Health Insurance certification Study guides, Class notes & Summaries

owners rights if an individual health insurance policy provides a death benefit, the policyowner will be able to designate a beneficiary and, unless the beneficiary designation is irrevocable, to change the beneficiary. the power to change the beneficiary is provided in the change of beneficiary provision. the policyowner also has the right to make any other change without the consent of the beneficiaries. dependent children benefits the group coverage may be extended to cover the insur...

An organization that transacts insurance only with its own members is a(n): Fraternal The ____________ has the power to issue rules and regulations to help enforce insurance laws. Commissioner, Superintendent, or Director All of the following are essential elements of a legal contract, EXCEPT: Representation Which of the following manufactures and sells insurance coverage in the form of insurance policies or contracts of insurance? Insurance companies The contract...

Which of the following laws requires an insurer to notify an applicant in writing that an investigative consumer report may be made on the applicant? -Uniform Provisions Law. -Freedom of Information Act. -Medical Information Bureau Disclosure Act -Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) Group health insurance specifies that what percentage of eligible individuals MUST be ...

The stated amount or percent of liquid assets that an insurer must have on hand that will satisfy future obligations to its policyholders is called: Reserves An insurance applicant MUST be informed of an investigation regarding his/her reputation and character according to the: Fair Credit Reporting Act A nonprofit incorporated society that does not have capital stock and operates for the sole benefit of its members is known as: A fraternal benefit society What I the name...

A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as Usual, customary and reasonable What provision would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner? Payment of Claims All of the following are true about gr...

Accidental Death and Dismemberment An insurance policy which pays a specified amount or a specified multiple of the insured's benefit if the insured dies, loses his/her sigh, or loses two limbs due to an accident Adhesion A contract offered on a "take-it-or-leave-it" basis by an insurer, in which the insured's only option is to accept or reject the contract. Any ambiguities in the contract will be settled in favor of the insured. Authorized Insurer An insurance company that ...

Rules of Construction Help to identify and establish the intent of the parties to the contract Utmost good faith Each party is entitled to rely on the representation of the other, and each party should have a reasonable expectation that the other is acting in good faith without attempts to conceal or deceive. Aleatory Contract A contract under which one party's performance is contingent on an uncertain event. property and casualty agent has the power to bind the insurer...

Final Exam: California Life, Accident, and Health Insurance 2023 with complete solution 1. What is considered the most common type of specified disease insurance policy?: Cancer 2. Minimum participation standards exist for a group health insurance plans in order to: Prevent Adverse

Final Exam: California Life, Accident, and Health Insurance 2023 with complete solution 1. What is considered the most common type of specified disease insurance policy?: Cancer 2. Minimum participation standards exist for a group health insurance plans in order to: Prevent Adverse

Final Exam: California Life, Accident, and Health Insurance 2023 with complete solution 1. What is considered the most common type of specified disease insurance policy?: Cancer 2. Minimum participation standards exist for a group health insurance plans in order to: Prevent Adverse