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Ch. 3 (Part 2) Eligibility Study Guide
Eligibility - Answer✔✔-defined as the quality or qualities that make someone eligible. Fit to be
chosen or legally or morally qualified.
Employee Eligibility - Answer✔✔-most contracts define participants also called employees,
subcribers, members or insureds.
Eligibility Requirements - Answer✔✔-based on the amount of HOURS per week.
The Law - Answer✔✔-does not usually create an obligation for plans to pay for well-baby or
custodial care.
Contributory plan - Answer✔✔-the employees contribute to the cost of the coverage, usually
through payroll.
Non-contributory plan - Answer✔✔-the employer bears the complete cost of coverage and the
employee DOES NOT contribute.
Evidence of Insurability - Answer✔✔-the employee may be required to submit proof of good
health.
Evidence of Insurability - Answer✔✔-good health also means...
Active WORK or Actively-at-work - Answer✔✔-usually means performing the regular duties of a
full workday for the employer.
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Ch. 3 (Part 2) Eligibility Study Guide
Eligibility - Answer✔✔-defined as the quality or qualities that make someone eligible. Fit to be
chosen or legally or morally qualified.
Employee Eligibility - Answer✔✔-most contracts define participants also called employees,
subcribers, members or insureds.
Eligibility Requirements - Answer✔✔-based on the amount of HOURS per week.
The Law - Answer✔✔-does not usually create an obligation for plans to pay for well-baby or
custodial care.
Contributory plan - Answer✔✔-the employees contribute to the cost of the coverage, usually
through payroll.
Non-contributory plan - Answer✔✔-the employer bears the complete cost of coverage and the
employee DOES NOT contribute.
Evidence of Insurability - Answer✔✔-the employee may be required to submit proof of good
health.
Evidence of Insurability - Answer✔✔-good health also means...
Active WORK or Actively-at-work - Answer✔✔-usually means performing the regular duties of a
full workday for the employer.
Page 1/3
