Health 1 Flashcards
Which term describes the specific dollar amount beyond which the insured no longer participates in the sharing of expenses?
Stop-loss
why: The insurer pays 100% of the expanses that are above the specified stop-loss limit.
Under what employer-sponsored plan are the benefits taxable to an employee in proportion to the amount of premium paid by the employer?
Disability Income
why: In disability income insurance, the part of the benefit that is provided by the employer’s contribution is income taxable to the employee.
In which Medicare supplemental plans are the core benefits found?
All plans (A-N)
Why: The benefits in plan A are considered the core benefits and must be included in all Medicare supplement plans (A-N).
How long do short-term disability group plans pay benefits?
For a period of less than 2 years
Why: Short-term disability group plans usually have a benefit period of less than 2 years.
What is the tax advantage of the employer paying premiums for its employees for disability income insurance?
Premiums are deductible as a business expense
Why: In group disability income policies, premiums paid by the employer for its employees are considered tax deductible as a business expense.
what type of health insurance would pay for hiring a replacement for a valuable employee who becomes disabled
Key Person Disability Insurance
Why: It protects a business from potential expenses or loss of income if a key employee becomes disabled. The business is the policy owner and the beneficiary.
How can accidental death and dismemberment (AD&D) coverage be written?
As a rider to a health insurance policy, or as a separate policy
Why: AD&D coverage can be written as a rider to a health insurance policy or as a separate policy.
What is the purpose of respite care in long-term care insurance?
To provide relief for a major caregiver
Why: Respite care is designed to provide relief to the caregiver (usually a family member) of the insured.
How do insures determine the cost for a group health policy?
The main variables are the ratio of men and women in a group and the average age of the group
Why: Underwriting of group policies is unique in that it concentrates on the group as a whole. It considers mainly the ratio of men and women and the average age of the group.
What is the time requirement for terminated employees to convert the group health coverage to an individual plan without evidence of insurability?
31 days after terminated of the employment
Why: A terminated employee has 31 days from termination to convert a group health policy to an individual plan without evidence of insurability.
