Exam 3: Health: Health and Dental

When putting together a major medical insurance plan, what factors must be established?

The type of health plan that allows insureds to choose which doctor and other medical services providers they will use is:

With regard to group health insurance, a company must have at least __________ employees in order to qualify as a "group"

The __________ allows the employees who are enrolled in a company's dental PPO plan to roll a portion of their unused annual maximum over into an account in case they should need more extensive dental care in the future.

Some dental insurance plans include a(n) __________ , which can be met by any or all covered members of a family dental plan.

In most cases, unless it is otherwise stated, it is assumed that the applicant on a health insurance policy is also the __________.

Traditional dental insurance typically pays for three classes of treatment. These are:

The limitation of coverage to in-network providers and non-payment of claims for self-inflicted injuries are examples of policy __________.

The __________ is the group of state officials that is charged with regulating insurance.

The payment of health insurance benefits to the health care provider rather than to the insured is referred to as __________.

All of the following are types of health insurance policies EXCEPT:

The type of dental insurance coverage that offers dental care from a network of dental care providers in exchange for some type of prepayment from the insured in is known as a(n) __________.

When an individual is covered under more than one health insurance policy, _________ is the policy that provides claim payment after the primary coverage.

Some features of dental PPO plans include:

The __________ fee is the amount that an insurance company will actually pay a dentist for a particular procedure.

A __________ may provide discounted health coverage to members on services such as medical care, vision, dental, hearing, and prescriptions - although they are not considered to be true insurance plans.

A(n) __________ is considered to be an official request for money from an insurer.

The __________ in an insurance policy is the statement that sets out the element of insurance to pay for losses that are covered in the policy by the issuing insurance company.

What type of plan does not require that a participant obtain a referral prior to visiting another provider in the network?

If, due to serious health conditions, an individual is not eligible for a traditional individual health insurance policy, they may be able to obtain coverage through __________.