Wisconsin Health & Accident Insurance ( Latest 2023/2024 ) Latest Questions With Complete Grade A Answers
- Health Insurance
Answer: A general way of describing insurance against loss through sickness or
accidental bodily injury. This term applies to many different types of insurance, not just medical that pays for doctor and hospital visits.
Examples:
- Accident & Health
- Accident & Sickness
- Sickness & Accident
- Disability insurance
- Disability (Income) Insurance
Answer: A form of health insurance that provides periodic payments to replace
income when the insured is unable to work as a result of illness, injury, or disease not as a result of a work-related accident or condition.
- Medical Expanse Insurance
Answer: Pays benefits for non surgical doctor's fees commonly rendered in a
hospital; sometimes pays for home and office calls.
- Interim Coverage
Answer: A short-term policy purchased on an interim basis typically when in
between jobs or waiting for a new policy to start.
- Accidental Death and Dismemberment Insurance (AD&D)
Answer: The purest form of accident insurance which provided the insured with a
lump sum benefit amount in the event of accidental death or dismemberment under accidental circumstances.
- Nonparticipating Plan
Answer: Insurance under which the insured is not entitled to share in the divisible surplus of the company.
- Participating Plan
Answer: A plan under which the policy owner receives shares (commonly called
dividends) of the divisible surplus of the company.
- Patient Protection and Affordable Care Act
Answer: This is the health care reform law of 2010. Focuses on reform of the 1 / 2
private health insurance market; providing better coverage for those with pre- existing conditions; improving prescription drug coverage in Medicare. Was shortened to Affordable Care Act (Obamacare) and does not apply to all health insurance policies.
- Group Health Insurance
Answer: Health insurance consisting of contracts written be- tween a group,
(employer, union, etc.) and the health care provider. These normally do not require individual underwriting nor evidence of insurability.
- Renewability Provisions
Answer: Define the rights of the insurer to cancel the policy at different points during the life of the policy. Generally speaking, the more advantageous the renewability provisions to the insured, the more expensive the coverage. There are 5 principal
renewability classifications:
- Cancellable
- Optionally renewable
- Conditionally renewable
- Guaranteed renewable
- Noncancellable
- Cancellable Policies
Answer: Allows the insurer to cancel or terminate the policy at any time. This type of renewability is prohibited in most states.
- Optionally Renewable Policies
Answer: Give the insurer the option to terminate the policy on a date specified in the contract. If the insurer decides to renew (not cancel) the policy, they also have the option (and usually choose to) increase the premiums on the anniversary date.
- Conditionally Renewable Policies
Answer: A conditionally renewable policy allows an insurer to terminate the
coverage but only in the event of one or more conditions stated in the contract. They typically are related to the insured reaching a certain age or losing gainful employment.
- Guaranteed Renewable Policies
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Answer: The renewal provision in a guaranteed renewable policy specifies that the policy MUST be renewed (as long as premiums are paid) until the insured reaches a specified age, such as 60 or 65. The insurer still has the option (and usually chooses to) increase the premiums on the anniversary date. Medicare supplement policies and long term care policies are the most common types of guaranteed renewable