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Health Care

Health Care
1.    How does rate making for insurance differ from the pricing of other products?
2.    Identify and provide examples of the significant underwriting principles that apply to the process of classifying and identifying insurance applicants.
3.    Define the underlying principles of reinsurance. In what situations would reinsurance be utilized?
4.    Discuss the regulatory process for the insurance industry. Compare and contrast the state versus federal regulatory processes in your response.
5.    ” Insurers believe there is a high correlation between an applicant’s credit record and future claim expense”. Do you agree or disagree with this statement. Support your answer with information from the text or outside source.
6.    Define the term facultative reinsurance. In what situations would this term be applicable?
7      Why have so many insurers had to increase their risk-based capital requirements?
1.    Explain the law of agency and how it affects the actions of insurance agents.
2.    What are the three general rules of agency that govern the actions of agents and their relationships with insured’s?
3.    Define the concept of coinsurance and deductible as each relates to health insurance policies.
4.    Why are other insurance provisions necessary in insurance contracts?
5    Describe the coordination of benefits provision that is included with most group insurance plans. In what situations is it utilized? Provide examples with your response.
1.    Explain in detail the fundamental legal principles that are reflected in insurance contracts. (Requires one page).
2    Discuss the required components of an insurance contract. (1 page)
1.    Define the term POS. Give examples of such plans.
2.    Describe the basic characteristics of a cafeteria plan. Describe the ways insurance companies use the coordination of benefits provision in their payments to providers of health care.
3.    Discuss how self-insured health plans are operated. Do employers save money with these type of plans?
4.    Explain the evolution of the Patient Bill of Rights. Compare and contrast how it is utilized in different health care settings.
1.    What is managed care? How do managed care plans differ from the traditional group health insurance plans? (1 page)
2.    What is a PPO? How do PPO’s differ from EPO’s? Give examples of each with your answer. (1 page)
3.    How are preexisting conditions provisions and coordination of benefit provisions often used in group health insurance plans?
4.    What coverage is typically provided through group basic medical expense plans?
5.    What are the four major health care problems in the United States? Identify each of these and include examples with your response.
1.    Identify the major benefits offered under the Medicare Program.
2.    What is Medigap insurance? Describe the development of such plans and the reasons they came about.
3.    Describe the primary objectives of unemployment insurance. How is eligibility determined under this program?
4    Discuss the Medicare Advantage program alternatives to Medicare Part A and Medicare Part B.
1.    Discuss the basic benefits offered under the Part B side of the Medicare program. How are these benefits paid for?
2    Identify the basic characteristics of Social Insurance.
1.    What are the three categories of torts? Be sure to differentiate between each type of tort in your response.
2.    Describe the common defenses against negligence?
3.    What are the primary elements of a negligence?
4.    Explain the concept of compensatory damages. Differentiate between special damages and general damages.
5.    Define the term Res Ipsa Loquitur, expounding on the background of this legal concept. Give examples with your answer.
6.    What is a personal umbrella policy? Name the exclusions normally present in this type policy.
7.    In your opinion, what is the cause of the medical malpractice crisis in the health care industry. Support your answer and include appropriate examples.
1. Describe the common elements of a casualty insurance contract.
2. Identify the purpose of a claim’s made malpractice insurance policy and compare andcontrast the claims made and the standard malpractice insurance policy.
3. Describe the typical commercial umbrella policy and identify it’s major policy provisions.
4. What is the purpose of business interruption insurance? Compare and contrast the business interruption insurance with business casualty insurance policies.

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