Law and the Insurance Contract
Uses of health Insurance
Florida Laws and Rules
Numbers!!!
Long-term Care
100
This term is used for the voluntary relinquishment of a known right.
Waiver
100
How is the disability buy-out benefit paid?
lump-sum payment benefit
100
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
100
With 3 partners in a business, how many life insurance policies would be required to insure a cross-purchase buy-sell plan?
6
100
What is the minimum age limit for LTC?
79
200
What is the transfer of ownership in the contract?
Assignment
200
Name 3 Business Continuation Plans.
1. Business Overhead Expense, 2. Business Health Insurance, 3. Disability Buy-Out
200
What is the other name for "Florida Health Insurance Coverage Continuation Plan"?
"Mini-COBRA"
200
The amount of time allowed for a delayed disability may be___, ___, ___ days.
30, 60, 90
200
Name any 3 organic cognitive disorders covered by Long-term care policy
1. Alzheimer's disease, 2. senile dementia, 3. Parkinson's disease
300
This rule states that when parties put their agreement in writing, all previous verbal statements come together in that writing, and the written contract can not be changed or modified by oral evidence
Parol Evidence Rule
300
This type of insurance plan is designed to help the day-to-day operation of the business during the period of disability
Business Overhead Expense Insurance
300
The body of laws which serves as the broad legal framework prescribing the general standards for the insurance industry
The Insurance Code
300
In Medicare Part B, participants are required to pay monthly premium of $___ (in 2010) and responsible for an annual deductible $___(in 2010)
$96.40 ; $155
300
List at least 6 activities of daily living
1. Eating, 2. Continence, 3. Transferring, 4. Toileting, 5. Dressing, 6. Bathing, 7. Mobility
400
The applicant is presumed to be competent, with 3 possible exceptions. Name those exceptions!!!
1. Minors, 2. The mentally infirm, 3. Those under influence of alcohol or narcotics
400
What is the elimintaion period in key-person disability insurance? (from___to____)
30-90 days
400
According to Florida Law, any agent who represents or aids an unauthorized insurer commits a __________ felony.
third-degree felony Remember this for state exam (p. 511)
400
Evander earns $2000 a month and buys a disability policy that pays @1000 a month for total disability and a residual rider. He goes back to work after being totally disabled for 1 year. The first month back he earns 60% of pre-disability income, his policy will pay___
$400 (see question # 253 from 400 pmreview)
400
What is the name of a plan or program where insureds obtain a form of long-term partnership with insurers who will give them a certain amount of long-term care insurance protection.
State Partnership Programs for Long -term Care (see p. 346 for State Exam!!!!!!!!)
500
List 8 Characteristics of Insurance Contract
1. Aleatory, 2. Adhesion, 3. Unilateral, 4. Conditional, 5. Valued or Indemnity, 6. Utmost Good Faith, 7. Insurable Interest, 8. Not personal
500
What are the methods of keeping premium costs to minimum in health policy? (Name 3)
1. Modifying benefit amounts, 2. Increasing the deductible, 3. Extending the elimination period
500
Under HIPAA requirements,how many months of "creditable coverage" are required in order for a person who does not have access to other health insurance to be given the opportunity to purchase an individual health insurance policy
18 months
500
According to Health Care Perform Act, what will be the annual fine for not purchasing insurance after 2014?
$695
500
Name 3 levels of services and support associated with long-term care
1. Institutional Care, 2. Home-Based Care, 3. Community Care
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