Group medical expense - Study guides, Class notes & Summaries

When life insurance proceeds are used to pay inheritance taxes and federal estate taxes, it is known as - Answer- Estate conservation In group insurance, the primary purpose of the Coordination of Benefits provision is to - Answer- Prevent overinsurance Which of the following statements is NOT true regarding health insurance policy provisions? - Answer- All additional provisions written by insurers are cataloged by their respective states. The policyowner has an option to pledge the lif...

Barbara's policy includes a rider which allows her to purchase additional insurance at specific dates or events without evidence of insurability. This rider is called a(n) Answers>>Guaranteed insurability rider A guaranteed insurability rider allows for the insured to purchase additional insurance at specific dates or events without evidence of insurability. Disability Income plans which require that the insurer can NEVER change or alter premium rates are usually considered Answers&...

PRIMERICA LIFE INSURANCE EXAM WITH 100% CORRECT ANSWERS 2025 An insured purchased an insurance policy 5 years ago. Last year, she received a dividend check from the insurance company that was not taxable. This year, she did not receive a check from the insurer. From what type of insurer did the insured purchase the policy? a. mutual b. reciprocal c. nonprofit service organization d. stock - Correct answer-A. mutual funds not paid out after paying claims and other operating costs are re...

Certain conditions, such as dismemberment or total and permanent blinds, will automatically qualify the insured for full disability benefits. Which disability policy provision does this describe? - presumptive disability Which provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss? - notice of claim Because an insurance policy is a legal contract, it must conform to the state laws governing contracts which require all of the following el...

Xcel solutions final exam Insuring Which health policy clause specifies the amount of benefits to be paid - Answer ️️ - Insuring The investment gains from a universal life policy usually go to - Answer ️️ -The cash value L takes out a life insurance policy and dies 10 years later. During the claim process, the insurer finds out that the applicant misstated their age. What will the insurer do? - Answer ️️ -Adjust the death benefit to a reduced amount An employee is covered unde...

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...

A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as Usual, customary and reasonable What provision would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner? Payment of Claims All of the following are true about gr...

NY Series 17-52 Questions and Answers 100% Pass How many eligible employees must be included in a contributory health insurance plan? 50% 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, The insurance through his company is primary. What is the period of coverage for events such as death or divorce under COBRA? 36 months Twenty-five days after ...

Florida 240 Practice Exam Questions And Answers 100% Verified A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as - answerUsual, customary and reasonable What provision would prevent an insurance company from paying a reimbursement claim to someone other than the policyow...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-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 - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...