A health insurance plan issued to an employer that covers a defined group of employees under one master contract, with employees receiving individual certificates of coverage, is an example of:
A. Individual health insurance
B. Group health insurance
C. Blanket accident insurance
D. Credit health insurance
Source: General insurance principle
Compared to group health insurance, individual health insurance typically involves which of the following?
A. No underwriting of any kind, ever
B. Underwriting and pricing based more heavily on the individual applicant's own risk profile, subject to applicable guaranteed-issue rules
C. Coverage that can never be renewed
D. Premiums that are always lower than group rates for comparable coverage
Source: General insurance principle
The specific dollar amount a policyholder must pay out of pocket for covered services before the health plan begins to pay is called the:
A. Copayment
B. Coinsurance
C. Deductible
D. Premium
Source: General insurance principle
After a policyholder meets their deductible, a plan that pays 80% of covered costs while the policyholder pays the remaining 20% is describing which cost-sharing feature?
A. Copayment
B. Coinsurance
C. Elimination period
D. Pre-existing condition exclusion
Source: General insurance principle
Under the Affordable Care Act and Colorado's guaranteed issuance statute, a carrier offering individual major medical coverage generally must do what for an eligible applicant?
A. Deny coverage based on the applicant's pre-existing health conditions
B. Issue the applicable health benefit plan to the eligible applicant who applies and agrees to pay premiums, without medical underwriting
C. Charge a different premium based solely on the applicant's claims history
D. Require a waiting period before any coverage becomes effective for a healthy applicant
Source: C.R.S. § 10-16-105
