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NC Health Insurance Questions and Answers 100% Correct
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Exam of 19 pages for the course North Carolina accident and health insurance at North Carolina accident and health insurance (NC Health Insurance)

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Document information

  • October 14, 2024
  • 19
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • nc health insurance

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  • North Carolina accident and health insurance
  • North Carolina accident and health insurance

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NC Health Insurance

risk avoidance - answer occurs when individuals evade risk entirely

risk reduction - answer occurs when chances of risk are lessened

risk retention - answer is being aware of the risks involved and taking precautions for
financial protection.

risk transference - answeris the act of shifting the responsibility of risk to another in the
form of an insurance contract.

physical - answerA bodily disease of endangerment, such as cancer, presents a _____
hazard.

morale - answerA mental trait, such as road rage, presents a ____ hazard.

moral - answerAn unhealthy habit, such as smoking, presents a _____ hazard.

avoidance - answerRisk ___________ occurs when an individual eludes risk entirely.

reduction - answerRisk _____________ is when the chances of loss are lessened.

retention - answerRisk _____________ occurs when an individual takes precautions for
protection by allowing another party to maintain a portion of the risk.

transference - answerRisk _______________ occurs when an individual shifts the
responsibility of covering the risk to another.

a provider - answeran individual who is licensed, certified, or otherwise authorized North
Carolina General Statutes or under the laws of another state to provide health care
services in the ordinary course of business or practice of a profession or in an approved
education or training program.

government insurers - answersocial security (OASDI), social security hospital
insurance, supplemental medical insurance, medicaid, workers' compensation, US
armed services and veterans

private insurers - answerstock insurers, mutual insurers, reciprocal insurers, lloyds of
london, risk retention groups, reinsurers, fraternal benefits societies, service insurers,
home service insurers

,mutual life insurance - answerThe operating objective of a ____________________
company is to provide insurance to its owners (the policyholders) at the lowest possible
net cost.

demutualization - answeris the process of converting a mutual insurance company to a
stock insurance company

pure assessment mutual company - answerA _____________________________
bases premium costs on the loss sharing method. Members do not pay premiums in
advance and the total loss experience is divided among the members so each pays a
portion of the total.

advance premium assessment mutual - answerThe
____________________________________ charges specific premium amounts. If the
actual loss is less than the total of the collected premiums, members receive a refund in
the form of dividend payments. If the actual loss is more than the total premium amount
collected, members' premium rates will be increased to adjust accordingly.

lloyd's of london - answer_____________ is actually not considered an insurer. Instead,
it is an association of individuals and companies that individually underwrite insurance.

reinsurance - answer____________ is an arrangement through which one insurance
company transfers a portion of a risk it has assumed to another insurer

risk retention groups (RRGs) - answer_____________ are a form of mutual insurer as
well. They provide liability coverage to insure groups of individuals who are of the same
group (or class).

service insurers - answer_____________ contract for and sell medical and hospital care
services. Medical care services are provided in exchange for premiums paid.

health maintenance organizations (HMOs) - answeris a health care delivery system
which provides comprehensive health care services for its members. The members are
typically enrolled on a group basis by their employer.

self-insurers - answer________________ create their own reserves to provide
coverage for future losses. Self-insurance is a risk management method whereby an
eligible risk is retained, but a calculated amount of money is set aside to compensate for
any potential future losses.

True - answerT/F: In a reciprocal insurer structure, each policyholder insures the risks of
the other policyholders.

independent - answerAn _______________ agent represents several insurers and their
different insurance products.

, Fair Credit Reporting Act - answerThrough the ______________________, the federal
government determined that consumers have a fundamental right to be informed when
their credit will be checked.

True - answerT/F: There are two principles involved in the needs-based selling process:
(1) Fact-finding and (2) Education.

True - answerT/F: There are two principles involved in the needs-based selling process:
(1) Fact-finding and (2) Education.

True - answerT/F: Twisting is referred to as "external replacement" and is the practice of
inducing a person to drop existing insurance to buy similar coverage with another
producer or company.

True - answerT/F: Churning is also called "internal replacement" and is the practice of
inducing a person to drop their existing policy to buy another policy with the same
company.

agent - answerThe __________ bears the burden of proving a policy replacement is in
the client's best interest.

misrepresentation - answeroverstating promises and guarantees is a form of
________________

False - answerT/F: An agent may intermingle premium payments with the agent's
personal funds only if the funds are collected at a time when the agency is closed.

The National Association of Insurance and Financial Advisors (NAIFA) and the National
Association of Health Underwriters (NAHU) -
answer________________________________________ are organizations designed to
protect agents. Both organizations consist of insurance agents who are dedicated to
protecting fellow agents through strict adhesion to their Codes of Ethics.

assessments - answerState guaranty associations are funded by insurance companies
through ______________________

True - answerT/F: NAIFA is dedicated to supporting the life insurance industry, whereas
NAHU is dedicated to supporting the health insurance industry.

True - answerT/F: NAIC has no legal power

law of large numbers - answerBasic principle of insurance that the larger the number of
individual risks combined into a group, the more certainty there is in predicting the
degree or amount of loss that will be incurred in any given period.

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