Question 1

Insurers use retrospective utilization reviews to determine that all treatment claims were legitimate.(Utilization Reviews)

Accepted Answer

A) True 
 B)False

Question 2

Under this provider payment system,managed care plans hold primary care physicians accountable for the cost of services rendered to each assigned patient.(Provider Payment Systems)

Accepted Answer

A) Full capitation 
B) Full capitation plus 
C) Partial capitation 
D) Semi capitation 
A) Full capitation 
B) Full capitation plus 
C) Partial capitation 
D) Semi capitation

Question 3

In most companies,employers choose whether an employee will participate in wellness programs,thus initiating a lifestyle intervention.(Lifestyle Interventions)

Accepted Answer

A) True 
 B)False

Question 4

The top reason companies outsource benefits functions is for the expertise.(Outsourcing the Benefits Function)

Accepted Answer

A) True 
 B)False

Question 5

Under provider payment systems,agreements may include one or more cost saving features.Which of the following is not one of these cost saving features? (Provider Payment Systems)

Accepted Answer

A) Percentage discounts 
B) Capped fee schedules 
C) Partial capitation 
D) Whole capitation 
A) Percentage discounts 
B) Capped fee schedules 
C) Partial capitation 
D) Whole capitation

Question 6

ERISA limits waiting periods before participation in employer-sponsored health-care programs to a maximum of 90 days.(Waiting Periods)

Accepted Answer

A) True 
 B)False

Question 7

Explain why educating employees about the cost of health care is essential to controlling the rising costs of health-care programs.(Employee Education)

Accepted Answer

Main Points -Employees tend to inadverte

Question 8

Employers are obligated to distribute summary plan descriptions to employees and DOL within 90 days of the plan becoming subject to ERISA's reporting requirements.(Legal Considerations in Benefits Communication)

Accepted Answer

A) True 
 B)False

Question 9

If employees don't choose the maximum benefits limits in a core-plus-option cafeteria plan they lose the difference.(Types of Flexible Benefit Plan Arrangements)

Accepted Answer

A) True 
 B)False

Question 10

After-tax contributions reduce the amount of annual income subject to income tax.(Employee Contributions)

Accepted Answer

A) True 
 B)False

Question 11

Flexible spending accounts and premium-only plans are versions of which cafeteria plan? (Types of Flexible Benefit Plan Arrangements)

Accepted Answer

A) Modular 
B) Pretax salary reduction 
C) Core-plus-option 
D) Mix-and-match 
A) Modular 
B) Pretax salary reduction 
C) Core-plus-option 
D) Mix-and-match

Question 12

Insurers may conduct concurrent utilization reviews shortly after hospital admission (Utilization Reviews)

Accepted Answer

A) True 
 B)False

Question 13

Which of the following is not an ERISA requirement pertaining to employer-sponsored benefits plans? (Legal Considerations in Benefits Communication)

Accepted Answer

A) Written notices must be written for the "average" participant to understand. 
B) The waiting period before participation in employer-sponsored health-care programs is limited to a maximum of 90 days. 
C) Employers are obligated to distribute summary plan descriptions to employees within 120 days of the plan becoming subject to reporting and disclosure requirements. 
D) Employees must receive a summary plan description within 90 days of becoming a plan participant.
Essay Questions 
A) Written notices must be written for the "average" participant to understand. 
B) The waiting period before participation in employer-sponsored health-care programs is limited to a maximum of 90 days. 
C) Employers are obligated to distribute summary plan descriptions to employees within 120 days of the plan becoming subject to reporting and disclosure requirements. 
D) Employees must receive a summary plan description within 90 days of becoming a plan participant.
Essay Questions

Question 14

Describe outsourcing of benefits functions and provide reasons for outsourcing.(Outsourcing the Benefits Function)

Accepted Answer

Main Points -Outsourcing of benefits fun

Question 15

Fee-for-service plans establish provider payment systems to control the costs of health care.(Provider Payment Systems)

Accepted Answer

A) True 
 B)False

Question 16

Which of following statements is true of outsourcing benefits functions? (Outsourcing the Benefits Function)

Accepted Answer

A) Outsourcing agreements are on a monthly basis. 
B) Outsourcing refers to an employer transferring responsibility to a third-party provider to manage one or more benefits. 
C) Outsourcing some or all benefits administration is decreasing. 
D) Companies outsource roughly one-tenth of all their benefits functions. 
A) Outsourcing agreements are on a monthly basis. 
B) Outsourcing refers to an employer transferring responsibility to a third-party provider to manage one or more benefits. 
C) Outsourcing some or all benefits administration is decreasing. 
D) Companies outsource roughly one-tenth of all their benefits functions.

Question 17

Summary plan descriptions are generally short and only present the "big picture" of a benefit plan.(Legal Considerations in Benefits Communication)

Accepted Answer

A) True 
 B)False

Question 18

This type of utilization review judges whether additional inpatient hospitalization is medically necessary.(Utilization Reviews)

Accepted Answer

A) Prospective 
B) Certification 
C) Concurrent 
D) Retrospective 
A) Prospective 
B) Certification 
C) Concurrent 
D) Retrospective

Question 19

Some companies have adopted high-deductible workers' compensation plans,substantially lowering their premiums.(High-Deductible Plans)

Accepted Answer

A) True 
 B)False

Question 20

Employers have been shifting health related costs to employees partly because of the economic downturn starting in the 2000s.(Employee Education)

Accepted Answer

A) True 
 B)False

Insurers use retrospective utilization reviews to determine that all treatment claims were legitimate.(Utilization Reviews)

Under this provider payment system,managed care plans hold primary care physicians accountable for the cost of services rendered to each assigned patient.(Provider Payment Systems)

In most companies,employers choose whether an employee will participate in wellness programs,thus initiating a lifestyle intervention.(Lifestyle Interventions)

The top reason companies outsource benefits functions is for the expertise.(Outsourcing the Benefits Function)

Under provider payment systems,agreements may include one or more cost saving features.Which of the following is not one of these cost saving features? (Provider Payment Systems)

ERISA limits waiting periods before participation in employer-sponsored health-care programs to a maximum of 90 days.(Waiting Periods)

Explain why educating employees about the cost of health care is essential to controlling the rising costs of health-care programs.(Employee Education)

Employers are obligated to distribute summary plan descriptions to employees and DOL within 90 days of the plan becoming subject to ERISA's reporting requirements.(Legal Considerations in Benefits Communication)

If employees don't choose the maximum benefits limits in a core-plus-option cafeteria plan they lose the difference.(Types of Flexible Benefit Plan Arrangements)

After-tax contributions reduce the amount of annual income subject to income tax.(Employee Contributions)

Flexible spending accounts and premium-only plans are versions of which cafeteria plan? (Types of Flexible Benefit Plan Arrangements)

Insurers may conduct concurrent utilization reviews shortly after hospital admission (Utilization Reviews)

Which of the following is not an ERISA requirement pertaining to employer-sponsored benefits plans? (Legal Considerations in Benefits Communication)

Describe outsourcing of benefits functions and provide reasons for outsourcing.(Outsourcing the Benefits Function)

Fee-for-service plans establish provider payment systems to control the costs of health care.(Provider Payment Systems)

Which of following statements is true of outsourcing benefits functions? (Outsourcing the Benefits Function)

Summary plan descriptions are generally short and only present the "big picture" of a benefit plan.(Legal Considerations in Benefits Communication)

This type of utilization review judges whether additional inpatient hospitalization is medically necessary.(Utilization Reviews)

Some companies have adopted high-deductible workers' compensation plans,substantially lowering their premiums.(High-Deductible Plans)

Employers have been shifting health related costs to employees partly because of the economic downturn starting in the 2000s.(Employee Education)

Introducing Employee Benefits

The Psychology and Economics of Employee Benefits

Regulating Employee Benefits

Employer-Sponsored Retirement Plans

Employer-Sponsored Health-Care Plans

Employer-Sponsored Disability Insurance, life Insurance, and Workers Compensation

Government-Mandated Social Security Programs

Paid Time-Off and Flexible Work Schedule Benefits

Accommodation and Enhancement Benefits

Nonqualified Deferred Compensation Plans for Executives

Global Employee Benefits at a Glance

Filters

Exam 10: Managing the Employee-Benefits System

Insurers use retrospective utilization reviews to determine that all treatment claims were legitimate.(Utilization Reviews)

Under this provider payment system,managed care plans hold primary care physicians accountable for the cost of services rendered to each assigned patient.(Provider Payment Systems)

In most companies,employers choose whether an employee will participate in wellness programs,thus initiating a lifestyle intervention.(Lifestyle Interventions)

The top reason companies outsource benefits functions is for the expertise.(Outsourcing the Benefits Function)

Under provider payment systems,agreements may include one or more cost saving features.Which of the following is not one of these cost saving features? (Provider Payment Systems)

ERISA limits waiting periods before participation in employer-sponsored health-care programs to a maximum of 90 days.(Waiting Periods)

Explain why educating employees about the cost of health care is essential to controlling the rising costs of health-care programs.(Employee Education)

Employers are obligated to distribute summary plan descriptions to employees and DOL within 90 days of the plan becoming subject to ERISA's reporting requirements.(Legal Considerations in Benefits Communication)

If employees don't choose the maximum benefits limits in a core-plus-option cafeteria plan they lose the difference.(Types of Flexible Benefit Plan Arrangements)

After-tax contributions reduce the amount of annual income subject to income tax.(Employee Contributions)

Flexible spending accounts and premium-only plans are versions of which cafeteria plan? (Types of Flexible Benefit Plan Arrangements)

Insurers may conduct concurrent utilization reviews shortly after hospital admission (Utilization Reviews)

Which of the following is not an ERISA requirement pertaining to employer-sponsored benefits plans? (Legal Considerations in Benefits Communication)

Describe outsourcing of benefits functions and provide reasons for outsourcing.(Outsourcing the Benefits Function)

Fee-for-service plans establish provider payment systems to control the costs of health care.(Provider Payment Systems)

Which of following statements is true of outsourcing benefits functions? (Outsourcing the Benefits Function)

Summary plan descriptions are generally short and only present the "big picture" of a benefit plan.(Legal Considerations in Benefits Communication)

This type of utilization review judges whether additional inpatient hospitalization is medically necessary.(Utilization Reviews)

Some companies have adopted high-deductible workers' compensation plans,substantially lowering their premiums.(High-Deductible Plans)

Employers have been shifting health related costs to employees partly because of the economic downturn starting in the 2000s.(Employee Education)

Introducing Employee Benefits

The Psychology and Economics of Employee Benefits

Regulating Employee Benefits

Employer-Sponsored Retirement Plans

Employer-Sponsored Health-Care Plans

Employer-Sponsored Disability Insurance, life Insurance, and Workers Compensation

Government-Mandated Social Security Programs

Paid Time-Off and Flexible Work Schedule Benefits

Accommodation and Enhancement Benefits

Nonqualified Deferred Compensation Plans for Executives

Global Employee Benefits at a Glance

Filters