Home | Purchase | Student Logon | Tech Support

Chapter 9: Health Insurance Laws and Regulations

I.
Introduction
Mandatory Policy Provisions
Entire Contract
Time Limit on Certain Defenses
Grace Period
Reinstatement
Notice of Claim
Claim Forms
Proof of Loss
Timely Payment of Claims
Payment of Claims
Physical Exam and Autopsy
Legal Actions
Change of Beneficiary
Print Section 1*
II.
Optional Policy Provisions
- Change of Occupation
- Misstatement of Age
- Illegal Occupation
- Insurance with Other Insurers
- Insurance with Other Insurers (cont)
- Relation of Earnings to Insurance
- Unpaid Premiums
- Cancellation
- Conformity with State Statutes
- Other Insurance with This Insurer
- Intoxicants and Narcotics
III.
Required Disclosure Provisions
- Renewal, Continuation or Nonrenewal Provision
- Signed Acceptance
- Preexisting Conditions
- Accident Only Policy
- Free Look Provision (Right to Return)
- Delivery Receipt
- Conversion Privilege
- Conversion Privilege
- Specified Disease Policies
- Outline of Coverage
- Additional Requirements of a Health Insurance Contract
Print Section 3*
IV.
Common Exclusions or Restrictions
- Policy Exclusions
- Policy Exclusions (cont)
- Maternity Benefits
- Preexisting Conditions
- Waivers for Impairments
- Deductibles
Health Insurance Riders
- Impairment Rider
- Guaranteed Insurability Rider
-
Print Section 4*
V.
Rights of Renewability
- Cancellable
- Noncancellable
- Guaranteed renewable
- Conditionally renewable
- Optionally renewable
- Period of time
Return of Unearned Premium
Miscellaneous Policy Provisions
- Coverage for Newborn Children
- Physically and Mentally Handicapped Children
- Attention Deficit Hyperactivity Disorder
- Immunizations for Dependent Children
- Group Dependent Child and Grandchild Coverage
- Full-Time Students to Age
- Adopted Children
- Terminal Illness Coverage
- Standards for Use of Genetic Testing
- Reinstatement of Coverage for Military Personnel
- Continuation of Coverage
- Continuation of Coverage – Surviving Spouse
- Preexisting Condition Exclusion
- Creditable Coverage, Special Enrollment & Affiliation Periods
Print Section 5*
VI.
Service Corporations
- Hospital Service Corporation
- Medical Service Corporation
- Dental Service Corporation
- Health Service Corporation
Advertising of Accident & Health Insurance
- Form and Content
- Deceptive Words, Phrases or Illustrations Prohibited
- Exceptions Reductions and Limitations
- Preexisting Conditions
- Renewability, Cacellability & Termination
- Insurer Identification
- Advertising File
- Certificate of Compliance
Print Section 6*
VII.
Take Chapter 9 Test

* Adobe Acrobat Reader is required to view and print PDF files. If you do not have Acrobat Reader installed, click here for a free download.

Home | Purchase | Student Logon | Tech Support