Explore the essential role of field underwriting in health insurance—a preliminary decision made by the insurance agent to determine a prospect’s eligibility based on underwriting standards.
Understanding the concept of Identification of Benefits in Health Insurance, which covers the reimbursement for finding and entrusting the care of a disabled insured to their relatives.
Primary coverage refers to insurance coverage that pays claims submitted without waiting for another policy to pay first. Understand how primary coverage works in health and general insurance.
Learn about the role of an examiner in the insurance industry, including general, health, and life insurance. Understand their responsibilities in auditing insurers and examining prospective policyholders for health and life insurance.
Learn about the coinsurance cap in health insurance and how it limits the amount policyholders need to pay. Discover its significance and impact on healthcare costs.
Learn about the grievance procedure in health insurance, a process for policyholders to file complaints. Understand how to navigate and utilize this process effectively.
Explore the Voluntary Employee Beneficiary Association (VEBA) and how it is used to pre-fund health care for employees. Learn about the benefits and structure of VEBAs in health insurance.
Learn about optionally renewable health insurance contracts, where the insurer reserves the right to terminate the policy at specific intervals such as the policy anniversary or premium due date.
Learn about the elimination period in health insurance policies, an important waiting or probation period that affects when benefits begin.
Learn about Disability Insurance, a vital policy that offers financial protection by paying out benefits when the insured is unable to earn an income due to disability. Understand the coverage for total, catastrophic, or residual disabilities.
Explore the concept of 24-hour care coverage which combines work-related and non-work-related benefits to offer continuous protection for illnesses and injuries.
Learn about Guaranteed Standard Issue in health insurance, a group plan that ensures coverage for all policyholders regardless of their medical history.
Explore Long Term Care Insurance and how it provides daily benefits when insured individuals become residents in nursing homes. Ensure your healthcare financial security by understanding this crucial aspect of health insurance.
Learn about Medical Payments Insurance, an optional coverage in vehicle and liability insurance policies that covers health care costs regardless of fault.
Learn about the Omnibus Budget Reconciliation Act (OBRA) and its impact on health insurance, specifically in extending COBRA continuation coverage for disabled individuals from 18 to 29 months.
Learn the role and importance of a Participating Provider in Health Insurance, including their approval process in Medicare and how they are compensated.
Understand the role of peer review in health insurance, a process where medical treatments are evaluated by equally trained medical professionals to ensure quality and adherence to standards.
Learn about Multiple Employer Trusts (METs) where small employers within the same industry pool together to purchase group insurance at reduced costs or establish self-funded plans.
Explore the Return of Premium clause in health insurance. Learn how it can benefit policyholders by returning the premiums paid, minus claims, under specific conditions.
Explore the concept of Small Group Pooling in health insurance, where small businesses combine into one pool to achieve more accurate rates and improved coverage options.
Learn what the Medical Information Bureau is and how it impacts health and life insurance. Discover how insurers use this bureau to access coded health condition information on individuals.
Learn about the role of a third party payor in health insurance, such as Medicare or Blue Cross/Blue Shield, and their importance in healthcare coverage.
Understand the concept of recurrent disability in health and life insurance, including its definition, implications, and how it affects policyholders. Learn how recurrent disabilities are managed within insurance frameworks.
Learn about co-pay in health insurance, where the insured pays a portion of the cost for services, and the provider covers the remaining balance.
Learn about the Certificate of Authority in health insurance, a state-issued certificate crucial for the licensing and operation of health maintenance organizations.
Explore the concept of funding level in health insurance, which refers to the amount needed for a medical care program whether through premium costs or anticipated claim loss and fees.
Learn about the illegal high-pressure tactics used in selling health insurance policies and how to identify and prevent being a victim. High-pressure tactics often involve threats, intimidation, or coercion, especially in marketing Medicare supplemental policies.
Explore the Uniform Billing Code of 1992, a federal regulation that mandates the standardized itemization of hospital bills for services provided to patients.
Learn all about the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), the former health insurance program for military families, including its coverage of mandatory care and services.
