FLORIDA 2-40 HEALTH LICENSE CHAPTERS REVIEW QUESTIONS WITH VERIFIED
CORRECT ANSWERS LATES
owners rights - (ANSWER)if an individual health insurance policy provides a death benefit, the
policyowner will be able to designate a beneficiary and, unless the beneficiary designation is irrevocable,
to change the beneficiary. the power to change the beneficiary is provided in the change of beneficiary
provision. the policyowner also has the right to make any other change without the consent of the
beneficiaries.
dependent children benefits - (ANSWER)the group coverage may be extended to cover the insureds
dependents. eligible dependents include the insureds children, spouse, dependent parents, and anyone
else upon which dependency can be proven.
every policy providing coverage for a dependent child until a specified age will not terminate that
coverage if the child is dependent upon the insured and is incapable of self support because of physical
or mental handicaps. proof of the dependency is required within 31 days of the child attaining the
maximum age. upon request, proof of dependency is required annually after a 2 year period following
attainment of maximum age
modes of premium payment - (ANSWER)higher frequency of payments = higher premium payments
nonduplication and coordination of benefits - (ANSWER)the purpose of the coordination of benefits
(COB) provision, found only in group health plans, is to avoid duplication of benefit payments and
overinsurance when an individual is covered under multiple group health insurance plans. the provision
limits the total amount of claims paid from all insurers covering the patient to no more than the total
allowable medical expenses
primary plan - (ANSWER)the plan that is responsible for providing the full benefit amounts as it specifies.
secondary or excess plan - (ANSWER)once the primary plan has paid its full promised benefit, the
insured submits the claim to the secondary provider for any additional benefits payable (including
deductibles and coinsurance). in no case will the total amount the insured receives exceed the costs
incurred or the total maximum benefits available under all plans.
loss - (ANSWER)amount covered by primary plan = amount covered by secondary plan
, FLORIDA 2-40 HEALTH LICENSE CHAPTERS REVIEW QUESTIONS WITH VERIFIED
CORRECT ANSWERS LATES
occupational coverage - (ANSWER)provides benefits for illness, injury or disability resulting from
accidents that occur on or off the job
nonoccupational coverage - (ANSWER)only covers claims that result from accidents or sickness occurring
off the job
personally owned health insurance - (ANSWER)premium payments on personally owned disability
income policies are non deductible by the individual. however, desability income benefits are recieved
income tax free by the individual.
in either medical expense insurance policies or long term care insurance policies, premiums paid by the
individual policyholder are deductible as a medical expense to the extent that when added to all other
unreimbursed medical expenses, the total exceeds 7.5% of the taxpayers adjusted gross income.
however, there is a limit on the amount of premium that can be deducted depending on the age of the
insured (taxpayer) at the end of the year. the IRS sets annual limits for that amount, and any premium
above these limits will not be considered a medical expense, and therefore, cannot be tax deductible.
the provision only applies if the insured itemizes these deductions on his/her tax return
employer provided health insurance-premiums - (ANSWER)paid by the employer for disability income
insurance for its employees are deductible as a business expense and are not covered as taxable income
to the employee.
employer provided health insurance- benefits - (ANSWER)received by an employee that are attributable
to employer contributions are fully taxable to the employee as income
when the employer and employee share in premium contributions, the employees contribution is not
deductible; however, benefits received by the employee are attribuible to their portion of the
contribution are not taxable as income. the taxation of income received by the employee would depend
on the type of a group plan:
- noncontributory- meaning the employer pays the entire cost, so the income benefits are included in
the employees gross income and taxed as ordinary income
CORRECT ANSWERS LATES
owners rights - (ANSWER)if an individual health insurance policy provides a death benefit, the
policyowner will be able to designate a beneficiary and, unless the beneficiary designation is irrevocable,
to change the beneficiary. the power to change the beneficiary is provided in the change of beneficiary
provision. the policyowner also has the right to make any other change without the consent of the
beneficiaries.
dependent children benefits - (ANSWER)the group coverage may be extended to cover the insureds
dependents. eligible dependents include the insureds children, spouse, dependent parents, and anyone
else upon which dependency can be proven.
every policy providing coverage for a dependent child until a specified age will not terminate that
coverage if the child is dependent upon the insured and is incapable of self support because of physical
or mental handicaps. proof of the dependency is required within 31 days of the child attaining the
maximum age. upon request, proof of dependency is required annually after a 2 year period following
attainment of maximum age
modes of premium payment - (ANSWER)higher frequency of payments = higher premium payments
nonduplication and coordination of benefits - (ANSWER)the purpose of the coordination of benefits
(COB) provision, found only in group health plans, is to avoid duplication of benefit payments and
overinsurance when an individual is covered under multiple group health insurance plans. the provision
limits the total amount of claims paid from all insurers covering the patient to no more than the total
allowable medical expenses
primary plan - (ANSWER)the plan that is responsible for providing the full benefit amounts as it specifies.
secondary or excess plan - (ANSWER)once the primary plan has paid its full promised benefit, the
insured submits the claim to the secondary provider for any additional benefits payable (including
deductibles and coinsurance). in no case will the total amount the insured receives exceed the costs
incurred or the total maximum benefits available under all plans.
loss - (ANSWER)amount covered by primary plan = amount covered by secondary plan
, FLORIDA 2-40 HEALTH LICENSE CHAPTERS REVIEW QUESTIONS WITH VERIFIED
CORRECT ANSWERS LATES
occupational coverage - (ANSWER)provides benefits for illness, injury or disability resulting from
accidents that occur on or off the job
nonoccupational coverage - (ANSWER)only covers claims that result from accidents or sickness occurring
off the job
personally owned health insurance - (ANSWER)premium payments on personally owned disability
income policies are non deductible by the individual. however, desability income benefits are recieved
income tax free by the individual.
in either medical expense insurance policies or long term care insurance policies, premiums paid by the
individual policyholder are deductible as a medical expense to the extent that when added to all other
unreimbursed medical expenses, the total exceeds 7.5% of the taxpayers adjusted gross income.
however, there is a limit on the amount of premium that can be deducted depending on the age of the
insured (taxpayer) at the end of the year. the IRS sets annual limits for that amount, and any premium
above these limits will not be considered a medical expense, and therefore, cannot be tax deductible.
the provision only applies if the insured itemizes these deductions on his/her tax return
employer provided health insurance-premiums - (ANSWER)paid by the employer for disability income
insurance for its employees are deductible as a business expense and are not covered as taxable income
to the employee.
employer provided health insurance- benefits - (ANSWER)received by an employee that are attributable
to employer contributions are fully taxable to the employee as income
when the employer and employee share in premium contributions, the employees contribution is not
deductible; however, benefits received by the employee are attribuible to their portion of the
contribution are not taxable as income. the taxation of income received by the employee would depend
on the type of a group plan:
- noncontributory- meaning the employer pays the entire cost, so the income benefits are included in
the employees gross income and taxed as ordinary income
