Retrospective rating Study guides, Class notes & Summaries

CRC EXAM QUESTIONS AND ANSWERS 100% PASS Risk Adjustment Data Element - Correct Answer ️️ -Age, Gende, Socioeconomic status, Disability status, Insurance status(Medicaid, dual-eligible,) Claims data elements such as procedure codes, place of service codes, special patient-specific conditions hospice, ESRD RAF - Correct Answer ️️ -Risk Adjustment Factor Scores Three main types of reviews - Correct Answer ️️ -Retrospective, Concurrent and prospective Retrospective - Correct Ans...

What is *retrospective rating plan*? : The retrospective rating plan is based on the insured's actual loss experience during the policy term. The client and insurer agree on a formula under which the ultimate cost of claims will be borne by the insured. Min and Max premium, LO - Explain the difference between ratemaking and the rating process : *Ratemaking* is preformed by actuaries and involves analyzing stats of past claims, estimating cost of settling current outstanding claims, and...

Which of the following is a property policy with a provision agreed upon by the insurer and insured as to the amount of insurance that represents a fair valuation for the property at the time the insurance is written and suspends any coinsurance or other contribution clauses in the policy? a) Market value b) Agreed value c) Replacement cost d) Stated amount. Answer - B With regard to fire insurance premiums, structures with which of the following type of construction would most likely have th...

adverse selection - Occurs when high risk individuals, that is, people who are more likely to use many health services, enroll in health insurance plans in greater numbers, compared to people who are healthy *When adverse selection occurs, premiums have to be raised for everyone adjusted community rating - AKA "modified community rating" *Overcomes the drawbacks of experience rating and pure community rating *Under this method, price differences take into account demographic fa...

Prospective Loss Costs (Pure Premium) - Amount needed to pay future claims and loss adjustment expenses. Class (Manual) Rating: Frequency*Severity Lloyd's of London - Specialized lines of business. Brokers - represent policyholders to arrange coverage with syndicates. Legally represents insured. Syndicates - Offer insurance contracts in the market. Managing Agents - Manage the syndicates, who typically specialize in certain lines. Underwriters - Work for the syndicates to assess risks a...

CEBS GBA2 Terms and Definitions Exam Questions and Answers Bounded Rationality - Answer-When the consumer is functional only up to a certain point after which his/her choices are constrained or bound by limed knowledge and understanding of the available choices. Free Market Basic Assumption - Answer-Rational consumers will make informed decisions about value, quality, and price Moral Hazzard - Answer-Consumer will spend someone else's money different than their own Transparency on c...

Nj Property and Casualty Insurance Exam | Complete Solutions, Latest Answers 2023 | Graded A+. Examples of surplus lines—State level Personal auto insurance plan PAIP an assigned risk plan , commercial auto insurance plan an assigned risk plan, The fair plan (property insurance) , Worker's Compensation assigned risk programs binder A temporary written or oral agreement to provide insurance coverage until a formal written policy is issued. Certificate of Insurance A legal document tha...

In property insurance, actual cash value is defined as which of the following? a) Market value of the property at the time of the loss b) Stated value of the property as shown on the declaration c) The actual amount of a loss payable, less the policy deductible d) Replacement cost at the time of the loss, less depreciation. - D With regard to fire insurance premiums, structures with which of the following type of construction would most likely have the most favorable premium rate for the pe...

ASP - Safety Management Systems 2024 All Answers Rated A+ Indirect costs - uninsured costs costs of time & resources other than cash; costs are estimated safety management theory, accidents in the workplace are considered to be management failure safety management must Plan, organize, implement and control symptoms of Management must function to make decisions and have those decisions implemented Participative management style flow of information within the organization is in...

Judgement rating - Rating used by underwriters to rate one-of-a-kind risks. Schedule Rating - A rating plan that awards debits and credits based on specific categories, such as the care and condition of the premises or the training and selection of employees, to modify the final premium to reflect factors that the class rate does not include. expierence rating - insureds own past loss experience enters into the determination of the final premium Retrospective rating - A self-rating plan...