| A | B |
|---|
| The Consolidated Omnibus Budget Reconciliation Act is also known as | COBRA |
| Cobra is also | a snake |
| COBRA is a federal law that requires | employers with 20 or more employees to include a continuation of benefits provision for former employees and their dependents |
| COBRA pertains to employers with how many employees? | 20 |
| COBRA guarantees that participants can continue what kind of coverage? | group coverage |
| Who pays for COBRA ? | the participants |
| Qualifying event in COBRA | death of employee, termination of employment, or reduction in work hours |
| case in which termination of employment is not a qualify event | if employee was terminated due to gross misconduct |
| COBRA insurance only applies to this insurance | group health insurance |
| COBRA must be requested within | 31 days |
| Employees must work for this time period in order to get COBRA | 3 months |
| Mini COBRA is | a snake wearing a miniskirt |
| Mini COBRA applies to employers with | less than 20 employees |
| Florida Employee Health Care Access Act makes group health insurance available to employers with | 50 or fewer employees |
| Florida Employee Health Care Access Act requires that all sm. group health benefit plans be issued on a | "guaranteed-issue" basis |
| with guaranteed issue health insurance, the insurance is offered to everyone regardless of | pre-existing conditions |
| Florida Healthy Kids Corporation is for ages | 5-18 |
| Familes with Florida Healthy Kids Corporation pay | only a portion of the premium |
| Long Term Care provides coverage for many services in a setting other than an | acute care unit of a hospital |
| To sell Long Term Care insurance in FL, you need | a health insurance agent license |
| Long Term Care insurance provides coverage for at least | 12 months |
| Notice to buy must be located | on the first page of each long term care policy |
| Notice to buyer | explains that some long term care costs may not be covered |
| 3 requirements of Outline of Coverage | summary, statement and description |
| Summary of Outline of Coverage explains | exclusions and limitations |
| Statement of outline of coverage explains | renewal and cancellation provisions |
| Description of outline of coverage explains | benefits and coverage |
| Pre-existing conditions as they apply to Long Term Coverage covers time frame of | 6 months preceding the effective date of the policy |
| Individual long term care policies shall contain an approximately captioned renewablity provision on the | first page of each long term care policy |
| renewability provision for long term care states | coverage is guaranteed renewable or noncancellable |
| Free look for long term care is | 30 days |
| an inflation protection feature | provides for automatic future increase in the level of benefits without evidence of insurability |
| all insurers issuing long term care insurance must offer an optinoal benefit of | an inflation protection feature |
| a lapse notice msut be mailed at least ____ days prior to the effective date of cancellation | 30 days (1) |
| Long term care policies must pay for "at home" care | at the same daily amt. as pd. for a nursing if insured meets qualifications for nursing home care |
| Exclusion or limitations on the basis of Alzheimer's Disease | is not permitted with Long Term Care policies |
| Exclusions for long term care may be placed on | preexisting diseases, alcoholism/drug addiction,war, felony, riot, insurrection, suicide or self inflicted injury, aviation |
| An insurer must submit any medicare supplement advertisements to | the Commissioner |
| Medicare supplemental insurance marketing is regulated to | prevent sales of excessive insurance, inaccurate policy comparisons and failure to display notice of limitations to buyer |
| every agent providing medicare supplements must provide | a suitability form |
| this must appear on the medicare supplement form | question about replacement |
| if a medicare supplement policy is sold, the agent must deliver | outline of coverage no later than when the application is taken |
| when a medicare supplement policy is purchased during the open enrollment period | policy must be issued regardless of health status |
| Free look period for medicare supplements is | 30 days (2) |
| Open enrollment period for medicare andmedicare supplements begin | 3 months before the 65th birthday and lasts for 7 months |
| insurer may exclude coverage for a preexisting condition on a medicare supplement policy for | 6 months |
| using misrepresentation or inaccurate comparisons to induce a person to terminate or borrow against their current insurance policy to take out an insurance policy with another insurer | Twisting |
| used to induce the purchase of insurance through force, threat, fright or undue pressure | High pressure tactics |
| Failure to disclose that the purpose of the marketing effort is insurance solicitation | Cold lead advertising |
| Misrepresentating a material fact and selling a long term care insurance policy | Misrepresentation |
| An insurer may NOT issue a/an | HMO Contract |
| suscriber of an HMO must receive a benefit package including | HMO contract, certificate andmember's handbook |
| when dental insurance is part of a health benefit package with a single deductible the deductible is called | integrated deductible |
| with prepaid dental plans, coverage is limited to | a closed panel of dentists |
| Affordable Care Act is also called | ACA |
| Purpose of ACA is to help individuals and small busineesess | purchase health care coverage |
| goals of ACA | deduce # uninsured, facilitate purchase/sale of qualified health plans to individuals, assist qualified employers in the state, assist individuals in acessing public programs, premium credits, & cost saving reductions |
| under ACA the health insurance exchange will perform | certify health plans as qualified, utililze individual unique formats and verify & resolve inconsistent info provided to the exchange by applicants |
| bronze, silver, gold, platinum | 60,70,80, 90% of actuarial coverage provided |
| plans purchased before March 23, 2010 are consider | grandfathered plans |
| grandfathered plans | do not need to follow ACA rules & dont' need to provide all the services of ACA plans |
| exception to rules on grandfathered | do not put lifetime limits on how much health care coverage people may receive |
| small group health plans will be allowed to vary rates ONLY | based on whether the plan covers an individual or familiy, geographic area, age and tobacco use |
