2024 Health Insurance Ohio Exam: |2024
ACTUAL EXAM QUESTIONS AND VERIFIED
ANSWERS /GET IT 100% ACCURATE|ALREADY
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Terms in this set (238)
ACCIDENTAL AND ...
HEALTH INSURANCE
BASICS STARTS: 15%
Two major perils under a Policies may cover both accident and sickness or
health insurance policy: accident only.
An unforeseen and unintended injury that resulted
Accidental bodily injury:
from an accident rather than a sickness.
Normally defined as an illness, which first manifests
Sickness: itself while the policy is in force. This is where a
majority of health insurance claims result from.
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, 12/9/24, 1:43 PM 2024 Health Insurance Ohio Exam: |2024 ACTUAL EXAM QUESTIONS AND VERIFIED ANSWERS /GET IT 100% ACCURAT…
Loss of income caused by accident or sickness
Loss of income from
causing an insured the inability to work and earn in
disability:
come.
Limited health insurance policies only cover specific
Limited Vs accidents or diseases.
Comprehensive: Comprehensive plan would cover all sickness or
accidents that are not specifically excluded.
-A group large enough to reasonably predict future
loss experience.
-Sound statistical data to support the self-funding
A successful self funded
concept.
plan will have the
-A stop-loss contract to assume losses beyond the
following characteristics:
insured's retention.
(5)
-A third party administrator who services claims.
-Flexibility in plan design and administrative
procedures.
Employee Retirement A federal law that was enacted to ensure that
Income Security Act of employees receive the pension and other benefits
1974 (ERISA): promised by their employers.
Can buy group insurance for its members. The
group must have at least 100 members, be
Association (alumni or
organized for a reason other than buying insurance,
professional) group:
have been active for two years, have a constitution,
by-laws, and must hold at least annual meetings.
Made up of two or more employers in similar or
Multiple-Employer Trust
related businesses who do not qualify for group
(MET):
insurance on their own.
Can be any entity, other than a duly admitted
insurer, that establishes an employee benefit plan
for the purpose of offering or providing accident
Multiple Employer
and sickness or death benefits to the employees of
Welfare Associations
at least 2 employers, including self-employed
(MEWAs):
individuals and their dependents.
They pool their risks in order to self-insure
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