Life & Health Insurance Health Insurance Fundamentals Flashcards
7 cards from real Life & Health Insurance Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Life & Health Insurance Health Insurance Fundamentals flashcards as text
Under the ACA, what is the required waiting period before an employer-sponsored health plan must cover a new employee?
Answer: Up to 90 days
The ACA limits employer waiting periods for health plan enrollment to a maximum of 90 days.
Which of the following is NOT a qualifying life event that triggers a special enrollment period?
Answer: Voluntary termination of prior coverage
Voluntarily dropping prior coverage does not qualify as a special enrollment trigger; only involuntary loss of coverage qualifies.
A Point-of-Service (POS) plan combines features of which two plan types?
Answer: HMO and PPO
A POS plan blends HMO structure (PCP gatekeeper, lower in-network costs) with PPO flexibility (option to use out-of-network providers at higher cost).
What is the grace period for an individual health insurance policy under most state laws?
Answer: 31 days
Most states require at least a 31-day grace period for individual health insurance policies, during which the policy remains in force even if a premium is overdue.
Which federal law requires group health plans covering 20 or more employees to offer continuation coverage to terminated employees?
Answer: COBRA
COBRA (Consolidated Omnibus Budget Reconciliation Act) mandates continuation of group health coverage for up to 18 months after qualifying events such as job loss.
A health insurance policy's 'elimination period' most closely resembles which other policy provision?
Answer: Waiting period / deductible period
An elimination period is a time-based deductible — a set number of days that must pass before benefits begin, common in disability and LTC policies.
Under the ACA's essential health benefits requirement, which of the following services must all individual and small-group plans cover?
Answer: Mental health and substance use disorder services
Mental health and substance use disorder services are one of the ten essential health benefit categories that ACA-compliant individual and small-group plans must cover.