Florida Statutes, Rules, and Regulations Pertinent To Health Insurance Exam With Complete Solutions

Florida Statutes, Rules, and Regulations Pertinent To Health Insurance Exam With Complete Solutions Grandfathered health plan - answeris any group health plan to which a plans participant's right to maintain existing coverage when the insured changes plans, and to have creditable coverage count toward HIPAA eligibility relating to pre-existing conditions exclusions. Nongrandfathered health plans - answerare health insurance policies or HMO contracts that do not provide the credible coverage benefits. Exclusive Provider Organization (EPO) - answeris a type of preferred provider organization in which individual members use particular preferred providers rather than having a choice of a variety of preferred providers. Multiple Employer Welfare Associations (MEWAs) - answercan be any, other than a duly admitted insurer, that establishes an employee benefit plan for the purpose of offering or providing accident and sickness or death benefits to the employees of at least 2 employers, including self-employed individuals and their depndents. Multiple-Employer Trust (MET) - answeris made up of two or more employers in similar or related businesses who do not qualify for group insurance on their own. fee-for-service - answerwhere providers receive a payment for their billed charges for each service provided. Prepaid plans - answerprovide medical and hospital benefits in the form of service rather than dollars. Indemnity-based plans - answerpay health policy benefits to the insured based on a predetermined, fixed rate, regardless of the actual expense incurred. Expense-based plans - answerpay health policy benefits as a reimbursement of actual expenses. Discount medical plans - answermeans a business arrangement or a contract (not insurance) in which a person, for a fee, provides access for plan members to providers of medical services and the right to receive those services