Chapter 11 Flashcards
The ____________ rider assists and insured in getting back to work after a disability.
Rehabilitation
Which non profit service provider provides benefits for the expenses related to a doctor?
Blue shield
Which type of health care delivery program emphasizes preventative care?
A health maintenance organization
What term is used to describe a primary care provider that verifies the need for additional and specialized benefits?
Gatekeeper
What is Blue Cross?
A nonprofit service provider that provides benefits for hospital expenses
What organization provides the benefits of both an HMO and a PPO?
A point of service organization
Creating a ___________ trust lets small employers with a commons affiliation join together to buy group benefits.
Multiple Employer
What type of A&H policy is designed to provide income to an insured?
Disability income
What is the elimination (waiting) period?
The period of time that must elapse on a disability income policy prior to income benefits being received
What provision states that the amount of disability coverage allowed is directly related to a persons income?
The relation of earnings to insurance provision
Which concept indicates that the insured will be indemnified for actual losses and not profit from her injury/illness?
The no loss/ no gain statute
What is the future increase option or guaranteed insurability rider?
The rider which allows for additional coverage without being required to take a medical exam
T/F: A preferred red provider organization actually provides the insured with medical benefits.
F; a PPO negotiates and creates the rate structure used between employer groups and medical providers
What is the name for the medical issues that exist prior to policy issuance that may not be covered by a new policy?
Preexisting conditions
What term is used to describe the contract that a PPO creates between an employer group and a medical provider?
Preferred Provider Arrangement (PPA)
