Group Life - Vocabulary + Key Terms

Please review the following key terms before starting this chapter. Familiarity with their basic meanings will enhance your understanding of the material.

Blanket Health Policies

- Blanket health policies are designed to cover a group exposed to similar risks, with a constantly changing membership.

- Such policies may be issued to entities like airlines or schools to cover passengers or students, respectively.

- Unlike group insurance, blanket health plans do not provide individual certificates of coverage.

- Example:

- A university purchased a blanket health policy to cover all students participating in sports events throughout the academic year.

Certificate of Insurance

- A certificate of insurance is a document provided by an insurance company or broker that verifies coverage under specific conditions for listed individuals.

- In group insurance, the policyholder is the employer (or other organization) who maintains the master policy, while the insured employees receive a certificate of insurance instead of an individual policy.

- Example:

- When Jake started his new job, he received a certificate of insurance confirming his coverage under the company's group health insurance plan.

Contributory Plan

- A contributory plan is a group insurance plan where both the employer and employees share the cost.

- Usually, at least 75% of eligible employees must participate in the plan.

- Employees contribute to the premium payments.

- Example:

- The company’s health insurance was a contributory plan, so Emma and her coworkers each paid a portion of the premium along with their employer.

Conversion Privilege

- The conversion privilege allows a policyholder to replace an expiring insurance policy with a new one, continuing the coverage without proving insurability.

- Conversion can be based on the insured's attained age (age at conversion) or original age (age at the initial policy issue).

- This option is common in term life and group insurance policies.

- Example:

- When Jack left his job, he used the conversion privilege to switch his group life insurance to

an individual policy without needing to prove his health status.

Credit Policies

- Credit policies are intended to assist the insured in repaying a loan if they become disabled due to an accident or illness, or in the event of their death.

- In the event of disability, the policy supplies monthly benefits that are equivalent to the required loan payments.

- Upon the insured's death, the policy will provide a lump sum payment to the creditor to settle the remaining loan balance.

- Example:

- When Mike took out a car loan, he also purchased a credit policy to ensure the loan would be paid if he became disabled or passed away unexpectedly.

Franchise Insurance

- Franchise insurance is a life or health insurance plan that covers groups of individuals with separate policies that have uniform provisions but may vary in benefits.

- These policies are typically solicited within an employer's business with consent

- Franchise insurance is typically designed for groups that are too small to meet the requirements for standard group coverage.

- When the policy is life insurance, it is often referred to as wholesale insurance.

- Example:

- A small accounting firm with ten employees offered franchise insurance, providing each employee with individual health insurance policies tailored to their needs.

Master Policy

- The master policy is issued to the employer as part of a group plan and includes all the insuring provisions that outline employee benefits.

- Individual employees who are covered under the group plan receive certificates that summarize their coverage details.

- Example:

- Jane's company issued a master policy for their group health insurance plan, and each employee received a certificate of insurance highlighting their specific benefits.

Noncontributory Plan

- In a noncontributory plan, the employer pays the total cost of employee benefits.

- Most states require coverage be provided for all eligible employees.

- Employees do not contribute to the premium payments.

- Example:

- At Linda's workplace, the noncontributory health insurance plan meant she didn't have to pay anything for her medical coverage, as the employer covered all the costs.

Persistency

- Persistency in insurance refers to the proportion of policies that continue to be in effect with the insurer after a certain amount of time.

- Persistency is reduced when policies are replaced by other insurers, canceled by the policyholder, or lapse because of nonpayment.

- Businesses with stronger persistency rates are typically more secure and generate higher profits than those with weaker persistency.

- Typically, companies strive to achieve an 80% persistency rate after three years and a 60% rate after five years, indicating that 60% of the policies issued five years prior should still be active.

- Example:

- An insurance company with a high persistency rate demonstrates strong customer retention, indicating policyholders are satisfied with their coverage and service.