Life, Accident and Health Exam
Annuity - ANS-A contract between a person and an insurance company that requires the insurer
to make payments to you.
-You buy an annuity by making either a single payment or a series of payments
-Annuity Death benefits are NOT tax deductible or taxfree
Dividends - ANS-Declared by the board of directors and cannot be guaranteed
-A sum of money paid regularly by a company to its shareholders out of its profits
Stock Insurers - ANS-Owned by the stockholders who elect the board of directors.
-Profits are paid to the stockholders.
Frequency - ANS-When the pricing principle is defined in a disability policy by a financial loss in
a certain group occuring over a certain period of time.
Beneficiary - ANSOne who receives benefits
Medi-Cal - ANShealth care program for the poor
Medicare - ANSA - provides coverage for hospital services, free to those who reach 65)
B - provides coverage for doctor services (optional)
C - does NOT cover prescription drugs
D - Prescription Drugs
Utmost Good Faith - ANS-Allows each party to rely on the representation made by other party
Patient Protection & Affordable Care Act (PPACA) - ANSThis is the health care reform law.
Focuses on reform of the private health insurance market; providing better coverage for those
with pre-existing conditions; improving prescription drug coverage in Medicare.
Period - ANSProbationary-
Elimination- the waiting period included in disability income policies
Grace-
Waiting (deductible)- The period of time the insured is not eligible for benefits once they become
disabled (30, 60, 90days)
Coinsurance - ANS-Feature of Major Medical insurance
-Defined as sharing the loss after the deductible has been satisfied
-Usually expressed as percentage sharing of the loss between the insurer and the insured
-Insurer pays the larger percentage, such as 90/10
, Gatekeeper - ANS-Primary Care Physician
-Cannot be a specialist, must be a general practice doctor.
COBRA - ANS-Consolidated Omnibus Budget Reconciliation Act
-A law that allows people who leave employment to continue their health insurance under the
company plan for a limited period of time
HIPCAP - ANS-Free counseling
Coordination of Benefits - ANS-Provision that applies in group insurance when an insured has
coverage under multiple plans at one time.
-Coordination of benefits is included in all group health insurance policies in order to reinforce
the principle of indemnity and determine which coverage is primary, which is the coverage the
insured has where they work.
Keogh plan - ANS-A retirement plan for the self-employed
The Social Security Blackout - ANS-Period of time when surviving family members are NOT
eligible for Social Security survivors benefits
-Begins at 16
-Ends at 60
Premium - ANS-The amount the insured pays the insurer for the coverage provided.
Solvent Insurer - ANSHas enough reserves to pay for all its liabilities
Types of Life Policy Riders: - ANS-Waiver of Premium- Waives the insured's premium if the
insured becomes disabled
-Disability Income- Pays a replacement of the insured's lost income if the become disabled.
-Accidental Death Benefit- Pays double the face amount if the insured dies in an accident, and
is also known as double indemnity.
-Guaranteed Insurability- Allows the insured to purchase additional amounts of life insurance
w/o having to prove insurability.
-Cost of Living- increases the policy death benefit based upon the rate of inflation
Indemnity - ANS-Security or protection against a loss or other financial burden.
Hospital Confinement Policy - ANS-Pays a set amount per day if the insured in confined in the
hospital.
Annuity - ANS-A contract between a person and an insurance company that requires the insurer
to make payments to you.
-You buy an annuity by making either a single payment or a series of payments
-Annuity Death benefits are NOT tax deductible or taxfree
Dividends - ANS-Declared by the board of directors and cannot be guaranteed
-A sum of money paid regularly by a company to its shareholders out of its profits
Stock Insurers - ANS-Owned by the stockholders who elect the board of directors.
-Profits are paid to the stockholders.
Frequency - ANS-When the pricing principle is defined in a disability policy by a financial loss in
a certain group occuring over a certain period of time.
Beneficiary - ANSOne who receives benefits
Medi-Cal - ANShealth care program for the poor
Medicare - ANSA - provides coverage for hospital services, free to those who reach 65)
B - provides coverage for doctor services (optional)
C - does NOT cover prescription drugs
D - Prescription Drugs
Utmost Good Faith - ANS-Allows each party to rely on the representation made by other party
Patient Protection & Affordable Care Act (PPACA) - ANSThis is the health care reform law.
Focuses on reform of the private health insurance market; providing better coverage for those
with pre-existing conditions; improving prescription drug coverage in Medicare.
Period - ANSProbationary-
Elimination- the waiting period included in disability income policies
Grace-
Waiting (deductible)- The period of time the insured is not eligible for benefits once they become
disabled (30, 60, 90days)
Coinsurance - ANS-Feature of Major Medical insurance
-Defined as sharing the loss after the deductible has been satisfied
-Usually expressed as percentage sharing of the loss between the insurer and the insured
-Insurer pays the larger percentage, such as 90/10
, Gatekeeper - ANS-Primary Care Physician
-Cannot be a specialist, must be a general practice doctor.
COBRA - ANS-Consolidated Omnibus Budget Reconciliation Act
-A law that allows people who leave employment to continue their health insurance under the
company plan for a limited period of time
HIPCAP - ANS-Free counseling
Coordination of Benefits - ANS-Provision that applies in group insurance when an insured has
coverage under multiple plans at one time.
-Coordination of benefits is included in all group health insurance policies in order to reinforce
the principle of indemnity and determine which coverage is primary, which is the coverage the
insured has where they work.
Keogh plan - ANS-A retirement plan for the self-employed
The Social Security Blackout - ANS-Period of time when surviving family members are NOT
eligible for Social Security survivors benefits
-Begins at 16
-Ends at 60
Premium - ANS-The amount the insured pays the insurer for the coverage provided.
Solvent Insurer - ANSHas enough reserves to pay for all its liabilities
Types of Life Policy Riders: - ANS-Waiver of Premium- Waives the insured's premium if the
insured becomes disabled
-Disability Income- Pays a replacement of the insured's lost income if the become disabled.
-Accidental Death Benefit- Pays double the face amount if the insured dies in an accident, and
is also known as double indemnity.
-Guaranteed Insurability- Allows the insured to purchase additional amounts of life insurance
w/o having to prove insurability.
-Cost of Living- increases the policy death benefit based upon the rate of inflation
Indemnity - ANS-Security or protection against a loss or other financial burden.
Hospital Confinement Policy - ANS-Pays a set amount per day if the insured in confined in the
hospital.
