Which of the following would likely be treated as a common exclusion found in most health insurance policies?
Which of the following statements is (are) true concerning benefit payments under long-term care insurance?
The employees of a corporation must each pay a portion of the premium for their group insurance. This means they are members of a _____________.
Erin cancels her individual health insurance policy before the end of the policy term. The insurer will:
R lives in a small rural town and bought a home a few years ago for $75,000. If the home were completely destroyed it would cost $150,000 to rebuild. Since R would probably replace this home by buying another home in town for $80,000, that is the price R wants to insure the current home for. This method of insuring the home is known as:
Steve is diagnosed with inoperable cancer and learns that he has only a few months to live. He wants to take an extended vacation with his spouse and needs some immediate funds. He has held a whole life insurance policy for many years. Which of the following options would be the best source of funds, if Steve wants a lump-sum payment?
If an insurer uses a general rate at the beginning of the year and then modifies the rate to reflect a debit or credit based on actual losses sustained during the policy period, what type of rating system is the insurer using?
Dirk required surgery for a kidney impairment. His total bill for medical services was $50,000. Dirk has a medical expense policy with a $1,000 calendar-year deductible and a $5,000 annual out-of-pocket limit. His coinsurance percentage is 20 percent. The out-of-pocket limit applies to coinsurance only. Assuming this surgery and hospitalization were the first medical care that Dirk received during the year and that all of the hospital services were eligible for coverage under the policy, how much of the $50,000 bill will the insurer pay?
Bob works as a coal miner. He decides to change jobs and become an insurance agent. He notified his insurance company about his job change. According to the change of occupation provision, the insurer will:
When the insured is restored (in whole or part) to the position that they were in prior to having a loss, but not gaining in the process, is due to this principle
All of the following are correct regarding employer group health insurance plan’s eligibility requirements EXCEPT:
Kristen has an individual medical expense policy with a $1,000 calendar-year deductible, a $5,000 annual out-of-pocket limit, and a 20 percent coinsurance requirement. Kristen was hospitalized for a surgical procedure in March, her first health care treatment received during the year. The total bill was $20,000. Considering the deductible and coinsurance, how much of this amount must Kristen pay?
Pablo insured his home for $50,000. It was destroyed in a fire and the building was determined to have had an ACV of $100,000 at the time of loss. If the actual cost to rebuild the building was $80,000 and Pablo had a coinsurance clause in his policy, how much money will the insurer pay to rebuild the home?
Betty accidentally misstates her age on her application for an individual health insurance policy. The insurer discovers this error after the incontestability period. What will the insurer do?
A Taft-Hartley Trust would be formed to provide health and welfare benefits to which of these employees?
The Smith family has a $1,000 annual family deductible with a coinsurance provision of 80/20. The family’s claims for the year are $200, $300, $400, $500, $300, and $300, totaling $2,000. The insurer is responsible for paying:
When a licensee is accused of any act, omission, or misconduct that would subject the licensee to a license suspension or revocation, with the approval of the Commissioner, the license may be surrendered for a period of
A(n) _________________ is issued to the sponsor of the group, and employees receive an outline of coverage or other summary of benefits, which offers information about the plan’s major benefits and principal exclusions.
A list of perils that have a reduction in the amount of coverage afforded is located in which section of an insurance policy?
Which of the following types of limited policies would a common carrier purchase to provide medical and surgical benefits in excess of any primary coverage?
The reinstatement provision in life insurance policies in this state allows an owner of a lapsed policy to reestablish it within how many years?
The Time Limit on Certain Defenses (Incontestable) period is _____ years under individual health and disability contracts.
Purposes of the coinsurance provision in medical expense insurance policies include which of the following?
Which policy covers inpatient doctor visits and may be expanded to include payment for office visits, diagnostic x-rays, laboratory charges, ambulance and nurse’s expenses when not hospitalized, and maternity benefits for an additional premium?
The following provisions are required in individual accident and health insurance policies issued, EXCEPT:
Under the Affordable Care Act, if a health insurer does not meet the minimum loss ratio requirement, the insurer must
If an insured suffers a loss he/she must provide a complete inventory of damaged goods as well as written records:
