WLAH Wyoming Life & Accident and Health - Set 5 - Part 3
Test your knowledge of technical writing concepts with these practice questions. Each question includes detailed explanations to help you understand the correct answers.
Question 41: An individual purchases and personally pays all premiums for his own disability income insurance policy using after-tax dollars, without any employer involvement or reimbursement. If he later becomes disabled and receives monthly benefits from that policy, how are those benefit payments generally taxed?
Question 42: An employer pays the full premium for a group disability income policy covering its employees, and an employee later becomes disabled and begins receiving monthly benefit payments from that employer-paid policy. How are those disability benefit payments generally taxed to the employee?
Question 43: An employer pays premiums for a group medical expense insurance plan covering its employees, and one covered employee later submits a claim and receives reimbursement for covered medical expenses under that same plan. Considering both the premium payment and the benefit received, what is generally true about the tax treatment?
Question 44: A health plan requires each enrolled member to select a primary care physician who coordinates all of that member's care and must approve referrals before the member sees a specialist, in exchange for lower out-of-pocket costs than a traditional indemnity plan. Which type of managed care organization does this describe?
Question 45: A preferred provider organization contracts with a network of physicians and hospitals who agree to discounted fees for a higher volume of patients, while still allowing members to see outside providers at a higher personal cost. What advantage does this structure offer members compared with a health maintenance organization?
Question 46: Before an insured undergoes a scheduled non-emergency hospital admission, the health insurance plan requires the treating physician to obtain the insurer's own approval confirming that the planned procedure is truly medically necessary. Which cost containment technique does this particular approval requirement represent?
Question 47: A health insurance plan requires that before certain elective surgeries are performed, the insured obtain an opinion from a second, independent physician confirming that the recommended surgery is medically appropriate. What is the primary purpose of this second surgical opinion requirement as a cost containment tool?
Question 48: An individual disability income policy contains a provision reducing or offsetting the policy's own monthly benefit by any amount the insured simultaneously receives from a workers compensation claim for the same disabling injury. What is the general purpose of including this type of offset provision?
Question 49: An employee suffers an injury that occurred entirely outside the scope of his employment and is therefore not eligible for workers compensation benefits, though the injury does leave him totally unable to work for an extended period. Which type of disability income coverage would respond to this particular claim?
Question 50: A health insurer pays a covered claim for medical expenses an insured incurred after being injured by a negligent third party, and the policy's subrogation provision lets the insurer pursue recovery of that amount from the party responsible for the injury. What does this right allow the insurer to do?
Struggling With Exams?
Less Time Studying, More Time Living – Finish Your Degree Faster! Pay-After-you-Pass!
Get Exam Support