Module 4

Question 1

Benefits intended to
address the primary needs
of most of the group
members.

Answer 1

Core benefits

Question 2

Additional voluntary
benefits generally fully
paid for by the plan
member.

Answer 2

optional benefits

Question 3

Benefits that reflect needs
that influence an
individual’s well-being and
work productivity.

Answer 3

Ancillary benefits

Question 4

Provisions in a master
contract addressing
definitions, eligibility
requirements,
commencement and
termination of insurance.

Answer 4

insuring provisions

Question 5

Provisions in a master
contract addressing
waiver of premium,
definition of disability
qualifying period, benefit
period.

Answer 5

benefit provisions

Question 6

Provisions in a master
contract addressing
requirements and
processes for
adjudication and
settlement of claims.

Answer 6

claims provisions

Question 7

Provisions in a master
contract addressing
obligations for paying
premium, including
grace period.

Answer 7

premium provisions

Question 8

Lump sum benefits to
mitigate financial losses
due to death of a
covered person.

Answer 8

death benefits

Question 9

Protection against loss of
income in the event of
illness or injury resulting in
disability.

Answer 9

income replacement benefits

Question 10

Non-cash compensation
that protects against
expenses arising from
unexpected or ongoing
medical conditions.

Answer 10

EHC benefits

Question 11

A benefit plan where the
plan sponsor makes all
the decisions about what
benefits to provide.

Answer 11

traditional benefits

Question 12

Benefits that plan
members can choose to
supplement coverage in
certain areas and pay for
through payroll
deduction.

Answer 12

add-ons

Question 13

A plan that provides
members with at least
two predefined benefit
modules or packages.

Answer 13

modular flex

Question 14

A plan that offers a wide
range of different
options to plan
members.

Answer 14

full flex

Question 15

A plan that gives plan
members extensive
choice, including pay,
benefits,
pension/retirement
contributions and
vacation.

Answer 15

total rewards flex

Question 16

The amount a covered
individual must pay
before any
reimbursement on
expenses.

Answer 16

deductibles

Question 17

Percentage of eligible
expenses that is eligible
for reimbursement under
the benefits plan.

Answer 17

coinsurance

Question 18

Internal or overall limits
on amount of benefit
that may be paid to any
one eligible person
covered by the plan.

Answer 18

maximums

Question 19

Limits on the dispensing
fee portion of a drug
claim to a maximum
specified amount.

Answer 19

caps

Question 20

In a master contract,
provisions addressing
issues including
conformity to legislation
and disclosure provisions.

Answer 20

general provisions

Question 21

Under a multi-employer
plan, the crediting of
excess hours over the
minimum required for
eligibility for benefits in a
specified period.

Answer 21

hour bank

Question 22

Description of how much
benefit will be provided
for each type of benefit,
including deductible,
maximums.

Answer 22

benefit schedule

Question 23

Once in a lifetime lump
sum payment to an
insured who has been
diagnosed with and
survived a life
threatening illness.

Answer 23

CI insurance