The basis upon which a major medical insurance policy determines the amount of a
medical fee it will cover.
UCR rates are based on the amount that is usual or common for the geographical
area in which the service is performed or that is based on the usual fee charged by
most other health care providers of similar training or experience.
Give this one a try later!
Usual, Customary, and Reasonable (UCR)
A form of life insurance in which policy values may rise and fall to reflect changes in
equity-based subaccounts. The cash value is not guaranteed.
Variable life insurance premiums are invested in investment subaccounts selected by
the policyowner and managed by the insurer in its separate account. The policy
,guarantees a minimum death benefit, but the cash values and the death benefit rise
and fall based on the subaccounts' investment performance.
Give this one a try later!
Variable Life Insurance
A mandatory health insurance contract provision that requires insureds to notify their
insurer within 20 days following a covered loss.
A notice of claim serves as a notice for the insurer to send the insured the required
claims forms. Insureds who cannot notify the insurer within 20 days are expected to
do so "as soon as reasonably possible."
Give this one a try later!
Notice of Claim Provision
A disreputable form of third-party ownership of life insurance in which an investor(s)
arranges for a consumer to buy a life insurance policy that is then purchased by the
investor(s).
Give this one a try later!
STOLI (stranger-originated life insurance)
This life policy rider pays a monthly benefit to the insured if s/he becomes
permanently disabled.
,The monthly income provided under a disability income benefit rider may be paid for
as long as the disability lasts or for a limited time. Most disability income benefit riders
also include a provision for a waiver of premium.
Give this one a try later!
Disability Income Benefit Rider
Loss must be definable and measurable.
The covered peril must be accidental or outside the insured's control.
The risk must be shared by a large group of similar risks.
The loss must not be catastrophic.
The risk must not be generally excluded from coverage.
Give this one a try later!
Insurable Risk (5 Criteria)
A mandatory health insurance contract provision that allows the policyholder limited
time beyond the due date to pay a late premium.
Grace periods vary by premium mode (i.e., frequency):
7-day grace period for weekly mode
10-day grace period for monthly mode
31-day grace period for quarterly, semi-annual, or annual mode
Give this one a try later!
Grace Period Provision
, An optional health insurance contract provision that requires the insurer to adjust
benefits or premiums if the insured changes to a more or less hazardous occupation.
If the insured changes to a more hazardous occupation, this provision allows the
insurer to reduce benefits. If the insured changes to a less hazardous occupation, this
provision requires the insurer to reduce the premium.
Give this one a try later!
Change of Occupation Provision
the employer
Give this one a try later!
Before people can join an employer's group health plan, they have to meet
the criteria for eligibility. Which of the following usually sets these criteria?
The amount of Social Security retirement income a worker will receive at full
retirement age or upon total disability.
A worker's PIA is determined by applying a formula to the worker's average indexed
monthly earnings (AIME). All other Social Security benefits are based off the worker's
PIA.
Give this one a try later!
Primary Insurance Amount (PIA)
medical fee it will cover.
UCR rates are based on the amount that is usual or common for the geographical
area in which the service is performed or that is based on the usual fee charged by
most other health care providers of similar training or experience.
Give this one a try later!
Usual, Customary, and Reasonable (UCR)
A form of life insurance in which policy values may rise and fall to reflect changes in
equity-based subaccounts. The cash value is not guaranteed.
Variable life insurance premiums are invested in investment subaccounts selected by
the policyowner and managed by the insurer in its separate account. The policy
,guarantees a minimum death benefit, but the cash values and the death benefit rise
and fall based on the subaccounts' investment performance.
Give this one a try later!
Variable Life Insurance
A mandatory health insurance contract provision that requires insureds to notify their
insurer within 20 days following a covered loss.
A notice of claim serves as a notice for the insurer to send the insured the required
claims forms. Insureds who cannot notify the insurer within 20 days are expected to
do so "as soon as reasonably possible."
Give this one a try later!
Notice of Claim Provision
A disreputable form of third-party ownership of life insurance in which an investor(s)
arranges for a consumer to buy a life insurance policy that is then purchased by the
investor(s).
Give this one a try later!
STOLI (stranger-originated life insurance)
This life policy rider pays a monthly benefit to the insured if s/he becomes
permanently disabled.
,The monthly income provided under a disability income benefit rider may be paid for
as long as the disability lasts or for a limited time. Most disability income benefit riders
also include a provision for a waiver of premium.
Give this one a try later!
Disability Income Benefit Rider
Loss must be definable and measurable.
The covered peril must be accidental or outside the insured's control.
The risk must be shared by a large group of similar risks.
The loss must not be catastrophic.
The risk must not be generally excluded from coverage.
Give this one a try later!
Insurable Risk (5 Criteria)
A mandatory health insurance contract provision that allows the policyholder limited
time beyond the due date to pay a late premium.
Grace periods vary by premium mode (i.e., frequency):
7-day grace period for weekly mode
10-day grace period for monthly mode
31-day grace period for quarterly, semi-annual, or annual mode
Give this one a try later!
Grace Period Provision
, An optional health insurance contract provision that requires the insurer to adjust
benefits or premiums if the insured changes to a more or less hazardous occupation.
If the insured changes to a more hazardous occupation, this provision allows the
insurer to reduce benefits. If the insured changes to a less hazardous occupation, this
provision requires the insurer to reduce the premium.
Give this one a try later!
Change of Occupation Provision
the employer
Give this one a try later!
Before people can join an employer's group health plan, they have to meet
the criteria for eligibility. Which of the following usually sets these criteria?
The amount of Social Security retirement income a worker will receive at full
retirement age or upon total disability.
A worker's PIA is determined by applying a formula to the worker's average indexed
monthly earnings (AIME). All other Social Security benefits are based off the worker's
PIA.
Give this one a try later!
Primary Insurance Amount (PIA)
