Maine Life Insurance Exam Questions and Answers 100% Pass

Maine Life Insurance Exam Questions and Answers 100% Pass Contributory Health Insurance If the employees share a portion of the premium. Often require participation by 75% of eligible members. Noncontributory Health Insurance If the employer pays the entire premium. Most require 100% participation by eligible members. (Funding of Group Insurance) Shared funding Allows employer to self-fund health care expenses, select a deductible and pay covered expenses for any individual incurring claims up to that max, insurer assumes risk (Funding of group insurance) Min. premium arrangement Employer self-insure the normal and expected claims up to a given amount and the insurer funds only the excess amounts (Funding of group insurance) retrospective premium arrangement Insurer agrees to collect a provisional premium but may collect additional premium/make a premium refund at the end of the year based on actual incurred losses. (Funding of group insurance) Self-funding arrangement Large employers may elect to fully self-fund, or may self-fund a plan but contract for administrative services only (ASO). Conversion privilege An employee can convert their group certificate to an individual medical expense policy w/ same insurer, if/when they leave employer. Employee must make an application for a converted policy within a given period of time (usually 31 days) depending on the state. Health Insurance Portability and Accountability Act (HIPAA) Provides the ability to transfer and continue health insurance when someone changes or loses their job HIPAA Requirements Employers with 20 or more employees have to allow former employees to continue benefits. Rules apply to all types of group health plans except disability income plans HIPAA pre-existing conditions Health issues that existed, were treated, diagnosed within 6 months prior to employment COBRA Requires employers with 20+ employees to continue coverage for terminated workers, (as well as dependents) for up to 18 months. Employee is required to pay premiums (up to 102%) Group Disability Income Plans Specify benefits based on a percentage of the employees wages Blanket Health Plans Cover a group who