Health and Accident Insurance Flashcards

Questions and Answers

Which of these circumstances is a Business Disability Buy-Sell policy designed to help in the sale of a business?

Owner selling the business

Business owner becoming disabled (correct)

Loss of business license

Legal issues in business

Accidental Death coverage is provided to commercial airline passengers in which of the following types of policies?

Accidental Death policy

Individual Accident policy

Blanket Accident policy (correct)

Group Accident policy

The Health Insurance Portability and Accountability Act (HIPAA) gives privacy protection for health information.

True

What is the maximum amount J will receive from his Accidental Death and Dismemberment policy with a principal sum of $50,000 if he cuts off one finger?

$25,000 Signup and view all the answers

Which of these types of coverage is best described as a short-term medical policy?

Interim coverage Signup and view all the answers

How would a contingent beneficiary receive the policy proceeds in an Accidental Death and Dismemberment (AD&D) policy?

If the primary beneficiary dies before the insured Signup and view all the answers

Under which circumstances will the benefits under COBRA continuation coverage end?

When all group health plans are terminated by the employer Signup and view all the answers

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers the right to what?

Continue group health benefits Signup and view all the answers

When an employee is required to pay a portion of the premium for an employer/employee group health plan, the employee is covered under which plan?

Contributory Signup and view all the answers

Who is qualified to change the beneficiary designation on an Accidental Death and Dismemberment (AD&D) insurance policy?

Policyowner Signup and view all the answers

Which contract permits the remaining partners to buy out the interest of a disabled business partner?

Disability Buy-Sell Signup and view all the answers

What type of designation would fulfill the need to change the beneficiary on an Accidental Death and Dismemberment (AD&D) insurance policy and make it permanent?

Irrevocable Signup and view all the answers

In the scenario where P, Q, and R are involved in a car accident, who will the Accidental Death benefits be paid to?

P only Signup and view all the answers

Which type of policy pays benefits to a policyholder covered under a Hospital Expense policy?

Reimbursement Signup and view all the answers

Which of the following claims are typically excluded from Medical expense policies?

Intentionally self-inflicted injuries Signup and view all the answers

Which of the following statements is correct regarding an employer/employee group health plan?

The employer receives a master policy and the employees receive certificates. Signup and view all the answers

Which statement is TRUE regarding a group accident & health policy issued to an employer?

The employer receives the policy and each employee is issued a certificate. Signup and view all the answers

Which characteristic is associated with a large group disability income policy?

No medical underwriting Signup and view all the answers

Which of the following medical expenses does Cancer insurance NOT cover?

Arthritis Signup and view all the answers

What is the minimum percentage of eligible employees that must be covered in a company that pays the entire premium for its group health plan?

100% Signup and view all the answers

What is issued to each employee of an employer health plan?

Certificate Signup and view all the answers

All students attending a large university could be covered by what type of policy?

Blanket policy Signup and view all the answers

What is true after the expiration of COBRA laws for an employee wanting to convert their group health coverage to an individual policy?

She does NOT need to provide evidence of insurability. Signup and view all the answers

The federal income tax treatment of employer-provided group Medical Expense insurance can be accurately described as?

Employee's premiums paid by the employer is tax-deductible to the employer as a business expenditure. Signup and view all the answers

Which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries caused by a third party?

Subrogation Signup and view all the answers

Which statement is true regarding a minor beneficiary?

Normally, a guardian is required to be appointed in the Beneficiary clause of the contract. Signup and view all the answers

If the insured and primary beneficiary are both killed in the same accident, where are the death proceeds directed under the Uniform Simultaneous Death Act?

Insured's contingent beneficiary Signup and view all the answers

A policyowner's rights are limited under which beneficiary designation?

Irrevocable Signup and view all the answers

What type of beneficiary allows the policyowner to change the designation at any time?

Revocable Signup and view all the answers

How much of the death benefit will the mother receive if T and S die in an accident and S's death precedes the father's?

$0 Signup and view all the answers

What is the difference between group insurance and blanket health policies?

Blanket health policies do not issue certificates. Signup and view all the answers

Under the Model Group Coordination of Benefits provision, when T files a claim, his employer's plan is considered the what?

Primary carrier Signup and view all the answers

Which statement BEST describes how a policy that uses the 'accidental bodily injury' definition of an accident differs from one that uses the 'accidental means' definition?

Less restrictive Signup and view all the answers

An insurance company would MOST likely pay benefits under an Accidental Death and Dismemberment policy for which loss?

Loss of eyesight due to an accidental injury Signup and view all the answers

Group/voluntary long-term care policy premiums are typically deducted from the employee's income and?

Are less costly as compared to individual long-term care coverage Signup and view all the answers

What will the insurance company do if T requests a change of beneficiary on an AD&D policy with an irrevocable beneficiary?

Request of the change will be refused Signup and view all the answers

The benefits under a Disability Buy-Out policy are?

Payable to the company or another shareholder Signup and view all the answers

Which of the following statements does NOT accurately describe the tax treatment of premiums and benefits of individual Accident and Health insurance?

Disability income policy premiums are tax-deductible Signup and view all the answers

Study Notes

Business Disability Buy-Sell Policy

Designed to assist in the sale of a business when an owner becomes disabled.

Accident Coverage

Commercial airline passengers are covered under a Blanket Accident policy for Accidental Death.

HIPAA

Protects the privacy of health information.

Accidental Death and Dismemberment (AD&D) Policy

If a policyholder with a $50,000 policy loses a finger, the maximum payout is $25,000 (capital sum).
An irrevocable beneficiary designation prevents changes without beneficiary consent.

Short Term Medical Policies

Best described as interim coverage.

COBRA Regulations

Allows continued group health benefits for workers whose employment has been terminated.
Coverage can end if the employer terminates all group health plans.

Group Health Plans

Employees contribute premiums in a contributory plan.
The employer receives a master policy while employees get certificates.

Number of Employees Coverage

Noncontributory group health plans require 100% participation by eligible employees.

Insurance Beneficiary Designations

A contingent beneficiary receives proceeds if the primary beneficiary dies before the insured.
If both insured and primary beneficiary die in an indistinguishable manner, proceeds go to the contingent beneficiary under the Uniform Simultaneous Death Act.

Medical Expense Policies

Exclude claims for intentionally self-inflicted injuries.

Policy and Coverage Types

Business Overhead Expense policies cover fixed business expenses during the owner's disability.
Accident policies typically pay benefits for off-the-job accidents.
Blanket policies cover transient groups with changing members, like university students.

Claims Procedures

Reimbursement for injuries caused by a third party is known as subrogation.
If an employee dies, dependents can continue coverage under COBRA regulations for up to 36 months.

Insurance Payment Structures

Business Overhead Expense policies cover fixed expenses like utilities and office rent during an owner's disability.
Individual disability income policy premiums are not tax-deductible; however, benefits are tax-free.

Accident Coverage Definitions

Policies using "accidental bodily injury" are less restrictive compared to those using "accidental means".

Common Disaster Clause

In accidents where both insured and beneficiary die, proceeds are paid to a contingent or secondary beneficiary.

Additional Points

Group voluntary long-term care insurance premiums are typically lower than individual policies.
An employer must allow a new employee to sign an enrollment card for group health insurance without needing to provide evidence of insurability after COBRA expiration.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on health and accident insurance with these flashcards. This quiz covers important concepts such as Business Disability Buy-Sell policies and Accidental Death coverage for commercial airline passengers. Perfect for students or professionals looking to reinforce their understanding.