LESSON 18: HEALTH INSURANCE UNDERWRITING

Major Risk Factors

Match the following risk classifications with their respective definitions.

a)	Lower premiums (better than average risk)	Choose... Standard Substandard Preferred
b)	Normal premiums (standard terms and rates)	Choose... Standard Substandard Preferred
c)	Higher premiums (higher than average risk)	Choose... Standard Substandard Preferred
a) Preferred, b) Standard, c) Substandard, (Lesson 18.1.1)

The three most important factors analyzed when classifying risks are:

	a)	morbidity, interest and expenses.
	b)	physical condition, moral hazards and occupation.
	c)	age, gender and health history.
	d)	health history, age and occupation.
CORRECTTRY AGAIN (Lesson 18.1.1)Your answer has been saved.

Premium Factors

Which of the following is NOT a factor in determining health insurance premiums?

	a)	Morbidity
	b)	Mortality
	c)	Interest
	d)	Expenses
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Tax Treatment of Premiums and Benefits

In individual plans, premiums paid for personal disability income insurance by an individual are nontaxable.

	a)	True
	b)	False
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If an insurance company reimburses the insured for medical expenses, the insured can deduct that amount from their federal income tax.

	a)	True
	b)	False
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All medical care including premiums is fully tax deductible if a person is self-employed.

	a)	True
	b)	False
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Managed Care

Medical cost management is a means of controlling claims expenses. Which answer contains all four of the general approaches plans utilize?

	a)	Optional second opinions, precertification, ambulatory surgery, and case management
	b)	Mandatory second opinions, precertification review, ambulatory surgery, and case management
	c)	Precertification review, ambulatory surgery, mandatory second opinions, and customer service
	d)	Case management review, optional second opinions, precertification, and ambulatory surgery
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Match the following with their respective descriptions.

a)	When an insured must obtain permission from the insurer before seeking nonlife-threatening hospital care.	Choose... Ambulatory Surgery Precertification Review Case Management
b)	Provides insureds with the choice of outpatient or inpatient surgery.	Choose... Ambulatory Surgery Precertification Review Case Management
c)	The process of reviewing cases that may potentially become large claims.	Choose... Ambulatory Surgery Precertification Review Case Management
a) Precertification Review, b) Ambulatory Surgery, c) Case Management, (Lesson 18.4.1)

Mandatory second opinions are not necessary before an insured undergoes any nonlife-threatening surgery.

	a)	True
	b)	False
CORRECT - CONGRATULATIONS on completing Lesson 18. Now complete the Florida study manual Unit 23 Questions for Review.TRY AGAIN (Lesson 18.4.1)Your answer has been saved.