Multiple Employer Welfare Arrangement (MEWA) provides what type of benefits?
Insurance
XYZ Company pays the entire premium for its group health plan. The MINIMUM percentage of eligible employees that must be covered is
100%
In Major Medical Expense policies, what is the intent of Stop Loss provision?
Limits an insured's out-of-pocket medical expenses
Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy with a $100 deductible and 80/20 coinsurance. How much will Q be responsible for paying on this claim?
$2,100
Omitting information that affects the issuance or the rate of an insurance contract is called
concealment
Florida requires that coverage for newborns begins "from the moment of birth" and continues for
18 months
In order to establish a Health Reimbursement Arrangement (HRA), it MUST
be established by the employer
Which provision allows a portion of any used medical benefits to be restored following a particular amount of benefits has been used, or after the policy has been in effect for a particular period of time?
Restoration of used benefit
Disability policies do NOT normally pay for disabilities arising from which of the following?
War
According to Florida law, when must an agent deliver the Outline of Coverage to a Medicare Supplement applicant?
At the time of application
An agent selling Medicare Supplement policies must provide every applicant with a(n)
Suitability form
One definition of replacement is "the act of replacing an existing insurance policy with another". Replacement is
closely regulated and requires full disclosure
Who makes the legally enforceable promises in a unilateral insurance policy?
insurance company
Which of the following acts is an agent NOT authorized to do on behalf of an insurer?
Authorize claim payments
Which of the following BEST describes a Hospital Indemnity policy?
Coverage that pays a stated amount PER DAY of a covered hospitalization
What is required in the Florida Employee Health Care Access Act?
Small group benefit plan are to be issued on a "guarantee-issue" basis
The waiting period for a pre-existing condition under a Medicare Supplement policy may NOT go beyond
6 months
J purchased a Disability Income Policy that ONLY J can terminate and on which the rates will never increase above those illustrated in the policy. Which of the following types of policies did J purchase?
Noncancelable
What is the elimination period of an individual disability policy?
Time period a disabled person must wait before benefits are paid
This type of deductible provision waives the deductible for all family members after some of them have satisfied individual deductibles within the same year
Family maximum deductible
Under an Individual Disability policy in Florida, what is the minimum schedule of time in which claims must be made to an insured?
Monthly
Under a Long Term Care policy, which benefit would be typically excluded or limited?
Alcohol rehabilitation
P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating in a carjacking. How will the insurer most likely handle this claim?
Claim will be denied
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