Group health insurance

How many members must in association have to qualify for group insurance

100 members

What is a probationary period in group health insurance

The period of time that must lapse before an employee is eligible for group health coverage

What do individual insurances receive as proof of their group health coverage?

Certificate of insurance

In group Insurance, who is issued a certificate of insurance

Individual insured

In health insurance, when would an excessive plan pay benefits

After the primary plan has paid its full promised benefit. The access plan will pay the balance.

According to the coordination of benefits provision, if both parents have coverage for a child from their employers policies, which policy will pay first

The order of payment will be determined by the birthday rule, the coverage of the parent, whose birthday is earlier in the year will be considered primary

Does group health insurance require medical examination?

No, the underwriter evaluates the group as a whole, rather than each individual member

What type of groups are eligible for group health insurance

Employer/sponsored and association/ sponsored groups

What is the purpose of COBRA

To allow continuation of health insurance coverage for terminated employees

In group Insurance, what is the name of the policy?

Master policy

If a group health policy covers individuals that reside in more than one state which state has jurisdiction over the group policy

The state in which the policy was delivered

What is a birthday rule in a coordination of benefits provision?

The coverage of the parent whose birthday is earlier in the year is considered primary

How do Insurance determine the cost for a group health policy

The main variables are the ratio of men and women in the group, and the average age of the group

If the insurance shared the cost of health insurance premiums with the employer, this would be known as what type of group health plan

Contributory

Who are the parties in a group health contract?

The employer and the insurer

Creditor

A lender of funds

Debtor

A borrower of funds

Extension of benefits

A provision that allows coverage to continue beyond the policies, expiration date for importance, who are not actively at work due to disability or have dependence hospitalized on that date(coverage continues only until the employee returns to work or the dependent leaves the hospital)

HIPPA

My health insurance portability, and accountability act is a federal law that protects health information

Persistency

The tendency or likelihood of insurance policies, not lapping or being replaced with insurance from another insurer

Self funded programs

A non-insured plan that uses a trust fund to pay for employees healthcare expenses directly

underwriting

Risk selection and classification process