Lifeexam-Ch5

Front 1

franchise(wholesale)

Back 1

mater policy not issued and indiviudal policies are issued. may require insurability. minimum number of participants

Front 2

group(6)

Back 2

1.employer issued master policy/employee gets certificate of insurance.
2. no insurability. factors are size of group, average age. together other than cheap insurance and 31 grace period
3. GREATEST concern is adverse selection
4. conversion period of 31 days which can go to individaul without insurability
5. renewable term basis and incontesability clause of 2 years
6. continuation after retirement with employe paying equal premium and employee pays for reduced benefit

Front 3

types of group- single employer(4)

Back 3

1. partnerhsip, corp, or sole
2. contributory- employee contribute with 75% participatin
3. contributory- all employer pays but 100% participation
4. full time employe, subsidiary, or eligible
5. if doesnt enroll when first eligible must wait to open or provide proof of insurability

Front 4

types of group-labor unions(3)

Back 4

1. benefit of someone other than union
2.taft-hartley act says cannot turn funds over to union, seperate fund must be set up to manage
3. some plans come BOTH fund and union

Front 5

type so group-METs mutiple empoloyer trusts

Back 5

1. sponsored by insurers, independeatn admins, or 2 more employers of SAME industry
2. sponsor desgins plan and selects groups to participate
3. each MET has a trustee with all transaction through it
4. entire group is experience rated....greater credibility
5. MET members do NOT have to purchase all benefits
6. most METS are self insured and dont name insurere as admin. BUT if MET is insured, it can be admined by insurere

Front 6

types of group-industrial (home service)

Back 6

to low income workers with med exam. face usually less than 1K for funereal costs.

Front 7

facility of payment clause

Back 7

insurere can pay to any relative or anyone it deems entitled to benefits in absence of beneficiary

Front 8

funding of SS

Back 8

1. both employee and employer through FICA
2. self-employed pay equal to employer and employee
3. fund managed by 2 public trustee and sec's of treasury, laobr HHS
4. actuarial value of contributions are NOT related to amount of benefits
5. NOT fully funded and provideds only MINIMAL base of income

Front 9

SS - fully insured status

Back 9

1. 40 quarters of covered employement since 1936. if insured is 21 after 1950 fully insured if 6 quarters of covered employement with 1 quarter of each year over age 21

Front 10

benefits under fully insured status

Back 10

1. retirement at age 62 or older
2. spouse retirement at age 62
3. dependent child of retired worker
4. spouse of retired at ANY age if caring for dependent child
5. widower age 60, or 50 if disablied
6. dependent parent or deceased coworker

Front 11

SS-currently insured

Back 11

6 quarters druing full 13 quarter period ending in which he/she does, disabled, or eligible for benefits. only benefits at death are childs, mother and father, and lump sum death of $255

Front 12

4 types of SS benefits

Back 12

1. retirement-age 65 or reduced benefit at 62
2. death/survivor-benefit to family of covered
3. disability income- benefit to covered worker and dependents
4. medicare- cover health insurance for qualifying

Front 13

how are survivor benefits calculated

Back 13

Primary insurance amount PIA.

Front 14

whens widow blackout period

Back 14

youngest child is 16