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Questions and Answers
What does the classification 'Small Employer' mean in terms of employee count?
What does the classification 'Small Employer' mean in terms of employee count?
At least 2 and not more than 50
What classification best describes Company Y, which had 20 employees last year?
What classification best describes Company Y, which had 20 employees last year?
What is the term for a long-term care policy that can be kept in force by making timely premium payments without changes from the insurer?
What is the term for a long-term care policy that can be kept in force by making timely premium payments without changes from the insurer?
Guaranteed renewable
Medicare supplement policies do not have to be guaranteed renewable.
Medicare supplement policies do not have to be guaranteed renewable.
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Within how many days must an insured notify the insurer of a child's birth?
Within how many days must an insured notify the insurer of a child's birth?
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Which provision allows the insurer the right to change premium amounts?
Which provision allows the insurer the right to change premium amounts?
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Where in the long-term care policy must the insurer state the renewal provision?
Where in the long-term care policy must the insurer state the renewal provision?
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Which entity is allowed to receive HIV-related test results?
Which entity is allowed to receive HIV-related test results?
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Basic information about supplementary policies is required to be stated in the outline of coverage for long-term care policy.
Basic information about supplementary policies is required to be stated in the outline of coverage for long-term care policy.
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How long is a newborn covered without notification to the insurer?
How long is a newborn covered without notification to the insurer?
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What is the maximum age up to which dependent children are covered under the Patient Protection and Affordable Care Act?
What is the maximum age up to which dependent children are covered under the Patient Protection and Affordable Care Act?
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To be eligible for tax credits under the ACA, individuals must have an income that is what percent of the Federal Poverty Level?
To be eligible for tax credits under the ACA, individuals must have an income that is what percent of the Federal Poverty Level?
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Which individuals are eligible for coverage on the Health Insurance Marketplace?
Which individuals are eligible for coverage on the Health Insurance Marketplace?
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What is the minimum renewability standard for long-term care policies issued?
What is the minimum renewability standard for long-term care policies issued?
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A group health insurance policy can exclude newborn children from coverage.
A group health insurance policy can exclude newborn children from coverage.
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According to the ACA, which of the following is required preventive care for women?
According to the ACA, which of the following is required preventive care for women?
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If an insurance company offers Medicare supplement policies, it must offer which plan?
If an insurance company offers Medicare supplement policies, it must offer which plan?
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What type of policy has premiums that increase as a result of the insured's age?
What type of policy has premiums that increase as a result of the insured's age?
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Under the ACA, health insurance can no longer be underwritten based on which factor?
Under the ACA, health insurance can no longer be underwritten based on which factor?
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How many essential benefit categories are established under the Affordable Care Act?
How many essential benefit categories are established under the Affordable Care Act?
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Study Notes
Small Employer Classification
- "Small Employer" classification includes businesses with at least 2 and not more than 50 employees.
- Company Y, with 20 employees, is classified as a small employer.
Long-Term Care Insurance
- A guaranteed renewable policy allows the insured to maintain the policy by making timely premium payments without changes by the insurer.
- Long-term care policies must clearly state renewal provisions on the first page.
- Minimum renewability standard for long-term care policies is guaranteed renewable.
Children’s Coverage
- An insured must notify the insurer of a child's birth within 31 days to maintain coverage.
- Newborns are covered from the moment of birth, but notification is required within 31 days.
Medicare Supplement Policies
- Medicare supplement policies must be guaranteed renewable.
- Insurance companies offering Medicare supplement policies must include Plan A.
Health Coverage Regulations
- Under the Patient Protection and Affordable Care Act (ACA), coverage for dependent children is mandatory until age 26.
- Individuals eligible for ACA tax credits must have an income between 100% and 400% of the Federal Poverty Level.
- The ACA prohibits underwriting based on an applicant's health condition.
Essential Health Benefits and Preventive Care
- The ACA mandates 10 essential benefit categories in all healthcare plans.
- Required preventive care services under the ACA do not include cervical cancer exams for women starting at age 40.
Group Health Insurance
- Group health insurance policies cannot exclude newborn children from coverage.
- The continuity provision in policies states the insurer's right to change premium amounts.
Disclosure and Rights
- Insurers can disclose HIV-related test results to authorized entities, but not to other insurers.
- The outline of coverage for long-term care policies is not required to include basic information about supplementary policies.
Attained Age Policies
- Insured individuals experiencing premium increases due to age hold attained age policies, where premiums rise as the policyholder ages.
Health Insurance Marketplace Eligibility
- Permanent residents lawfully present in the U.S. are eligible for coverage on the Health Insurance Marketplace.
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Description
Test your knowledge on Texas statutes and rules relevant to accident and health insurance through these flashcards. This quiz covers various definitions and classifications important for understanding the insurance landscape for small employers. Perfect for students and professionals alike!
