Health Insurance Basics and Tax Deductions
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Questions and Answers

What are the tax ramifications of health insurance premiums paid by Lorenzo, who is self-employed with an S corporation?

100% of his health insurance costs can be deducted from his gross income

How are premiums paid by the insured for personally owned disability income insurance treated for tax purposes?

Not tax-deductible

Which of the following is considered to be a point of service (POS) plan?

  • Exclusive Provider Organization (EPO)
  • Preferred Provider Organization (PPO)
  • Health Maintenance Organization (HMO)
  • Managed-care plan (correct)
  • What is a requirement for any change in an insurance application?

    <p>Change must be initialed by the applicant</p> Signup and view all the answers

    What is the gatekeeper's role when used by an HMO?

    <p>Obtaining referrals to specialists from primary care physicians</p> Signup and view all the answers

    Which of the following is considered a tax-deductible medical expense under the IRS rule allowing deduction of medical expenses that exceed 7.5% of adjusted gross income?

    <p>Long-Term care insurance premiums</p> Signup and view all the answers

    What happens when an insurance policy is backdated?

    <p>The policy's effective date is earlier than the present</p> Signup and view all the answers

    What is the difference between pre-certification and concurrent review?

    <p>Pre-certification occurs before the treatment is provided</p> Signup and view all the answers

    What is the insurer's liability when an insured is injured as an innocent bystander during a felony?

    <p>Liable for the loss</p> Signup and view all the answers

    What is the appropriate tax consequence when XYZ Corp pays the tax-deductible insurance premiums for a key employee disability policy?

    <p>Benefits are fully taxable</p> Signup and view all the answers

    Study Notes

    Health Underwriting Overview

    • Self-employed individuals with S corporations can deduct 100% of health insurance premiums from gross income.
    • Disability income insurance premiums paid by the insured are not tax-deductible.
    • Point of Service (POS) plans function as managed-care plans, blending features of HMO and PPO models.

    Insurance Application Changes

    • Any alterations to an insurance application must be initialed by the applicant to be valid.

    HMO Gatekeeper Role

    • In a Health Maintenance Organization (HMO), the gatekeeper (primary care physician) is responsible for obtaining specialist referrals.

    Tax Deductions for Medical Expenses

    • The IRS allows taxpayers to deduct medical expenses exceeding 7.5% of their adjusted gross income, which includes long-term care insurance premiums.

    Backdating Insurance Policies

    • Backdating an insurance policy means its effective date is set to a time before the date of application.

    Pre-Certification vs. Concurrent Review

    • Pre-certification is the process that occurs prior to the treatment, ensuring medical necessity and policy compliance.

    Liability for Insured Incidents

    • Insurers are liable for losses incurred by insured individuals, even if they are innocent bystanders in a felony situation.

    Key Employee Disability Insurance Tax Implications

    • When a corporation pays tax-deductible premiums on a disability policy for a key employee, the benefits received by the employee are fully taxable.

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    Description

    Test your knowledge on health insurance concepts, including tax deductions for health premiums and the roles within various insurance plans. This quiz covers essential topics related to self-employed individuals, HMO structures, and the handling of insurance applications.

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