Maine Life Insurance Exam with answers \| \| \| \| \|
Contributory Health Insurance - CORRECT ANSWERS ✔✔If the employees
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share a portion of the premium. Often require participation by 75% of eligible
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members.
Noncontributory Health Insurance - CORRECT ANSWERS ✔✔If the \| \| \| \| \| \| \| \|
employer pays the entire premium. Most require 100% participation by
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eligible members. \|
(Funding of Group Insurance) Shared funding - CORRECT ANSWERS
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✔✔Allows employer to self-fund health care expenses, select a deductible and
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pay covered expenses for any individual incurring claims up to that max,
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insurer assumes risk
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(Funding of group insurance) Min. premium arrangement - CORRECT
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ANSWERS ✔✔Employer self-insure the normal and expected claims up to a
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given amount and the insurer funds only the excess amounts
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(Funding of group insurance) retrospective premium arrangement -
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CORRECT ANSWERS ✔✔Insurer agrees to collect a provisional premium but
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may collect additional premium/make a premium refund at the end of the
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year based on actual incurred losses.
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,(Funding of group insurance) Self-funding arrangement - CORRECT
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ANSWERS ✔✔Large employers may elect to fully self-fund, or may self-fund a
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plan but contract for administrative services only (ASO).
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Conversion privilege - CORRECT ANSWERS ✔✔An employee can convert \| \| \| \| \| \| \| \| \|
their group certificate to an individual medical expense policy w/ same
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insurer, if/when they leave employer. Employee must make an application for
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a converted policy within a given period of time (usually 31 days) depending
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on the state. \| \|
Health Insurance Portability and Accountability Act (HIPAA) - CORRECT
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ANSWERS ✔✔Provides the ability to transfer and continue health insurance
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when someone changes or loses their job
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HIPAA Requirements - CORRECT ANSWERS ✔✔Employers with 20 or more
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employees have to allow former employees to continue benefits. Rules apply
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to all types of group health plans except disability income plans
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HIPAA pre-existing conditions - CORRECT ANSWERS ✔✔Health issues that
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existed, were treated, diagnosed within 6 months prior to employment
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COBRA - CORRECT ANSWERS ✔✔Requires employers with 20+ employees
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to continue coverage for terminated workers, (as well as dependents) for up to
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18 months. Employee is required to pay premiums (up to 102%)
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Group Disability Income Plans - CORRECT ANSWERS ✔✔Specify benefits
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based on a percentage of the employees wages
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, Blanket Health Plans - CORRECT ANSWERS ✔✔Cover a group who may be
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exposed to the same risk, no certificates issued
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Taxation of group health premiums - CORRECT ANSWERS ✔✔Employers are
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entitled to take a tax deduction for premium contributions made to group
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plans
Taxation of group health benefits - CORRECT ANSWERS ✔✔Any benefit
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received under a medical expense plan are not considered taxable income.
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Accidental means - CORRECT ANSWERS ✔✔Requires that both the cause
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and the result of an accident must be unintentional
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accidental results - CORRECT ANSWERS ✔✔only the injury resulting from
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the accident must be unintentional.
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3 basic categories of health insurances - CORRECT ANSWERS ✔✔Medical
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Expense, Disability Income Insurance, AD&D \| \| \| \|
Health insurance premium factors - CORRECT ANSWERS ✔✔Interest,
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expenses, types of benefits, morbidity, age, sex, occupation
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Disability Buy-Sell (business income policy) - CORRECT ANSWERS ✔✔Legal
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agreement that specifies how a business will pass between owners when one
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of the owners dies or becomes disabled
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Contributory Health Insurance - CORRECT ANSWERS ✔✔If the employees
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share a portion of the premium. Often require participation by 75% of eligible
\| \| \| \| \| \| \| \| \| \| \| \| \|
members.
Noncontributory Health Insurance - CORRECT ANSWERS ✔✔If the \| \| \| \| \| \| \| \|
employer pays the entire premium. Most require 100% participation by
\| \| \| \| \| \| \| \| \| \|
eligible members. \|
(Funding of Group Insurance) Shared funding - CORRECT ANSWERS
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✔✔Allows employer to self-fund health care expenses, select a deductible and
\| \| \| \| \| \| \| \| \| \| \|
pay covered expenses for any individual incurring claims up to that max,
\| \| \| \| \| \| \| \| \| \| \| \|
insurer assumes risk
\| \|
(Funding of group insurance) Min. premium arrangement - CORRECT
\| \| \| \| \| \| \| \| \|
ANSWERS ✔✔Employer self-insure the normal and expected claims up to a
\| \| \| \| \| \| \| \| \| \| \|
given amount and the insurer funds only the excess amounts
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(Funding of group insurance) retrospective premium arrangement -
\| \| \| \| \| \| \| \|
CORRECT ANSWERS ✔✔Insurer agrees to collect a provisional premium but
\| \| \| \| \| \| \| \| \| \|
may collect additional premium/make a premium refund at the end of the
\| \| \| \| \| \| \| \| \| \| \| \|
year based on actual incurred losses.
\| \| \| \| \|
,(Funding of group insurance) Self-funding arrangement - CORRECT
\| \| \| \| \| \| \| \|
ANSWERS ✔✔Large employers may elect to fully self-fund, or may self-fund a
\| \| \| \| \| \| \| \| \| \| \|
plan but contract for administrative services only (ASO).
\| \| \| \| \| \| \| \|
Conversion privilege - CORRECT ANSWERS ✔✔An employee can convert \| \| \| \| \| \| \| \| \|
their group certificate to an individual medical expense policy w/ same
\| \| \| \| \| \| \| \| \| \| \|
insurer, if/when they leave employer. Employee must make an application for
\| \| \| \| \| \| \| \| \| \| \|
a converted policy within a given period of time (usually 31 days) depending
\| \| \| \| \| \| \| \| \| \| \| \| \|
on the state. \| \|
Health Insurance Portability and Accountability Act (HIPAA) - CORRECT
\| \| \| \| \| \| \| \| \|
ANSWERS ✔✔Provides the ability to transfer and continue health insurance
\| \| \| \| \| \| \| \| \| \|
when someone changes or loses their job
\| \| \| \| \| \|
HIPAA Requirements - CORRECT ANSWERS ✔✔Employers with 20 or more
\| \| \| \| \| \| \| \| \| \|
employees have to allow former employees to continue benefits. Rules apply
\| \| \| \| \| \| \| \| \| \| \|
to all types of group health plans except disability income plans
\| \| \| \| \| \| \| \| \| \|
HIPAA pre-existing conditions - CORRECT ANSWERS ✔✔Health issues that
\| \| \| \| \| \| \| \| \|
existed, were treated, diagnosed within 6 months prior to employment
\| \| \| \| \| \| \| \| \|
COBRA - CORRECT ANSWERS ✔✔Requires employers with 20+ employees
\| \| \| \| \| \| \| \| \|
to continue coverage for terminated workers, (as well as dependents) for up to
\| \| \| \| \| \| \| \| \| \| \| \| \|
18 months. Employee is required to pay premiums (up to 102%)
\| \| \| \| \| \| \| \| \| \|
Group Disability Income Plans - CORRECT ANSWERS ✔✔Specify benefits
\| \| \| \| \| \| \| \| \|
based on a percentage of the employees wages
\| \| \| \| \| \| \|
, Blanket Health Plans - CORRECT ANSWERS ✔✔Cover a group who may be
\| \| \| \| \| \| \| \| \| \| \| \|
exposed to the same risk, no certificates issued
\| \| \| \| \| \| \|
Taxation of group health premiums - CORRECT ANSWERS ✔✔Employers are
\| \| \| \| \| \| \| \| \|
entitled to take a tax deduction for premium contributions made to group
\| \| \| \| \| \| \| \| \| \| \| \| \|
plans
Taxation of group health benefits - CORRECT ANSWERS ✔✔Any benefit
\| \| \| \| \| \| \| \| \| \|
received under a medical expense plan are not considered taxable income.
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Accidental means - CORRECT ANSWERS ✔✔Requires that both the cause
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and the result of an accident must be unintentional
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accidental results - CORRECT ANSWERS ✔✔only the injury resulting from
\| \| \| \| \| \| \| \| \| \|
the accident must be unintentional.
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3 basic categories of health insurances - CORRECT ANSWERS ✔✔Medical
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Expense, Disability Income Insurance, AD&D \| \| \| \|
Health insurance premium factors - CORRECT ANSWERS ✔✔Interest,
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expenses, types of benefits, morbidity, age, sex, occupation
\| \| \| \| \| \| \|
Disability Buy-Sell (business income policy) - CORRECT ANSWERS ✔✔Legal
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agreement that specifies how a business will pass between owners when one
\| \| \| \| \| \| \| \| \| \| \| \|
of the owners dies or becomes disabled
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