Self insured plans - Study guides, Class notes & Summaries

What kind of retirement plan can a 75-employee for profit corporation establish? - ANSWER-Simple IRA The taxable portion of a monthly income benefit paid during the annuity phase from a nonqualified annuity is calculated using the - ANSWER-Exclusion ratio Unfair claims settlement methods and practices by an insurance company include all of the following acts EXCEPT - ANSWER-failure to pay all claims that are reported within 90 days after a loss occurs The settlement option that allows p...

AU62 Course Exam Practice Questions & Answers, 100% Accurate. Verified. An organization may incur losses from legal liabilities in a number of different ways. Which one of the following actions would best be described as an intentional tort? - -A newspaper mistakenly identifies the driver in an alcohol-related hit and run accident as John Doe, a prominent local attorney. Martin, a 15-year-old boy, carelessly tossed a glass bottle over the heads of several people toward a recycling bin 15...

CA Life and Health Exam Questions and Answers Already Passed What is insurance? Insurance is the legal contract where two parties agree that if something will happen, a value will be exchanged. What's the difference between pure risk and speculative risk? Pure risk is when you'll lose it all or there will be no change. Speculative risk you can either win or lose. What is peril? peril is the causes of loss insured against in an insurance policy What is hazard? conditions that increase the pr...

Entire Contract Provision - ANSWER found at the beginning of the policy, saying that the policy cannot refer to any outside documents as being part of the contract and prohibiting the insurer from making any changes to the policy after it has been issued. (can only make good changes not bad) Insuring Clause - ANSWER sets forth the company's basic promise to pay benefits upon the insured's death. Free-Look Provision - ANSWER gives policyowners the right to return the policy for a full pre...

VA Health and Life Insurance Questions and Answers Already Passed Why would a large corporation choose to self-insure rather than buy an insurance policy from an insurance company? a) to avoid having to comply with individual state laws b) to cover against an occasional but high-severity loss c) to insure against frequent but low-severity losses d) for tax abatement purposes c) to insure against frequent but low-severity losses A large company that is willing and financially able...

Why were Exchanges implemented by the Affordable Care Act (ACA)? To create a one-stop market for standardized health insurance plans. Provide an additional stream of income for the Federal government. To enforce every U.S citizen to purchase health insurance. Assist in the conversion of individual policies to government mandated plans. - To create a onestop market for standardized health insurance plans. A licensee whose name or address changes must notify the Commissioner within 15 days b...

Disability Buy-Out plans feature: - ANSWER Long elimination plans up to two years (A disability buy-out plan funded with disability insurance has a long elimination period of generally two years. The elimination period begins the day of the disability. Then the disability policy will provide a lump sum to buy the disabled partner out. They want to make sure that the partner is not going to recover and come back to work) When MUST the Office of Insurance Regulation conduct a market conduct exa...

What Act shaped how commercial insurance carriers approached the concepts of paying for medical care? - ANSWER-HMO Act of 1973 ACA - ANSWER-Affordable Care Act HMO (Health Maintenance Organization) - ANSWER-The organization is both the insurer and provider of a set of defined services. Patients within this network must use an in-network provider for their services to be covered. Capitation Payment - ANSWER-part of prospective payment in which healthcare providers receive fixed monthly p...

CEBS - GBA 1 AND 2- PRACTICE EXAM QUESTIONS AND ANSWERS 2024 WITH COMPLETE SOLUTION Which of the following statements correctly describes minimum requirements that group benefit plans typically must meet in order to be prospectively rated on contract renewal? Ans- The more unpredictable the event that will trigger a claim, the larger the minimum group size and premium requirements Which of the following statements correctly describes the term graduation as it applies to mortality tables?...

Medical billing and coding latest version graded A+ Medical Insurance Financial plan (the payer) that covers the cost of hospital and medical care Policyholder Person who buys an insurance plan; the insured, subscriber, or guarantor Health Plan Individual or group plan that provides or pays for the cost of medical care Benefits What a health plan pays for services covered in an insurance policy; listed in the schedule of benefits. Medical Necessity Reasonable services of prov...