type of care is provided with intermediate care?

Occasional nursing or rehabilitative care

In long-term care insurance, what type of care is provided with intermediate care?

Occasional nursing or rehabilitative care

Under the Accidental Death and Dismemberment (AD&D) coverage, what type of benefit will be paid to the beneficiary in the event of the insured's accidental death?

Principal sum

Which of the following answers does NOT describe the principal goal of a Preferred Provider Organization?

Provide medical services only from physicians in the network

Todd has been informed that he has a hernia which requires repair. When Todd researches the cost, he learns that his insurance plan will cover 200 points worth of surgical expenses. Each point represents $10, which means that $2000 of the surgery will be covered by his insurance plan. What system is Todd's insurance company using

Relative Value

Which of the following special policies covers unusual risk that are NOT normally included under Accidental Death and Dismemberment coverage?

Special Risk Policy

Which of the following would an accident-only policy NOT cover?

Surgery to repair a wrist damaged by tendonitis.

An insured who has an Accidental Death and Dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy?

The capital amount in a lump sum

How do employer contributions to a Health Savings Account affect the insured's taxes?

The employer contributions are not included in the individual insured's taxable income.

In a relative value system of determining coverage for a given procedure, what term describes the total amount payable per point

conversion factor

In a relative value system of determining coverage for a given procedure, what term describes the total amount payable per point?

conversion factor

Bethany studies in England for a semester. While she is there, she is involved in a train accident that leaves her disabled. If Bethany owns a general disability policy, what will be the extent of benefits that she receives?

none

All of the following long-term care coverages would allow an insured to receive care at home EXCEPT

skilled care