Utah Life and Health Exam- Chapter 8 Prep Exam And 100% Solved Solutions.

Ray has an individual major medical policy that requires a coinsurance payment. Ray very rarely visits his physician and would prefer to pay the lowest premium possible. Which coinsurance arrangement would be the best for Ray? a- 75/25 b- 80/20 c- 90/10 d- 50/50 - Answer d- 50/50. After the deductible has been paid, the insurance company will pay a specified amount for a physician's visit, while the insured pays the remaining percentage. This is called "coinsurance". Plans will often be listed in a fraction format, with the first number representing the amount that will be paid by the insurer. The less the insurer must pay with coinsurance payments, the lower the premiums will be. Therefore, Ray should choose the 50/50 plan. Which of the following statements is true concerning the alteration of optical policy provisions? a- Once any kind of provision is written, it cannot be changed. b- An insurer may change the wording of optional provisions, as long as the change does not adversely affect the policyholder. c- An insurer may change the wording of optional provisions, regardless of its effect on the policyholder. d- An insurer may change the wording of optional policy provisions that would adversely affect the policyholder but must first receive state permission before the change goes into effect. - Answer b- An insurer may change the wording of optional provisions, as long as the change does not adversely affect the policyholder; Optional policy provisions can be changed by an insurer, as long as the changes do not adversely affect the policyholder. Which of the following is NOT an exclusion in medical expense insurance policies? a- Routine dental care b- Coverage for dependents c- Military duty d- Self-inflicted injuries - Answer b- Coverage for dependents; Most medical expense policies will not cover expenses for dental care, self-inflicted injuries, or injuries incurred as a result of military service (among other exclusions). Most policies include coverage for dependents.