ILLINOIS HEALTH INSURANCE UPDATED EXAMS
TEST PAPER QUESTIONS AND ANSWERS SURE A+
✔✔Deductable - ✔✔is an initial amount of loss which the insured must pay before the
insurance company will begin to indemnify; most often annually
✔✔Coinsurance also known as - ✔✔Policyholder participation; insurance co pays a %
and the insured pays the rest
✔✔Stop Loss - ✔✔the stated level of eligible expenses where the insurance company
begins indeminifying 100% of the insured's expenses and where the insured's losses
stop
✔✔Maximum Out-of-Pocket - ✔✔is the max the insured will be required to pay under
both the deductible and policyholder participation requirements
✔✔Co-Payment - ✔✔is a small, specific amount that the insured must pay before the
insurance company begins to indemnify for a particular type of expense
✔✔Purpose of co-payment, deductible, and policy holder participation... - ✔✔is to
encourage the insured to avoid unnecessary expenses and to eliminate small claims
that the insured can afford and which would cost the insurance company to administer
, ✔✔High Limit of Liability - ✔✔Major medical coverage always has a high limit of liability
except in the affordable care act
✔✔Health Savings Accounts (HSAs) - ✔✔cover hospital/medical expenses not covered
by a high deductible health plan
✔✔(tax) contributions to HSAs are - ✔✔usually tax deductible
✔✔Flexible Spending Accounts (FSA) - ✔✔the employer reduces the employee's
wages by an agreed amount; these amounts are credited to a Flex spending account
✔✔Cafeteria plan - ✔✔part of the FSA is used to pay premiums on the employee's
health insurance. the employee can select coverage options. it allows the employee to
tailor benefits to his/her personal or family needs
✔✔Disability - ✔✔is when a person is unable to work due to an illness or injury
✔✔Disability income insurance protects - ✔✔an insured against the financial risk of loss
of income due to disability
✔✔Disability income indemnifies when the insured - ✔✔is permanently and totally
disabled
✔✔Disability income will be paid even if the insured - ✔✔is not confined to a hospital
✔✔Disability income are usually - ✔✔non-coordinating
✔✔(tax)Individual Disability income policy premiums usually - ✔✔cannot be tax
deducted; no tax on ind. Disability income benefits (tax free)
✔✔(tax) Group Disability income policy premiums usually - ✔✔can be tax deducted by
the employer; benefits usually are subject to tax
✔✔Definitions of Total Disability: Insured's own occupation - ✔✔the policy pays benefits
as long as the insured is unable to perform functions of his/her own occupation (high
premiums; very liberal; highly compensated or specialized positions)
✔✔Definitions of Total Disability: Any occupation for which the insured is reasonably
suited by education and background - ✔✔most skilled, business, technical people
✔✔Definitions of Total Disability: Any occupation - ✔✔insured is unable to perform the
functions of any occupation at all (low premiums; most conservative)
TEST PAPER QUESTIONS AND ANSWERS SURE A+
✔✔Deductable - ✔✔is an initial amount of loss which the insured must pay before the
insurance company will begin to indemnify; most often annually
✔✔Coinsurance also known as - ✔✔Policyholder participation; insurance co pays a %
and the insured pays the rest
✔✔Stop Loss - ✔✔the stated level of eligible expenses where the insurance company
begins indeminifying 100% of the insured's expenses and where the insured's losses
stop
✔✔Maximum Out-of-Pocket - ✔✔is the max the insured will be required to pay under
both the deductible and policyholder participation requirements
✔✔Co-Payment - ✔✔is a small, specific amount that the insured must pay before the
insurance company begins to indemnify for a particular type of expense
✔✔Purpose of co-payment, deductible, and policy holder participation... - ✔✔is to
encourage the insured to avoid unnecessary expenses and to eliminate small claims
that the insured can afford and which would cost the insurance company to administer
, ✔✔High Limit of Liability - ✔✔Major medical coverage always has a high limit of liability
except in the affordable care act
✔✔Health Savings Accounts (HSAs) - ✔✔cover hospital/medical expenses not covered
by a high deductible health plan
✔✔(tax) contributions to HSAs are - ✔✔usually tax deductible
✔✔Flexible Spending Accounts (FSA) - ✔✔the employer reduces the employee's
wages by an agreed amount; these amounts are credited to a Flex spending account
✔✔Cafeteria plan - ✔✔part of the FSA is used to pay premiums on the employee's
health insurance. the employee can select coverage options. it allows the employee to
tailor benefits to his/her personal or family needs
✔✔Disability - ✔✔is when a person is unable to work due to an illness or injury
✔✔Disability income insurance protects - ✔✔an insured against the financial risk of loss
of income due to disability
✔✔Disability income indemnifies when the insured - ✔✔is permanently and totally
disabled
✔✔Disability income will be paid even if the insured - ✔✔is not confined to a hospital
✔✔Disability income are usually - ✔✔non-coordinating
✔✔(tax)Individual Disability income policy premiums usually - ✔✔cannot be tax
deducted; no tax on ind. Disability income benefits (tax free)
✔✔(tax) Group Disability income policy premiums usually - ✔✔can be tax deducted by
the employer; benefits usually are subject to tax
✔✔Definitions of Total Disability: Insured's own occupation - ✔✔the policy pays benefits
as long as the insured is unable to perform functions of his/her own occupation (high
premiums; very liberal; highly compensated or specialized positions)
✔✔Definitions of Total Disability: Any occupation for which the insured is reasonably
suited by education and background - ✔✔most skilled, business, technical people
✔✔Definitions of Total Disability: Any occupation - ✔✔insured is unable to perform the
functions of any occupation at all (low premiums; most conservative)
