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MI Pre-Insurance Lic
N-P - Vocabulary Words
| Term | Definition |
|---|---|
| National Association of Insurance Commissioners (NAIC) | An association of state insurance commissioners (also known as directors) active in insurance regulation and recommendation of insurance legislation. |
| Net Premium | Calculated by an actuary using 2 factors - risk - investment income. Loading is not a factor. |
| Network | With managed care plans, as selected group of physicians, clinics, hospitals, etc. |
| Noncancelable and Guaranteed Renewable | A health insurance contract that guarantees the continuation, for a substantial period of time, and the premium. |
| Noncontributory Plan | A group insurance policy where the policyowner (employer) pays the premium for employees' benefits. It must insure 100% of all eligible employees. |
| Nonforfeiture Options | Privileges to protect the cash value of a lapsed permanent life policy |
| Nonforfeiture Values | Benefits accorded by law to the policyowner will not forfeit cash value. |
| Nonparticipating | A policy that does not allow the policyholder to share in the company's divisible surplus. |
| Nonqualified Retirement Plan | A retirement plan that has not been approved by the IRS; therefore does not receive favorable tax treatment. |
| Notice of Claim | A policy provision that describes the policyowner's responsibility and obligation to notify the insurer upon suffering a loss within a reasonable amount of tie, usually 20 days. |
| Offer | One party proposes something of value to another party. Applicant - signed application and premium; Insurer - Issues policy |
| Old Age, Survivors, Disability & Hospital Insurance (OASDI) | The federal program commonly called SS that provides benefits for retirement, death or disability. |
| Open Enrollment | A period of time when eligible individuals (usually employees) can apply, enroll inn or transfer between available programs without proof of insurability. |
| Optionally renewable | A health insurance provision that gives the insurance company the right to terminate coverage at the policy anniversary, usually an annual premium due date. |
| Ordinary Life Insurance | Policies sold in multiples of 1,000.00 that provide coverage for the life of the insured or a specified period of time. |
| Original Age | The age of the insured when the policy was purchased. |
| Other Insureds | A term rider that covers a family member other than the insured and is attached to the insured's "base" policy. |
| Outline of Coverage | Information material describing the policy's features and benefits. In IL an outline of coverage must be given at time of solicitation for long-term care insurance and Medicare supplement policies |
| Over Insurance | An excessive amount of insurance that would cover more than the actual loss or more than incurred expenses. |
| Own Occupation | A definition of total disability that requires the insured to be unable to perform the duties of his or her own occupation in order to receive disability income benefits. |
| Outpatient | A person who has received health care services without being admitted to a hospital or skilled nursing facility. |
| Paid-Up Additions | A dividend option that purchases additional life insurance with the dividends at the insured's attained age. |
| Partial Disability | An illness or injury that prevents an insured from performing one or more of the important duties of their job, but not all of the occupational duties. |
| Participating | A policy that allows the policyholder to share in the company's divisible surplus. |
| Participating Physician | A medical provider that accepts Medicares allowable charge and will not charge more than this amount. |
| Payor Rider | An attachment to a juvenile policy that waives future premiums if the policyowner dies or becomes disabled until the juvenile reaches the age of majority. |
| Period Certain Annuity | A contract offered by the life insurance industry that guarantees a definite minimum number of payments. |
| Permanent Life Insurance | A type of ordinary life insurance that guarantees coverage for life and has cash value. |
| Point of Service Plan (POS) | A Type of health maintenance organization (HMO) that allows the member to use in-network services; thus giving members freedom of choice. |
| Policy | The insurance contract and all attached riders or endorsements |
| Policy Loan | The insurance company must allow the policyowner to borrow money using the policy's cash value as collateral to secure the loan. One of the nonforfeiture options. |
| Policy Provision | Another term for policy conditions or terms. |
| Policy Proceeds | The net amount payable upon death of the insured to the beneficiary |
| Policyowner | The person who has the legal and ownership rights in a life insurance policy |
| Policy Summary | A document that briefly describes the coverage, benefits, limitations, exclusions and costs. In IL, a life insurance policy summary must be before or with policy delivery. |
| Precertification | The insurer's advance approval for admission to a hospital or for a surgical procedure. |
| Pre-Existing Condition | An illness or medical condition that existed before a policy's effective date. |
| Preferred Provider Organization (PPO) | An organization of health care providers that agree to provide health care services at a predetermined negotiated fee. |
| Preferred Risk | A person, according to underwriting standards, receives a lower premium due to an indication of longevity or unimpaired life; such as excellent physical condition or low risk occupation. |
| Premium | The cost of insurance, the payment necessary to keep an insurance policy in force. |
| Premium Mode | The frequency of payments. |
| Presumptive Disability | A physical condition which presumes, for disability income benefits, that the insured is disabled regardless of the ability to work or not. i.e. blindness. |
| Preventive Care | A method of health care to possibly prevent illnesses before they occur. Routine physical exams, immunizations. |
| Primary Beneficiary | The recipient of a life or accident policy payable upon the death of the insured. |
| Primary Care Physician (PCP) | In HMO gatekeeper system, the physician that has been selected by the member to coordinate all the member's health care. |
| Primary Insurance Amount (PIA) | A SS Calculation to determine the amount of the workers benefit. |
| Principal Sum | The benefit provided for accidental death. |
| Private Insurer | A commercial insurer not associated with the federal or state government. |
| Probationary Period | A specified number of days (IL is 30) after the policy's effective date that coverage is not available for sickness, though accidents are covered. |
| Producer | A person licensed by the state insurance authority to sell insurance products. A general term that applies to insurance agent or broker. |
| Proof of Loss | A mandatory health insurance provision that states the insured must provide a completed claim form signed by the attending physician to the insurer within 90 days of the loss. |
| Proposed Insured | The person whose life is to be insured by the life insurance policy. |
| Provisions | Stipulations and conditions in the policy that state the insurance company's and policyowner's rights and obligations. |
Created by:
Rosemj42
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