2025 QUESTIONS AND ANSWERS
Risk type expenses - ANS cannot be planned and is unintended
Purpose of health insurance is - ANS to protect a insured against the risk of financial loss
he/she cannot individually afford caused by illness, injury, or diability
Indeminity - ANS Reimbursement
Coordination of Benefits provision - ANS is in some health insurance policies; allows
insurance companies to reduce benefits so that the insured will be paid no more that his/her
actual loss. prevents the insured from collecting under multiple policies more than his/her
actual loss
Coordination policy - ANS is a policy that includes a coordination of benefits provision
Non-coordinating policy - ANS is a policy that does not include a coordination of benefits
provision
Accepted questions on application to base premiums - ANS age, family composition,
geographic region of residency, tobacco use
unacceptable question on application to base premiums - ANS past medical history, gender,
occupation, ethnicity
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, Attending Physician Statement - ANS the underwriter contacts physician who has treated the
applicant in the past for an evaluation; it's purpose is to confirm information on the medical
report
Errors and Changes on the Application - ANS if error on application, underwriter may require
it be corrected and changes must be approved and initialed by the applicant
Medical information bureau (MIB) report - ANS it is a clearing house for medical information
for insurance companies that belong to it
Credit Report - ANS Determines if total benefits are reasonable compared to applicant's
income so as to avoid disincentive
Inspection report - ANS to verify that the producer completed the application accurately and
completely is the first purpose of an inspection report
Incontestability Clause - ANS after the policy has been in effect two years the insurance
company cannot contest a policy doe to any misstatement or concealment unless it can prove
fraud
(tax) premiums on ind. hospital/medical expense policies - ANS can sometimes be tax
deducted; depends on whether an ind is self-employed and if ind. itemizes on tax returm
(tax) premiums paid by an ind. on ind. diability income policies - ANS usually cannot be tax
deducted (non qualified)
(tax) ind. expense policies, ind disability income policies, are usually - ANS tax free and have
no tax on the benefits
(tax) premiums paid by employer usually - ANS can be tax deducted by the employer (tax
qualified)
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