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Colorado Health insurance > Terms to Know > Flashcards

Terms to Know Flashcards

1
Q

Agent/Producer

A

A legal representative of an insurance company; Producer includes agents and brokers; agents of the insurer

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2
Q

applicant or proposed insured

A

person applying for insurance

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3
Q

consent

A

permission to do something

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4
Q

insurable interest

A

the policy owner facing the possibility of losing something of value in the event of loss

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5
Q

insurance policy

A

contract between policy owner (and/or insured) and an insurance company agrees to pay the insured or beneficiary for loss caused by specific events

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6
Q

insured

A

person covered by the insurance policy (may/maynot be the policy owner)

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7
Q

insurer (principle)

A

company who issues an insurance policy

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8
Q

policyowner

A

a person entitled to exercise the rights and privileges in the policy

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9
Q

premium

A

the money paid to the insurance company for the insurance policy

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10
Q

accidental bodily injury

A

an unforseen and unintended injury that results from an accident rather than sickness

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11
Q

cafeteria plan

A

type of employee benefit plan that allows insureds to choose between different types of benefits

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12
Q

cancellation

A

termination of an in-force insurance policy, by either the insured or insurer, prior to the expiration date on policy

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13
Q

comprehensive coverage

A

health insurance that provides coverae for mot types of medical expenses

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14
Q

deductible

A

a specified dollar amount that the insured must pat first before the insurance company will pay the policy benefits

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15
Q

lump sum

A

a payout method that pays the beneficiary the entire benefit in one payment

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16
Q

nonrenewal

A

termination of an insurance policy at its expiration fate y not offering a continuation of the existing policy or a replacement policy

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17
Q

riders

A

added to the basic insurance policy to add, modify, or delete policy provisions

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18
Q

sickness

A

an illness, which first manifests itself while the policy is in formce

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19
Q

tax exempt

A

not subject to taxation

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20
Q

taxable

A

subject to taxation

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21
Q

underwriting

A

risk selection and classification process

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22
Q

Guaranteed renewable

A

a policy that is written on a noncancellable basis with the right to renew guaranteed

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23
Q

irrevocable beneficiary

A

beneficiary who has vested interest in the policy resulting in the policy owner not being able to exercise certain rights without beneficiaries consent

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24
Q

NAIC (National Association of Insurance Commissioners)

A

An organization composed of insurance commissioners from all 50 States

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25
Q

total disability

A

inability of the insured to preform any occupation for which the insured is reasonably suited by education, training, or experience.

26
Q

waiver

A

relinquishment of a right or interest

27
Q

Adjusted gross income

A

gross income (all income) minus adjustments to income

28
Q

Affordable care act (ACA or PPACA)

A

a federal law that mandates increased preventive, educational, and community-based health care services, and that established the health insurance marketplace to make health coverage available to any uninsured individuals.

29
Q

Estate

A

a persons net worth

30
Q

overinsurance

A

insurance that exceeds in amount the actual value of the person or property insured or insurance in a greater amount than the insured can afford

31
Q

tax deductible

A

a qualified expense that may reduce the amount of income subject to taxation

32
Q

taxable

A

subject to taxation

33
Q

aggregate

A

combined;total

34
Q

authorized insurer

A

insurer who has received a certificate of authority from the department of insurance to transact insurance in this state

35
Q

business entity

A

corporation, association, partnership, limited liability company, limited liability partnership, or other legal entity

36
Q

cease and desist

A

to stop; discontinue

37
Q

commission

A

payment to the agent by the insurance company for placing insurance, usually percentage of the policy premiumm

38
Q

commissioner

A

the head of the division of insurance

39
Q

disclosure

A

revealed information to help someone make an intelligent and educated decision

40
Q

exempt

A

not subject to an obligation

41
Q

immunity

A

exemption from a duty or legal obligation or protection against a liability

42
Q

inducement

A

an offer that attempts to influence the other party

43
Q

moral turpitude

A

conduct that is contrary to community standards of justice, honesty, or good morals

44
Q

promulgate

A

to make public, to put into action
(laws, court decrees)

45
Q

solvency

A

ability to meet financial obligations

46
Q

salute

A

a formal written law enacted by legislature, insurance statutes can be found i the state insurance code

47
Q

subpoena

A

an order for someone to appear as a witness or submit testimony or evidence

48
Q

benefit period

A

a period of time during which benefits are paid under the policy

49
Q

enrollee

A

a person enrolled in a health insurance plan, an insured.
(doesn’t include dependents of the insured)

50
Q

pre-existing conditions

A

conditions for which the insured has received a diagnosis, advice care, or treatment during a specific time period prior to the application for health coverage

51
Q

premium

A

money paid to the insurance company for the insurance coverage

52
Q

Social Security Disability insured Status

A

fully insured or currently insured, depending on the number of coverage credits earned

53
Q

waiting period

A

a period of time that must pass after a loss occurs before the insurer start paying policy benefits

54
Q

dependent

A

someone relying on the insured for support

55
Q

nonrenew

A

terminate an insurance policy at its expiration date

56
Q

PPACA (Patient Protection and Affordable Care Act)

A

a federal law that mandated health care services for all eligible U.S. citizen and nationals

57
Q

solicitation

A

an attempt to persuade a person to buy an insurance policy, and it can be orally or in writting

58
Q

suitability

A

a requirement to determine if an insurance product is appropriate for a customer

59
Q

warranty

A

Absolutely true statement upon which the validity of the insurance policy depends

60
Q

Representations

A

statements believed to be true to the best of ones knowledge

Colorado Health insurance (8 decks)

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