Types of Health Insurance Policies quiz questions
An insured's long term care policy is scheduled to pay a fixed amount of coverage of $120 per day. The long term care facility only charged a $100 per day. How much will the insurance company pay?
$120 a day
What is the typical deductible for basic surgical expense insurance?
0$
An insured owns a general disability policy and is injured during a war, rendering him disabled.What will be the extent of benefits that he will receive?
0%
How many consecutive months of coverage (other than in an acute care unit of a hospital) must LTC insurance provide in this state?
12
What is the period of coverage for events such as death o divorce under COBRA?
36 months
How is emergency care covered for a member of an HMO?
A member of an HMO can receive care in or out of the HMO service area, but care is preferred in the service area
Which of the following individuals is eligible for a Health Savings Account?
Allison is injured by a High Deductible Health Plan (HDHP)
A small business owner is the insured under a disability policy that funds a buy-sell agreement. If the owner dies or becomes disabled, the policy would provide which of the following?
Cash to the owners business partner to accomplish a buyout
Other than for a qualified life event, when can a change be made in benefits for a Flexible Spending Account (FSA)?
During the open enrollment period
Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital?
Indemnity
If your health care plan has characteristics of an HMO and PPO, what type of plan do you have?
POS (point of service)
The period of time immediately following a disability during which benefits are not payable is?
The elimination period
Which of the following would an example of a limited accident and health insurance policy?
a dread disease policy
Which is NOT a characteristic of group health insurance?
a policy is issued to each insured individual
What kind of LTC benefit would provide coverage for care for functionally impaired adults on a less than 24-hour basis?
adult day care
Which of the following statements regarding Business Overhead Expense policies is NOT true?
benefits are usually limited to six months XXXXXXXXXX
If an employee terminates her employment, which of the following provisions would allow her to continue health coverage under an individual policy, if requested within 31 days?
conversion
A small company offers group health insurance to its employees, but 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
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 of the following is NOT covered by Health Maintenance Organizations (HMOs)?
elective services
An insured is hospitalized with a back injury. Upon checking his disability income policy, he learned that he will not be eligible for benefits for atleast 30 days. This would indicate that his policy was probably written with a 30 day
elimination period
Long term care coverage may be available as any of the following options EXCEPT
endorsement to a health policy
An insured is involved in an accident that renders him permanently deaf, although he does not sustain any other major injuries. The insured is still able to perform his current job. To what extent will he receive presumptive disability benefits?
full benefits
Regarding long term care coverage, as the elimination period gets shorter, the premium
gets higher
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 employees expense.
Regarding long term care coverage, the longer the benefit period, the premium will be
higher
Which of the following types of LTC is NOT provided in an institutional setting?
home health care
In which of the following locations would skilled care most likely be provided?
in an institutional setting
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.
What is the initial period of time specified in a disability income policy that must pass, after the policy is in force, before a loss can be covered?
probationary
All of the following long term care coverages would allow an insured to receive care at home EXCEPT
skilled care
Which of the following would be a qualifying event as it relates to COBRA?
termination of employment due to downsizing
An employee becomes insured under a PPO plan provided by his employer. If the insured decides to go to physician who is not a PPO provider, which of the following will happen?
the PPO will pay reduced benefits
An insured is covered by a high-deductible health plan and makes regular contributions to this HSA. How are those contributions treated in regards to taxation?
the contributions are tax deductible
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.
Which statement if 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 a deductible
Hospital indemnity/hospital confinement indemnity policy will provide payment based on
the number of days confined in a hospital
