RHU study guide
RHU · Work through your exam, one topic at a time.
The Registered Health Underwriter (RHU) is a professional designation for people who advise on and administer health and related employee benefits: brokers and agents, group benefits account managers, carrier underwriters, claims and compliance staff, and HR benefits leads. It signals that the holder can speak credibly about how health coverage is designed, priced, sold, funded, and delivered in the U.S., rather than about a single product line. The RHU study guide has 7 sections and about 2,240 words.
01Health Insurance Fundamentals, Policy Design, and Regulation
Every health policy is a risk-transfer device built on pooling: many insureds contribute premium so the few who incur large claims are made whole. Understand law of large numbers , adverse selection (sicker-than-average buyers concentrating in a plan), moral hazard (benefit design changing utilization), and morbidity vs.
350 words, about 2 min02Individual Medical Expense and Disability Income Insurance
Outside the ACA marketplaces, individual medical policies are medically underwritten, so producers must master the application, the conditional receipt (coverage effective only if the applicant proves insurable), and disclosure duties. Standard provisions include the free-look period (commonly 10 days), the grace period , reinstatement (often automatic within 31 days of lapse with required premium), and the incontestability clause (usually two years).
339 words, about 2 min03Group Health Plans and Employee Benefit Design
Group coverage rests on a master contract between insurer and employer, with certificates issued to participants. Underwriting emphasizes group characteristics , not individual health: participation percentages, eligibility classes, and an actively-at-work requirement.
311 words, about 2 min04Health Care Financing, Managed Care, and Cost Containment
Managed care controls cost and utilization through network design and provider payment. Know the spectrum: HMO (closed network, gatekeeper, capitation-friendly), PPO (open network, negotiated discounts, no gatekeeper), POS (HMO-style in-network with an out-of-network option), and EPO (network-only, no referrals).
280 words, about 1 min05Public and Senior Health Programs: Medicare, Medicaid, and the ACA Marketplace
Part A covers inpatient hospital, skilled nursing after a qualifying stay, hospice, and some home health, and is premium-free with 40 quarters of work history. Part B covers physician and outpatient services with an income-related premium (IRMAA).
335 words, about 2 min06Worksite and Voluntary Benefits: Enrollment and Administration
Worksite and voluntary benefits are employee-paid coverages offered through payroll deduction: accident, critical illness, hospital indemnity, short- and long-term disability, dental, vision, term life, and legal/identity products. They are typically written as group or individual policies with simplified or guarantee-issue underwriting inside an enrollment window and evidence of insurability outside it.
305 words, about 2 min07Ethics, Fiduciary Responsibility, and Professional Practice
Producers owe duties grounded in state insurance law and, for ERISA plans, federal fiduciary standards. ERISA fiduciaries must act with loyalty , prudence , for the exclusive benefit of participants, follow plan documents, and avoid prohibited transactions.
320 words, about 2 min