chapter 6: Group Health Insurance

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.

An insured has a primary group health plan and an excess plan, each covering losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any copayments or deductibles, how much will the excess plan pay?

$5,000

In a noncontributory health insurance plan, what percentage of eligible employees must participate in the plan before the plan can become effective?

100%

Which of the following is true regarding METs?

They allow several small employers purchase less expensive insurance together.

When employees are actively at work on the date coverage can be transferred to another insurance carrier, what happens to coinsurance and deductibles?

They carry over from the old plan to the new plan.

Jason is insured under his employer's group health insurance. He splits the cost of the premiums with his employer. This is an example of

A contributory plan.

All of the following statements describe a MEWA EXCEPT

MEWAs are groups of at least 3 employers.

In group insurance, what is the policy called?

Master policy

In order to be eligible for group health insurance, all of these are conditions an employee must meet EXCEPT

Must have dependents.

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

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

Which of the following statements concerning group health insurance is CORRECT?

The employer is the policyholder.

In a group policy, who is issued a certificate of insurance?

The individual insured

Who is the beneficiary in a credit health policy?

The lending institution

Why do group health providers usually require a certain amount of participation in the plan by eligible employees?

To guard against adverse selection and reduce cost

What is the purpose of COBRA?

To provide continuation of coverage for terminated employees