Health Insurance Chapter 1 Flashcards
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Questions and Answers

The employer is the policyowner and each employee receives a certificate of coverage regarding a group accident & health policy issued to an employer.

True

What is the maximum amount J will receive from his Accidental Death and Dismemberment policy after losing a finger?

$25,000

Which of the following statements best describes how a policy that uses the 'accidental bodily injury' definition differs from one that uses the 'accidental means' definition?

  • No difference
  • Less restrictive (correct)
  • More restrictive
  • Only applies to workplace accidents
  • Which of the following characteristics are associated with a large group disability income policy?

    <p>No medical underwriting</p> Signup and view all the answers

    What does a Business Overhead Expense policy cover?

    <p>Business expenses such as rent and utilities</p> Signup and view all the answers

    What type of policy could cover all students attending a large university?

    <p>Blanket policy</p> Signup and view all the answers

    What must a new employee do during the open enrollment period to obtain group Major Medical insurance from an employer?

    <p>Sign an enrollment card</p> Signup and view all the answers

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

    <p>Certificate</p> Signup and view all the answers

    What does the Coordination of Benefits provision do?

    <p>Prevents an insured from making a profit on a covered loss</p> Signup and view all the answers

    An accident policy will most likely pay a benefit for what type of accident?

    <p>Off-the-job accident</p> Signup and view all the answers

    Study Notes

    Group Accident & Health Policy

    • In a group accident and health policy, the employer acts as the policyowner.
    • Each employee receives a certificate of coverage detailing their benefits.

    Accidental Death and Dismemberment (AD&D) Policy

    • The maximum benefit for loss of a finger under an AD&D policy with a principal sum of $50,000 is $25,000.

    Definitions of Accidents

    • A policy using the "accidental bodily injury" definition is less restrictive compared to one using the "accidental means" definition.

    Group Disability Income Policy

    • Large group disability income policies typically do not require medical underwriting, simplifying access for employees.

    Business Overhead Expense Policy

    • This type of policy covers essential business expenses, such as rent and utilities, ensuring continuity during a disability.

    Blanket Policy for Students

    • A blanket policy offers coverage to all students at a large university, providing collective health insurance benefits.

    Enrollment for Major Medical Insurance

    • New employees must sign an enrollment card during the open enrollment period to obtain group Major Medical insurance from their employer.

    Certificate Issuance

    • Employees in an employer health plan receive a certificate outlining their specific coverage and benefits.

    Coordination of Benefits Provision

    • The Coordination of Benefits provision prevents individuals covered by multiple health plans from profiting from a covered loss, ensuring fair compensation.

    Accident Policy Coverage

    • Accident policies typically cover benefits for off-the-job accidents, providing financial support for incidents occurring outside of work-related activities.

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    Description

    Test your knowledge with these flashcards focused on Chapter 1 of Health Insurance. Each flashcard presents key concepts and questions related to group policies and benefits. Perfect for students preparing for exams in health insurance topics.

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