Which of the following statements about preferred provider organization (PPO) health plans is (are) true? I. A PPO plan contracts with health care providers to provide medical services to members at reduced fees. II. Plan members are given a financial incentive to use PPO providers rather than other providers. A) I only B) II only […]
Which of the following statements about group insurance is true? A) Individual contracts are issued to each person covered under a group insurance plan. B) The cost of group insurance is usually higher on a per-person basis than the cost of individual insurance. C) The actual experience of a large group is a factor in […]
A deductible under which expenses are accumulated on an annual basis, and once a specified total is reached, the deductible is satisfied for the year is called a A) calendar-year deductible. B) prospective deductible. C) straight deductible. D) waiting period. ANSWER Answer: A
Which of the following statements about group term life insurance is true? A) It usually is written in the form of 5-year level term insurance. B) An employee who leaves the group is usually not permitted to convert to individual coverage. C) Experience rating is used in group term life insurance plans. D) It represents […]
Which of the following is (are) characteristics of HMO managed care plans? I. Unlimited choice of physicians and hospitals II. Emphasis on controlling the cost of covered services A) I only B) II only C) both I and II D) neither I nor II ANSWER Answer: B
The period of time during which an employee can sign up for group insurance coverage without furnishing evidence of insurability is called a(n) A) probationary period. B) noninsurability window. C) waiting period. D) eligibility period. ANSWER Answer: D
Which of the following statements about HMO managed care plans is (are) true? I. There is an emphasis on controlling costs. II. They provide narrow, limited, medical services to members. A) I only B) II only C) both I and II D) neither I nor II ANSWER Answer: A
Connors Company self-funds the medical expense benefits that it provides to its employees. Connors Company has a contract with a commercial health insurance company providing that the health insurance company will pay all claims in excess of $250,000. The arrangement with the health insurance company is called A) reinsurance. B) managed care. C) stop-loss insurance. […]
Reasons for having a minimum participation requirement before a group is eligible for insurance include which of the following? I. To lower the expense rate per unit of insurance II. To minimize the possibility of insuring a group which consists largely of unhealthy individuals A) I only B) II only C) both I and II […]
High deductible group health insurance plans have all of the following characteristics EXCEPT A) health savings accounts or health reimbursement arrangements. B) high dollar deductibles. C) low coverage limits. D) coinsurance. ANSWER Answer: C
