Questões de Other Insurance Concepts (Health)

1. TDI-PEARSONVUE — 2026

Which premium mode typically results in the lowest total annual premium cost?

1. A)Monthly
2. B)Quarterly
3. C)Semi-annual
4. D)Annual

Gabarito: D

Annual premium mode is the least expensive on a total cost basis because it reduces administrative expenses and allows the insurer to invest the full premium immediately, resulting in a discount compared to more frequent payment modes.

2. TDI-PEARSONVUE — 2026

Premiums paid by an employer for group health insurance are generally treated how for tax purposes?

1. A)Taxable income to employees
2. B)Tax-deductible to employer, not taxable to employees
3. C)Not deductible to employer
4. D)Taxable to both employer and employees

Gabarito: B

Employer-paid group health insurance premiums are tax-deductible business expenses for the employer and are not counted as taxable income to employees.

3. TDI-PEARSONVUE — 2026

Which premium payment mode typically has the shortest grace period?

1. A)Annual
2. B)Semi-annual
3. C)Quarterly
4. D)All modes have the same grace period

Gabarito: D

The grace period for health insurance is typically 31 days regardless of premium mode. The payment frequency does not affect the length of the grace period.

4. TDI-PEARSONVUE — 2026

Which statement correctly describes the tax treatment of individually purchased disability income insurance?

1. A)Premiums are tax-deductible and benefits are taxable
2. B)Premiums are tax-deductible and benefits are tax-free
3. C)Premiums are not tax-deductible and benefits are taxable
4. D)Premiums are not tax-deductible and benefits are tax-free

Gabarito: D

For individual disability income policies paid with personal (after-tax) funds, premiums are not tax-deductible by the insured. However, benefits received are received income tax-free. This contrasts with employer-paid plans where benefits are typically taxable.

5. TDI-PEARSONVUE — 2026

A surgeon loses his right hand in an accident but begins working as a medical consultant. Under an 'own occupation' disability policy, what is the likely result?

1. A)No benefits, since he is gainfully employed
2. B)Full disability benefits, since he cannot perform surgery
3. C)Partial benefits based on income reduction
4. D)Benefits denied due to change of occupation

Gabarito: B

Under a true own occupation definition, the insured receives full benefits if unable to perform the material duties of his own occupation (surgery), regardless of whether he works in another capacity.

6. TDI-PEARSONVUE — 2026

An insured pays health insurance premiums monthly instead of annually. Compared to annual mode, the total annual cost will typically be:

1. A)Lower, due to administrative efficiency
2. B)The same, as mode does not affect total cost
3. C)Higher, due to increased administrative costs and lost investment income
4. D)Higher in the first year only, then equalized

Gabarito: C

More frequent premium payments (monthly, quarterly) result in higher total annual premiums than less frequent modes (semi-annual, annual) because of increased billing costs and the insurer's loss of investment income.