State RegulationsPA specificDifficulty 1/5
Under Pennsylvania insurance regulation, which type of coverage is subject to the limited health policy standards that govern critical illness and dread disease benefits?
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
31 Pa. Code 88.169 sets the standards Pennsylvania applies to limited health policies, including critical illness and dread disease coverage, and 31 Pa. Code 88.193 adds further requirements for these policies. Because a cancer-only or specified-disease policy pays by schedule rather than covering broad medical expenses, the Pennsylvania Insurance Department treats it as a limited policy and holds it to these dedicated standards rather than to the major medical framework.
Why the other options are wrong
- B) Comprehensive major medical is not a limited policy; it covers broad medical expenses and is not measured against the specified-disease standards of 31 Pa. Code 88.169.
- C) An accelerated death benefit modifies a life policy's proceeds; it is not a limited health policy subject to the specified-disease rules.
- D) Automobile medical payments are motor-vehicle coverage, entirely outside the limited health policy standards.
Memory hook
Fixed benefit for a named disease = limited policy = Pennsylvania's special standards apply.