United States
Hong KongTypes of accident and health policies: the biggest section on the paper
Section V carries 16 questions, the largest published count on the paper. It covers seven families: disability income, accidental death and dismemberment, medical expense, Medicare supplement, group insurance, long term care, and a catch-all of dental, vision, cancer and similar policies.
Sixteen questions. That is more than any other section of this exam, more than either of the big life sections, and it is the reason candidates who ration their study by chapter order run out of time before the health products are secure.
The seven families
| Family | What it pays for | Sub-items in the outline |
|---|---|---|
| Disability income | Lost income while the insured cannot work | Five, including business overhead and buyout |
| Accidental death and dismemberment | A lump sum for accidental death or specified losses | One |
| Medical expense | The cost of care | Eight, including HMO, PPO, POS, FSA, HDHP with HSA, HRA |
| Medicare supplement | What Medicare leaves the beneficiary to pay | One |
| Group insurance | Coverage under an employer or association plan | Three, including COBRA |
| Long term care | Custodial and skilled care over an extended period | Two |
| Other policies | Dental, vision, cancer, critical illness, worksite, hospital indemnity, short-term medical, accident | Eight |
Count the right-hand column and the shape of the section appears. Medical expense and the other-policies catch-all carry eight sub-items each, which is half the section between them. Disability income carries five. Those three headings are where the 16 questions mostly live.
The sort that makes this section manageable
Ask what triggers payment. Every product in section V answers to one of three triggers, and once you have sorted them that way the names stop mattering.
- Income replacement: the insured cannot work. Disability income, business overhead expense, disability buyout.
- Expense reimbursement: a cost has been incurred. Basic and major medical, managed care plans, Medicare supplement, dental and vision.
- Fixed indemnity: a defined event has happened, and the policy pays a stated sum regardless of cost. Hospital indemnity, critical illness, cancer, accidental death and dismemberment.
That third category is the one candidates handle worst, because a fixed indemnity policy pays the same amount whether the actual bill was large or small. It is not insurance against a cost. It is insurance against an event.
The accounts, which are not insurance at all
Three of the eight medical expense sub-items are accounts rather than policies: flexible spending accounts, health savings accounts and health reimbursement accounts. They pay for care with money set aside for it, and they appear here because a producer sells them alongside coverage. They have their own page in this cluster because the three are constantly confused.
Accidental death and dismemberment is listed here as a standalone accident and health product, and again in section II as a rider attached to a life policy. Same benefit, two contracts, two sections. If a stem describes a rider, you are in the life half; if it describes a policy, you are here.
What to study first
- Largest section on the paper
- 16 questions, section V
- Next largest
- Sections I, II and VI at 15 each
- Health total
- Sections V and VI together, 16 plus 15
- Sub-item heavy headings
- Medical expense and other policies, eight each
- Our estimate for managed care
- 3 or 4 questions, ours and not published
The managed care figure is ours, derived from the number of sub-items, and it is the one worth acting on: HMO, PPO and POS between them are three of the eight medical expense sub-items, and HMOs get another three questions of their own in the Texas portion. Managed care is the single best-rewarded topic in the health half.
The opinion, and the concession
Start the health half here rather than with provisions, and start section V with managed care rather than with disability income. Most study material runs disability first because the outline does, and the outline's order is not a difficulty order or a value order. Follow the sub-item counts instead. They are the closest thing to a weighting Pearson gives you below the section level.
The concession: our sub-item arithmetic is a proxy for weight, not a measurement of it. A heading with eight sub-items could carry two questions and a heading with one could carry three. What we can say with certainty is the published 16 for the section, and every page here that goes below that number says whose number it is.
Common questions
How many questions are on accident and health policy types?
Sixteen, which is the largest published section count on the paper. Section VI, the accident and health provisions, carries a further 15, so between them the health product and provision content is close to a third of the 100 general questions.
What are the three ways a health policy pays?
Income replacement, where the trigger is inability to work; expense reimbursement, where the trigger is a cost incurred; and fixed indemnity, where the trigger is a defined event and the policy pays a stated sum whatever the cost. Sorting products that way is faster than learning names.
Are health savings accounts insurance?
No. Flexible spending accounts, health savings accounts and health reimbursement accounts are ways of setting money aside to pay for care, not contracts that transfer risk. They appear in the medical expense heading because producers sell them alongside coverage, particularly high deductible plans.
Which health topic is worth the most study time?
Managed care. HMO, PPO and POS plans are three of the eight medical expense sub-items in a 16-question section, and Texas HMO regulation is a separate three-question section in the state portion. No other health topic is rewarded from two directions like that.