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5 Cards in this Set
- Front
- Back
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When one party may receive much more from a contract than the other party gives in exchange. this is known as what type of contract? |
An aleatory contract.
The term aleatory defines two unequal parts. Insurance contracts are aleatory contracts*premiums vs benefit. |
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Which of the following statements about Medicare Part B is correct? |
There is no statutory limit on the amount of the Part B co-insurance.
Enrollment in Part B is optional, at a monthly premium. Part B pays 80% of eligible medical expenses after a $100 annual deductible but the 20% co-insurance has no cap. |
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The Affordable Care Reform Act madates all employers employing ____ or more full time employees must provide health care insurance for their workforce. If an employer, with this size workform refuses to comply with this mandate, the employer will be: |
50/ fined $2000 per worker per year if any worker receives federal subsidies to purchase health insurance is
This is a federal mandate enforced by the I.R.S. However, current mandates under the ACT are subject to change. |
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2nd surgical opinions, precertification, concurrent and retrospective reviews, and out patient/ambulatory services are all elements of a cost-containment system commonly known as: |
Case Management
Cost containment provisions are an effort to manage and control costs associated with a health claim under the concept called case management. |
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Disability income policies generally show a benefit amount as: |
A dollar amount stated in the declartions.
Policies must state the actual benefits payable in dollars in the declaration pages. Also, almost all states require benefits to be payable no less frequently than monthly. |
