Deck 6: Health: Theory in Life Insurance

Question 1

What type of benefit pays monthly or weekly for disabilities due to accident or sickness?

A)Accidental death and dismemberment
B)Medical expense benefits
C)Loss of time insurance
D)Long-term care Insurance

Answer 1

Loss of time insurance

Question 2

What does accidental death and dismemberment pay?

A)Principal sum
B)Medical expenses
C)Burial expenses
D)Survivor benefits

Answer 2

Principal sum

Question 3

Which of the following is not a means of including an accidental death and dismemberment benefit?

A)Rider
B)Disability income insurance
C)Separate policy
D)Annuity addendum

Answer 3

Annuity addendum

Question 4

What type of insurance benefit should Laura look for if she wants to make sure both in-hospital and outpatient expenses are covered?

A)Reimbursement medical
B)Prepaid medical
C)Medical expense insurance
D)Blanket medical policy

Question 5

Dental insurance is usually sold

A)As part of life insurance
B)As part of health insurance
C)As an individual plan
D)As group life insurance

Question 6

What is the purpose of long term care insurance?

A)Provides coverage for death or injury resulting from accidents
B)Pays for the care of persons with chronic diseases or disabilities
C)Pays specified amounts on a daily weekly or monthly basis
D)Pays coverage from an accident but does not cover illness

Question 7

Which of the following is not a special health insurance policy providing limited coverage?

A)Travel accident
B)Specified disease
C)Credit insurance
D)Workers compensation

Question 8

What is the purpose of blanket insurance?

A)To provide coverage for a variety of circumstances
B)To provide coverage for a variety of people
C)To provide coverage for people and things in one policy
D)To provide coverage for life, health, and dental combined

Question 9

Rebecca and Phil recently moved to a new town and have not established a family doctor. Phil gets sick and needs to see someone. Which of the following would be an option for Phil to see a physician after hours?

A)Surgi-centers
B)Urgent care centers
C)Skilled nursing facilities
D)Home health care

Question 10

Which type of health care provider would provide care for individuals who cannot currently take care of themselves?

A)Home health care
B)Urgent care centers
C)Surgi-centers
D)Hospitals

Question 11

What is the purpose of managed care?

A)To impose control on health care uses
B)To impose taxes on health care
C)To impose annual health checks
D)To impose higher cost health care

Question 12

How are Blue Cross and Blue Shield different from traditional commercial insurance companies?

A)Majority of benefits are on a reimbursement plan
B)Majority of benefits are on a service basis
C)Insured can see any doctor
D)Non-participatory doctors are subject to the same costs

Question 13

ABC Company funds claims in house but uses EFG Company as the liaison between the employees and ABC Company. EFG Company makes sure that the plan runs smoothly for ABC Company. What type of arrangement would this be?

A)HMO
B)Multiple-party organization
C)Multiple employer trust
D)Third-party administrator

Question 14

Why would a provider agree to be part of a preferred provider organization?

A)Guaranteed payment and potential increase in patients
B)Increased fees for services offered
C)Being able to limit the services they offer
D)Guaranteed number of patients each month

Question 15

Which of the following is not an advantage of self-insurance?

A)If the companies losses are less than the premiums, they will save money
B)Contracts are not regulated by insurance companies
C)Company has the use of the money
D)Expenses of carrying insurance are reduced.

Question 16

When employees select health benefits from a variety of coverage options, this is called what?

A)501(c)(9) trust
B)MET
C)Cafeteria plan
D)MEWA

Question 17

When small businesses are part of specific industries, health insurance benefits are established through a series of trusts. Who provides this type of coverage?

A)501(c)(9) trusts
B)MET
C)Cafeteria plan
D)MEWA

Question 18

What is an arrangement that allows very small groups to have some of the benefits of group insurance, specifically the lower costs?

A)501(c)(9) trusts.
B)MEWA
C)Blanket policy
D)Franchise policy

Question 19

Which of the following is not a benefit of workers compensation?

A)Medical
B)Dental
C)Death
D)Income

Question 20

Under a worker's compensation claim, which benefit is provided without limit?

A)Medical
B)Dental
C)Death
D)Rehabilitation

Question 21

Which worker's compensation benefit is usually paid in addition to other included benefits?

A)Medical
B)Dental
C)Vision
D)Death

Question 22

Which of the following would not be included in rehabilitation benefits?

A)Vocational training
B)Costs of travel and lodging
C)Therapy
D)Educational expenses

Question 23

For an individual 65 or over, what is the supplemental option for covering additional expenses?

A)Medicare
B)Medicaid
C)Tricare Prime
D)Tricare Extra

Question 24

One of the largest health care systems is operated by the Department of Defense. Which of the following programs offers HMO-style care through a primary care manager?

A)TRICARE Prime
B)TRICARE Extra
C)TRICARE Standard
D)TRICARE Ultra

Question 25

For military individuals who want to use civilian doctors, which would be the best option?

A)TRICARE Prime
B)TRICARE Extra
C)TRICARE Standard
D)TRICARE Ultra

Question 26

As another option to managed care, point-of-service plans provide:

A)In-network care
B)Out-of-network care
C)Both in and out-of-network care
D)Emergency care only

Question 27

What is an exclusive provider organization?

A)A type of PPO
B)A type of HMO
C)A type of POS
D)A type of PHO

Question 28

What is a multiple option plan?

A)Plan with multiple coverage options
B)Plan with multiple providers
C)Plan with services of multiple groups
D)None of these

Question 29

Andrew has a PPO through Acme. The list of preferred providers does not include his primary care physician. If Andrew continues to see this doctor, what will happen?

A)Andrew will have to pay out of pocket
B)Andrew can file his claims for reimbursement
C)A reduced amount will be paid and Andrew will pay the rest
D)A reduced amount will be negotiated and Andrew will owe nothing

Question 30

Which of the following is not a managed care plan?

A)Indemnity arrangement
B)Health maintenance organization
C)Point-of-service plan
D)Preferred provider organization

Question 31

What kind of policy would pay expenses incurred for in-hospital medical treatment as well as some of the expenses that are incurred on an outpatient basis?

A)Disability income policy
B)Hospital income insurance policy
C)Long-term care policy
D)Medical expense insurance policy

Question 32

When an individual is recuperating at home and receiving income based on a disability from illness or injury, what type of policy might they have?

A)Disability income policy
B)Hospital income insurance policy
C)Long-term care policy
D)Medical expense insurance policy

Question 33

If a provider is paid a specific monthly fee for each subscriber to the plan, this is known as:

A)Capitation fee
B)Fee-for-service
C)Indemnity
D)Managed care.

Question 34

Fred and Wilma are both over 65 and receive benefits from Medicare. If Wilma becomes terminally ill, what options will Fred likely use to help supplement his Medicare to cover Wilma's medical expenses?

A)Medicaid
B)Medical expense insurance
C)Hospital insurance
D)TRICARE Ultra

Question 35

Which TRICARE program offers a network of civilian hospitals or clinics that have agreed to charge an approved rate?

A)TRICARE Prime
B)TRICARE Extra
C)TRICARE Standard
D)TRICARE Ultra