Types of Health Insurance PART 1

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  1. 1. Contracts that are prepared by
    one party and submitted to the other party on a "take it or leave it"
    basis are classified as
    • A
    • Contracts of adhesion.

    B Unilateral contracts.

    C Aleatory contracts.

    D Binding contracts.



    • Insurance policies are written by
    • the insurer and submitted to the insured on a "take it or leave it"
    • basis. The insured does not have any input into the contract, but simply
    • adheres to the contract.
  2. 2.
    Insurable interest can be best described by which of the following?
    • A It is not necessary for the
    • insured to be aware of the insurable interest or give permission for the insurance
    • that is to be written

    • B
    • The applicant must experience a financial loss due to an accident or sickness
    • that befalls the insured.

    • C The insured must be genuinely
    • interested in the life of the applicant.

    • D All beneficiaries need to have
    • notification of their status.



    • Insurable interest means that the
    • applicant must experience a financial loss when the insured is hurt or sick.
    • Insurable interest is only needed by the applicant and only at the time of
    • application.
  3. 3. When a client is considering
    replacing existing health insurance, all of the following would be areas of
    concern EXCEPT
    A Waivers for impairments.

    • B
    • Reciprocity.

    C Time limit on certain defenses.

    D Pre-existing conditions.



    • When a new health insurance policy
    • is issued, the insurer may contest statements on the application for 2 years.
    • Also, certain claims could be denied because of waivers for impairments or
    • pre-existing conditions provisions in the policy. Reciprocity refers to writing
    • insurance across state lines.
  4. Which of the following would be an
    example of a limited accident and health insurance policy?
    A A long-term care policy

    • B
    • A dread disease policy

    C An automobile liability policy

    D A Medicare policy



    • Limited risk policies cover specific
    • illness or accidents.
  5. 5
    This arrangement specifies who will
    purchase a disabled partner’s interest in the event he or she becomes disabled.
    A Business overhead expense

    B Key-person insurance

    C Employee benefit plan

    • D
    • Disability buyout



    • Incorrect! 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.
  6. 6. Which of the following LTC
    Coverages would NOT encourage an insured to receive care at home?



    A Respite Care

    B Home Health Care

    C Adult Day Care

    D
    Residential Care
    • Respite care, home health care, and
    • adult day care are all coverages used to reduce the necessity of admission into
    • a care facility.
  7. 7. Which statement accurately
    describes group disability income insurance?



    A There are no participation
    requirements for employees.

    B Short-term plans provide benefits
    for up to 1 year.

    C
    The extent of benefits offered is determined by the insured’s income.

    D In long-term plans, monthly
    benefits are limited to 75% of the insured’s income.
    • Group plans usually specify the
    • benefits based on a percentage of the worker’s income. Short-term group plans
    • usually provide maximum benefit periods of 13 to 26 weeks. Group long-term
    • plans provide monthly benefits usually limited to 60% of the individual’s
    • income. Group disability plans also have minimum participation requirements -
    • usually the employee must have worked for 30 to 90 days before they become eligible
    • for coverage.
  8. 8. Long term care coverage may be
    sold in all of the various ways EXCEPT



    A Endorsement to life policy.

    B
    Endorsement to health policy.

    C Group long term care.

    D Individual long term care.
    • Long-term care insurance policies
    • may be purchased on an individual or group basis, or as an endorsement to a
    • life insurance policy.
  9. 9. After a person's employment is
    terminated, it is possible to obtain individual health insurance after losing
    the group health coverage provided by the employer. Which of the following is
    NOT true?



    A The employee can convert from
    group to individual insurance within 31 days of termination.

    B The premium of the individual
    health insurance policy can be higher than the original policy.

    C
    By law, the new, individual policy must provide the same benefits as the group
    insurance policy.

    D Continuation of group coverage
    need not include dental, vision, or prescription drug benefits.
    • Terminated employees have 31 days to
    • convert to an individual health insurance policy, without having to provide
    • proof of insurability. The insurer can adjust the new, individual health
    • policy’s premium as it sees fit, as long as coverage is provided. The new
    • policy could offer lesser benefits than the original group health policy.
  10. 10. All of the following are correct
    about the cancellation of an individual health policy EXCEPT



    A
    X Unearned premiums are retained by the insurance company.

    B Cancellation is on a
    "short-rate" basis if insured cancels.

    C Claims incurred before
    cancellation must be honored.

    D An insurance company may cancel
    upon meeting statutory requirements.
    • Any unearned premium must be
    • returned to the policyholder. If the insured requests cancellation, the
    • unearned premium will be returned on a "short rate" basis. If the
    • insurer cancels, the unearned premium will be returned on a 'pro rata' basis.
  11. 11. Teresa pays a monthly premium of
    $100 for her health insurance. What would be the duration of the grace period
    under her policy?

    A 60 days

    B 7 days

    C
    X 10 days

    D 31 days
    • The grace period is seven days if
    • paid weekly, 10 days if paid monthly, 31 days for all other modes.

Card Set Information

Author:
skarlet90
ID:
77379
Filename:
Types of Health Insurance PART 1
Updated:
2011-04-05 22:06:19
Tags:
Health Insurance Policies Underwriting Riders
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Description:
Health Insurance
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