Podcast
Questions and Answers
Which type of policy provides income to an individual who is unable to work due to disability?
Which type of policy provides income to an individual who is unable to work due to disability?
Which provision ensures that the insurance contract is upheld as a complete agreement?
Which provision ensures that the insurance contract is upheld as a complete agreement?
Which type of medical expense insurance is characterized by a managed care system?
Which type of medical expense insurance is characterized by a managed care system?
What is the primary purpose of a waiver of premium rider?
What is the primary purpose of a waiver of premium rider?
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Which type of long-term care policy is aimed at covering eligibility for care services?
Which type of long-term care policy is aimed at covering eligibility for care services?
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What does the term ‘preexisting conditions’ refer to in policy clauses?
What does the term ‘preexisting conditions’ refer to in policy clauses?
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Which type of policy typically includes a guaranteed renewable option?
Which type of policy typically includes a guaranteed renewable option?
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In terms of Medicare, what does Part D specifically cover?
In terms of Medicare, what does Part D specifically cover?
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Study Notes
Types of Policies
-
Disability Income: Covers income loss due to disability
- Individual disability income
- Business overhead expense policy
- Business disability buyout policy
- Group disability income policy
- Key employee policy
- Accidental Death and Dismemberment: Insurance for death or injury from accidents
-
Medical Expense Insurance: Covers medical costs
- Basic hospital, medical, and surgical
- Major medical policies
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Point of Service (POS) plans
- Flexible Spending Accounts (FSAs)
- High Deductible Health Plans (HDHPs) and Health Savings Accounts (HSAs)
- Health Reimbursement Accounts (HRAs)
- Medicare Supplement Policies: Add-on coverage for Medicare
-
Group Insurance: Offered to groups of people (e.g., employees)
- Differences between individual and group contracts
- General characteristics
- COBRA (Consolidated Omnibus Budget Reconciliation Act)
-
Long Term Care (LTC): Covers assisted living or nursing home care
- Eligibility criteria
- Levels of care
-
Other Policies: Various types of insurance
- Dental
- Vision
- Cancer
- Critical illness
- Worksite (employer-sponsored)
- Hospital indemnity
- Short-term medical
- Accident
Policy Provisions, Clauses, and Riders
-
Mandatory and Optional Provisions: Key components of insurance policies
- Entire contract (all terms and conditions)
- Time limit on certain defenses (incontestable)
- Grace period (time for payment before late penalties)
- Reinstatement (returning to policy after lapse)
- Notice of claim (procedure for filing claims)
- Claim forms
- Proof of loss (evidence required to justify claim)
- Time of payment (when benefits will be distributed)
- Payment of claims
- Physical examination (in some cases)
- Legal actions (how disputes can be resolved)
- Change of beneficiary
- Misstatement of age or gender (policy implications)
- Change of occupation
- Illegal occupation
- Relation of earning to insurance (in some policies)
-
Other Provisions and Clauses:
- Insuring clause (basic coverage description)
- Free look (period to review the policy)
- Consideration clause
- Probationary period
- Elimination period (waiting time before coverage starts)
- Waiver of premium
- Exclusions and limitations (activities or conditions not covered)
- Preexisting conditions (coverage restrictions)
- Coinsurance (shared cost of care)
- Deductibles (amount to pay before insurance covers)
- Eligible expenses
- Copayments (fixed amount per visit)
- Pre-authorizations/prior approval
- Usual, reasonable, and customary (URC) charges (average costs)
- Lifetime, annual, or per cause maximum benefit limits (policy limits)
-
Riders: Adds on or modifies some policies
- Impairment/exclusions
- Guaranteed insurability
- Future increase option
-
Rights of Renewability: Potential policy conditions
- Noncancelable
- Cancelable
- Guaranteed renewable
Social Insurance
- Medicare (Parts A, B, C, D): Federal health insurance program for seniors and disabled.
- Medicaid: Federal and state program that helps with medical costs
- Social Security benefits: Benefits for retirement, disability or survivors
Other Insurance Concepts
- Disability: Total, partial, recurrent, residual
- Owner's rights: Legal rights
- Dependent children benefits: Insurance for minors
- Primary and contingent beneficiaries: Person who benefits
- Modes of premium payments: How payments are made
- Nonduplication and coordination of benefits: Avoiding double payment
- Occupational vs. non-occupational: Relation to ones work
- Tax treatment: Tax implications on premiums and proceeds
- Managed care: Types of care delivery
- Workers Compensation: Insurance to compensate employees injured at work
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Description
This quiz covers a variety of insurance policies, including disability income, accidental death and dismemberment, medical expense insurance, and more. Test your knowledge on individual, group, and supplemental policies to understand their key features and differences. Perfect for anyone studying insurance or personal finance.
