Passtrak Health Insurance License Exam Manual

Overview

A History of Quality and Innovation Dearborn is a leader in providing innovative career education and compliance management systems to the financial services industry. For more than 30 years, we have partnered with insurance companies, securities firms and banks to provide high quality, personalized training to more than 750,000 financial services professionals.

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Overview

A History of Quality and Innovation Dearborn is a leader in providing innovative career education and compliance management systems to the financial services industry. For more than 30 years, we have partnered with insurance companies, securities firms and banks to provide high quality, personalized training to more than 750,000 financial services professionals.

Cutting-edge Compliance Management Systems Our cutting-edge compliance management systems give you desktop access to the most current state- or company-mandated training requirements and online reports that track individual course completion and compliance status at the individual, branch office or national level.

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Product Details

  • ISBN-13: 9780793153534
  • Publisher: Kaplan Publishing
  • Publication date: 12/14/2001
  • Edition description: New Edition
  • Pages: 280
  • Product dimensions: 8.48 (w) x 10.94 (h) x 0.62 (d)

Table of Contents

Acknowledgments vii
Introduction ix
How to Use the License Exam Manual xi
Part 1 Principles of Insurance 1
1. Purpose of Insurance 3
The Role of Insurance 3
An Industry Overview 4
The Nature of Insurance 5
The Concept of Risk 7
Elements of Insurable Risk 10
Economic Basis of Health Insurance 11
Summary 11
Key Concepts 12
2. The Insurance Industry 17
Types of Insurers 18
How Insurance Is Sold 22
Regulation of the Insurance Industry 25
Summary 33
Key Concepts 33
3. Law and the Insurance Contract 39
General Law of Contracts 39
Special Features of Insurance Contracts 42
Agents and Brokers 48
Other Legal Concepts 51
Summary 53
Key Concepts 54
Part 2 Principles of Health Insurance 59
4. Introduction to Health Insurance 61
Basic Forms of Health Insurance Coverage 61
How Health Insurance Is Purchased 63
Characteristics of Health Insurance 64
Summary 66
Key Concepts 67
5. Health Insurance Providers 73
Commercial Insurance Providers 74
Service Providers 74
Government Insurance Programs 77
Alternative Methods of Providing Health Insurance 79
Summary 81
Key Concepts 82
6. Medical Expense Insurance 87
Purpose of Medical Expense Insurance 87
Basic Medical Expense Plans 88
Major Medical Expense Plans 92
Other Types of Medical Expense Coverage 99
Summary 100
Key Concepts 100
7. Disability Income Insurance 105
Purpose of Disability Income Insurance 106
Disability Income Benefits 106
Disability Income Policy Provisions 111
Disability Income Policy Riders 114
Summary 115
Key Concepts 116
8. Accidental Death and Dismemberment Insurance 121
Nature of AD&D Policies 121
AD&D Benefits 122
Other Forms of AD&D 123
Summary 124
Key Concepts 125
9. Government Health Insurance Programs 131
Original Medicare Plan 132
Medicare+Choice Program 134
Medicaid 136
State Workers' Compensation Programs 137
Summary 138
Key Concepts 138
10. Private Insurance Plans for Seniors 143
Medicare Supplement Policies 144
Long-Term Care Insurance 146
LTC Policy Provisions and Limits 150
Summary 153
Key Concepts 154
11. Health Insurance Policy Provisions 159
NAIC Model Health Insurance Policy Provisions 160
Common Exclusions or Restrictions 167
Renewability Provisions 169
Summary 170
Key Concepts 171
12. Health Insurance Underwriting and Premiums 179
Risk Factors in Health Insurance 180
Health Insurance Premium Factors 183
Tax Treatment of Health Insurance Premiums and Benefits 185
Managed Care 189
Summary 191
Key Concepts 191
13. Group Health Insurance 197
Nature of Group Health Insurance 198
Group Health Insurance Coverages 201
Tax Treatment of Group Health Plans 208
Summary 209
Key Concepts 210
14. Uses of Health Insurance 215
A Proper Health Insurance Program 216
Individual Needs for Health Insurance 216
Business Needs for Health Insurance 218
Summary 221
Key Concepts 221
Final Exam 227
Glossary 243
Appendix 259
Index 277
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