WEBCE LIFE & HEALTH EXAM QUESTIONS AND CORRECT ANSWERS/ 5 STAR RATED

Four distinct levels of medical insurance coverage as stipulated by the Patient Protection and Affordable Care Act. The four metal levels, ranked by level of coverage: Platinum plan (best)—90% of expenses paid by plan/10% paid by insured Gold plan—80% plan/20% insured Silver plan—70% plan/30% insured Bronze plan (worst)—60% plan/40% insured Expense charge (load factor) Medicare Part b Utilization Review Metal Levels (PPACA) 1 of 280 A tax classification that is assigned to a life insurance policy that violates tax code funding rules, resulting in loss of some tax advantages common with life insurance. Any permanent life insurance policy becomes a MEC (and is thus subject to less favorable income tax treatment) if it fails to meet the 7-pay test. Do not confuse a MEC with a traditional endowment contract. Entire contract provision Term life insurance Right to examine ("free look") provision Modified Endowment Contract (MEC) 2 of 280 EXAM A managed care health plan sponsored by an HMO that functions like a PPO. The HMOs' answer to PPOs. As with an HMO, members of a POS select a primary care physician (PCP) who becomes their primary contact for medical care. As with a PPO, POS plan members may go outside the network (though higher co-payments and even deductibles will usually apply). Preferred provider organization (ppo) Consumer-driven health plan (cdhp) Point-of-Service Plan (POS) Health maintenance organization (hmo) 3 of 280 The maximum time during which a disability insurance policy's benefits will be paid. The benefit period is the time during which benefits will be paid. It begins at the end of the elimination period and is usually expressed in the contract as the maximum period benefits will be paid for a single disability. Experience Rating Medicare Initial Enrollment Period (IEP) Benefit Period Managed Care Plan 4 of 280 EXAM Monthly payments from a federal social benefits program to eligible workers who become totally disabled. Fully insured workers are eligible for Social Security disability benefits if they remain totally disabled after a five-month waiting period. Spouses and young children may also be eligible for a family benefit, which is a percentage of the retired worker's benefit. Group Insurance Difference Between Ssi & Ssdi Social Security Disability Benefits Substantive Due Process