Illinois Insurance Licensing & Health Policy Fundamentals
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Income in the event an illness or ac-
What does a disability income policy
cident results in a disability that pre-
provide?
vents the insured from working.
What percentage of current net earn- Usually 60% to 70% of the insured's
ings does an individual disability in- current net earnings at the time of
come policy typically cover? disablement.
What does a business overhead ex- Office rent, utilities, and employee la-
pense policy cover? bor, but not loss of income.
What is the purpose of a business To benefit the corporation or business
disability buyout policy? partners in case of a disability.
What type of policy is a group disabil-
Offered on a nonoccupational basis.
ity income policy?
What is the principal sum in an Ac-
100% for the loss of 2 limbs or death
cidental Death and Dismemberment
within 90 days of an accident.
(AD&D) policy?
Costs incurred in the prevention or
What does medical expense insur-
treatment of injury or disease, includ-
ance cover?
ing doctor visits and prescriptions.
, Illinois Insurance Licensing & Health Policy Fundamentals
Study online at https://quizlet.com/_jrfx9j
Not designed to provide coverage for
What is a basic hospital, medical, and
catastrophic losses and has no de-
surgical policy designed for?
ductible.
What do major medical policies cov- Catastrophic and prolonged injury or
er? illness with high maximum limits.
A maximum of 2-3 deductibles will
What is a family deductible in major
satisfy the deductible requirement for
medical policies?
the entire family per calendar year.
What is the role of primary care physi-
They act as gatekeepers to specialists
cians (PCPs) in Health Maintenance
and emphasize preventative care.
Organizations (HMOs)?
What is a key feature of Preferred They will cover services out of network,
Provider Organizations (PPOs)? but at a lower percentage.
What do Point of Service (POS) plans
Benefits of both PPO and HMO plans.
combine?
What happens to contributions in They are 'use it or lose it' and self-em-
Flexible Spending Accounts (FSAs)? ployed individuals are not eligible.
, Illinois Insurance Licensing & Health Policy Fundamentals
Study online at https://quizlet.com/_jrfx9j
What is required for a plan to qual-
The annual deductible must meet the
ify as a High Deductible Health Plan
minimum amount set by the IRS.
(HDHP)?
What do Medicare supplement poli- They supplement Medicare Part A & B
cies (Medigap) do? plans.
It allows dependents to continue cov-
What is COBRA in relation to group erage for 36 months in the event of
insurance? death or legal separation of the in-
sured.
Convalescent care for events expected
What does Long Term Care (LTC) in-
to last 12 months, including diagnos-
surance cover?
tic and rehabilitative services.
What does a dental insurance policy Diagnostic checkups, fillings, crowns,
typically cover? dentures, and orthodontics.
The cost to replace prescription safety
What does vision insurance not cover? glasses and medical expenses from
diseases like cataracts.
What is the purpose of cancer insur- To cover experimental treatments that
ance? traditional insurance excludes.
What is a hospital indemnity policy?
Study online at https://quizlet.com/_jrfx9j
Income in the event an illness or ac-
What does a disability income policy
cident results in a disability that pre-
provide?
vents the insured from working.
What percentage of current net earn- Usually 60% to 70% of the insured's
ings does an individual disability in- current net earnings at the time of
come policy typically cover? disablement.
What does a business overhead ex- Office rent, utilities, and employee la-
pense policy cover? bor, but not loss of income.
What is the purpose of a business To benefit the corporation or business
disability buyout policy? partners in case of a disability.
What type of policy is a group disabil-
Offered on a nonoccupational basis.
ity income policy?
What is the principal sum in an Ac-
100% for the loss of 2 limbs or death
cidental Death and Dismemberment
within 90 days of an accident.
(AD&D) policy?
Costs incurred in the prevention or
What does medical expense insur-
treatment of injury or disease, includ-
ance cover?
ing doctor visits and prescriptions.
, Illinois Insurance Licensing & Health Policy Fundamentals
Study online at https://quizlet.com/_jrfx9j
Not designed to provide coverage for
What is a basic hospital, medical, and
catastrophic losses and has no de-
surgical policy designed for?
ductible.
What do major medical policies cov- Catastrophic and prolonged injury or
er? illness with high maximum limits.
A maximum of 2-3 deductibles will
What is a family deductible in major
satisfy the deductible requirement for
medical policies?
the entire family per calendar year.
What is the role of primary care physi-
They act as gatekeepers to specialists
cians (PCPs) in Health Maintenance
and emphasize preventative care.
Organizations (HMOs)?
What is a key feature of Preferred They will cover services out of network,
Provider Organizations (PPOs)? but at a lower percentage.
What do Point of Service (POS) plans
Benefits of both PPO and HMO plans.
combine?
What happens to contributions in They are 'use it or lose it' and self-em-
Flexible Spending Accounts (FSAs)? ployed individuals are not eligible.
, Illinois Insurance Licensing & Health Policy Fundamentals
Study online at https://quizlet.com/_jrfx9j
What is required for a plan to qual-
The annual deductible must meet the
ify as a High Deductible Health Plan
minimum amount set by the IRS.
(HDHP)?
What do Medicare supplement poli- They supplement Medicare Part A & B
cies (Medigap) do? plans.
It allows dependents to continue cov-
What is COBRA in relation to group erage for 36 months in the event of
insurance? death or legal separation of the in-
sured.
Convalescent care for events expected
What does Long Term Care (LTC) in-
to last 12 months, including diagnos-
surance cover?
tic and rehabilitative services.
What does a dental insurance policy Diagnostic checkups, fillings, crowns,
typically cover? dentures, and orthodontics.
The cost to replace prescription safety
What does vision insurance not cover? glasses and medical expenses from
diseases like cataracts.
What is the purpose of cancer insur- To cover experimental treatments that
ance? traditional insurance excludes.
What is a hospital indemnity policy?
