RESOLUTION HEALTH UNDERWRITERS EXAM

Resolution Health Underwriters Exam 2010
Please make sure your information is correct and then proceed with the exam :
First Name:
Surname:
Cell number:
Email:
Brokerage:
Broker Consultant:
Region:


This is a multiple question exam. With each question, there is only ONE correct answer.


Goodhealth's International Healthcare Plan covers expats: Residing in Africa Residing anywhere in the world What will happen if the HIV Programme client whom is on the CareWorks programme and taking ARV's, resigns from the company? ARV's stop as membership ends The company will pay for ARV's after resignation CareWorks will provide the client with 2 additional months of ARV's Client will get ARV's as long as he lives Which Hospitals can the Goodhealth (Aetna Global Benefits) client use? No hospitals, only clinics Only hospitals in his country of birth Only hospitals in the selected area The client is free to use a Hospital of his choice provided adequate and suitable treatment can be provided What is the Medical Aid Death Benefit's premium? Depends on which option is chosen R55 R50 R85 Name an advantage of Sapmeds to the broker An annuity income could be generated Resolution Underwriters does most of the admin work and it's therefore little hassle to the broker Sapmeds could be offered to a wide range of potential clients All of the above Can the Goodhealth (Aetna Global Benefits) client seek Treatment anywhere in the world? Only in the UK Only in Africa or India Only, within the geographical area chosen Only in the USA What is the Essential! premium? Depends on whether the family of individual policy are chosen R85 R110 R75 Can the HIV Programme client see his/her confidential information on the internet? No Yes Regarding Premium Waiver; for the Redundancy cover the incident limit would be paid for 1 month 12 months 3 months 6 months Which is correct? Gap Cover provides the insured with two options: A R50 option (excess of R500/incident) / and a R75 option (no excess) A R50 option (annual limit of R1m) / and a R75 option (annual limit of R2m) A R55 option (excess of R750/once off) / and an R85 option (no excess) a & b How many options are there on the Resolution's HIV programme? Four, Treatment, ACT, ACT and Treatment, and the Peer Facilitator programme One, the Treatment programme Three, Treatment, Act and Peer Facilitator programme Two, Treatment and ACT programme There are two Goodhealth (Aetna Global Benefits) plans available, Executive Healthcare Plan and International Healthcare Plan. Yes No The employer will qualify for a full tax deduction on member's contributions to the HIV programme. Yes, it is an expense No Premium Waiver has the following options R25 for R1500 p/m R35 for R2500 p/m R60 for R3500 p/m All of the above With Sapmeds, what is the maximum entry age? 55 60 65 There is none Goodhealth's Major Medical option is: Complete medical care including in-patient and out-patient treatment, primary care and evacuation Essential in-patient treatment including evacuation Please explain what support the HIV Programme client can expect? Only ARV's Whatever his family gives him Counselling, regular calls from Careworks and medication None Goodhealth's Executive Healthcare Plan covers expats: Residing in Africa Residing anywhere in the world Regarding Goodhealth (Aetna Global Benefits); for normal day to day expenses: The client pays for it himself, and is then reimbursed by Goodhealth Goodhealth settles the account directly with the medical service provider Can the HIV Programme client talk to somebody who knows about HIV related topics face to face? Yes, CareWorks has counsellors country wide that you may consult No, the client will have to speak to his GP The Area of coverage on Goodhealth's International Healthcare Plan, means: The premium is based on where the member resides Treatment worldwide is included, except for the USA Area 5 rates are for expats living worldwide that require treatment in the USA All of the above If you (a Sapmeds client) get into an accident, how would the ambulance personnel know whether they can take you to a private hospital and not the public hospital? They will always take you to a public hospital, unless you can show that you're on another medical scheme You will always have to be diagnosed and get pre-auth before you will be hospitalised They will take your word for it, and Sapmeds would pay the hospital at a later stage You will have a Sapmeds membership card which you must show Sapmeds has benefits that include 24 hour medical advice, medical assistance and emergency medical response. False True Transportation of mortal remains or the cost of a local burial/cremation is covered up to a maximum of $2,250 under the Goodhealth (Aetna Global Benefits) Foundation Plan. No Yes What is the waiting period on the Medical Aid Death Benefit policy? There are none 12 months General 3 month waiting period Sapmeds could not be used if the insured is already on a Medical Hospital Plan False True If I'm not on a medical aid, would I still be covered by the Medical Aid Death Benefit product? Yes No Is there a maximum entry age with regards to Gap Cover? Yip, 55 Nope No, except when more than one insured under one policy exceeds 65 Yip, 65 A broker needs to be accredited as follows in order to do business with Resolution Underwriters: Health Investments Long term Short Term The Area of coverage on Goodhealth's Executive Healthcare Plan, means: The area where the client wishes to have treatment The area where the client is residing Regarding Gap Cover. What happens if the insured's medical aid already covers more than the 100% of the NHRPL? For example, Resolution's Prestige Plan that covers 200% of the NHRPL. Gap will cover the next 100% to make the total cover 300% Gap will cover not cover this, because of legislative reasons Gap will still cover up to the next 300% to make the total cover 500% Gap will cover the next 200% to make the total cover 400% Please name 3 of the additional benefits to the Sapmeds product. R150 000 for Passive War Expenses R 60 000 for Emergency Services R 5 000 000 for Travel Insurance All of the above If a child is stillborn, would the insured receive any benefits on the Medical Aid Death Benefit policy? Yes, R800 No The client can select an excess, which means the client will pay x amount per incident, after which Goodhealth (Aetna Global Benefits) will cover the rest. Yes No Are there any excess amounts payable with Sapmeds? Yes, it's calculated according to age brackets. No Yes, R 500 Only with options 4 to 7 If the insured needs more cover than what one Premium Waiver policy can provide, he/she could take out more than one policy. For example, if the insured wants to cover a premium of up to R5000/month, he/she could take out options 1 and 3. True False Gap Cover will pay� A stated benefit as difference between the NHRPL and the private tariffs up to 300% 3 Times of whatever the doctors would charge you Exactly 300% of the NHRPL 100% of your hospital bill Does Gap Cover still pay out if the insured's medical aid has been depleted? Yes, but Gap will just ignore the first 100% and then pay the rest up to 300% Yes, but Gap will then just cover the first 100% in the place of the medical aid No, unless the insured gets pre-authorization from the Bethlehem office No, Gap is directly dependent on the medical aid payment Goodhealth's Foundation Plan is: Essential in-patient treatment including evacuation Complete medical care including in-patient and out-patient treatment, primary care and evacuation If the insured claims, Sapmeds would pay a stated benefit as calculated on the Sapmeds calculator True False The Essential! policy will cover: Just the policy holder and a spouse A family of 5 members Just the policy holder A family of 3 members (main member, spouse, and one child dependant) Regarding Premium Waiver; for the Death/Disability cover the incident limit would be paid for 12 months 3 months 1 month 6 months Goodhealth's premiums are: Rand based Dollar based Pound based All of the above It is possible to have a medical history disregard for pre-existing conditions on the Goodhealth (Aetna Global Benefits) policy. No, never Yes, for compulsory groups of 10 or more How many people are covered under one Medical Aid Death Benefit policy? A family of five Just the main member A tonsillectomy should cost R500 according to the NHRPL. This is what the patient's medical aid pays. The doctor asks private in-patient tariffs of R2500 for the whole procedure. What amount would Gap Cover pay? R1500 R 500 R 2000 R1000 Are there any general waiting periods to Essential!? If so, how long? Nope Yip, 1 month Yip, 3 months Yip, depends on the amount of insured people on one policy Please name an exclusion(s) to Essential!. Three month waiting period 12 month pre-existing exclusion Aids / HIV All of the above Under the Redundancy section of Premium Waiver, the insured would receive a benefit for three months. What will happen if the insured gets re-employed before the three month period has ended? The benefit would still be paid out The benefit payment would cease Gap has the following exclusions: General 3 month waiting period; Pre-existing conditions excluded for minimum 12 months; Maximum entry age of 65; a & b None of the above