Group Health Insurance Flashcards
Individuals I’m Group Insurance are issued what as evidence of coverage?
Certificate of Insurance
What policy is, how to file claim, length of coverage
Contributory v Noncontributory
75% all employees must participate
Contribute to premium
100% must be included
Don’t contribute to premium
Group Health:
Reason for the participation requirements ?
Guard insurer against adverse selection
Reduce admin costs
Two types of groups eligible for group insurance ?
Have to be a group for a purpose other than?
Employer sponsored
Association sponsored
Obtaining insurance
What is a Multiple Employer Trust ? MET
Two or more employers
Similar or related businesses
Don’t qualify for group ins alone
What is MEWAs purpose?
Health provide coverage two or more SELF EMPLOYED
OBJECT: Self Insure
Credit Group Insurance extra name and purpose?
Credit Life and Credit Disability Income Ins
Protects lending institution against death of borrower
Employer Group Health underwriting focus?
The group as a whole
Groups with more than 50 employees, underwriter cannot require what?
Medical Info
Individual Eligibility of group coverages depends on what.?
Employment type
Have to be:
Full time 30hr
Employed for 1 to 3 months
In group policies, what is not required f during open enrollment periods ?
Evidence of insurability
Purpose of coordination of benefits COB? Only in group health
Avoid duplicate benefit pmt
Overinsurance
COB establishes what?
Which plan gives full benefits Primary
Which plan covers any additional costs and Secondary
COBRA consolidated omnibus budget reconciliation act does what?
Extends Cov to terminated employees w 20 or more employees
What is a qualifying event for COBRA?
Termination w/o gross misconduct volun or involun
Employment status change full to part
