Across
- 2. 1st day of the month a person turns 65 if they qualify for: -social security or railroad retirement benefits -individual is entitled to monthly social security based upon their spouses work record and a spouse is over the age of 62.
- 3. Often a replacement for the partial disability benefit, because it sets the terms of what benefit will be paid. A formula is used that requires an insured earnings to have dropped a certain percentage from their prior to present disability levels (usually 66 2/3%). THIS PROVISION PAYS THE DIFFERENCE BETWEEN THEIR PRESENT PAY, AND EARNINGS PRIOR TO THIER DISABILITY.
- 4. employees with kidney failure (renal failure) must be provided with primary coverage for 30 months under employers plan. if employee has suffered from kidney failure for last 18 months the secondary insurance company will then pay claims not completely covered by group health plans.
- 6. waives the premiums and the policy remains in force if an insured becomes permanently disabled. They must be disabled for a specified time (90-180 days) before the waiver of premium rider begins.-it is guaranteed renewable and noncanceallable and is included in individual income policies.
- 7. Companies with 100 or more employees must have a provision to provide primary coverage for employees with disabilities who are under the age 65 and not retired.
- 9. 5 months, and the benefits begin at the beginning of the 6th month. they are not retroactive to the beginnings of one's disability.
- 11. the inability to engage in any substantially gainful activity by reason of any medical impairment that has lasted or is expected to last for 12 months or results in early death.
- 14. may be added to Disability Income policy and provides additional benefits during the FIRST YEAR of a disability claim while an insured is waiting for their social security benefits to begin. After a year the insurer ends the benfis and assumes that social security will begin the benefit payment.
- 16. when the insured is living the benefits will go to the insured. if the insured is deceased they go to the beneficiary, if there is no beneficiary it will go to the state.
- 17. voluntary act by insured or insurer. Must give at least 5 days written notice. if insured cancels the policy the premium refund will be handled on short rate basis which includes a cancellation fee in the refund.
- 18. Gives an insurer the right to expedite payments of urgently needed claim funds to relative or individual who is considered to be equitably entitled to the payments.
- 19. Medicare provided by a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). -do not require premiums beyond what is paid for medicare -advantage is that no claim forms are required -any medical problem is covered for a set fee -the HMO and PPO may pay for services that are usually not covered by medicare or medicare supplemental policies (ex: prescriptions, eye exams, hearing aids, or dental care)
- 20. if a person has insurance with different insurers that provide benefits with an expense-incured basis and their separate policies cover the same expenses each insurer will pay a proportionate amount of any claim submitted.
- 21. designed to provide protection for eligible workers and their dependents against the financial loss due to old age, disability, or death. It is a federal program known as Old Age Survivors Disability Insurance. -benefits are paid under U.S social security system to individuals who qualify under Qarter of Coverage Systemm (QC)
- 22. federally funded by a portion of monthly payroll taxes (FICA) -based on earned credits and premium is free at age 65
- 23. Pays for a condition in which an insured, as a result from injury or sickness, cannot perform all of the duties in their occupation but can perform some duties. Usually 50% of total benefit and contains a time limit.
Down
- 1. An insurance protection plan for an individual or their family against the financial loss that is a direct result of the total disability of the wage earner
- 5. benefits are paid monthly and are generally limited to a percentage of income at the exact time of application to prevent an over-insurance situation, and to avoid malingering.
- 8. it is paid with after-tax dollars by the insured and benefits are tax-free.-disability income provides payments to replace portion of income when an individual is unable to work as a direct result of an injury or sickness
- 10. will pay for 80% of approved charges after medical insurance deductible has been met. There is no maximum out of pocket limitation on the 20% coinsurance payable for medicare part b expenses.
- 12. Is a federal AND state government-funded needs program designed to provide medical assistance to impoverished people that are unable to provide for themselves.provides help with physicians, lab work, family planning, dental, eyeglasses, prescription drugs, and medical supplies. -in addition to being poor they must satisfy one of the following: blind, disabled, welfare benefits, pregnant, or over the age of 65being poor they must satisfy one of the following: blind, disabled, welfare benefits, pregnant, or over the age of 65
- 13. May only be terminated for certain conditions, at renewal, with possible premium increase.
- 15. ranges from 30-180 days and is a waiting period between an injury and receiving benefits.