TYPES OF POLICIES (Disability, Medicare Supplement, Group, COBRA, HIPAA)

Vocabulary flashcards covering key terms related to disability policies, group health, COBRA, HIPAA, and Medicare supplements from the notes.

Any occupation (disability definition)

A disability standard in which benefits are paid if you cannot perform any occupation for which you are reasonably suited by education, training, or experience.

Own occupation (disability definition)

A disability standard in which benefits are paid if you cannot perform the duties of your own occupation; typically more restrictive than 'any occupation'.

Occupation (underwriting factor in disability income)

A key underwriting factor used to determine risk, premiums, and eligibility based on the insured's job duties.

Business Overhead Expense (BOE) policy

A disability policy that reimburses ongoing business overhead costs (e.g., rent, utilities, payroll, taxes) when the business owner is disabled; typically does not cover raw materials.

Social Security disability definition (substantial gainful activity)

Disability defined as the inability to perform any substantial gainful activity.

Medicare Supplement (Medigap) core benefits

A policy that helps pay some costs not covered by Medicare (e.g., Part A/B coinsurance and hospital costs); generally does not cover long-term care.

Medicare Supplement not a core benefit

Long-term care expenses are not considered a core benefit of Medigap policies.

Master policy (group health insurance)

The group health policy issued to the employer or group sponsor; individuals receive certificates of insurance.

Certificate of Insurance

A document issued to individual employees or members proving coverage under the master/group policy.

Noncontributory plan

A group health plan funded entirely by the employer; 100% of eligible employees must be covered.

Contributory plan

A group health plan where employees contribute to the premium; not all eligible employees may be covered.

COBRA (Consolidated Omnibus Budget Reconciliation Act)

Federal law allowing eligible employees and dependents to continue group health coverage at their own expense after a qualifying event.

COBRA election period

The period (often 60 days) to elect continuation coverage after receiving COBRA rights.

HIPAA (Health Insurance Portability and Accountability Act)

Law that provides portability of health coverage and prohibits pre-existing condition exclusions when switching plans.

Disability income policy

Insurance that provides income replacement when the insured is unable to work due to disability.

Disability coverage in an accident scenario

Typically covers the insured's own lost income; it does not cover the disability of others or unrelated medical expenses.