A(n) _________________ is issued to the sponsor of the group, and employees receive an outline of coverage or other summary of benefits, which offers information about the plan's major benefits and principal exclusions.
Master policy
A Taft-Hartley Trust would be formed to provide health and welfare benefits to which of these employees?
Union-represented
All of the following are correct regarding an employer group health insurance plan's eligibility requirements EXCEPT:
Employees can enroll at any time without restrictions
In noncontributory group health plans, how many eligible employees must be covered by the plan?
100%
The employees of a corporation must each pay a portion of the premium for their group insurance. This means they are members of a _____________.
Contributory group plan
What can an employee do in order to obtain coverage when they have a pre-existing condition and find that their job was just eliminated?
Utilize the group plan's conversion privilege
What benefit does COBRA provide to employees when an employee is terminated?
Continuation of health insurance at the employee's expense for up to 18 months
How much time after a qualifying event has occurred and notice is given of their right to continue insurance does an employee or dependent have to elect continuation of the group health plan under COBRA?
60 days
What law provides the right of employees to continue health insurance coverage when changing employers by removing any restrictions against waiting periods and coverage in a new group health plan, as long as the employee has had creditable coverage?
HIPAA
Generally, regulatory jurisdiction over a group insurance plan belongs to the insurance commissioner of
The state in which the group contract was delivered to the policyowner
How many employees would an employer require in order to be considered a small employer:
50 or less
When group health insurance is being replaced, ongoing claims under the former policy must continue under the new policy, overriding any preexisting condition exclusion. This is a requirement under which of the following?
No Loss - No Gain Statutes
A small employer health benefit plan may be non-renewed for all of the following reasons, except:
High number of claims
COBRA is a federal law requiring employers with _____ or more employees to provide the option of continuing the employee's existing health coverage for dependents for up to _____ months following qualifying events.
20, 36
Which event does not cause termination of continuing coverage by COBRA?
Premium payments are made in a timely manner
When an individual carries more accident and health insurance than he/she would need for a loss, it is called:
Overinsurance
Under HIPAA, coverage may be non renewed for all of the following reasons, except:
Frequency of claims
The pregnancy discrimination act applies to groups with ______ or more employees.
15
Which of the following is not used to reduce adverse selection?
Establishing a maximum number of participants that can be covered under the plan
What percentage of employee participation is required for a contributory employer group plan?
75%
All of the following are requirements that insurers may place on a group plan to avoid adverse selection, except
Proof of insurability from each employee
An employer may require a former employee who has COBRA coverage to pay up to _____% of the premium
102
Under Small Employer Medical Expense Insurance, the insurer can non renew the health benefit plan for all of the following, except:
High claim frequency
Which of the following is incorrect regarding the group underwriting process?
Adverse selection is not a concern for group contracts
Group health plans usually cover:
Nonoccupational injury or disease
All of the following are true of the Coordination of Benefits Provision under a group plan, except:
In the event children are covered under two group plans, the insurer for the parent who is the oldest is primary, and the other parent's plan is secondary
For an employee to be eligible to participate in an employer's group health insurance plan, he/she must be considered full-time and work a minimum of _____ hours as established by the Affordable Care Act.
30
If a plan offers coverage to dependents, eligible dependents include all children, natural and adopted, married and unmarried, up to age ______.
26
Which statement would be considered inaccurate regarding the underwriting of a group plan?
Contributory plans require 100% employee participation
All of the following are accurate statements, except:
Group insurance normally covers occupational injury or disease
Which provision of group health plans is used to determine primary and secondary coverage when an insured is covered by more than one insurance plan?
Coordination of Benefits