Delaware health insurance
National association of insurance commissioners (NAIC) - ANS-composed of insurance
commissioners from all 50 states. The are responsible for enforcing laws and
regulations.
Stock Companies - ANS-Companies owned by the stockholders whose investments
provide the capital necessary to establish and operate the insurance company.
Mutual Companies - ANS-Owned by the policyowners and issue participating policies.
Fraternal Benefit Societies - ANS-Life or health insurance companies formed to provide
insurance for members of an affiliated lodge, religious organization, or fraternal
organization with a representative form of government.
Risk Retention Group - ANS-A liability insurance company owned by its members,
which are exposed to similar liability risks by virtue of being in the same business or
industry.
Social Security - ANS-any government system that provides monetary assistance to
people with an inadequate or no income.
medicare - ANS-A federal program of health insurance for persons 65 years of age and
older
Medicade - ANS-the government insurance program for low-income individuals &
familys that is funded both by the federal government & each individual state
1945 McCarran and Ferguson Act - ANS-States that while federal government has the
authority to regulate the insurance industry, it would not exercise that right if the
insurance industry was run effectively and adequately by the states
2001 USA Patriot Act - ANS-Expands authority of US law enforcement for purpose of
fighting terrorism (expands FBI electronic surveillance capabilities; foreign student
monitoring program
unfair trade practice acts - ANS-gives chief financial officer the power to investigate
insurance companies and producers to impose penalties
,advertising code - ANS-the code specifies certain words and phrases that are
considered misleading and are not to be used in advertising of any kind
Buyer's Guide - ANS-A booklet that describes insurance policies and concepts, and
provides general information to help an applicant make an informed decision.
Policy Summary - ANS-a written statement describing the features and elements of the
policy being issued
reserves - ANS-the funds that an insurance company has to insure that future
obligations to policyholders are able to be paid
Guaranty Association - ANS-A state mandated association of all insurance companies
designed to protect consumers from impaired or insolvent companies.
Liquidity - ANS-the insurers ability to make unpredictable payouts to policyowners
hazard - ANS-(n.) risk, peril; (v.) to expose to danger or harm; to gamble
risk - ANS-Degree of uncertainty of return on an asset; in business, the likelihood of loss
or reduced profit.
Human Life Value Approach - ANS-the present value of the family's share of the
deceased breadwinner's future earnings
health insurance - ANS-Insurance that covers medical illness or injury.
Legal Purpose - ANS-In contract law, the requirement that the object of, or reason for,
the contract must be legal.
Offer and Acceptance - ANS-The necessary elements of mutual assent; for example, an
agreement of one party to buy and another party to sell.
Aleatory Contract - ANS-a contract where the values exchanged may not be equal but
depend on an uncertain event
Contract of Adhesion - ANS-insurance contract has been written by insurance company
with no negotiation
unilateral contract - ANS-one sided agreement (insurance company is legally bound)
,warrranty - ANS-A statement made by and insurance company that is guaranteed to be
true
representations - ANS-A statement made buy insured that is best to their knowledge
Concealment - ANS-withholding information or facts by the applicant (ex. Smoking,
Diabetes)
insurable interest - ANS-An interest in the subject of an insurance policy that is not
unduly remote and that would cause the interested party to suffer financial loss if an
insured event occurred. insurable interest must be present during the application
process.
fiduciary responsibility - ANS-Duty of management to safeguard a company's assets
and handle its funds in a trustworthy manner.
Stranger-Originated Life Insurance (STOLI) - ANS-Life insurance arrangement in which
a person with no relationship to the insured purchases a life policy on the insured's life
with the intent of selling the policy to an investor and profiting financially when the
insured dies.
grace period - ANS-is in force to help make sure a policy doesn't lapse incase premium
payment is missed. (in delaware is 31 days)
Waiver of Premium - ANS-Continuation of life insurance coverage if the insured
becomes totally disabled and is unable to pay the premiums.
Subrogation - ANS-The process by which an insurer can, after it has paid a loss under
the policy, recover the amount paid from any party (other than the insured) who caused
the loss or is otherwise legally liable for the loss.
Key Person Insurance - ANS-protects against the loss of a key employee or key
executive by making the business the beneficiary if a key person dies. The business is
the owner, premium payor, and beneficiary.
Group Insurance - ANS-A type of health insurance in which all those insured have the
same coverage and pay a set premium
, noncontributory - ANS-100% of the eligible employees must be included, and the
participants do not pay part of the premium. The employer pays the entire premium
Contributory - ANS-A group insurance plan that requires the employees to pay part of
the premium.
Underwriting - ANS-the process of selecting, classifying, and pricing applicants for
insurance
COBRA Continuation of Benefits - ANS-guarantees continuation of their group policies if
their terminated for reasons other than misconduct. for 18 months following termination
Health Savings Account (HSA) - ANS-a tax-free savings account offered to individuals
who are covered by insurance plans with high deductibles
Blue Cross/Blue Shield - ANS-nonprofit
HMO (Health Maintenance Organization) - ANS-A managed care organization that
provides comprehensive medical services for a predetermined annual fee per enrollee.
PPO (Preferred Provider Organization) - ANS-A type of health plan that contracts with
medical providers, such as hospitals and doctors, to create a network of participating
providers. You pay less if you use providers that belong to the plan's network.
state workers compensation - ANS-provides benefits to workers who become sick or
injured because of a job-related event.
Recurrent Disability - ANS-A policy provision that specifies the period of time during
which the recurrence of an injury or illness will be considered a continuation of a prior
period of disability.
Residual Disability - ANS-used after full disability, used when insured goes back to work
with a reduced workload
probationary period - ANS-The period of time between the effective date of a health
insurance policy and the date coverage for all or certain conditions begins.
Elimination Period (Waiting Period) - ANS-A period of days (time) that must pass after
the onset of an illness or occurrence of an accident before benefits will be payable.
National association of insurance commissioners (NAIC) - ANS-composed of insurance
commissioners from all 50 states. The are responsible for enforcing laws and
regulations.
Stock Companies - ANS-Companies owned by the stockholders whose investments
provide the capital necessary to establish and operate the insurance company.
Mutual Companies - ANS-Owned by the policyowners and issue participating policies.
Fraternal Benefit Societies - ANS-Life or health insurance companies formed to provide
insurance for members of an affiliated lodge, religious organization, or fraternal
organization with a representative form of government.
Risk Retention Group - ANS-A liability insurance company owned by its members,
which are exposed to similar liability risks by virtue of being in the same business or
industry.
Social Security - ANS-any government system that provides monetary assistance to
people with an inadequate or no income.
medicare - ANS-A federal program of health insurance for persons 65 years of age and
older
Medicade - ANS-the government insurance program for low-income individuals &
familys that is funded both by the federal government & each individual state
1945 McCarran and Ferguson Act - ANS-States that while federal government has the
authority to regulate the insurance industry, it would not exercise that right if the
insurance industry was run effectively and adequately by the states
2001 USA Patriot Act - ANS-Expands authority of US law enforcement for purpose of
fighting terrorism (expands FBI electronic surveillance capabilities; foreign student
monitoring program
unfair trade practice acts - ANS-gives chief financial officer the power to investigate
insurance companies and producers to impose penalties
,advertising code - ANS-the code specifies certain words and phrases that are
considered misleading and are not to be used in advertising of any kind
Buyer's Guide - ANS-A booklet that describes insurance policies and concepts, and
provides general information to help an applicant make an informed decision.
Policy Summary - ANS-a written statement describing the features and elements of the
policy being issued
reserves - ANS-the funds that an insurance company has to insure that future
obligations to policyholders are able to be paid
Guaranty Association - ANS-A state mandated association of all insurance companies
designed to protect consumers from impaired or insolvent companies.
Liquidity - ANS-the insurers ability to make unpredictable payouts to policyowners
hazard - ANS-(n.) risk, peril; (v.) to expose to danger or harm; to gamble
risk - ANS-Degree of uncertainty of return on an asset; in business, the likelihood of loss
or reduced profit.
Human Life Value Approach - ANS-the present value of the family's share of the
deceased breadwinner's future earnings
health insurance - ANS-Insurance that covers medical illness or injury.
Legal Purpose - ANS-In contract law, the requirement that the object of, or reason for,
the contract must be legal.
Offer and Acceptance - ANS-The necessary elements of mutual assent; for example, an
agreement of one party to buy and another party to sell.
Aleatory Contract - ANS-a contract where the values exchanged may not be equal but
depend on an uncertain event
Contract of Adhesion - ANS-insurance contract has been written by insurance company
with no negotiation
unilateral contract - ANS-one sided agreement (insurance company is legally bound)
,warrranty - ANS-A statement made by and insurance company that is guaranteed to be
true
representations - ANS-A statement made buy insured that is best to their knowledge
Concealment - ANS-withholding information or facts by the applicant (ex. Smoking,
Diabetes)
insurable interest - ANS-An interest in the subject of an insurance policy that is not
unduly remote and that would cause the interested party to suffer financial loss if an
insured event occurred. insurable interest must be present during the application
process.
fiduciary responsibility - ANS-Duty of management to safeguard a company's assets
and handle its funds in a trustworthy manner.
Stranger-Originated Life Insurance (STOLI) - ANS-Life insurance arrangement in which
a person with no relationship to the insured purchases a life policy on the insured's life
with the intent of selling the policy to an investor and profiting financially when the
insured dies.
grace period - ANS-is in force to help make sure a policy doesn't lapse incase premium
payment is missed. (in delaware is 31 days)
Waiver of Premium - ANS-Continuation of life insurance coverage if the insured
becomes totally disabled and is unable to pay the premiums.
Subrogation - ANS-The process by which an insurer can, after it has paid a loss under
the policy, recover the amount paid from any party (other than the insured) who caused
the loss or is otherwise legally liable for the loss.
Key Person Insurance - ANS-protects against the loss of a key employee or key
executive by making the business the beneficiary if a key person dies. The business is
the owner, premium payor, and beneficiary.
Group Insurance - ANS-A type of health insurance in which all those insured have the
same coverage and pay a set premium
, noncontributory - ANS-100% of the eligible employees must be included, and the
participants do not pay part of the premium. The employer pays the entire premium
Contributory - ANS-A group insurance plan that requires the employees to pay part of
the premium.
Underwriting - ANS-the process of selecting, classifying, and pricing applicants for
insurance
COBRA Continuation of Benefits - ANS-guarantees continuation of their group policies if
their terminated for reasons other than misconduct. for 18 months following termination
Health Savings Account (HSA) - ANS-a tax-free savings account offered to individuals
who are covered by insurance plans with high deductibles
Blue Cross/Blue Shield - ANS-nonprofit
HMO (Health Maintenance Organization) - ANS-A managed care organization that
provides comprehensive medical services for a predetermined annual fee per enrollee.
PPO (Preferred Provider Organization) - ANS-A type of health plan that contracts with
medical providers, such as hospitals and doctors, to create a network of participating
providers. You pay less if you use providers that belong to the plan's network.
state workers compensation - ANS-provides benefits to workers who become sick or
injured because of a job-related event.
Recurrent Disability - ANS-A policy provision that specifies the period of time during
which the recurrence of an injury or illness will be considered a continuation of a prior
period of disability.
Residual Disability - ANS-used after full disability, used when insured goes back to work
with a reduced workload
probationary period - ANS-The period of time between the effective date of a health
insurance policy and the date coverage for all or certain conditions begins.
Elimination Period (Waiting Period) - ANS-A period of days (time) that must pass after
the onset of an illness or occurrence of an accident before benefits will be payable.
