Underwriting and HIV
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Insurer must approach the topic in an indiscriminate manner, without unfair
discrimination
Multi Employer Trust
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Entities formed by unrelated businesses in same or related industrial
classification
,TRICARE Prime
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The basic managed care health plan offered by TRICARE. Requires
premium but no out of pocket expenses for tests or procedures, etc, as
long as primary care manager is used. $12 copay for office visit and $11
daily charge for hospitalization.
Emergency care under ACA
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Emergency services under ACA must be covered without prior
authorization regardless of insurer participating status. In and out of
network are covered for the same cost.
Coverage Exclusions for Medical Expense
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Preexisting conditions, self inflicted injury, war, elective cosmetic surgery,
military service, overseas residency, felony commission or attempt
Medical expense optional benefits
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, Vision care, hearing, maternity rider
Renewablity of coverage
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Health benefit plans are renewable unless premiums are not paid, fraud or
misrepresentation occurs, noncompliance with carrier plan provisions
happens. Insurer cannot cancel for claim frequency
Accident and health insurance
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Policies covering perils of injury and sickness
Point of Service (POS)
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A hybrid of HMOs and PPOs, lets members choose which part of the plan
to use. Choice may be limited or unlimited.
cost of living rider
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, Automatically increases monthly benefits after the onset of a disability, as
the Consumer Price Index (CPI) increases. An adjustment in benefits is
made on each anniversary while the disability continues and protects the
insured against inflation.
Replacement
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Involves canceling old policy upon the purchase of a new policy. Evidence
of insurability may be required
Part A Blood Deductible
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Blood - There is a "deductible" amounting to the first 3 pints of blood
administered per calendar year. After the deductible is met, Part A will
cover the cost of inpatient blood transfusions for the remainder of the year.
Rehab benefits
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Give this one a try later!
Insurer must approach the topic in an indiscriminate manner, without unfair
discrimination
Multi Employer Trust
Give this one a try later!
Entities formed by unrelated businesses in same or related industrial
classification
,TRICARE Prime
Give this one a try later!
The basic managed care health plan offered by TRICARE. Requires
premium but no out of pocket expenses for tests or procedures, etc, as
long as primary care manager is used. $12 copay for office visit and $11
daily charge for hospitalization.
Emergency care under ACA
Give this one a try later!
Emergency services under ACA must be covered without prior
authorization regardless of insurer participating status. In and out of
network are covered for the same cost.
Coverage Exclusions for Medical Expense
Give this one a try later!
Preexisting conditions, self inflicted injury, war, elective cosmetic surgery,
military service, overseas residency, felony commission or attempt
Medical expense optional benefits
Give this one a try later!
, Vision care, hearing, maternity rider
Renewablity of coverage
Give this one a try later!
Health benefit plans are renewable unless premiums are not paid, fraud or
misrepresentation occurs, noncompliance with carrier plan provisions
happens. Insurer cannot cancel for claim frequency
Accident and health insurance
Give this one a try later!
Policies covering perils of injury and sickness
Point of Service (POS)
Give this one a try later!
A hybrid of HMOs and PPOs, lets members choose which part of the plan
to use. Choice may be limited or unlimited.
cost of living rider
Give this one a try later!
, Automatically increases monthly benefits after the onset of a disability, as
the Consumer Price Index (CPI) increases. An adjustment in benefits is
made on each anniversary while the disability continues and protects the
insured against inflation.
Replacement
Give this one a try later!
Involves canceling old policy upon the purchase of a new policy. Evidence
of insurability may be required
Part A Blood Deductible
Give this one a try later!
Blood - There is a "deductible" amounting to the first 3 pints of blood
administered per calendar year. After the deductible is met, Part A will
cover the cost of inpatient blood transfusions for the remainder of the year.
Rehab benefits
Give this one a try later!
