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Maine Life Insurance Exam with verified answers
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Maine Life Insurance Exam with verified answers
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Maine Life Insurance ExamContributory Health Insurance - correct answer ✔✔If the employees share a portion of the premium.
Often require participation by 75% of eligible members.
Noncontributory Health Insurance - correct answer ✔✔If the employer pays the entire premium. Most
require 100% participation by eligible members.
(Funding of Group Insurance) Shared funding - correct answer ✔✔Allows employer to self-fund health
care expenses, select a deductible and pay covered expenses for any individual incurring claims up to
that max, insurer assumes risk
(Funding of group insurance) Min. premium arrangement - correct answer ✔✔Employer self-insure the
normal and expected claims up to a given amount and the insurer funds only the excess amounts
(Funding of group insurance) retrospective premium arrangement - correct answer ✔✔Insurer agrees to
collect a provisional premium but may collect additional premium/make a premium refund at the end of
the year based on actual incurred losses.
(Funding of group insurance) Self-funding arrangement - correct answer ✔✔Large employers may elect
to fully self-fund, or may self-fund a plan but contract for administrative services only (ASO).
Conversion privilege - correct answer ✔✔An employee can convert their group certificate to an
individual medical expense policy w/ same insurer, if/when they leave employer. Employee must make
an application for a converted policy within a given period of time (usually 31 days) depending on the
state.
Health Insurance Portability and Accountability Act (HIPAA) - correct answer ✔✔Provides the ability to
transfer and continue health insurance when someone changes or loses their job
, HIPAA Requirements - correct answer ✔✔Employers with 20 or more employees have to allow former
employees to continue benefits. Rules apply to all types of group health plans except disability income
plans
HIPAA pre-existing conditions - correct answer ✔✔Health issues that existed, were treated, diagnosed
within 6 months prior to employment
COBRA - correct answer ✔✔Requires employers with 20+ employees to continue coverage for
terminated workers, (as well as dependents) for up to 18 months. Employee is required to pay premiums
(up to 102%)
Group Disability Income Plans - correct answer ✔✔Specify benefits based on a percentage of the
employees wages
Blanket Health Plans - correct answer ✔✔Cover a group who may be exposed to the same risk, no
certificates issued
Taxation of group health premiums - correct answer ✔✔Employers are entitled to take a tax deduction
for premium contributions made to group plans
Taxation of group health benefits - correct answer ✔✔Any benefit received under a medical expense
plan are not considered taxable income.
Accidental means - correct answer ✔✔Requires that both the cause and the result of an accident must
be unintentional
accidental results - correct answer ✔✔only the injury resulting from the accident must be unintentional.
3 basic categories of health insurances - correct answer ✔✔Medical Expense, Disability Income
Insurance, AD&D
Health insurance premium factors - correct answer ✔✔Interest, expenses, types of benefits, morbidity,
age, sex, occupation
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