Exam 16: Employee Benefits: Group Life and Health Insurance

The period of time during which an employee can sign up for group insurance coverage without furnishing evidence of insurability is called a(n)

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 key feature of group medical expense plans is the employee being required to pay a percentage of covered expenses in excess of the deductible. This feature is

All of the following statements about HMOs are true EXCEPT

Med Profs is a group of 18 doctors. These doctors work out of their own offices and treat patients on a fee-for-service basis. In addition, Med Profs doctors also agree to treat HMO members at reduced fees. The type of HMO that uses organizations like Med Profs is called a(n)

Doris started a business 2 years ago. The business has been successful, and Doris is thinking about offering some employee benefits for her workers. She plans to offer a group term life insurance benefit. All of the following are usual eligibility requirements for participation in a group life insurance plan EXCEPT

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

Which of the following statements is (are) true concerning high deductible health plans? I.An employee can withdraw money tax-free from a health savings account or health reimbursement arrangement to pay covered medical costs. II.There is a cap on an employee's out-of-pocket expenses under the plan.

Which of the following statements about group insurance is true?

New employees at Jarvis Company cannot participate in the group term life insurance plan until they have worked at the company for three months. This initial period before a new employee can participate is called a(n)

High deductible group health insurance plans have all of the following characteristics EXCEPT

Turner Company self-insures its group health insurance plan. Turner entered into an agreement with ABC Insurance through which ABC handles the plan design, claims processing, and record keeping for Turner. The agreement between Turner and ABC is called a(n)

Some employers offer employees a choice of health care plans which are designed to make employees more sensitive to health care costs, to provide an incentive to avoid unneeded care, and to seek low-cost health care providers. Such plans are called

Which of the following statements about Blue Cross Plans is (are) true? I.They provide coverage for physicians' and surgeons' fees. II.They usually provide benefits for hospital charges.

Maria is covered under a group medical expense plan as an employee. She is also covered under her husband's plan as a dependent. If Maria is hospitalized, how will each plan respond to her medical bills if both plans have the typical coordination-of-benefits provision?

Which of the following statements regarding group long-term disability income insurance plans is (are) true? I.These plans are usually limited to occupational disabilities. II.These plans typically use a more restrictive definition of disability after an initial period of disability, such as two years.

What is the purpose of stop-loss insurance that is used with self-insured group medical expense plans?

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.

Tracy is covered by a group dental insurance plan at work. At her latest check-up, the dentist notes that she needed crowns on two teeth. Under her plan, if the cost of dental work will exceed $500, the dentist submits the treatment plan to the insurer to calculate what the plan will cover and what the employee will pay. This provision is known as a

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