Ohio Health Insurance Exam Latest Updated 2024 Q&A

Ohio Health Insurance Exam Latest Updated 2024 Q&A ACCIDENTAL AND HEALTH INSURANCE BASICS STARTS: 15% - CORRECT ANSWER-... Two major perils under a health insurance policy: - CORRECT ANSWER-Policies may cover both accident and sickness or accident only. Accidental bodily injury: - CORRECT ANSWER-An unforeseen and unintended injury that resulted from an accident rather than a sickness. Sickness: - CORRECT ANSWER-Normally defined as an illness, which first manifests itself while the policy is in force. This is where a majority of health insurance claims result from. Loss of income from disability: - CORRECT ANSWER-Loss of income caused by accident or sickness causing an insured the inability to work and earn in come. Limited Vs Comprehensive: - CORRECT ANSWER-Limited health insurance policies only cover specific accidents or diseases. Comprehensive plan would cover all sickness or accidents that are not specifically excluded. A successful self funded plan will have the following characteristics: (5) - CORRECT ANSWER--A group large enough to reasonably predict future loss experience. -Sound statistical data to support the self-funding concept. -A stop-loss contract to assume losses beyond the insured's retention. -A third party administrator who services claims. -Flexibility in plan design and administrative procedures. Employee Retirement Income Security Act of 1974 (ERISA): - CORRECT ANSWER-A federal law that was enacted to ensure that employees receive the pension and other benefits promised by their employers. Association (alumni or professional) group: - CORRECT ANSWER-Can buy group insurance for its members. The group must have at least 100 members, be organized for a reason other than buying insurance, have been active for two years, have a constitution, by-laws, and must hold at least annual meetings. Multiple-Employer Trust (MET): - CORRECT ANSWER-Made up of two or more employers in similar or related businesses who do not qualify for group insurance on their own.