Shared Flashcard Set

Details

Health Insurance
State Health Insurance Exam Practice Set
22
Business
Professional
06/27/2010

Additional Business Flashcards

 


 

Cards

Term
What are the two major causes of loss under a health insurance policy?
Definition
Accidental Bodily Injury and Sickness
Term
What are the four types of losses and benefits?
Definition
Loss of Income From Disability
Medical Expense
Dental Expense
Long-Term Care Expense
Term
There are two separate types of insurance included in the generic term "health insurance" What are they?
Definition
loss of income and expenses related to health care.
Term
What are the three most important underwriting factors considered in in accepting or classifying health insurance applicants?
Definition
Occupation
Moral or Morale Hazards
Physical Condition of the Applicant
Term
Why man an underwriter's attitude toward group risks be less restrictive than with individual policies?
Definition
Group policies are subject to annual reevaluation on the anniversary date.
Term
Private insurance companies provide much of our individual and group health insurance. The Federal Government, however, provides coverage for...
Definition
some disabled individuals and those over age 65 in the form of Medicare.
Term
Medicaid offers assistance as both a ____ and _____ sponsored program.
Definition
Federal and State
Term
What's the difference between limited and comprehensive insurance?
Definition
Limited health insurance policies only cover specific accidents and diseases. A comprehensive plan would cover all sickness or accidents that are not specifically excluded.
Term
The limited policy notice must be what?
Definition
plainly state on the first page of the policy "THIS IS A LIMITED POLICY"
Term
What are the 7 types of Limited Policies?
Definition
Accident-Only
Specified (Dread) Disease
Hospital Indemnity (Income)
Credit Disability
Blanket Insurance
Prescription Drugs
Vision Care
Term
What's a Hospital Indemnity policy provide?
Definition
Set amount of money on a daily, weekly, or monthly basis. Based upon the number of days confined in a hospital, irrespective of medical expenses incurred.
Term
What's a credit disability policy?
Definition
In case of disability, payments to the creditor will be made for them until able to return to work by the definition of the policy.
Term
What is blanket insurance?
Definition
Insurance for a particular group when participating in a particular activity. Often the individual's name is not known.
Term
What is a Prescription Drug policy?
Definition
An optional benefit under a group policy in which the insured pays a co-payment, insurer pays balance. There are limits on the amount of drugs purchased.
Term
Name the 7 common exclusions from coverage?
Definition
Pre-existing conditions
Intentionally self-inflicted injuries
War or an act of war
Elective cosmetic surgery
Conditions covered by workers compensation
Government plans
Participation in criminal activity
Term
When may the Elective Cosmetic Surgery exclusion non apply?
Definition
When due to correct a condition due to an accident or due to birth defect.
Term
Pre-existing conditions are conditions for which in the insured has received diagnosis, advice, care, or treament during the last ___ months prior to the application.
Definition
Six (months)
Term
Under the Pre-existing Conditions Exclusion, group health may be put on probation for ___ months unless there is creditable coverage within the last ___ days.
Definition
12 (months), 62 (days)
Term
It is an unfair trade practice to make any statement that an insurer's policies are guaranteed by the existence of the...
Definition
Life and Health Guaranty Association
Term
What does malingering mean?
Definition
To feign an illness or other incapacity to avoid duty or work.
Term
A "notice to the applicant" must be issued to all applicants for health insurance to inform them of what?
Definition
The insurer will obtain credit history and past history/applications with other health insurers.
Term
Any change in an insurance application must be made in two ways:
Definition
cross out the incorrect answer and write the correct answer in, or start with a fresh application.
Supporting users have an ad free experience!