With the accidental death rider, the death must occur within how many days of an accident?
90
Employees must apply for COBRA within how many days of termination?
60
Relief for family caregiver is known as?
Respite care
Take it or leave it is known as
Adhension
Occasional nursing or rehabilitative care by skilled medical personnel is known as?
Intermediate Care
What 2 things must the policy owner do to complete their steps of consideration?
statements on application/premium payment
Who is eligible for HRA?
All employees
This type of insurer is incorporated outside of the US
Alien
Insurance that covers expenses for hiring and training replacement at a business
Key person
Medicare Supplement policies have a free-look period of how many days?
30
What is the most basic type of health plan called on healthcare.gov?
Bronze
True/False: If the disability income premium is paid by the employer, then the benefit is taxed?
True
How long is the grace period for weekly premium policies?
7 days
Employee pays what percentage of the COBRA premium?
102%
Insured must notify the insurer of a loss within how many days?
20
How long is the grace period for monthly premium policies?
10 days
Per ACA, dependent children age equals?
26 years old or younger (may vary in different states)
Applications are deemed accepted if not rejected within how many days?
45
This medical plan type has high limits and is comprehensive.
Major Medical
Assistance with personal needs; nonmedical personnel; institutional setting or home is known as?
Custodial Care
What is the most enhanced health plan called on healthcare.gov?
Platinum
This type of insurer is incorporated in another state or territory?
Foreign
The nonprofit legal entity that protects insureds against insolvent insurers is known as:
Insurance Guaranty Association
Who is the main contributor of a FSA?
Employee, employer or both.
Who is eligible for HSA?
Individuals covered by an HDHP and not eligible for Medicare
True/False: If the disability income premium is paid by the individual/employee, then the premium is deductible.
False
A fixed monthly amount paid per member of an HMO is known as?
Capitation
Accidents are covered immediately but sickness has a probation period of how many days?
10
True/False: Agents may hold more than one appointment with multiple insurance carriers.
True
Skilled nursing services in a person's home is known as?
Home Health Care
True/False: The DOI establishes the fines/penalties in each state.
False (Those are defined by law)
One-sided promise is known as
Unilateral
True/False: Representations are not guaranteed to be true.
True
Who is the main contributor on a HSA?
Individual/Employee
How long is the LTC elimination period?
30 days
Nursing and rehabilitative care by medical personnel is known as?
Skilled care
What 3 factors determine the "competent parties"?
legal age/mentally competent/not under the influence of drugs or alcohol
Medicare Part A covers up to how many days of hospitalization each year?
90
True/False: If the disability income benefit is partly taxed, then the premium is partly paid by both employer and employee?
True
This major medical plan type is limited. Think of a closed box. An insured can only see providers within the box (in network). Lower premium, but less freedom.
HMO
True/False: The funds on a HRA can be carried over?
True
False, misleading or deceptive statements about policy terms or benefits is known as?
Misrepresentation
This major medical plan is like a box with a lid. Can operate as either an HMO or PPO. Lower premium than in PPO, but has more freedom than HMO.
POS
True/False: The funds on the FSA can be carried over?
False
When the insurance company issues a policy is known as?
Acceptance
Insurance that pays for rent, utilities, employee salaries, etc.
Business overhead expense
Applicant submits an application for insurance is known as what?
Offer
How long is the grace period for all other modes such as quarterly/yearly?
31 days
Insurance that specifies how the business will pass between owners.
Disability Buy-Sell
This major medical plan type is a lot more open. Think of a box with no lid. Insureds can save money by seeing providers in the box (in network), but have the freedom to leave and see any provider (out-of-network).
PPO
Unequal exchange is known as:
Aleatory
Who is eligible for a FSA?
All employees except self-employed
Elimination period is also known as what?
Time deductible
Maliciously critical statements about a person or company is known as?
Defamation
If the insured wants to sue the insurance company, the must wait how many days after submitting proof of loss? (But not wait longer than 3 years in most states)
60 (Memory trick: "60 to 3 to sue")
Medicare Part A covers up to how many days in a Skilled Nursing Facility each year?
100
True/False: Warranties are absolutely true statements?
True
Who is the main contributor on a HRA?
Employer
The legal process by which an insurance company seeks recovery of the amount paid to the insured from a third party who may have caused the loss is known as:
Subrogation
The penalties for fraud or making false statements can be:
a fine and/or imprisonment (10-15 years)
True/False: The funds on a HSA can be carried over?
True
Offering benefits or services not specified in the policy is known as?
Rebating
Money paid by the insured at the time of service is known as what?
Copayment
COBRA coverage extends for up to how many months?
18
This type of insurer is incorporated in the same state?
Domestic
Insured must submit proof within how many days of the loss?
90
Misleading comparison of policies to persuade insured to cancel or switch policies is known as?
Twisting
This medical plan has NO deductible/First Dollar Coverage.
Basic medical
Functionally impaired adults; community center; meals; activities are examples of?
Adult Day Care
COBRA coverage extends for how many months for dependents after employee's death or divorce?
36
When an insurance company promises to pay a claim, it is known as what?
Consideration
If you are eligible for CSR, what plan type must you enroll in?
Silver
True/False: If you are under the age of 30, the bronze plan is the most basic plan you can get?
False
Information that was misrepresented that would have changed the insurer’s underwriting decision is known as what?
A material misrepresentation
What does legal purpose mean?
Not against public policy.
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