Types of Health Insurance Policies - 18% Flashcards
Health Savings Accounts (HSAs) are designed to
A. Provide duplicate coverage for health care expenses
B. Help individuals save for qualified health expenses
C. Increase individual interest income
D. Insure against catastrophic losses
HSAs help individuals save for qualified out-of-pocket health care expenses such as the deductible expense from a high deductible health plan
An association could buy group insurance for its members if it meets all of the following requirements EXCEPT
A. Has a constitution and by-laws
B. Holds annual meetings
C. Is contributory
D. Has at least 50 members
All of the above characteristics would make a association group eligible for buying group insurance, except the group must have at least 100 members
Long-term care insurance policies must cover which of the following?
A. Alzheimer’s disease
B. All mental disorders
C. Treatment of Alcoholism
D. Injuries caused by an act of war.
Most long-term care policies exclude coverage for drug and alcohol dependency, acts of war, self-inflicted injuries and non-organic mental conditions. Organic cognitive disorders such as Alzheimer’s disease, senile dementia and Parkinson’s disease are covered.
At what age may an individual make withdrawals from an HSA for non-health purposes with out being penalized?
A. 55
B. 59 1/2
C. 62
D. 65
After age 65, a withdrawal from an HSA used for a non-health purpose will be without a penalty, although taxed.
This arrangement specifies who will purchase a disabled partners interest in the event he or she becomes disabled.
A. Employee benefit plan
B. Disability buyout
C. Business overhead expense
D. Key-person insurance
The disability buyout agreement specifies who will purchase a disabled partner’s interest and legally obligates that person or party to purchase such interest upon disability.
COBRA applies to employers with at least
A. 20 employees
B. 80 employees
C. 60 employees
D. 50 employees
Under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), any employer with 20 or more employees must extend group health coverage to terminated employees and their families.
All of the following are true regarding key person disability income insurance except
A. The employer receives the benefits if the key person is disabled
B. The employer pays the premiums.
C. The employee is the insured.
D. Premiums are tax deductible as a business expense
In key person disability insurance, the contract is owned by the business, the premium is paid by the business, and the business is the beneficiary. The key person is the insured, and the business must have the key person’s consent to be insured in writing.
which type of a hospital policy pays a fixed amount each day that the insured is in the hospital?
A. Surgical
B. Blanket
C. Medigap
D. Indemnity
A Hospital Indemnity policy pays a fixed amount each day the insured is hospitalized, unrelated to medical expenses.
In long-term care insurance, what type of care is provided with intermediate care?
A. Daily care, but not nursing care
B. Intensive care
C. Occasional nursing or rehabilitative care
D. Nonmedical daily care
Intermediate care is nursing and rehabilitative care provided by medical personnel for stable conditions that require assistance on a less frequent basis than skilled care.
Hospital indemnity/hospital confinement indemnity policy will provide payment based on
A. The premiums paid into the policy
B. The medical expense incurred
C. The number of days confined in a hospital
D. The type of illness
Hospital indemnity/hospital confinement indemnity policy provides payment based only on the number of days confined in a hospital.
Which statement accurately describes group disability income insurance?
A. Short-term plans provide benefits for up to 1 year
B. The extent of benefits is determined by the insured’s income.
C. In long-term plans, monthly benefits are limited to 75% of the insured’s income.
D. There are no participation requirements for employees
Group plans ussually specify the benefits based on a percentage of the worker’s income group long-term plans provide monthly benefits usually limited to 60% of the individual’s income.
The period of time immediately following during which benefits are not payable is
A. The probationary period
B. The grace period
C. The blackout period
D. The elimination period
The elimination period is a waiting period, expressed in days, not dollars, imposed on the insured from the onset of disability until benefit payments commence
If a dental plan is integrated, it is combined with what type of plan?
A. Medical
B. Secondary dental
C. Supplemental
D. Life
Integrated plans allow for dental plans to be included in a medical plan, providing coverage for both under a single contract. Sometimes the deductibles are merged, but this does not have to be the case.
An insured’s long term care policy is scheduled to pay a fixed amount of coverage of $120 per day. The long-term care facility only charged $100 per day. How much will the insurance company pay?
A. 80% of the total cost
B. 20% of the total cost
C. $120 a day
D. $100 a day
Most LTC policies will pay the benefit amount in a specific fixed dollar amount per day, regardless of actual cost of care.
Which of the following would and accident-only policy NOT cover?
A. Surgery to repair a wrist damaged by tendonitis.
B. Hospitalization costs due to a boating accident
C. Death from a motorcycle accident
D. Amputation of a leg that was burned during a house fire
Accident-only policies cover medical costs caused by accidents, not sickness. Because the wrist was damaged by a sickness, not an accident, the policy would not cover any medical claims relating to surgery or the condition itself.
