Insurance Planning Flashcards
(114 cards)
4 Elements of Insurable Risks
1) Sufficiently large number of homogeneous exposure units
2) Loss produced by risk must be definite and measurable
3) Loss must be fortuitous or accidental
4) Loss must not be catastrophic to the insurance company
Advantages of Self Insurance
1) Avoid cost associated with commercial insurance
2) Reserves held for claims can be invested in short-term MMs, and earnings can offset program costs.
Disadvantages of Self Insurance
1) Can leave company exposed to catastrophic loss
2) Company must duplicate services of insurance company
3) Company may have to pay income taxes on reserves held at year end
When a small company self-insures up to a certain point but acquires insurance to pay for claims above that, this is called _____.
Stop loss coverage (also partially self-funded plan or cash flow plan)
5 Methods to Control Losses
1) Avoidance
(don’t buy house with a pool)
2) Diversification
(duplicate assets across locations)
3) Risk Reduction
(sprinkler or burglary systems)
4) Retention
(deductibles & self insurance)
5) Transfer
(purchase insurance)
For risks that involve high loss severity and low loss frequency, the most suitable technique(s) is/are probably _____.
Risk Transfer (i.e. insurance)
For risks that involve high loss severity and high loss frequency, the most suitable technique(s) is/are probably _____.
Avoidance (because premiums would be very expensive)
For risks that involve low loss severity and high loss frequency, the most suitable technique(s) is/are probably _____.
Retention and reduction (because high frequency will make a transfer costly)
For risks that involve low loss severity and low loss frequency, the most suitable technique(s) is/are probably _____.
Retention
The principle underlying most insurance contracts where the insurer seeks to reimburse the insured for approx. the amount lost (but no more, no less) is called _____.
Principle of indemnity
A right or relationship with regard to the subject matter of an insurance contract such that the insured will suffer financial loss from damage, loss, or destruction of that subject matter is called _____.
Insurable Interest
Insurable interest must exist at the time of _____ for property/casualty insurance.
For life insurance, it must exist at the time of _____.
Loss; issue
When only a president, VP, or secretary can alter a contract, this is called _____.
Waiver Provision
_____ is represented by the fact that an insured may pay a large premium and never receive proceeds, whereas another insured may pay only a small premium and receive a large settlement. In other words, the outcome is affected by chance.
Aleatory
The process by which an insurer takes over the legal rights its insured has against a responsible third party is called _____.
Subrogation
Medicare Part A
-Hospital Insurance (think Ambulance)
-For everyone 65+ who is also eligible for SS benefits
-Disabled workers at any age
-Disabled widows/widowers age 50+
-Free to anyone who has paid Medicare taxes for more than a decade (or married to someone who has)
Medicare Part B
-Same eligibility as Medicare Part A
-Health Benefits (think Benefits)
-Pays 80% of the balance of approved charges
-No stop loss applies
-Unique Coverage: doctor-administered drugs, free preventive care services,
-Exclusions: Dental, Vision, most immunizations (except yearly flu shot), prescription drugs
-Charged a monthly premium based on income (IRMAA- Income Related Monthly Adjustment Amount)
-Will be penalized if you do not sign up at 65, with one primary exception
Even if you are working and have health benefits, you need to sign up for Medicare Part A at age _____.
65
Once covered under Medicare Part A, you lose the ability to _______ an HSA plan.
Contribute to
The one circumstance where people can avoid signing up for Medicare Part B at age 65 is _____.
When they have health insurance through their own or a spouse’s current job at a workplace with 20+ employees.
Medicare Part C
-AKA Medicare Advantage
-Covers Parts A and B (A+B=C)
-Issued through a private Company (C for Company)
-May cover vision, dental, or other items typically excluded
Medicare Part D
-D for Drugs
-Must have Part A and B to get Part D
HMO’s
-Primary care doc is the gatekeeper
-Must use doc affiliated with the HMO
-Monthly fee paid to provider
PPO’s
-Generally paid on fee-for-service basis
-Can go to doc outside of network (but generally at reduced benefits)