UNDERWRITING
Male 54 ... 2 BP meds, Cholesterol med, Sleep Apnea
What is a decline?
What's the difference between plan 1 and plan 3 on premier choice
Surgery benefits, dr benefits and amounts
The lump-sum amount that is paid out in a critical event
What is Medguard
Renews every couple of months and underwrites on the back end
What is a short term plan?
Female breast cancer 12 years ago, 1 BP med, height 5'8 weight 140
What is an approval?
The client has a heart attack on premier med and steps up 4 months later, what's his coverage and how does premier med work?
3k deductible, 100% coverage after that, short term plan, has to jump off next OE
The client has saver plus dental for over a year, the child needs braces. What is the coverage?
Not covered
Organization where medical expenses are paid from a pool of money contributed by members
What is a healthshare policy?
Male 34 healthy, owns a liquor distribution company
What is a decline? (what is a changed occupation) lol
The client has premier choice plan 3 and has been on the plan for 3 months and the son needs tubes in his ear. What's the coverage?
No coverage, 6 month waiting period for ENT
The client has the highest level of accident protector and is out drinking one night and falls and breaks his arm. What is his coverage using the accident protector?
No coverage, the client was out drinking company won't cover the claim
What's the standard duration of a COBRA plan
Female 52, sleep apnea controlled with a CPAP machine, been taking lisinopril for 4 years, been taking atorvastatin for 4 years, height and weight 5'4 130
Male 53, been taking amlodipine and hydrochlorothiazide for 3 years, take timolol eye drops for glaucoma for 6 months, height and weight 5'10 200
What is a decline?
The client is on secure advantage with a 5k deductible 70/30 coinsurance, what is their total out of pocket max?
What is 11k? ... 5k ded ... 6k out of pocket
Client has medguard and is diagnosed with life-threatening cancer within 60 days of having coverage, what is his benefit amount?
No, they get $500, any cancer within 90 days only gets $500
What type of plan is appropriate to supplement a high deductible major medical plan
What is a limited benefit plan
Family plan ... dad has been taking lisinopril for 2 years, height and weight 6'0' 180, also takes fluoxetine
Mom ... has been taking lisinopril for over a year, gastric surgery 3 years ago ... height and weight 5'8 170
Son- rotator cuff surgery 7 months ago
Daughter- 19 has been taking sertraline for a year
what is a partial decline?
The client has plan 1 premier choice with executive diamond, they are in the hospital for 7 days and 2 days in the ICU (9 days total). What is their total benefit amount?
What is 10,800k? .. 400 daily (7 days)from premier choice coverage for the hospital + 800 per each day (2 days) for ICU + 800 a day (8 days) after 1 day elimination period from association
61-year-old male wants to purchase life protector, what is his max benefit?
Have to be 60 or younger to purchase life protector
What's a situation that allows someone to keep COBRA for 36 months?
When an employee dies, spouse and kids are eligible to keep COBRA for 36 months