Accident & Health Insurance - Ch. 4 Flashcards
(34 cards)
Medical Expense Insurance covers…
Non surgical doctors fees
Renewability Provisions
Define the insurer’s rights to cancel a policy at various stages during its term
Waiting Period
Usually 12 months, starting from the effective date of a health insurance plan during which benefits for pre-existing conditions are not provided.
Cafeteria Plans
Employees select from a range of benefits to tailor a package to their individual needs
Probationary Period
A set number of days after a policy’s issue date during which coverage for sickness is not provided. Accidents typically don’t apply.
Conversion Privilege
Allows a policyholder to switch to a new policy before the original policy expires to maintain coverage. This must be converted within 31 days.
Preexisting Conditions
Health issues that were present, treated,
or diagnosed within the six months leading up to employment.
Creditable Coverage
Refers to prior insurance coverage that had no break in coverage for 63 days or more. This can reduce or eliminate the waiting period for preexisting conditions on a
new plan.
COBRA Act of 1985
allows terminated employees and their families to continue group health
coverage at their own expense for up to 18 months.
Franchise Health Plan
Individual policies are provided directly to members, with the association or society
acting only as the plan’s sponsor
Credit Policies
Designed to help cover loan payments if the insured becomes disabled due to an accident or
illness, or in the event of their death.
Nonoccupational Coverage
Policy that excludes coverage for losses from incidents related to the insured’s employment.
Health Savings Accounts
tax-advantaged savings accounts for medical expenses, available to U.S. taxpayers who are covered by a high-deductible health plan
AD&D Insurance
Accidental Death & Dismemberment Insurance
Principal Sum in an AD&D Policy
The max amount of insurance the policy will pay
Capital Sum in an AD&D Policy
A portion of the total coverage being provided
Limited Risk Policy
Offers coverage for particular types of accidents or illnesses, such as injuries from travel accidents or medical expenses related to a specified disease
Special Risk Policy
Covers unique hazards not typically included under standard accident and health insurance
Primary Beneficiary
The first person designated to receive death benefits.
Secondary (Contingent) Beneficiary
The person who receives the death benefit proceeds if the primary beneficiary is already deceased.
Tertiary Beneficiary
The person who receives the death benefits if both the primary and secondary
beneficiaries pass before them.
Revocable Beneficiary
The beneficiary can be altered by the policy owner at any time, without needing to inform or obtain consent from the beneficiary.
Irrevocable Beneficiary
The beneficiary can only be changed with the written approval of the beneficiary
Per Stirpes (By the Bloodline)
If a beneficiary dies before the insured, their portion of the benefits will be passed to their heirs.
