What is an important feature of a dental expense insurance plan that is not typically found in a medical expense insurance plan?
Diagnostic and preventive care
What IS TRUE regarding HMO coverage?
It is divided into geographic territories
What type of hospital policy pays a fixed amount each day that the insured is in a hospital?
Indemnity
A small company offers group health insurance to its employees, but recently has decided to terminate the health insurance contract, leaving the workers without insurance. What can the employees do regarding their insurance?
Convert to an individual health policy
What is the initial period of time specified in a disability income policy that must pass, after the policy is in force, before a loss can be covered?
Probationary period
Benefit periods for individual short-term disability policies will usually continue from
6 months to 2 years
In long-term care (LTC) policies, as the benefit period lengthens, the premium
increases
Occasional visits by what medical professionals will NOT be covered under LTC's home health care?
Attending physician
The insured's health policy only pays for medical costs related to accidents. What type of policy does the insured have?
Accident-only
Concerning Accidental Death and Dismemberment coverage, what what would NOT be a correct statement?
Death benefits are paid only if death occurs within 24 hours of an accident
The corridor deductible derives its name from the fact that it is applied between the basic coverage and the
Major medical coverage
What is NOT true regarding key person disability income insurance?
Premiums are tax deductible as a business expense.
Kevin and Nancy are married; Kevin is the primary breadwinner and has a health insurance policy that covers both him and his wife. Nancy has an illness that requires significant medical attention. Kevin and Nancy decide to legally separate, which means th
COBRA
Todd has been informed that he has a hernia which requires repair. When Todd researches the cost, he learns that his insurance plan will cover 200 points worth of surgical expenses. Each point represents $10, which means that $2000 of his surgery will be
Relative value
What is the period of coverage for events such as death or divorce under COBRA?
36 months
What would basic medical expense coverage NOT cover?
Surgeon's services
Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital?
Indemnity
A typical Accidental Death & Dismemberment policy covers all of the following losses EXCEPT
Income
What accurately describes group disability income insurance?
The extent of benefits is determined by the insured's income
A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is known as
Critical illness
What type of dental plan is incorporated into a major medical expense plan is a/an
Integrated dental plan
In diability income insurance, the time between the onset of an injury or sickness and when benefits begin is known as the
elimination period
An employee insured under a group health plan has been paying $25 monthly premium for his group health coverage. The employer has been contributing $75, for the total monthly cost of $100. If the employee leaves the company, what would be his maximum mont
$102
A small hardware store owner is involved in a car accident that renders him totally disabled for half a year. What type of insurance would help him pay for expenses of the company during the time of his disability?
Business overhead expense (BOE) policy
What is considered a presumptive disability under a disability income policy?
Loss of two limbs
The gatekeeper of an HMO helps
Control specialist costs
What is NOT a characteristic or a service of an HMO plan?
Contracting with insurance companies.
(HMOs seek to identify medical problems early by providing preventive care. They encourage early treatment and whenever possible provide care on an outpatient basis rather than admitting the member into the hospital.
What statement regarding Business Overhead Expense policies would NOT be true?
Benefits are usually limited to six months.
(The purpose of reimbursing the policyholder for business overhead expenses during a period of total disability.)
If a business owner becomes totally disabled, a Business Overhead Expense policy will pay all of the following EXCEPT
loss of the owner's income
Which of the following special policies cover unusual risks that are NOT normally included under Accidental Death and Dismemberment Coverage?
Special Risk Policy
An Insured is covered by a disability income policy that contains an accidental means clause. The insured exits a bus by jumping down the steps and breaks an ankle. What coverage will apply?
No coverage will apply, since the injury could have been foreseen.
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?
$120 a day
Which of the following is true regarding inpatient hospital care for HMO members?
Care can be provided outside of the service area
Which of the following statements is NOT correct concerning the COBRA Act of 1985?
It requires all employers, regardless of the number or age of employees, to provide extended group health coverage.
Which of the following special policies covers unusual risks that are NOT normally included under Accidental Death and Dismemberment coverage?
Special Risk Policy