NC Health Insurance Questions and Answers(A+ Solution guide)

Which of the following provides coverage on a first-dollar basis? - Basic expense. Which of the following answers does NOT describe the principal goal of a Preferred Provider Organization? - Provide medical services only from physicians in the network. A small business owner is the insured under a disability policy that funds a buy-sell agreement. If the owner dies or becomes disabled, the policy would provide which of the following? - Cash to the owner's business partner to accomplish a buyout. What is the maximum age for qualifying for a catastrophic plan? - 30. In a relative value system of determining coverage for a given procedure, what term describes the total amount payable per point? - Conversion factor. According to the PPACA rules, what percentage of the health care costs will be covered under the bronze plan? - 60%. An insured is hospitalized for a back injury. Upon checking his income disability, he learns that he will not be eligible for benefits for at least 30 days. This would incdicate that his policy was probably written with a 30 day - Elimination period. Which type of medical policy pays a fixed amount each day that the insured is in the hospital? - Indemnity. Social Security Supplement (SIS) or Social Security Riders would provide for the payment of income benefits in each of the situations below EXCEPT - When the amount payable under Social Security is more than the amount payable under the rider.A brain surgeon has an accident and develops tremors in her right arm. Which disability income policy definition of total disability will cover her of all losses? - "Own occupation" - less restrictive than other definitions. Under the Affordable Care Act, which classification applies to health plans based on the amount of covered costs? - Medal level classification. Which rider, when added to a disability income policy, provides for changes in benefits payable based on changes in the consumer price index? - Cost of living adjustment rider. Which of the following terms describes a specific dollar amount of the cost of care that must be paid by the member? - Copayment. What is the typical deductible for basic surgical expense insurance? - $0. Which of the following are the main factors taken into account when calculating residual disability benefits? - Present earnings and earnings prior to disability. What is the contract provision that allows the insurer to nonrenew health coverage if certain events occur? - Conditionally renewable.