Health insurance coverage Study guides, Class notes & Summaries

Can a group that is formed the sole purpose of obtaining group insurance qualify for group coverage? correct answer: No, the group must be formed for a purpose other than obtaining group insurance As it pertains to group health insurance, COBRA stipulates that correct answer: Group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense After a person's employment is terminated, it is possible to obtain individual health insura...

LA Life, Health & Accident Insurance Series 103 Practice Exam Questions and Answers Already Passed Under which situation must insurable interest exist between the applicant and insured at the time of application? When a third-party applicant names themselves beneficiary. Which of the following is true about a decreasing term life policy? The face amount reaches zero at policy expiration. Which of the following occurs immediately after the application is submitted and the initial premium paid?...

the transfer of an insured's right to seek damages from a negligent party to the insurer is found in which of the following clauses? correct answer: Subrogation the purpose of managed care health insurance is to correct answer: control health insurance claims expenses a man works for company A and his wife works for company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim correct answer: the ins...

A broker requests a hearing with the Commissioner. Within how many days of the request must the hearing be held? - 30 Collision coverage extends to rented passenger vehicles that have been rented for - No more than 30 days. Every vehicle insurance policy issued and delivered in Maryland must provide coverage for medical, hospital and disability benefits, unless - Waived by the first named insured. When an insurer desires to cancel or non-renew a property insurance policy, they must give ad...

Group Insurance - A method of providing life or health insurance coverage for a group of people under one insurance contract. commonly provide: - life insurance, medical expense insurance, disability insurance, and dental insurance coverage Master group insurance contract - An insurance contract that insures a number of people. Group insured - An individual covered by a group insurance policy. Group policyholder - The person or organization that decides what types of group insurance cover...

National Coverage Determination (NCD) - Which of the following Medicare policies determines if a particular item or service is covered by Medicare? Adjudication - Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Encounter Form - A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Admitting clerk - A patient comes to the hospital for an inpatient procedure. Which of the following hospi...

MHA 710/ MHA710 Exam 4: (Latest 2024/ 2025) Questions and Verified Answers| Grade A| 100% Correct Q: Which of the following provisions included in the Affordable Care Act (ACA) was responsible for the largest number of newly insured? Answer: Expansion of Medicaid Q: The most costly expansion of Medicaid since its inception is referred to as: Answer: The State Children's Health Insurance Program. Q: Answer: In 2008, the state of Oregon used a lottery to ex...

Colorado Health Insurance Exam| Questions and Verified Answers| Grade A (2023/2024) QUESTION J has a physical impairment, attends school, and is incapable of self-sustaining employment and/ or self care. Which of the following statements is CORRECT about J's medical coverage under J's father's group plan? A. J's coverage ceases, but J may apply for group student coverage. B. J's coverage automatically discontinues at age twenty-six. C. J's coverage continues only as long ...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage HMO Conventional PPO and POS H...

What is an eligible building for flood insurance?: A structure with 2 or more outside rigid walls and a fully secure roof, built on a permanent site, with 50% or more of the value above ground level and located within an eligible community What is Builders Risk Coverage?: Covers buildings in the course of completion. Proper coverage is 100% of expected completed value Do all Homeowners policies contain Coverage A?: No, HO-4 (Renters person- al property) What is casual labor in workers' compe...