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Questions and Answers
What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 allow an employee to do?
What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 allow an employee to do?
Credit Accident and Health plans are designed to?
Credit Accident and Health plans are designed to?
Ron has a new employer and wishes to enroll in the company's group health plan. In determining whether his pre-existing health condition applies, Ron cannot have more than a ___ day gap without previous health insurance.
Ron has a new employer and wishes to enroll in the company's group health plan. In determining whether his pre-existing health condition applies, Ron cannot have more than a ___ day gap without previous health insurance.
Health insurance involves two perils, accident and ____.
Health insurance involves two perils, accident and ____.
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Which of the following would evidence ownership in a participating health insurance contract?
Which of the following would evidence ownership in a participating health insurance contract?
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Under the subrogation clause, legal action can be taken by the insurer against the?
Under the subrogation clause, legal action can be taken by the insurer against the?
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Sole proprietors are permitted tax deductions for health costs paid from their earnings in the amount of?
Sole proprietors are permitted tax deductions for health costs paid from their earnings in the amount of?
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The election of COBRA for continuation of health coverage will?
The election of COBRA for continuation of health coverage will?
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How many employees must an employer have for a terminated employee to be eligible for COBRA?
How many employees must an employer have for a terminated employee to be eligible for COBRA?
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Coordination of Benefits regulation applies to all of the following plans EXCEPT?
Coordination of Benefits regulation applies to all of the following plans EXCEPT?
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According to the Health Insurance Portability and Accountability Act (HIPAA), when can a group health policy renewal be denied?
According to the Health Insurance Portability and Accountability Act (HIPAA), when can a group health policy renewal be denied?
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An insurer has the right to recover payment made to the insured from the negligent party. These rights are called?
An insurer has the right to recover payment made to the insured from the negligent party. These rights are called?
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A master contract and certificate of coverage can be found in which type of policy?
A master contract and certificate of coverage can be found in which type of policy?
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Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA?
Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA?
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What is the contract called that is issued to an employer for a Group Medical Insurance plan?
What is the contract called that is issued to an employer for a Group Medical Insurance plan?
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Which of the following would be considered a possible applicant and contract policyholder for group health benefits?
Which of the following would be considered a possible applicant and contract policyholder for group health benefits?
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Under a disability income policy, which provision would be payable if the cause of an injury is unexpected and accidental?
Under a disability income policy, which provision would be payable if the cause of an injury is unexpected and accidental?
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According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual?
According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual?
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Which type of business insurance is meant to cover the costs of continuing to do business while the owner is disabled?
Which type of business insurance is meant to cover the costs of continuing to do business while the owner is disabled?
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Which of the following is typically NOT eligible for coverage in a group health policy?
Which of the following is typically NOT eligible for coverage in a group health policy?
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Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n)
Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n)
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The purpose of the Coordination of Benefits provision in group accident and health plans is to?
The purpose of the Coordination of Benefits provision in group accident and health plans is to?
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The policyholder for a group health benefit plan is considered to be the
The policyholder for a group health benefit plan is considered to be the
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When are group disability benefits considered to be tax-free to the insured?
When are group disability benefits considered to be tax-free to the insured?
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A group Disability Income plan that pays tax-free benefits to covered employees is considered?
A group Disability Income plan that pays tax-free benefits to covered employees is considered?
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Continued coverage under COBRA would be provided to a(n)
Continued coverage under COBRA would be provided to a(n)
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Sonya applied for a health insurance policy on April 1. Her agent submitted the information to the insurance company on April 6. She paid the premium on May 15 with the policy indicating the effective date being May 30. On which date would Sonya have coverage?
Sonya applied for a health insurance policy on April 1. Her agent submitted the information to the insurance company on April 6. She paid the premium on May 15 with the policy indicating the effective date being May 30. On which date would Sonya have coverage?
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Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the
Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the
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A common exclusion with Vision plans is
A common exclusion with Vision plans is
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Which of the following does Coordination of Benefits allow?
Which of the following does Coordination of Benefits allow?
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Study Notes
COBRA and Health Insurance Regulations
- COBRA (Consolidated Omnibus Budget Reconciliation Act) allows employees to maintain group health insurance after termination by paying premiums.
- Employers must have at least 20 employees for COBRA eligibility after a termination.
- COBRA continuation of coverage maintains the same coverage but increases premiums.
Credit Accident and Health Plans
- Designed to assist in paying off existing loans during periods of disability.
Pre-existing Conditions and Coverage
- A gap of no more than 63 days in health insurance coverage is allowed for determining pre-existing conditions.
Health Insurance Perils
- Health insurance primarily covers two perils: accident and sickness.
Ownership Evidence in Insurance Contracts
- Policy ownership is required for evidence in participating health insurance contracts.
Subrogation Rights
- The subrogation clause permits insurers to take legal action against a responsible third party for recovery of payments made to the insured.
Tax Deductions for Sole Proprietors
- Sole proprietors can deduct 100% of health costs from taxable income.
Coordination of Benefits
- The purpose of Coordination of Benefits is to prevent overpayment of claims in group plans and it applies to various plans, excluding Preferred Provider Organization plans.
HIPAA Regulations
- HIPAA prevents denial of group health policy renewal unless participation or contribution rules have been violated.
- Creditable coverage under HIPAA may reduce waiting periods for preexisting conditions in a new employer's health plan.
Group Health Benefits
- A master policy and certificate of coverage are associated with group health insurance plans.
- Employers are considered the policyholder for group health benefit plans.
Disability Income Policies
- Accidental bodily injury provision pays benefits if an injury is unexpected and accidental.
Tax-Free Benefits in Disability Income
- Disability benefits are tax-free if premiums are paid by the insured.
Eligibility Under Group Health Policies
- Typically, temporary employees are not eligible for coverage under group health policies.
Conversion of Health Insurance
- Transitioning from a group to an individual plan after employment termination is termed conversion.
Lasik Surgery Exclusion
- Lasik surgery is commonly excluded from vision plan coverage.
Payments Coordination
- Coordination of Benefits allows primary and secondary payers to ensure total claim payments do not exceed 100%.
Business Insurance Options
- Business overhead expense policies cover costs of continuing business while the owner is disabled.
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Description
Test your knowledge with these flashcards from XCEL Chapter 11, focusing on the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. Learn about employee benefits related to health insurance continuation after employment termination. This quiz is designed to enhance your understanding of essential healthcare laws.
