VII. Group Health Insurance

Question 1

In group health insurance, what does the employee receive which shows the amount of coverage?

Answer 1

Certificates of insurance

Question 2

What types of groups are eligible for group insurances?

Answer 2

2 types: employers sponsored and association sponsored.

Question 3

With group health insurance, who provides coverage?

Answer 3

employer

Question 4

What is a multiple employer trust? describe the general circumstances of the people/groups who tend to comprise the METs

Answer 4

Individuals or small groups in the same or similar fields that join together to get enough members to qualify for group rates.

Question 5

According to the Coordination of Benefits (cob) provision, if both parents have coverage where they are employed, under who are the dependents covered and for how long?

Answer 5

If both parents have the children listed under their plans, that which ever parent is born earlier in the year is considered the primary.

Question 6

Under Cobra, when are dependents covered and for how long?

Answer 6

extended up to 18 months. For events such as death, divorce or legal separation the period is 36 months for dependents.

Question 7

What are the requirements for terminated employees to convert the group health insurance to an individual plan without evidence of insurability?

Answer 7

Have to sign up within 31 days (the conversion period),
Insurer can determine standard or substandard but may not deny coverage,
It will have lesser benefits and a higher premium.

Question 8

When a group health plan is terminated, how long is an extension of benefits provided for any totally disabled employee or dependent?

Answer 8

12 months

Question 9

When ees are actively at work on the date coverage can be transferred to another insurance carrier, what happens to coinsurance and deductibles?

Answer 9

They carry over from the old plan to the new