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35 Questions
| Total Attempts: 556
Ron has a new employer and wishes to enroll in the company's group health plan. In determining whether his pre-existing health condition applies, Ron cannot have more than a (blank) day gap without previous health insurance.
Group health plans may deny participation based upon the
Member's pre-existing condition
Member' part-time employment status
How many employees must an employer have for a terminated employee to be eligible for COBRA?
Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA?
It would be considered taxable income to the employee
The employee would not be allowed to an HSA
The employer would pay payroll tax and FICA on the contribution amount
The employer would not be allowed to deduct the contribution from the employee's pay
Sonya applied for a health insurance policy on April 1. Her agent submitted the information to the insurance company on April 6. She paid the premium on May 15 with the policy indicating the effective date being May 30. On which date would Sonya have coverage?
Credit Accident and Health plans are designed to
Permit creditors the ability to require that coverage be purchased through insurers of their choice
Provide permanent protection
Help pay off existing loans during periods of disability
Not permit free choice of coverage selection
What is the contract called that is issued to an employer for a Group Medical Insurance Plan?
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's benefits must
Be less extensive and premium cannot exceed 102%
Be the same and the premium cannot exceed 102%
Be more extensive and the premium cannot exceed 102%
Be the same as well as the premium
Which of the following would evidence ownership in a participating health insurance contract?
Irrevocable beneficiary status
An employer is issued a group medical insurance policy. This single contract is known as a(n)
Under group health insurance, a certificate of coverage is issued to the
Under a disability income policy, which provision would be payable if the cause of an injury is unexpected and accidental?
Presumptive disability provision
Absolute accidental provision
Accidental death benefit provision
Accidental bodily injury provision
Health insurance involves two perils, accident and (blank).
Health insurance will typically cover which of the following perils?
Which of the following does Coordination of Benefits allow?
Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid
Allows both a group health plan and individual health plan to coordinate their benefit payments
Allows the deductible to be spread out between all the health providers
Allows each health provider to pay 100% of the claim
The purpose of the Coordination of Benefits provision in group accident and health plans is to
Avoid overpayment of claims
Reduce out-of-pocket costs
Lower the cost of premiums
Sole proprietors are permitted tax deductions for health costs paid from their earnings in the amount of
Costs that exceed 7 1/2 % of AGI
Costs that exceed 10% of AGI
A person covered with an individual health plan
Is issued a certificate of medical costs
Does not contract directly with the insurance company
Is not subject to medical underwriting
According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual
Is eligible for coverage upon hire
Must wait 360 days to be eligible for coverage
Must continue coverage with the previous employer
Is eligible for only health insurance, not life or dental insurance
When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)?
When a change of management has occurred within the group
When the annual number of claims has increased by 25%
When contribution or participation rules have been violated
When group participation has increased by 25%
An insurer has the right to recover payment made to the insured from the negligent party. These rights are called
Which of the following decisions would a Health Savings Account (HSA)owner NOT be able to make?
The amount contributed by the employer
The amount contributed by the owner
The underlying account investments used
The medical expenses paid for by the HSA
In an employer-sponsored group accident and health plan, a master contract is issued to the
Adminstrative Services Organization
In an employer-sponsored contributory group Disability Income plan, the employer pays 60% of the premium and each employee pays 40% of the premium. Any income benefits paid are taxed to the employee at