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2012 CFP > Insurance > Flashcards

Insurance Flashcards

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1
Q

What are the 2012 Health Savings Account (HSA) limits for:

1) maximum contribution,
2) maximum out-of-pocket, and
3) minimum deductible?

A

1) single $3,100 ($1k catchup @ 55)
family $6,250

2) single $6,050, family $12,100
3) single $1,200, family $2,400

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2
Q

How are non-qualified distributions from HSA treated?

A

Ordinary income plus 20% penalty unless attained age of 65, disabled, or died

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3
Q

Who is exempt from COBRA? (3)

A
  • government
  • churches
  • small companies with fewer than 20 full-time employees (2 part-time = 1 full-time)
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4
Q

What are the rules of risk management? (3)

A

1) don’t risk more than you can afford to lose
2) consider the odds
3) don’t risk a lot for a little

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5
Q

Hazard

A

Condition that increases the probability of loss

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6
Q

Peril

A

The cause or reason for loss (ie, fire)

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7
Q

Risk

A

The potential for loss

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8
Q

What are the components of a legal insurance contract? (5)

A

1) offer and acceptance
2) consideration
3) legal object
4) competent parties
5) legal form

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9
Q

What are the special characteristics of insurance contracts? (7)

A

1) aleatory
2) adhesion
3) conditional
4) personal
5) unilateral
6) utmost good faith
7) contract of indemnity

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10
Q

Aleatory

A

Subject to chance and involves unequal dollars

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11
Q

Adhesion

A

if you wrote it, you are stuck with it

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12
Q

What is the difference between “negligence” and “negligence per se?”

A

“Per se” is against a specific group

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13
Q

Res ispa loquitur

A

“The thing speaks for itself” (plaintiff did NOT contribute to the accident

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14
Q

Doctrine of waiver

A

Party gives up a right

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15
Q

Doctrine of estoppel

A

Party is prevented from asserting a right that was previously misstated or given away

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16
Q

Staff model HMO

A

Corp owns everything…equipment, staff, doctors

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16
Q

Group Practice HMO

A

Doctors contracted and work in the HMO facility

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16
Q

IPA HMO

A

Different practices join together to form HMO

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16
Q

HSA minimum deductible for 2012

A

SGL 1,200

FAM 2,400

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16
Q

HSA max out of pocket for 2012

A

SGL 6,050

FAM 12,100

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16
Q

HSA max contribution of 2012

A

SGL 3,100

FAM 6,250

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22
Q

Adjuster’s duties

A
  • investigate loss
  • determine liability
  • determine payment amount
  • be fair
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23
Q

Parole evidence rule

A

Written overrules verbal

24
Q

Elements of an insurability risk

A
  • law of large numbers
  • definite and measurable loss
  • accidental
  • loss not catastrophic to insurER
25
Q

Methods of handling risk

A 
Avoidance
Reduction 
Retention
Transfer
Sharing
26
Q

What is a family income policy?

A

Provides decedent’s family with income for a period of time usually build with permanent insurance with a decreasing term

27
Q

What is the 5th dividend option?

A

When policy dividends are used to buy 1 year term policy at attained age

28
Q

Premium for Medicare Part A

A

30-39 quarters, $248/mo

<30, $451

29
Q

Deductible for Medicare Part A

A

$1,156 per spell

30
Q

Medicare Part A coinsurance amount

A

0 for 60 days (per spell)
$289 for days 61-90
$512 for 90-150-the 60 lifetime reserve days

31
Q

Medicare Part A maximum stay

A

150 days per single cause stay

32
Q

Medicare Part B premium

A

Sliding scale based on income

SGL/JNT 85/170-$99.90/mo.
Indexed to 213k@ $319/mo.

33
Q

Medicare Part B deductible

A

ANNUAL $140

34
Q

Medicare Part B coinsurance amount

A

20%

35
Q

Medicare Part D deductible

A

$320 annual deductible
25% copayment on next $2930
Donut hole for next $3,647.50
5% coinsurance after donut hole

36
Q

Medicare Medical Savings Account requirements

A 
Medicare Advantage (Part C)
HDHP with max deductible @ $10,500
37
Q

Capitation

A

The annual fee paid to a healthcare provider per subscriber to the HCP

38
Q

Split definition disability

A

Insured must be unable to perform own occupation for stated period, then changes to any occ or modified any occ

39
Q

Presumptive disability

A

Loss of sight
Loss of hearing/speech
Loss of 2 limbs

40
Q

Noncancelable

A

Premiums guaranteed for contract period

41
Q

Medicare LTC coverage

A

3 days as an admitted patient
Enter Medicare approved facility within 30 days
Expected to recover

20 days fully covered
21-100 with $144.50 daily deductible

42
Q

Medicaid LTC coverage

A

Medically certified as needing care

Impoverished

43
Q

Basic HO coverages

A

Fire, lightning, theft, & WC SHAFER

Wind
Civil disorder
Smoke
Hail
Aircraft
Vandalism
Explosion
Riot
44
Q

Broad HO coverage

A 
Basic plus
Volcano
Power surge
Frozen plumbing
Hot water, a/c
Plumbing discharge
Building collapse
Falling objects
45
Q

Structure of a HO policy

A 
Section I:
A - dwelling
B - other structures
C - personal prop
D - loss of use

Section II:
E - comprehensive liability
F - medical payments, damage to others

46
Q

HO 2

A

A - broad
B - broad
C - broad
D - 20% of A

47
Q

HO 3

A

A - open
B - open
C - broad
D - 20% of A

48
Q

HO 4

A

Renter’s insurance

A - none
B - none
C - broad
D - 20% of C

49
Q

HO 5

A

Comprehensive form

A - open
B - open
C - open
D - 30% of A

50
Q

HO 6

A

Condo insurance

A - min
B - incl. in A
C - broad
D - 40% of C

51
Q

HO 8

A

Historic buildings

A - basic
B - basic
C - basic
D - 10% of A

52
Q

HO 15

A

Added to HO 3 to increase C overage to open

53
Q

Max coverage calc

A

[(Have/reqr’d)*loss]- deductible

54
Q

Occurrence based professional liability insurance.

A

Policy in force at time of event pays

Seen more with manufacturing industry

55
Q

Claims-made based professional liability insurance

A

Policy currently in force pays

This is typical in most E&O policies in the service industry

56
Q

Subrogation

A

The insured cannot make a profit

2012 CFP (7 decks)

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