Chapter 7 Know This

What are the two major perils covered in health insurance policies?

Accidental bodily injury and sickness.

How are medical expense benefits classified in health insurance?

They are considered reimbursement benefits.

What do limited health insurance policies cover?

They cover a specific sickness or accident only.

In AD&D (Accidental Death and Dismemberment) policies, what does the principal sum represent?

The full face amount (100%).

What is the capital sum in AD&D policies?

A percentage of the face amount.

What is the agent's responsibility regarding insurance applications?

To ensure that the application for insurance is complete and accurate to the best knowledge of the applicant.

What must happen if there are changes on the insurance application?

They must be initialed by the applicant or insured.

What is required to avoid coverage gaps when replacing insurance coverage?

There cannot be any coverage gap between the existing coverage and replacement coverage.

Until what age must children of an insured be covered under the parent's health plan?

Until age 26.

What does the Affordable Care Act (ACA) require regarding health insurance plans?

All individual and group health insurance plans be issued on a guaranteed issue basis.

What benefit may be awarded under the ACA to low-income individuals?

Premium discounts, regardless of the chosen metal levels.