Insurance Ch 5

Question 1

When selecting disability, income insurance, the best definition of total disability for the benefits is _______.

Answer 1

Own Occupation

Question 2

Defined as the inability of the insured to engage in his or her own occupation

Answer 2

Own occupation

Question 3

The insured is unable to engage in any occupation for which he, or she is qualified by reason of training, education, or experience.

Answer 3

Modified any – occupation, or modified own-occupation

Question 4

Reflects the Social Security rules. The insured is deemed ________ if unable to engage in any substantial gainful activity by reason of any medically, determined, physical or mental impairment, which can be expected to result in death, or which has lasted, or can be expected to last for continuous period of not less than 12 months .

Answer 4

Totally disabled

Question 5

With a loss of income type disability insurance policy, the disability insurer will review the earning history for the prior _____.

Answer 5

Two years

Question 6

__________ disability contracts guarantee that the individual can keep the policy enforce by paying the stated premium, and that the premium will not increase.

Answer 6

Noncancelable

Question 7

_________ disability contracts, guarantee that the individual can keep the policy enforced by paying the premium, but the premium may be increased on a class basis, not an individual basis.

Answer 7

Guaranteed renewable

Question 8

_________ allows a noncable or guaranteed renewal policy to continue beyond age 65. The policy usually only has a two-year benefit, and the premium is adjusted for both benefits and age. It can only be extended if the insured is still an active employee.

Answer 8

Conditionally renewable

Question 9

Disability income insurance policies, no longer offer_______.

Answer 9

Lifetime coverage

Question 10

On a disability policy the________ acts like a deductible.

Answer 10

Elimination period / waiting period.

The longer the waiting period, the lower the premium.

Most policies written today feature a 90 day wait.

Question 11

_______ disability - that total disability benefits will be paid. If the insured loses sight, hearing, speech, both hands, both feet, or one hand and 1 foot.

Question 12

Disability underwriting requires _______ financial information, then life insurance underwriting.

Answer 12

More detailed

Question 13

If the employee owns the disability contract and pays the premium, benefits are ______ to the employee.

Answer 13

Tax-free

Question 14

Answer 14

Question 15

With a ________ plan, the employer pays the entire cost, and the benefits are included in an employee’s gross income.

Answer 15

Formal

Question 16

With a(n)_______ , the employer uses an employee bonus to pay the insurance premium on selected employees. The employee also pays income tax on that bonus, but would then receive the benefits tax free.

Question 17

If the premium is paid by the employee and the contract is owned by the employee, the benefits are _______ and the premiums are ________.

Answer 17

Tax-free / not deductible

Question 18

If the premium payment is paid by the employer under a salary continuation plan, and the contract is owned by the employee, the benefits are______ , and the premiums are ____ by the employer

Answer 18

Taxable /deductible

Question 19

A chronically ill person has been certified as meeting one of the following requirements:

The individual is expected to be unable to perform without substantial assistance from another person, at least _____ activities of daily living for a period of at least ______ days.

Substantial services are required to protect the individual from threats to health and safety, due to substantial cognitive impairment

Answer 19

2 / 90

Eligibility for benefits for long-term care insurance

Question 20

Name the six activities of daily living.

Answer 20

Eating
Bathing
Dressing
Transferring from bed to chair
Using the toilet
Maintaining continence

Question 21

______ policies contain both an elimination period of 30 days to 365 days and a maximum benefit period of two years to lifetime.

Answer 21

Long-term care

Question 22

The provision of a long-term care policy that is generally most important is ______. O

Answer 22

Inflation protection

Question 23

Premiums for long-term care insurance are seldom _______ .

Answer 23

Fully deductible

Question 24

To qualify for skilled nursing facility reimbursement under Medicare, the patients condition must be expected to______ within a predictable time.

Answer 24

Improve

Thus, Alzheimer’s coverage is excluded

Question 25

To qualify for skilled nursing benefits under Medicare part ______, the patient must meet all the following conditions:
-The patient condition requires skilled nursing ,
- The patient has been in the hospital for at least three days in a row before admission to a participating skilled nursing facility.
-The patient is admitted to the skilled nursing facility within a short time (generally within 30 days) leaving the hospital.
-The patient’s care in the skilled nursing facility is for a condition that was treated in the hospital.
_ a medical professional certifies that the patient needs and receives skilled nursing care.

Answer 25

Part A

Question 26

_______ is jointly financed by federal and state governments and administered by the states

Answer 26

Medicaid

Question 27

Other than LTC insurance, what other means provides nursing home care coverage for longer than 100 days?

Answer 27

Medicaid

Medicare is limited to 100 days. A Medicare supplement policy or a Medigap policy may provide for a rehabilitation stay, but not for nursing home coverage.

Question 28

Individuals are generally in eligible for Medicaid coverage, if they give money or assets away within_______ of incurring nursing home expenses.

Answer 28

5 years

Question 29

People are in eligible for Medicaid if they have more than approximately _______ in-home equity.

Answer 29

$650,000 in 2023

Question 30

Medicaid recipients, who have annuities, must name ________ as a remainder beneficiary to cover expenses.

Answer 30

The state