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Accident & Health Insurance Basics (AZ-AHS)

Perils, Losses, and Benefits

Definitions of Perils
Types of Losses and Benefits
Medical Expense
Loss of Income from Disability
Long-Term Care Expense
Dental Expense
Prescriptions
Exclusions

Classes of Health Policies

Individual vs. Group
Small Group vs. Large Group
Qualified Health Plan
Marketplace Plans
Stand-Alone Dental Plans
Private vs. Government
Limited vs. Comprehensive

Limited Policies

Limited Policies
Accident-Only
Specified (Dread) Disease
Hospital Indemnity (Income)
Credit Disability
Blanket (Teams, Passengers)
Prescription Drugs
Vision Care
Excepted Benefits

Privacy and Security

Notice of Information Practices
Access to Personal Information
Correction, Amendment, or Deletion

Producer Marketing Requirements

Insurable Interest
Advertising
Sales Presentations
Summary of Benefits and Coverage

Field Underwriting

Underwriting
Application Procedures
Application Part 1
Application Part 2
Agent’s Report
Application Signatures and Changes
Conditional Receipt
Disclosure of Information
Common Errors / Omissions

Insurer Underwriting

Underwriting Criteria
Guaranteed Availability of Coverage
Sources of Underwriting Information
Paramedical (Paramed) Report
Medical Information Bureau (MIB)
Medical Examination and APS
HIV Testing
QHP Rating Factors
Unfair Discrimination
Genetic Testing
Classification of Risks

Health Insurance Considerations

Replacing Health Insurance
Guaranteed Renewable
Termination of Coverage
Special and Late Enrollment
Open Enrollment
Discontinuation
Pre-Existing Conditions
No Lifetime or Annual Limits
Life and Disability Guaranty Fund

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