Health Insurance Markeitng Practices

Question 1

must be delivered to an applicant for a n issued policy

Answer 1

Outline of Coverage

Question 2

Guaranteed Renewability

Answer 2

Insurer obligated to continue coverage as long as payments are made

Question 3

Medicare Eligibility Expenses

Answer 3

Expenses Covered under Parts A & B

Question 4

Sickness

Answer 4

Manifests after effective date

Question 5

4 Parts of the Outline of Coverage

Answer 5

Cover page
Premium information
Disclosure pages
Charts

Question 6

What is the Buyers Guide

Answer 6

Medicare must provide pamphlet explaining Medicare health ins

Question 7

Free look period for Medicare supplement?

Answer 7

30 Days
Premium refunded

Question 8

Explain Medicare supplement and guarantee issue?

Answer 8

Issuer May issue coverage without evidence of insurability

Question 9

LTC Education Requirements?

Answer 9

8 hr training
4 hr on going training every 2 years

Question 10

Penalty for Health Care False Claim ?

Answer 10

Class C Felony
5 Years and/or 10,000$

Question 11

What is Health Insurance Reform ?

Answer 11

Residents with managed care programs have access to necessary info

Question 12

Who makes decisions about length of inpatient care Maternity Services ?

Answer 12

Attending Provider
Cannot be denied

Question 13

How long is A NewBorn child covered for under a mother ?

Answer 13

3 weeks !

Question 14

Free Look for accident & health insurance?

Answer 14

10 Days

Question 15

Grace Period for Weekly ? Monthly? Any other?

Answer 15

7 Days
10 Days
31 Days

Question 16

Obligations that come when Reinstating an insurance contract ?

Answer 16

Not obligated
Might need an application
Collect no more than 60 days of premium
PROOF OF INS
COND RECEIPT

Question 17

Waiting period for Reinstatement? Why?

Answer 17

10 days before loss relating to sickness are covered
Adverse selection

Question 18

Insured must notify insurer of loss in how many days ?
Notice of claim

Answer 18

20 days

Question 19

How long to provide proof of loss?

Answer 19

90 days no later than 1 year

Question 20

How long after submission of proof can insured take Legal actions ?

Answer 20

60Days
Litigation in 3 years

Question 21

Comprehensive health care services

Answer 21

Basic consultative, diagnostic, therapeutic, emergency preventative care inpatient outpatient phys care
LICENSED PROFESSIONALS

Question 22

Continuation of Group coverage by health care service contractors or health maintenance org HMO?

Answer 22

Have the right to continue for a period of time and rate agreed upon once ineligible.

Question 23

Age coverage stops for a child ?

Answer 23

26 Years

Question 24

Commissioners powers over individual and HMO agreements ?

Answer 24

Can disapprove them