Question 1

What is the difference between an HMO and a PPO in providing health care?

Accepted Answer

A HMO requires a capitation fee for each

Question 2

Explain why the definition of disability is important in disability income contracts. Provide some examples of disability showing the range of definitions.

Accepted Answer

The definition of disability is importan

Question 3

Which of the following is false?

Accepted Answer

A) Within the next two decades, about 50 million people born between 1946 and 1964 will retire 
B) Medicare insurance currently finances over 60 percent of all long-term nursing home care expenses 
C) The mobility of American families means that many disabled elderly persons will not have children living close enough to assist them 
D) As our society ages and health care costs increase, long-term care facilities will become more necessary 
A) Within the next two decades, about 50 million people born between 1946 and 1964 will retire 
B) Medicare insurance currently finances over 60 percent of all long-term nursing home care expenses 
C) The mobility of American families means that many disabled elderly persons will not have children living close enough to assist them 
D) As our society ages and health care costs increase, long-term care facilities will become more necessary

Question 4

Jean's health insurance policy has a 70/30 participation deductible. The policy has no other deductible provisions,nor does it have an annual out-of-pocket maximum limit. If Jean has brain transplant surgery that results in medical bills of $300,000,how much of the medical bills will her insurer pay?

Accepted Answer

A) $210,000 
B) $90,000 
C) $300,000 
D) Cannot be determined from the given information 
A) $210,000 
B) $90,000 
C) $300,000 
D) Cannot be determined from the given information

Question 5

Insurers cannot sell a Medigap policy to someone who already has such a policy,unless the new policy will replace the existing one.

Accepted Answer

A) True 
 B)False

Question 6

Group Medigap policies sold today must return in benefits at least 90 percent of the premium earned.

Accepted Answer

A) True 
 B)False

Question 7

The waiting period in disability income insurance:

Accepted Answer

A) eliminates payment for minor illness 
B) provides larger benefits to the insured 
C) provides indirect loss coverage 
D) integrates employment sick days with the disability plan 
A) eliminates payment for minor illness 
B) provides larger benefits to the insured 
C) provides indirect loss coverage 
D) integrates employment sick days with the disability plan

Question 8

Major medical insurance has relatively large deductibles.

Accepted Answer

A) True 
 B)False

Question 9

How does Blue Cross health insurance cover hospitalization?

Accepted Answer

A) by covering a specific number of days in the hospital 
B) it pays up to 80% of all usual and customary charges in a semi-private room 
C) it pays a flat dollar amount per day of hospitalization, regardless of the actual charges incurred 
D) hospitalization coverage is not provided by Blue Cross policies 
A) by covering a specific number of days in the hospital 
B) it pays up to 80% of all usual and customary charges in a semi-private room 
C) it pays a flat dollar amount per day of hospitalization, regardless of the actual charges incurred 
D) hospitalization coverage is not provided by Blue Cross policies

Question 10

Which of the following is a cost shifting technique in health insurance?

Accepted Answer

A) utilization review 
B) generic drugs 
C) second opinions 
D) increased deductibles 
A) utilization review 
B) generic drugs 
C) second opinions 
D) increased deductibles

Question 11

All of the following are individually-purchased health insurance products except:

Accepted Answer

A) Medicaid insurance 
B) Long-term care insurance 
C) Basic medical insurance 
D) Major medical insurance 
A) Medicaid insurance 
B) Long-term care insurance 
C) Basic medical insurance 
D) Major medical insurance

Question 12

Distinguish between cost shifting and cost containment in health care.

Accepted Answer

Cost shifting occurs when merely the cos

Question 13

Individual Medigap policies sold today must return in benefits at least 60 percent of the premium earned.

Accepted Answer

A) True 
 B)False

Question 14

Major medical insurance usually requires the insured to pay a percentage of all losses after a deductible up to an out-of-pocket limit.

Accepted Answer

A) True 
 B)False

What is the difference between an HMO and a PPO in providing health care?

Explain why the definition of disability is important in disability income contracts. Provide some examples of disability showing the range of definitions.

Which of the following is false?

Insurers cannot sell a Medigap policy to someone who already has such a policy,unless the new policy will replace the existing one.

Group Medigap policies sold today must return in benefits at least 90 percent of the premium earned.

The waiting period in disability income insurance:

Major medical insurance has relatively large deductibles.

How does Blue Cross health insurance cover hospitalization?

Which of the following is a cost shifting technique in health insurance?

All of the following are individually-purchased health insurance products except:

Distinguish between cost shifting and cost containment in health care.

Individual Medigap policies sold today must return in benefits at least 60 percent of the premium earned.

Major medical insurance usually requires the insured to pay a percentage of all losses after a deductible up to an out-of-pocket limit.

Fundamentals and Terminology

Defining the Insurable Event

Risk Management

Financial Services Companies

Insurance Occupations

the Insurance Market: the Economic Problem

Insurance Regulation

Insurance Contracts

Basic Property and Liability Insurance Contracts

Homeowners Insurance

the Personal Auto Policy

Professional Financial Planning

Life Insurance Policies

Standard Life Insurance Contract Provisions And Options

Annuities

Advanced Topics in Risk Management

Commercial Property Insurance

Commercial Liability Insurance

Bonding,Crime Insurance and Reinsurance

Employee Benefits

Social Security

Unemployment and Workers Compensation Insurance

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Exam 16: Medical Expense and Disability Insurance

What is the difference between an HMO and a PPO in providing health care?

Explain why the definition of disability is important in disability income contracts. Provide some examples of disability showing the range of definitions.

Which of the following is false?

Insurers cannot sell a Medigap policy to someone who already has such a policy,unless the new policy will replace the existing one.

Group Medigap policies sold today must return in benefits at least 90 percent of the premium earned.

The waiting period in disability income insurance:

Major medical insurance has relatively large deductibles.

How does Blue Cross health insurance cover hospitalization?

Which of the following is a cost shifting technique in health insurance?

All of the following are individually-purchased health insurance products except:

Distinguish between cost shifting and cost containment in health care.

Individual Medigap policies sold today must return in benefits at least 60 percent of the premium earned.

Major medical insurance usually requires the insured to pay a percentage of all losses after a deductible up to an out-of-pocket limit.

Fundamentals and Terminology

Defining the Insurable Event

Risk Management

Financial Services Companies

Insurance Occupations

the Insurance Market: the Economic Problem

Insurance Regulation

Insurance Contracts

Basic Property and Liability Insurance Contracts

Homeowners Insurance

the Personal Auto Policy

Professional Financial Planning

Life Insurance Policies

Standard Life Insurance Contract Provisions And Options

Annuities

Advanced Topics in Risk Management

Commercial Property Insurance

Commercial Liability Insurance

Bonding,Crime Insurance and Reinsurance

Employee Benefits

Social Security

Unemployment and Workers Compensation Insurance

Filters