Health and Accident Insurance - Test Questions Flashcards
Ron has a new employer and wishes to enroll in the company’s group health plan. In determining whether his pre-existing health condition applies, Ron cannot have more than a ______ day gap without previous health insurance?
63
A group Disability Income plan that pays tax-free benefits to covered employees is considered________.
Fully Contributory
A person covered with an individual health plan__________.
is issued a policy
Sonya applied for a health insurance policy on April 1. Her agent submitted the information to the insurance company on April 6. She paid the premium on May 15, with the policy indicating the effective date being May 30. On which date would Sonya have coverage?
May 30
A common exclusion with Vision plans is_____?
Lasik Surgery
According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual________.
Is eligible for insurance upon hire.
Under group health insurance, a certificate of coverage is issued to the_________.
Employee.
The policyholder for a group health benefit plan is considered to be the________.
Employer
The limited period of time given to all members to sign up for a group health plan is called the_________.
Enrollment Period
Group health plans may deny participation based upon the________.
Members part-time employment status
When are group disability benefits considered to be tax-free to the insured?
When the recipient pays the premium
Continued coverage under COBRA would be provided to all of the following_________,________________,________________.
former dependent of employee no longer of dependent status, terminated employee, divorced spouse of employee
Health Insurance Involves two perils, accident and _________.
Sickness
Without a Section 125 Plan in place, what would happen to an employee’s payroll contribution to an HSA?
It would be considered taxable income to the employee
Which of the following does Coordination of Benefits allow?
Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid
A master contract and certificate of coverage can be found in which type of policy?
Group
When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability act (HIPAA)?
When participation or contribution rules have been violated
Under the Health Insurance Portability and Accountability Act (HIPAA), the employee’s new Group Health Plan will verify Creditable Coverage so that the___________.
Employee’s waiting period for coverage of a preexisting condition can be reduced under the new employer’s health plan
If an employee contributes 50% toward the disability plan premium provided by an employer, what would be considered the taxable income of a $1000 monthly disability benefit?
$500
The election of COBRA for continuation of health coverage will________.
Maintain the same coverage and increase the premium
Which of the following is INELIGIBLE to participate in a Section 125 Plan?
An S-Corp owner with a greater than 2% share.
An employer is issued a group medical insurance policy. This single contract is known as a (n)__________.
Master Policy
The purpose of the Coordination of Benefits provision in group accident and health plans is to___________.
Avoid overpayments of claims.
Coordination of Benefits regulation applies to all of the following:
Group Vision plan, Self-funded group health plan, and group health plan.
Which of the following decisions would a Health Savings Account (HSA) owner be unable to make?
1) The amount contributed by the employer
2) The amount contributed by the owner
3) The underlying account investments used
4) The medical Expenses paid for by the HSA
The amount contributed by the employer
In an employer-sponsored contributory group Disability Income plan, the employer pays 60% of the premium and each employee pays 40% of the premium. Any income benefits paid are taxed to the employee at__________.
60% of the benefit.
Which of the following is typically NOT eligible for coverage in a group health policy?
1) Full-time employee
2) Temporary Employee
3) Business Owner
4) Partner in a partnership
Temporary Employee
HIPAA considers which of the follow as “individually identifiable health information”?
1) A person’s Employment history
2) a person’s net income
3) a person’s hire date
4) a person’s health claim information
A person’s health claim information
Health insurance will typically cover which of the following perils?
1) Death due to illness
2) Injury due to accident
3) Death due to accident
4) Dismemberment
Injury due to accident
Which of the following would be considered a possible applicant and contract policyholder for a group health benefits?
1) Human Resource Department
2) Employer
3) Insured employee
4) Insurance Company
Employer
