Health 3 Flashcards
What renewability provision will most likely appear on a travel accident policy?
Period of time
Why: The period of time (term) provision means that the policy will only last a certain period of time and cannot be renewed. Travel accident policies are short-term policies
What health policy renewability provision allows the insurer to terminate coverage for any reason and to increase the premiums for any class of insureds?
Optionally Renewable
Why: An optionally renewable policy gives the insurer the option to terminate the policy for any reason or increase premiums for a class of insureds on a specified date.
What health policy provision describes the insured’s right to cancel coverage?
Renewability Provision
Why: Renewability provisions are included in each health insurance contract and outline both the insurer’s right to cancel or renew coverage.
What is a presumptive disability provision?
Provisions found in most disability income policies that specifies the conditions that will automatically qualify for full disability benefits
Why: Presumptive disability plans offer full benefits for specified conditions. These policies typically provide a benefit for dismemberment, total and permanent blindness, or loss of speech or hearing.
What is a fee-for-service health plan?
Under a fee-for-service plan, providers receive payments for each service provided.
Why; Medical expense plans could be fee-for-service, in which providers receive a payment for their billed charges for each service provided.
If the insured pays a monthly premium for health insurance, how long would the grace period be on the policy?
10 days
Why: the grace period is 7 days if the premium is paid weekly, 10 days if paid monthly and 31 for all other modes.
A waiver of premium provision may be included with what type of health insurance policies?
Disability Income
Why: A waiver of premium rider exempts the insured from paying the policy’s premium during periods of total disability and is usually included in a basic disability income policy.
What does the amount of disability benefit that an insured can receive depend upon?
The insured’s income prior to a disability
Why: The amount of disability benefits that will be paid is usually limited to a percentage of the insured’s income, which gives the claimant a financial incentive to return to work.
When are LTC benefits received tax free by an individual?
LTC benefits are always received tax free
Why: Regardless of whether the insured can deduct individual Long-term care insurance premiums, the benefits are received income tax free by the individual.
In what type of health plans are providers paid for services in advance, regardless of the services provided?
Prepaid Plans
Why: Prepaid plans provide medical and hospital benefits in the form of service rather than dollars. In prepaid plans, the providers are compensated regularly whether or not they provide services.
