Shared Flashcard Set

Details

RMI3011
Final exam review
58
Insurance
Undergraduate 3
12/13/2011

Additional Insurance Flashcards

 


 

Cards

Term
What are the three approaches that can be used to estimate the amount of life insurance to own?
Definition
The human life value approach
Needs approach
Capital retention approach
Term
Life insurance policies can be classified in two general categories:
Definition
Term insurance provide temporary protection
Cash-value (whole) life insurance has a savings component and builds cash values
Term
A term to age 65 policy
Definition
provides protection to age 65, at which time the policy expires
Term
decreasing term insurance policy
Definition
the face value gradually declines each year
Term
Ordinary life insurance
Definition
a level-premium policy that provides lifetime protection [very basic]
Term
Variable life insurance
Definition
a fixed-premium policy in which the death benefit and cash values vary according to the investment experience of a separate account maintained by the insurer
Term
Universal Life Insurance
Definition
a flexible premium policy that provides lifetime protection
Term
Variable universal life
Definition
combines the features of UL and VL
These policies have relatively high expense charges
Term
Term insurance is appropriate when
Definition
The amount of income that can be spent on life insurance is limited
The need for protection is temporary
The insured wants to guarantee future insurability
Term
A whole life policy is appropriate when
Definition
lifetime protection is needed
You wish to save money for a specific need
Term
ownership clause
Definition
gives rights, such as naming beneficiaries, to the owner of the policy
Term
incontestable clause
Definition
the insurer cannot contest the policy after it has been in force two years
Term
suicide clause
Definition
if the insured commits suicide within two years after the policy is issued, the face amount of insurance will not be paid, premiums are refunded
Term
grace period
Definition
policyholder has a period of 31 days to pay an overdue premium
Term
reinstatement provision
Definition
owner can reinstate a lapsed policy under certain conditions, usually within 3-5 years after lapse
Term
misstatement of age or sex clause
Definition
if the insured’s age or sex is misstated, the amount payable is the amount that the premiums paid would have purchased at the correct age and sex
Term
policy loan provision
Definition
allows the policyowner to borrow the cash value
Term
a participating policy
Definition
pays dividends
Term
Dividends come from three main sources:
Definition
The difference between expected and actual mortality experience
Excess interest earnings
The difference between expected and actual operating expenses
Term
nonforfeiture or cash surrender options
Definition
The policy can be surrendered for its cash value
the cash surrender value can be applied as a net single premium to purchase a reduced paid-up policy
the cash surrender value can be used as a net single premium to extend the full face amount of the policy into the future as term insurance
Term
settlement options
Definition
Pay benefit as a lump sum
Proceeds retained by the insurer, and interest is paid to the beneficiary
Proceeds paid to a beneficiary over some fixed period of time
A fixed amount is periodically paid to the beneficiary until the principal and interest are exhausted
payments are paid as annuity to beneficiary until the beneficiary’s death
Term
An annuity is
Definition
a periodic payment that continues for a fixed period or for the duration of a designated life or lives
Term
A life annuity option
Definition
provides a life income to the annuitant only while the annuitant remains alive
Term
A life annuity with guaranteed payments
Definition
pays a life income to the annuitant with a certain number of guaranteed payments
Term
Fixed annuity
Definition
pays periodic income payments that are guaranteed and fixed in amount; may be deferred or immediate
Term
Variable annuity
Definition
pays a lifetime income, but the income payments vary depending on common stock prices
Term
A traditional IRA
Definition
allows workers to take a tax deduction for part or all of their IRA contributions
The investment income accumulates income-tax free on a tax-deferred basis
Distributions are taxed as ordinary income
Term
A Roth IRA
Definition
is another type of IRA that provides substantial tax advantages
The annual contributions to a Roth IRA are not tax deductible
The investment income accumulates income-tax free
Qualified distributions are not taxable under certain conditions
Term
An IRA rollover account
Definition
is an account established with funds distributed from another retirement plan
Term
qualified plans
Definition
Private plans that meet certain requirements and receive favorable income tax treatment
Term
defined-contribution plan
Definition
the contribution rate is fixed, but the retirement benefit is variable; investment risk falls on the employee!!
Term
defined-benefit plan
Definition
the retirement benefit is known, but the contributions will vary depending on the amount needed to fund the desired benefit; investment risk falls on the employer!!
Term
Under a unit-benefit formula
Definition
both earnings and years of service are considered
Term
Vesting refers to
Definition
the employee’s right to the employer’s contributions or benefits attributable to the contributions if employment terminates prior to retirement
Term
early distribution penalty
Definition
Funds withdrawn from a qualified plan before age 59½ are subject to a 10%
Term
A top-heavy plan
Definition
a retirement plan in which more than 60% of the plan assets are in accounts attributed to key employees
Term
A 401(k) plan
Definition
Contributions accumulate tax-free, and funds are taxed as ordinary income when withdrawals are made
Term
Roth 401(k) plan
Definition
you can make contributions with after-tax dollars, and qualified distributions at retirement are received income-tax free
Term
Section 403(b) plan
Definition
a retirement plan designed for employees of public educational systems and tax-exempt organizations
Term
Group Insurance
Definition
Defined as: more than one person covered under one contract
Cheaper to administer
Individual evidence of insurability is usually not required
Experience rating is used
Term
What do employers require for participation in a group plan?
Definition
Be a full time employee
Satisfy a probationary period
Apply for coverage during the eligibility period
Be actively at work when the coverage begins
Term
group term life insurance
Definition
Provides low-cost protection to employees in the form of yearly renewable term
Term
group universal life insurance
Definition
some employees make this available for their employees
Term
group medical expense insurance
Definition
insurance pays the cost of hospital care, physicians’ and surgeons’ fees, and related medical expenses; in particular, you should know about HMOs
Term
group disability insurance
Definition
pays weekly or monthly cash payments to employees who are disabled from accidents or illness; in particular, you should know about short term disability income insurance
Term
Traditional Health Insurance Plans
Definition
paid medical expenses on an indemnity basis.
These plans have declined in importance over time
Term
Managed care plans
Definition
offer medical expense benefits in a cost effective manner
Includes HMOs, PPOs, POSs, PSOs
Plans emphasize cost control and services are monitored
An employee’s choice of physicians and hospitals may be limited
Utilization review is done at all levels (referrals)
The quality (and quantity) of care provided by physicians is monitored
Health care providers share in the financial results through risk-sharing techniques
Preventive care and healthy lifestyles are emphasized
Term
A health maintenance organization (HMO)
Definition
is one type of managed care plan that provides comprehensive services to its members for a fixed, prepaid fee
The HMO enters into agreements with hospitals and physicians to provide medical services
Providers may receive a capitation fee
Most services are covered in full, with few maximum limits
Choice of providers is limited
Term
A gatekeeper physician
Definition
controls access to specialty care
Term
staff model
Definition
physicians are employees of the HMO and are paid a salary or a salary and an incentive bonus to hold down costs
Term
group model
Definition
physicians are employees of another group that has a contract with the HMO
Group receives a capitation fee for each member
Term
network model
Definition
: the HMO contracts with two or more independent group practices
The group practices receive a capitation fee for each member
Term
individual practice association (IPA) model:
Definition
an open panel of physicians agree to treat HMO members at reduced fees, on a fee-for-service basis
Term
Self insurance
Definition
means the employer pays part or all of the cost of providing health insurance to the employees
This is usually only an option for large employers!
Some employers have an administrative services only (ASO) contract with a commercial insurer
The commercial insurer only provides administrative services, such as claim processing and record keeping
Self-insured plans are exempt from state laws that require insured plans to offer certain state-mandated benefits
Term
A preexisting condition provision
Definition
: excludes coverage for a preexisting medical condition for a limited period after the worker enters the plan
Term
HIPAA establishes...
Definition
the portability of insurance coverage, whereby insurers must give an employee credit for previous coverage
Term
coordination-of-benefits provision
Definition
specifies the order of payment when an insured is covered under two or more group health insurance plans (like “other insurance” clauses)
Term
A coordination-of-benefits provision
Definition
Coverage as an employee is usually primary to coverage as a dependent
With respect to dependent children, the plan of the parent whose birthday occurs first during the year is primary
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