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16 Cards in this Set
- Front
- Back
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In group insurance, what is the name of the policy? |
Master policy |
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What types of groups are eligible for group health insurance? |
Employer-sponsored and association-sponsored groups |
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What do individual insureds receive as proof of their group health coverage? |
Certificate of Insurance |
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How many members must an association have to qualify for group insurance? |
100 members |
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What is a birthday rule in a coordination of benefits provisions? |
Coverage of the parent whose birthday is earlier in the year is considered primary. |
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What is a probationary period in a group health insurance? |
The period of time that must lapse before an employee is eligible for group health coverage. |
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How do insurers determine the cost for a group health policy? |
The main variables are the ratio of men and women in the group, and the average age of the group. |
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Who are the parties in a group health contract? |
The employer and the insurer |
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According to the Coordination of Benefits provision, if both parents have coverage for a child from their employers policies, which policy will pay first? |
The order of the payment will be determined by the birthday rule |
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If a group health policy covers individuals that reside in more than one state, which state has jurisdiction over the group policy? |
The state in which the policy was delivered |
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Does group health insurance require medical examinations? |
No, the underwriter evaluates the group as a whole, rather then each individual member |
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In group insurance, who is issued a certificate of insurance? |
Individual Insured |
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If the insureds share in the cost of health insurance premiums with the employer, this would be known as what type of group health plan? |
Contributory |
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What is the purpose of COBRA? |
To allow continuation of health insurance coverage for terminated employees |
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In health insurance, when would an excess plan pay benefits? |
After the primary pan had paid its full promised benefit. |
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Multiple Employer Welfare Arrangement (MEWA) |
A joining together by employers to provide health benefits for employee |
