Commercial Health Insurance
Coverage that provides two types of benefits, disability income (DI) and medical expenses. Sold by insurance companies whose business objective is the profit motive (as distinct from Blue Cross/Blue Shield) it can be classified by its renewal provision, and types of benefits provided.
- Renewal Provisions: (a) Optionally renewable. The insurance company has the option to renew the policy at the end of the termperiod (one year, six months, three months, or one month). If the company renews the policy, it has the option to adjust the premiumup or down; limit the types of perils insured against; and limit some or all of the benefits, (b) Nonrenewable for stated reasons only.When the insured reaches a certain age or when all similar policies are not renewed, the policy is said to be nonrenewable for the reasons stated, (c) Noncancellable. The insurance company must renew the policy and cannot change any of the provisions of thepolicy nor raise the premium while the policy is in force, (d) Guaranteed renewable. The company must renew the policy but thecompany has the option to adopt a new rate structure for the future renewal premiums.
- Benefits Provided: (a) Disability income for total and partial disability subject to a maximum dollar amount and maximum lengthof time. Limitations include: pre-existing injury or condition; elimination period beginning with the first day of disability during which no benefits are paid; probationary period during which no benefits are paid for a sickness contracted or beginning during the first 15, 20, 25, or 30 days that the policy is in force; a recurrent disability such that before the current disability will be deemed to be a new disability, the insured must have returned to full time continuous employment for at least six months, (b) medical expense benefits for hospital charges for room, board, nursing, use of theoperating room, physicians and surgeons fees; and miscellaneous medical expenses for laboratory tests, drugs, medicines, X-rays, anesthetics, artificial limbs, therapeutics, and ambulance service to and from the hospital.
Popular Insurance Terms
Same as term Underwriting Gain Loss): profit ( deficit) that remains after paying claims and expenses. Insurers generate profits from underwriting and from investment income. Their chief ...
Clause added to an insurance policy providing waiver of premium (WP) if the premium payer dies or becomes disabled. For example, this option is available on insurance policies on a child's ...
Named peril policy is how it’s called in the Real Estate Industry the insurance policies that specify the perils it covers. Under a named peril policy, if anything that isn’t ...
Policy provision that provides coverage for continuing payroll expense of all employees of an insured business (except for officers and executives) for the first specified number of days of ...
Minimum degree of injury or loss for which an injured party can sue, even though covered by no fault automobile insurance. Traditionally, an accident victim had to prove the other driver ...
In life insurance, the exchange of a series of installment payments, as the result of an installment settlement, for a lump sum distribution. ...
Percentage of total assets set aside by an insurance company to provide for unexpected losses. In general, a minimum of a 5% surplus ratio (5 cents in reserve for each $1 of assets) is ...
Separate trust established by a charitable entity whose purpose is to receive contributions from numerous donors. All the donors' contributions are commingled. Each donor can retain a ...
Specific date determined by the Internal Revenue Service on which a beneficiary has received a death benefit from an insurance company, an annuitant has received an income benefit, or a ...
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