MASSACHUSETTS HEALTH ACCIDENT INSURANCE EXAM

PDF Download MASSACHUSETTS HEALTH & ACCIDENT INSURANCE EXAM Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -99 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: Medicare Part A (Hospital Insurance)

Answer:

• hospitals, nursing care, and hospice
• starts the day entered hospital
• maximum 100 days per benefit period in a skilled nursing facility (days 1-20pay 100%; days 21-100

pay flat dollar amount per day)

• 190 days maximum inpatient psychiatric care
• funded by payroll and self employment taxes

Question 2: Premium

Answer:

The amount you pay for your health insurance every month

Question 3: Capital Sum

Answer:

amount payable for accidental loss of sight or accidental dismemberment

Question 4: Insurer

Answer:

An insurance company

Question 5: Blue Cross & Blue Shield

Answer:

• service base rather than reimbursement
• "subscribers"
• prepaid plans
• nonprofit

Question 6: Elimination Period

Answer:

time immediately following the start of a disability when benefits are not payable (longer period = lower premium)

Question 7: Commercial Insurance Providers

Answer:

life insurance companies, casualty insurance companies, and monoline companies Question 8: - federal protection for individuals health information and gives patients an array of rights in respect to health information

• individually identifiable = health claim information
• requires healthcare providers to disclose info
• notice of information practices must be given to a policyholder at least every 3 years

Answer:

HIPPA Security Rule

Question 9: Noncontributory

Answer:

• employer pays entire premium and employee does not contribute
• require 100% participation from eligible members
• minimum requirements protect insurer against adverse selection

Question 10: Interim

Answer:

the intervening time

Question 11: Group Long-Term Disability

Answer:

60% of participants income

Question 12: Employee Benefit Plans

Answer:

• help employee in event of disabling sickness or injury
• rare to not include provision of health insurance/benefits
• contributes to morale and productivity of employee
• provides needed benefits (helps hold down demands for wage increases)
• gives employer tax deductions
• enhances employer image

Question 13: Medical Expense Insurance

Answer:

Pays benefits for nonsurgical doctors' fees commonly rendered in a hospital; sometimes pays for home and officecalls

Question 14: - promote employee health and productivity

• reduce health related costs
• can be offered by insurance plans directly

Answer:

Group Disability Income Plans

Question 15: Key Person Disability Insurance

Answer:

• pays monthly benefit to a business for additional help or outside services when an essential person is

disabled

• key persons economic value to a business is determined by potential loss of business income that

could occur (hiring price)

• business = owner and premium payer of policy
• benefits tax-free
• premiums not tax deductible
• policies reserved for "hard to replace" employees or key sales members

Question 16: Tri-Care

Answer:

military families Question 17: - benefit arrangements where employees can pick and choose from a menu of benefits tailoring to their needs

• convert taxable cash benefit (salary) into nontaxable benefits
• able to pay for qualified benefit premiums before any taxes are deducted from paychecks
• S-Corp owner w/ 2% share is ineligible
• can forgo lesser important benefits
• Church employee welfare plans exempt (ERISA)

Answer:

Wellness Programs Question 18: provides technological safeguards to ensure confidentiality of electronic health information

Answer:

HIPPA Rules apply to...

Question 19: Insured

Answer:

A person or business covered by an insurance policy

Question 20: Dental/Vision/Prescription Drug Benefits

Answer:

Pregnancy Discrimination Act of 1978

Question 21: Health Insurance

Answer:

Broad field of insurance plans that provide protection against financial consequences of illness, accidents, injury, and disability

• Paid on a year-to-year basis
• Subject to periodic premium increases
• Benefits not fixed