Federal Laws and Regulations Flashcards
Fair Credit Reporting Act
Deals with consumer reports. Which when used for insurance are used to check for “moral hazards” Extra information - judgements will be on record for 7 years and bankruptcies will be on record for 10 years.
Federal Law 18 USC Section 1033
relates to those in the insurance businesses who knowingly and with the intent to deceive make false statements, reports, or willingly overvalue any land, property, or security in connection with any financial reports or documents for the purpose of influencing the actions of an insurance regulatory official, agency, appointed agent, or examiner. United States Code (USC) establishes definitions and penalties for crimes by or affecting persons engaged in the business of insurance whose activities affect interstate commerce.
Federal Law 18 USC Section 1034
USC Section 1034 sets civil penalties and injunctions for violations of section 1033.
Federal Law 18 USC Section 1035
Section 1035 addresses false statements relating to health care matters.
Affordable Care Act (ACA)
A health care reform law that was enacted to improve the quality of health insurance by adding coverages, making it more affordable, and by expanding insurance cover by lowering the cost to insureds, thus reducing the uninsured rate.
This was accomplished through subsidies, mandatory acceptance, and insurance exchanges. Furthermore, the law requires insurers to accept all applicants, cover a specific list of conditions, and charge the same rates regardless of pre-existing conditions or gender.
(ACA) Bronze Coverage
Lowest monthly cost, highest out of pocket, deductibles could be thousands per year, routine care is not covered and this plan is a good choice for those only interested in catastrophic coverage. 60/40 co-insurance.
(ACA) Silver Coverage
Moderate premium, moderate out fo pocket, lower deductibles than bronze plans, routine care is covered, and is a good choice for those willing to pay more monthly for lower out-of-pocket and no cost for routine care. 70/30 coinsurance.
(ACA) Gold Coverage
High premiums, lower out-of-pocket, low deductable, routine care is covered, and is a good choice for those needing a lot of care and want lower costs at the time of care. 80/20 coinsurance.
(ACA) Platinum Coverage
Highest monthly premiums, lowest out of pocket, low deductable, routine care is covered, good for those willing to pay more monthly and less at time of care. 90/10 coinsurance.
