Medical Plans

Question 1

Accidental bodily injury

Answer 1

an unforeseen and unintended injury that resulted from an accident rather than a sickness

Question 2

Cafeteria plan

Answer 2

type of employee benefit plan that allows insureds to choose between different types of benefits

Question 3

Cancellation

Answer 3

termination of an in-force insurance policy, by either the insured or the insurer, prior to the expiration date shown in the policy

Question 4

Comprehensive coverage

Answer 4

health insurance that provides coverages for most types of medical expenses

Question 5

Deductible

Answer 5

a specified dollar amount that the insured must pay first before the insurannce company will pay the policy benefits

Question 6

Lump sum

Answer 6

a payout method that pays the beneficiary the entire benefit in one payment

Question 7

Nonrenewal

Answer 7

termination of an insurance policy at its expiration date by not offering a continuation of the existing policy or a replacement policy

Question 8

Riders

Answer 8

added to the basic insurance policy to add, modify, or delete policy provisions

Question 9

Sickness

Answer 9

an illness, which first manifests itself while the policy is in force

Question 10

Tax exempt

Answer 10

not subject to taxation

Question 11

Taxable

Answer 11

subject to taxation

Question 12

Underwriting

Answer 12

risk selection and classification process

Question 13

Fee-for-service Plans

Answer 13

providers receive a payment for their billed charges for each service provided

Question 14

Prepaid Basis

Answer 14

provide medical and hospital benefits in the form of service rather than dollars

Question 15

Specified Coverage Policies

Answer 15

are those that insurance policies that limit coverage to one illness or one limiting group of coverages, e.g., cancer policies, prescription drug coverage, dental coverage, and other limited plans

Question 16

Comprehensive Care Policies

Answer 16

are those plans that provide coverage for most types of medical expenses

Question 17

What does HMO stand for?

Answer 17

Health maintenance organizations

Question 18

What does PPO stand for?

Answer 18

Preferred provider organization

Question 19

Medical Expense Insurance

Answer 19

Basic hospital, surgical, and medical policies, and major medical policies are commonly known as

They provide benefits for the cost of medical care that results from accidents or sickness

Question 20

3 Basic coverages

Answer 20

1. Hospital
2. Surgical
3. Medical

usually called first dollar coverage (usually do not require the insured to pay a deductible.

usually have more limited coverage than the Major Medical Policies