Chapter 9. Other Health Insurance Concepts Flashcards

1
Q

When a business receives benefits from its key person disability insurance, how are those benefits taxed?

A

The key person disability insurance benefits are received tax free.

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2
Q

What is subrogation in health insurance?

A

The legal process that gives the insurer the right to seek recovery from a third party that was responsible for the loss after the insurer has paid the insured for the loss

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3
Q

According to the Coordination of Benefits provision, if both parents have coverage for a child from their employers’ policies, which policy will pay first?

A

The order of payment will be determined by the birthday rule: the coverage of the parent whose birthday is earlier in the year will be considered primary

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4
Q

What is the tax advantage of the employer paying premiums for its employees for disability income insurance?

A

Premiums are deductible as a business expense

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5
Q

If the insureds share in the cost of health insurance premiums with the employer, this would be known as what type of group health plan?

A

Contributory

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5
Q

What type of health insurance covers partners or corporate officers of a closely held business?

A

Disability buy-sell

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5
Q

Under a fully contributory health plan, how are benefits received by the employee?

A

Income tax free

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5
Q

What are the four types of workers compensation benefits?

A

Medical, income, rehabilitation and death benefits

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6
Q

Under what employer-provided plan are the benefits taxable to an employee in proportion to the amount of premium paid by the employer?

A

Disability income

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6
Q

What type of insurance covers an employee who is hurt on the job?

A

Workers compensation

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6
Q

What is the purpose of managed care health insurance plans?

A

To control health insurance claims expenses

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7
Q

How are benefits received by the business from a key person disability insurance?

A

Income tax free

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8
Q

What type of health insurance is sold to small business owners to reimburse them for the overhead expenses?

A

BOE - Business Overhead Expense insurance

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8
Q

In health insurance, when would an excess plan pay benefits?

A

After the primary plan has paid its full promised benefit, the excess plan will pay the balance

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8
Q

How are individually-owned disability income benefits taxed once received by the insured?

A

Disability benefits are not taxed; they are received income tax free

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9
Q

For how long do short-term disability group plans pay benefits?

A

For up to 52 weeks

10
Q

In group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense?

A

100%

11
Q

What type of disabilities will be covered by occupational coverage?

A

Disabilities that result from accidents or sicknesses that occur on or off the job

12
Q

What are the five basic characteristics of managed care plans?

A

Controlled access to providers, comprehensive case management, preventive care, risk sharing, and high quality care

13
Q

What is a birthday rule in a coordination of benefits provision?

A

The coverage of the parent whose birthday is earlier in the year is considered primary