Health Insurance Exam-Illinois
Study online at https://quizlet.com/_4m3nfn
1. Risk type expens- cannot be planned and is unintended
es
2. Purpose of health to protect a insured against the risk of financial loss he/she cannot individually
insurance is afford caused by illness, injury, or diability
3. Indeminity Reimbursement
4. Coordination of is in some health insurance policies; allows insurance companies to reduce
Benefits provision 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
5. Coordination poli- is a policy that includes a coordination of benefits provision
cy
6. Non-coordinat- is a policy that does not include a coordination of benefits provision
ing policy
7. Accepted ques- age, family composition, geographic region of residency, tobacco use
tions on applica-
tion to base pre-
miums
8. unacceptable past medical history, gender, occupation, ethnicity
question on
application to
base premiums
9. Attending Physi- the underwriter contacts physician who has treated the applicant in the past for
cian Statement an evaluation; it's purpose is to confirm information on the medical report
10. Errors and if error on application, underwriter may require it be corrected and changes must
Changes on the be approved and initialed by the applicant
Application
, Health Insurance Exam-Illinois
Study online at https://quizlet.com/_4m3nfn
11. Medical informa- it is a clearing house for medical information for insurance companies that
tion bureau (MIB) belong to it
report
12. Credit Report Determines if total benefits are reasonable compared to applicant's income so
as to avoid disincentive
13. Inspection report to verify that the producer completed the application accurately and completely
is the first purpose of an inspection report
14. Incontestability after the policy has been in effect two years the insurance company cannot
Clause contest a policy doe to any misstatement or concealment unless it can prove
fraud
15. (tax) premiums can sometimes be tax deducted; depends on whether an ind is self-employed
on ind. hos- and if ind. itemizes on tax returm
pital/medical ex-
pense policies
16. (tax) premiums usually cannot be tax deducted (non qualified)
paid by an ind.
on ind. diability in-
come policies
17. (tax) ind. ex- tax free and have no tax on the benefits
pense policies,
ind disability in-
come policies, are
usually
18. (tax) premiums can be tax deducted by the employer (tax qualified)
paid by employer
usually
, Health Insurance Exam-Illinois
Study online at https://quizlet.com/_4m3nfn
19. (tax) group ex- no tax on benefits (tax free)
pense coverage is
usually
20. Private Health In- issue risk indeminity policies
surance Compa-
nies were origi-
nally established
to
21. Private Health In- fewest
surance Compa-
nies have the
_____ restrictions
to where the in-
sured can go for
service
22. Service Organiza- the subscriber is entitled to obtain hospital/medical services from any hospi-
tions tal/doctor service provider that is a member of the network; outside network will
not be covered
23. Blue Cross origi- hospital charges
nally assured pay-
ment of
24. Blue Shield origi- physician's charges
nally assured pay-
ment of
25. Preferred
Provider
Study online at https://quizlet.com/_4m3nfn
1. Risk type expens- cannot be planned and is unintended
es
2. Purpose of health to protect a insured against the risk of financial loss he/she cannot individually
insurance is afford caused by illness, injury, or diability
3. Indeminity Reimbursement
4. Coordination of is in some health insurance policies; allows insurance companies to reduce
Benefits provision 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
5. Coordination poli- is a policy that includes a coordination of benefits provision
cy
6. Non-coordinat- is a policy that does not include a coordination of benefits provision
ing policy
7. Accepted ques- age, family composition, geographic region of residency, tobacco use
tions on applica-
tion to base pre-
miums
8. unacceptable past medical history, gender, occupation, ethnicity
question on
application to
base premiums
9. Attending Physi- the underwriter contacts physician who has treated the applicant in the past for
cian Statement an evaluation; it's purpose is to confirm information on the medical report
10. Errors and if error on application, underwriter may require it be corrected and changes must
Changes on the be approved and initialed by the applicant
Application
, Health Insurance Exam-Illinois
Study online at https://quizlet.com/_4m3nfn
11. Medical informa- it is a clearing house for medical information for insurance companies that
tion bureau (MIB) belong to it
report
12. Credit Report Determines if total benefits are reasonable compared to applicant's income so
as to avoid disincentive
13. Inspection report to verify that the producer completed the application accurately and completely
is the first purpose of an inspection report
14. Incontestability after the policy has been in effect two years the insurance company cannot
Clause contest a policy doe to any misstatement or concealment unless it can prove
fraud
15. (tax) premiums can sometimes be tax deducted; depends on whether an ind is self-employed
on ind. hos- and if ind. itemizes on tax returm
pital/medical ex-
pense policies
16. (tax) premiums usually cannot be tax deducted (non qualified)
paid by an ind.
on ind. diability in-
come policies
17. (tax) ind. ex- tax free and have no tax on the benefits
pense policies,
ind disability in-
come policies, are
usually
18. (tax) premiums can be tax deducted by the employer (tax qualified)
paid by employer
usually
, Health Insurance Exam-Illinois
Study online at https://quizlet.com/_4m3nfn
19. (tax) group ex- no tax on benefits (tax free)
pense coverage is
usually
20. Private Health In- issue risk indeminity policies
surance Compa-
nies were origi-
nally established
to
21. Private Health In- fewest
surance Compa-
nies have the
_____ restrictions
to where the in-
sured can go for
service
22. Service Organiza- the subscriber is entitled to obtain hospital/medical services from any hospi-
tions tal/doctor service provider that is a member of the network; outside network will
not be covered
23. Blue Cross origi- hospital charges
nally assured pay-
ment of
24. Blue Shield origi- physician's charges
nally assured pay-
ment of
25. Preferred
Provider
