Learn about sole proprietorship insurance for health and life coverage to ensure the continuity and stability of your business.
Learn about inflation protection in health insurance, a crucial contract stipulation that adjusts benefits to keep pace with rising medical service costs. Ensure your health insurance plan is effectively safeguarding your financial interests.
Learn about respite care in health insurance. Understand how temporary care allows family caregivers to take a break while the patient receives professional care.
Learn about the role of a practical nurse in health insurance, focusing on their duties like assisting patients with daily tasks and the limitations such as not being able to dispense medicine.
Learn about large claim pooling in health insurance, a system that helps stabilize premium amounts for smaller groups by pooling larger claims together.
Discover the importance of extra percentage tables in health and life insurance which indicate the additional premiums for specific medical conditions.
Learn about employer contributions in health insurance, the fraction of a plan's cost paid by the employer. Understand its importance in reducing employee healthcare expenses.
Learn about the National Association of Health Underwriters (NAHU), an organization supporting professionals who service health care needs, including brokers, agents, and consultants.
Learn about 401h trusts, a limited-use account to fund employee insurance costs post-retirement. Discover tax benefits and employer contribution limits.
Discover how Continuing Care Retirement Communities offer residents seamless access to health care services, promoting healthier living in retirement.
Learn about surgical insurance benefits, a health insurance coverage option that helps cover the costs of losses due to surgical expenses.
Understand the role of a second surgical opinion in health insurance, its benefits in preventing unnecessary procedures, and how some health policies may require it before covering surgery costs.
Explore the role of diagnosis in health insurance, where diseases are identified through comprehensive testing and medical attention.
Learn about in-force business in the context of health and life insurance. Understand the total value of policies either fully paid or being processed, and its impact on insurer portfolios and premium volumes.
Learn what a Skilled Nursing Facility (SNF) is, and how it provides therapy and nursing care to patients under Medicare.
Learn about Multiple Employer Welfare Arrangements (MEWAs), funds and trusts financed by employers to provide medical benefits. Understand their structure and benefits.
Learn about the recurring clause in health insurance policies, which outlines the time period for considering a condition as a recurrent disability or a different condition.
Learn about the significance of the service area in health insurance, how it's defined by state regulatory agencies, and what it means for your health care plan.
Understand blanket coverage in health insurance. Learn how it differs from individual and group plans, providing comprehensive coverage for various risks under one plan.
Learn about the Enrollment Period in health insurance, a critical time frame for employees to sign up for health care plans. Get the key insights and deadlines to avoid missing out on coverage.
Explore the benefits of Group Disability Insurance, a group policy designed to provide income coverage during periods of disability or illness.
Learn about Health Maintenance Organization (HMO) health insurance plans, how they work, and the obligations for employers with more than 25 employees.
Understand the concept of uniform premium in health and life insurance, where premium amounts are determined without considering the insured’s age, occupation, or gender.
Explore the concept of conversion in life insurance, health insurance, and general insurance. Understand the transfer processes and legal implications.
Learn about Inside Limits in health insurance and how they apply to hospital expense benefits. Understand their significance compared to maximums stated in the policy contract.
Learn about modified community rating in health insurance, a method of determining medical expense rates using local data. Understand its impact on premiums and regulatory implications.
Understand the Non-disabling Injury Rider in disability income policies, which covers medical costs for injuries that do not result in total disability.
Learn about pre-admission certification, a process determining whether a hospital admission is necessary based on established criteria in health insurance.
A comprehensive guide to what qualifies as sickness in health insurance policies, excluding mental illness.
Learn about the role of the Pharmacy and Therapeutics Committee (P&T) in health insurance, how it influences prescription drug use, and its importance to health plans.
Understand what a confining condition in health insurance entails. Learn how illnesses or disabilities that force confinement at home or a medical facility affect your coverage.
Learn about covered expenses in health insurance, including what qualifies for reimbursement or coverage under your policy. Understand the essentials for managing your healthcare costs effectively.
Understand the concept of an exception in health insurance policies. Learn about clauses in policy contracts that void or remove the obligation for coverage, and how these can impact your health insurance benefits.
Learn about fraternal insurance, a special type of insurance specifically for members of a fraternal group or lodge that covers health and life insurance needs.
Understand the gatekeeper model in health insurance, where the primary care physician acts as a gatekeeper, directing patient care and referrals. Learn how this affects HMO and PPO plans.
Learn about the gender rule in health insurance, which determines which parent's policy will primarily cover dependent children. Find out how the father's policy is prioritized for claims under this rule.
Learn what an 'Outpatient' means in the context of health insurance, including how they receive treatment without staying overnight in a hospital.
Learn about the Ten Day Free Look period in health insurance, a consumer right that allows you to fully inspect your policy and return it within ten days for a full refund.
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.
Learn about open debits in health and life insurance, where designated territories are left without an assigned insurance agent. Explore its implications and relevance within the insurance domain.
Discover what the Paid Claims Loss Ratio in Health Insurance is, how it’s calculated, and its importance. Learn the key components and implications for policyholders and insurers.
Learn what secondary coverage in health insurance is and how it helps cover charges not covered by a primary policy. Discover the benefits and importance of secondary health insurance coverage.
Learn about supplemental services in health insurance, the extra services you can add to basic coverage to enhance your health plan benefits.
A comprehensive guide to surgical schedules in health insurance, detailing the list of surgeries and the associated benefits.
Learn about the waiting period in health insurance, also known as the elimination period. It is the time between the start of a disability and when benefits begin.
Learn about elective benefits in health insurance. Discover how specific injuries, such as dislocations, can be covered by a lump sum payment instead of installments.
Discover comprehensive shoppers guides for health and life insurance. Learn about types of coverage, and find the best policies to suit your needs. Make informed insurance decisions.
Learn about channeling in health insurance, a policy that safeguards unemployed hospital physicians against medical professional liability while increasing hospital patient admissions.
Learn about Drug Utilization Review (DUR) in health insurance, a process that evaluates the usage and effectiveness of drug treatments to ensure optimal healthcare outcomes.
Understand who qualifies as an eligible person under health insurance contracts. Learn the difference between eligible employees and persons, their qualifications, and eligibility criteria.
Learn about the Employee Certificate of Insurance in health and life insurance. Discover what this proof of membership in a group plan entails and the key elements it includes.
Learn about the enrolling unit in health insurance and its critical role in managing group health plan memberships. Discover how a company or group becomes an enrolling unit and the implications for members.
Learn about expected claims in health insurance, the anticipated amount of claims during a contract year, and how they are determined by statistical data.
Discover how franchise insurance, also known as wholesale insurance, provides group health insurance coverage for small groups, offering individual contracts and underwriting.
Discover the essentials of hospital affiliation in health insurance, including how agreements between hospitals and health plans affect the care received by members.
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.
An individual contract in health insurance is a policy that covers a particular individual and may extend to include other family members. Learn the essentials of individual health insurance contracts, including their benefits and coverage details.
Understand miscellaneous expenses in health insurance, covering additional charges during a hospital stay like diagnostic test fees. Learn about reimbursement limits for these expenses.
Learn about mortgage redemption insurance, a term policy that reduces monthly and can be used as mortgage insurance. Discover its role in health and life insurance.
Explore nonmedical policies in health and life insurance, where no medical examination is required. Understand the benefits and essentials of these insurance options.
Explore the meaning of office visits in health insurance, focusing on the services provided by physicians in their offices. Understand this essential aspect of health coverage.
Learn about 'Open Access' in health insurance, a concept that permits policyholders to visit specialists without referrals. Explore its benefits and implications.
Discover the importance of the Place of Service in health insurance, including common locations like hospitals and physicians' offices. Understand how it impacts your coverage and reimbursement.
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 proration of benefits in health insurance, an adjustment made to medical benefits due to duplicate coverage from another policy.
Discover the comprehensive retirement program that provides dedicated health insurance benefits to railroad workers. Learn about eligibility, coverage, and more.
Explore what a Social Security rider in health insurance entails and how it influences disability income policies by potentially providing extra benefits based on Social Security payouts.
Learn about the standard class rate in health insurance, a vital component in calculating group demographic information by applying a base rate for each participant.
Learn about therapeutic equivalence—a critical term in health insurance depicting different drugs controlling medical conditions similarly. Explore its impact.
Learn about aggregate indemnity in health insurance, the maximum amount that can be claimed under a policy. Understand its significance and limitations.
Learn about the term 'Encounter' in health insurance, which refers to a meeting with a healthcare provider where the insured receives any type of service.
Learn about Expense (Health Insurance) including underwriting costs, medical examination expenses, salaries, and other insurer operating expenditures associated with each policy.
Learn about limited policies in health and life insurance, which only pay under specific conditions as specified in the contract. Understand their low limits and limited forms.
Learn about Maximum Disability Policy in health insurance, a type of disability coverage that permits multiple claims for various disabilities with predefined limits for each claim.
Discover the role of miscellaneous benefits in health insurance, exploring how they cover most inpatient medical costs without including surgical expenses or room and board.
Learn about National Health Insurance, a system established by federal governments to cover nearly all citizens, and funded through tax money. Explore how this applies to the United States.
Learn about Preferred Provider Organization (PPO) networks in health insurance, how they operate, and their benefits compared to HMO plans. Discover the flexibility PPOs provide for choosing healthcare providers.
Learn what prescription medication means in the context of health insurance, and why it's essential for medications to be prescribed by a doctor.
Learn about referral providers in health insurance, including their role and importance in ensuring specialized care for insured individuals.
Learn about the terminally ill status in health insurance, including its definition and implications for policyholders and beneficiaries.
Learn about the cancellation provision clause in property and health insurance policies, allowing either party to terminate the agreement before its expiration date.
Learn about the Utilization and Review Committee in healthcare insurance, which monitors services and supplies provided to Medicare patients to ensure compliance and quality.
Explore the role of treatment facilities in health insurance, specifically focusing on centers that address substance abuse and mental illness.
Learn about variable contracts in life and health insurance, their regulations, and associated risks. Discover how these contracts differ from typical insurance agreements.
Explore the dependent care plan in health insurance, a notable employee benefit where employers reimburse childcare or provide on-site daycare facilities.
Discover the fundamental aspects of dependent coverage in health and life insurance, including eligibility for spouses and children, and applicable age limits.
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 Flexible Spending Accounts (FSAs) in health insurance, pre-tax deductions, and coverage for child care or medical expenses. Understand the benefits and limitations, including the forfeiture rule at year's end.
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.
Learn about Hospital Tax in Health Insurance, a mandatory social security tax that funds Medicare Part A costs. Discover its purpose and implications.
Learn about non-disabling injuries in health insurance, where lesser injuries may be eligible for small benefits compared to total or partial disabilities.
Explore the rating process in health insurance, which determines premium rates based on factors such as sex, age, benefits, and administrative costs.
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 utilization review in health insurance, a crucial process for controlling medical costs by monitoring the quality, necessity, and appropriateness of healthcare services. Understand how employers and insurance companies utilize this process to ensure optimal care.
Learn about the Flexible Benefit Plan in health insurance where employees can tailor their benefits package to suit their personal and family health needs.
Learn about permanent and total disability in health insurance, a designation for disabilities that persist beyond six months and are deemed incurable.
Learn about temporary partial disability, a short-term circumstance where an individual is temporarily unable to perform their usual duties but can work in some capacity until full recovery.
Learn the purpose and function of a surgi-center, a facility providing surgical services on an outpatient basis. Find out how it fits within the health insurance landscape.
Learn about weekly premium insurance policies in health and life insurance, where an agent visits the insured's home to collect premiums, typically for small amounts.
