Std Final Measurement - 1/12/15

33 Questions | Total Attempts: 12

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Std Final Measurement - 1/12/15

Questions and Answers
  • 1. 
    Please explain your answer to the question #5 above.
  • 2. 
    Jerry returns to work full time with the same employer on 04/19/04. On 04/23/04, he falls and breaks his right arm. Would his claim be recurrent? Contract has 14 day Recurrent provision. Please explain your answer.
  • 3. 
    What is the diagnosis?
  • 4. 
    According to the AP, what are the restrictions & limitations?
  • 5. 
    Review all sections of the claim form and relevant contract provisions for your NaviLink Training "Lee" claim. Plan your initial call to the claimant. List your questions to the claimant in the space below as you would document them in NaviLink. Assume the date you are placing the call is 05/25/2002.
  • 6. 
    When you complete the quiz questions 1-32, your trainer will provide you with an additional document that you will need to use to complete the rest of the Final Measurement. Based on the information obtained during the initial call, as well as the claim forms, develop your Action Plan and document a file direction.
  • 7. 
    Answer questions 1-7 based on the claim information provided below.Elizabeth is a 42 year old Registered Nurse with Multiple Sclerosis. Her physician states she cannot lift over 15 lbs. Contract SeriesCXCPolicy Effective Date01/01/1998EE contribYes, 40% pre-taxWP New EE30 DaysWP Present EENoneApplication of WPDay AfterDOH06/12/00DOD03/27/01Exclusions3/12 Pre-ExistingEnrollment Card Signed08/01/00What is Elizabeth's eligibility date? (use xx/xx/xx format) _______
  • 8. 
    What is her EDOC? (use xx/xx/xx format) 
  • 9. 
    If the policy has a 14 day EP, on what date would benefits begin? (use xx/xx/xx format)
  • 10. 
    What percentage of Elizabeth’s benefit is taxable (FICA)? 
  • 11. 
    Elizabeth was first diagnosed and treated for MS on 10/04/00. She has seen her physicians several times a month and has been taking medications since her diagnosis was made. Her condition worsened and she stopped working on 03/26/01. Based on the pre-existing provisions, would she be eligible for benefits?
    • A. 

      Yes

    • B. 

      No

  • 12. 
    Based on your answer from question #6, please provide the lookback period timeframe.
  • 13. 
    Answer questions 8-11 based on the claim information provided below.Jerry is 45 years old and was diagnosed with prostate cancer. He is an accountant who worked 40 hours a week prior to disability.  Contract SeriesCXC FIDefinition of DisabilityResidualLDW01/12/04Rate of Pay$37.23/hourEmployment StatusFull Time - 40 HoursYearly Bonus (2003)$5000.00Benefit %  Weekly60%Minimum Benefit$25.00The contract defines earnings as Salary W/Def Comp. What are Jerry's BWE?
  • 14. 
    What is Jerry’s gross disability payment amount? 
  • 15. 
    What are the basic weekly earnings? Earnings Definition = SAL W/O Def Comp; Gross Bi-Weekly Earnings = $1352.00; W2 Earnings = $58263.00; Bi-Weekly Pre-Tax Contributions = $153.00
    • A. 

      $676.00

    • B. 

      $560.50

    • C. 

      $599.50

  • 16. 
    For Questions 12-33 you will need to access the NaviLink Training Claim ("Lee Claim") provided by your trainer. Once you access the claim, maneuver through the claim, including viewing the images/claim forms and using NaviLink, to answer the remaining questions.What is the claimant's Social Security #?
  • 17. 
    Who is the claim owner?
  • 18. 
    What is the NaviLink claim number?
  • 19. 
    What is the claimant’s date of birth? (use date format mm/dd/yy)
  • 20. 
    What is the policy number for this claim?
  • 21. 
    What is the product for this claim?
    • A. 

      STD

    • B. 

      LTD

    • C. 

      VWB

    • D. 

      AD&D

  • 22. 
    What is the funding for this claim?
    • A. 

      Self Insured

    • B. 

      Fully Insured

  • 23. 
    What is the current statu of this claim?
    • A. 

      Closed

    • B. 

      Open

    • C. 

      Pended

  • 24. 
    Is the address on the EES the same as the one indicated on the Claim Profile?
    • A. 

      Yes

    • B. 

      No

  • 25. 
    Using the dates identified by the EE, ER, and AP, what is the DOD? (use format mm/dd/yy)
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