Health Insurance Underwriting and policy Issue

Pierre is covered by his employer's group major medical plan. His employer pays for 75% of the premium and he pays for 25%. How much would a $10,000 benefit be taxable as income under this plan?

$0

XYZ Corp pays the tax-deductible insurance premiums for a key employee disability policy. Which of the following would be the appropriate tax consequence?

benefits are fully taxable

which of the following is a requirement for any change in an insurance application?

change must be initiated by the applicant

one of the most important considerations when replacing health insurance would be the

exclusions on a new policy

XYZ Company has applied for group health insurance for its employees. What information would the insurer's underwriters likely use to determine the appropriate coverage and final premium rate given to the group?

experience rating

An insured was injured as an innocent bystander when someone committed a felony. The insurer is

liable for the loss

the IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted gross income. which of the following is considered a tax deductible medical expense under this rule?

long term care insurance premiums

which of the following typically does not provide a form of managed care?

major medical indemnity plan

which of the following is considered to be a point of service (POS) plan?

managed care plan

Lorenzo is self employed with an S corporation. He is unmarried and had a net profit for the tax year. What are the tax ramifications of his health insurance premiums paid for the year?

100% of his health insurance costs can be deducted from his gross income

a 10% excise tax is normally applied to an early withdrawal from an IRA. According to HIPAA, this tax will not be applied if the withdrawal is ued for medical expenses that exceed ______ of the individuals adjusted gross income

7.5%

in which of the following processes will the insurer oversee the insured's hospital stay to confirm everything is going according to schedule and that the insured will be released as planned?

concurrent review

Premium mode is a term used to describe the

frequency of the premium payment

How does rising morbidity rates affect health insurance?

increased premiums

which of the following factors is not used in underwriting health insurance policies?

intelligence

which of these is not a relevant factor in the health insurance principle of morbidity?

intelligence

an example of a primary care physician would be a

internist

Jim is the insured on a health insurance policy and holds 2 jobs. If "occupation" is used to classify the risk, the insurer will most likely classify Jim according to the occupation that

is most hazardous

Tara the producer is delivering a specified disease insurance policy to a new policyowner. Upon delivery, she may be expected to collect all of the following EXCEPT a(n)

modified application with a new signature

what is the term used to describe the frequency and severity of certain illnesses & accidents

morbidity

How are premiums paid by the insured for personally owned disability income insurance treated for tax purposes?

not tax deductible

which of these characteristics of an applicant is not taken into consideration when assessing risk for disability coverage?

number of children

The gatekeeper's role when used by an HMO is

obtaining referrals to specialists from primary care physicians

the difference between pre-certification and concurrent review is that pre-certification

occurs before the treatment is provided

which of the following is not an example of utilization review?

ongoing inspection of accident prone individuals

which of the following is not considered to be insurer expenses

policy premiums

which of the following is not considered to be insurer expenses?

policy premiums

which of the following is not a factor in determining the morbidity of the group of individuals?

race

which of these factors do not affect the rates of medical insurance

race

which of these factors do not affect the rates of medical insurance?

race

Bill the producer is collecting the initial premium on a health policy. Which of the following statements is true?

the contract is not in force without the initial premium being paid