Types Of Health Policies

Front 1

__________________ is another name for a primary care physician in an HMO?

Back 1

GateKeeper

Front 2

__________________best describes the “first-dollar coverage” principle in basic medical insurance?

Back 2

The insured is not required to pay a deductable

Front 3

Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within

Back 3

90 days

Front 4

Under the Accidental Death and Dismemberment (AD&D) coverage, what type of benefit will be paid to the beneficiary in the event of the insured’s accidental death?

Back 4

Adult Day Care

Front 5

An insured is hospitalized with a back injury. Upon checking his disability income policy, he learns that he will not be eligible for benefits for at least 30 days. This would indicate that his policy was probably written with a 30-day

Back 5

Elimination period

Front 6

Which of the following is true regarding optional benefits with long-term care policies?

Back 6

They are available for an additional premium

Front 7

A small business owner is the insured under a disability policy that funds a buy-sell agreement. If the owner dies or becomes disabled, the policy would provide _________________?

Back 7

Cash to the owner's business partner to accomplish a buyout

Front 8

_________________would be an example of a limited accident and health insurance policy

Back 8

dread disease policy

Front 9

A hospital indemnity policy will pay

Back 9

the benefit for each day the insured is in the hospital

Front 10

Occasional visits by ___________medical professionals will NOT be covered under LTC's home health care?

Back 10

attending physician

Front 11

Anna loses her left arm in an accident that is covered by her Accidental Death and Dismemberment policy. What kind of benefit will Anna most likely receive from this policy?

Back 11

The capital amount in a lump sum

Front 12

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?

Back 12

Probationary period

Front 13

_____________________ regarding Business Overhead Expense policies is NOT true?

Back 13

Benefits are usually limited to six months.

Front 14

regarding Business Overhead Expense policies is TRUE?

Back 14

• Premiums paid for BOE are tax-deductible.
  
• Any benefits received are taxable to the business.
  
• Leased equipment expenses are covered by the plan.
  

Front 15

___________________ provides coverage on a first-dollar basis?

Back 15

Basic Expense

Front 16

What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan?

Back 16

Diagnostic and preventive care

Front 17

Social Security Supplement (SIS) or Social Security Riders are used to supplement or replace benefits that might be payable under Social Security Disability. In what situation would these NOT provide for the payment of income benefits?

Back 17

When the amount payable under Social Security is more than the amount payable under the rider.

Front 18

_______________long-term care coverages would allow an insured to receive care at home

Back 18

Skilled Care

Front 19

In comparison to a policy that uses the accidental means definition, a policy that uses the accidental bodily injury definition would provide a coverage that is

Back 19

Broader in general.

Front 20

benefits of a POS plan?

Back 20

• It allows the employee to use a doctor not covered under the HMO.
  
• With the Point-Of-Service plan the employees do not have to make a decision between the HMO or PPO plans that lock them in.
  
• It allows the employee to use an HMO provided doctor.
  

Front 21

_________________ is true regarding a flexible spending account?

Back 21

• It is a cafeteria plan.
  
• It operates on “use-or-lose” basis.
  
• It provides an opportunity to receive benefits on a pretax basis.
  

Front 22

The gatekeeper of an HMO helps to

Back 22

Control the specialists costs

Front 23

In long-term care (LTC) policies, as the benefit period lengthens, the premium

Back 23

Increases

Front 24

________________ are differences between individual and group health insurance

Back 24

• In individual policies, the individual selects coverage options, while in a group plan all employees are covered for the same coverage which is chosen by the employer.
  
• Individual coverage can be written on an occupational or nonoccupational basis; group plans cover only nonoccupational.
  
• Individual policies are renewable at the option of the insured, while group usually terminates when the individual leaves the group.
  

Front 25

An insured has an Accidental Death & Dismemberment policy with a principal value of $50,000. He loses sight in both eyes in a hunting accident. How much will he receive?

Back 25

$50,000

Front 26

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 monthly premium for COBRA coverage?

Back 26

$102