Hmo-Pos

Front 1

HMO-POS

Back 1

The Plan is like a combination of the HMO & PPO plans. You are required to designate an In-Network Physician to be your Primary Health Care Provider. You may go out of Network, Bur in doing so you will have to pay most of the costs yourself.

Front 2

HMO.HEALTH Maintenance. .ORG

Back 2

Group Managed Health Insurance

Where you will need to receive most of all of your health care from a Network Provider.

HMOs : Require that you select a (Primary Care Physician). (PCP) which is responsible for managing and coordinating all of your Health Care.

Front 3

INDIVIDUAL

INSURANCE-COVERAGE

Back 3

Individual is available from most of the same Insurers that provide Group Coverage.

Front 4

LIFE - INS - PREMIUMS

LIFE INSURANCE PREMIUMS ARE CALCULATED (Based on what (3) Factors.

Back 4

1. Mortality-Factor

2. Expense Factor

3. Interest Factor

Front 5

INTEREST-FACTOR

Back 5

Insurance Companies Invest their Premiums they receive in effort to earn Interest. “The Interest allows Insurers to lower Insurance Rates.

Front 6

EXPENSE - FACTOR

Back 6

Also known as a “Loading Charge”. This Factor is used to Calculate Premiums by Assessing Operative Cost of the Business.

Front 7

POLICY- MODE

POLICY FEATURES

Back 7

Refers to the Policy Features that permits the Policy Owner to Select “ The Timing of Premium Payments.

Annually-Semi Annually-Quarterly

Front 8

MORTALITY-FACTOR

(Measures No# of Deaths in a given Population)

Back 8

Based on the “Prediction” of Life Expectancy and “Probability of Death for a given Group”.

Front 9

Social Security Hospital-Insurance & Supplemental Insurance

Back 9

1. Known as - (Medicare)

2. Agent Sales and Marketing

Practices.

Agent determines the clients needs and Determines which is best suited to address those needs.

Front 10

ACTUARIAL - DEPT

Back 10

Calculates “Policy Rates” Reserves & Dividends” Makes other Applicable Statistical Studies Studies, and Reports Focusing On Morbidity”

Condition of Being Diseased

And Mortality Tables.

Front 11

POLICY

Back 11

Describes Parameters of “Covered & Non-Covered Parameters, Defines what your Coverage is.

Front 12

CLAIM

Back 12

Official Documentation of an Inquiry with the Ins. Co.

Front 13

CARRIER

Back 13

Company which Insures the Individual.

Front 14

PRIMARY.INS.POLICY

Back 14

Carrier who Insures you First.

Front 15

SECONDARY INS.CO

Back 15

Activated when Primary does not cover all “Costs”.

Front 16

E.O.B

Back 16

Explains what was “Charged and then what was Paid”

Front 17

DEDUCTIBLES

Back 17

Amount of Dollars-Which is the Insured Person’s Responsibility (from $o-?). Pay up front Similar to Co-Pay.

Front 18

PROVIDER

Back 18

The Place that Charges you.

Point of Service (Hospital Doctors Office)

Front 19

PREMIUM

Back 19

Amount Paid to have the Ins Policy.