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
Method of underwriting by which one or a group of Lloyd's underwriters write business on behalf of a number of Lloyd's syndicates and other insurance companies. Among the benefits of ...
Coverage of two or more persons with the death benefit payable at the first death. Premiums are significantly higher than for policies that insure one person, since the probability of ...
Organization based in Washington, D.C., that is composed of risk and insurance managers of various public entities, to include municipalities and school boards. ...
Insurance arrangement in which all employees of a given business firm are accepted into a plan regardless of their physical condition. The employee cannot be required to take a physical ...
Use of engineering approved fire resistive construction materials exclusively within a structure. ...
Same as term Mortality Table: chart showing rate of death at each age in terms of number of deaths per thousand. ...
Coverage provided by the pension benefit guaranty corporation (pbgc) that guarantees participants a certain level of pension benefits even if the plan terminates without assets. The PBGC ...
Group arrangement in which a network of attorneys provides legal services to the participants in the plan with the attorney fees being reimbursed by the provider. The attorneys who are ...
Legal status giving an insurance company all rights to an insured's property. The abandonment clause is usually found in marine insurance and not in other property insurance policies such ...
Have a question or comment?
We're here to help.