Question 1

The network model compensates physicians using a fee schedule.(Prepaid Group Practice Model)

Accepted Answer

A) True 
 B)False

Question 2

Single employees pay a larger percentage of their health care premium than employees with family coverage pay.(Health-Care Coverage and Costs)

Accepted Answer

A) True 
 B)False

Question 3

Discuss and compare multiple-payer versus single-payer systems.(Defining and Exploring Health-Care Plans)

Accepted Answer

The answer of Discuss and compare multiple-payer versus single-payer systems.(Defining...

Question 4

Briefly discuss how insurers determine premiums.(Defining and Exploring Health-Care Plans)

Accepted Answer

The answer of Briefly discuss how insurers determine premiums.(Defining and...

Question 5

There has been much controversy over the Patient Protection and Affordable Care Act with arguments focused on the individual mandate.(Patient Protection and Affordable Care Act of 2010)

Accepted Answer

A) True 
 B)False

Question 6

This consumer-driven health care option contains contributions made by employers and the balance can be carried-over to the next year.(Consumer-Driven Health Care)

Accepted Answer

A) Flexible spending accounts 
B) Health reimbursement arrangements 
C) Health savings accounts 
D) Flexible savings accounts

Question 7

Canada,as opposed to the US,has a single-payer health-care system.(Defining and Exploring Health-Care Plans)

Accepted Answer

A) True 
 B)False

Question 8

Most plans specify the maximum amount a policyholder must pay per calendar year or plan year,known as the out-of-pocket maximum provision.(Out-of-Pocket Maximum)

Accepted Answer

A) True 
 B)False

Question 9

FAS 106 does not do which of the following? (Retiree Health-Care Benefits)

Accepted Answer

A) requires that companies disclose substantial information about the economic value and costs of retiree health-care plans. 
B) Reduces the amount of net profit companies list on balance sheets 
C) Benefits such as health care coverage establish an exchange between the employer and employee 
D) Post-retirement benefits are part of employee's compensation package
Essay Questions

Question 10

Coinsurance rates are generally higher in HMOs than in fee-for-service plans.(Features of Health-Care Plans)

Accepted Answer

A) True 
 B)False

Question 11

Staff model HMOs own the medical facilities and employ the medical and support staffs that work on the premises.(Prepaid Group Practice Model)

Accepted Answer

A) True 
 B)False

Question 12

This federal law requires group health plans to provide medical and surgical benefits for mastectomies.(The Employee Retirement Income Security Act of 1974 (ERISA))

Accepted Answer

A) Women's Health and Cancer Rights Act 
B) Health Insurance Portability and Accountability Act 
C) Pregnancy Discrimination Act 
D) Women with Disabilities Act

Question 13

The Mental Health Parity Act,which plays a prominent role in establishing parity requirements for mental health plans,was enacted in 2003.(Regulation of Mental Health and Substance Abuse Plans)

Accepted Answer

A) True 
 B)False

Question 14

IRC does not allow deductions for providing national health coverage.(Tax Regulations)

Accepted Answer

A) True 
 B)False

Question 15

Generally,health plans pay expenses according to a schedule of usual,customary and reasonable charges.(Surgical Benefits)

Accepted Answer

A) True 
 B)False

Question 16

What is coinsurance? (Coinsurance)

Accepted Answer

A) When both parents have employer-sponsored insurance coverage for their children 
B) Two insurance companies combine to offer a group policy to an employer 
C) The amount an employee has to pay out-of-pocket before the insurance kicks in 
D) The percentage of covered expenses paid by the insured

Question 17

Under the employer mandate of the Patient Protection and Affordable Care Act,companies with at least 10 employees are required to offer affordable health insurance to its full-time employees.(Patient Protection and Affordable Care Act of 2010)

Accepted Answer

A) True 
 B)False

Question 18

This consumer-driven health care option allows employees to contribute pre-tax wages annually to pay for qualified medical expenses,but they will lose the balance not used at year's end.(Consumer-Driven Health Care)

Accepted Answer

A) Flexible spending accounts 
B) Health reimbursement arrangements 
C) Health savings accounts 
D) Flexible savings accounts

Question 19

Title XVIII of the Social Security Act established the Medicaid program.(Origins of Health-Care Benefits)

Accepted Answer

A) True 
 B)False

Question 20

This type of group insurance plan is an arrangement made for employers with relatively small workforces.A single master trust holds each employer's contributions,and premiums are paid from the trust.(Exhibit 5.1,Types of Group Plans)

Accepted Answer

A) Voluntary employee beneficiary associations 
B) Multiemployer plans 
C) Pooled coverage 
D) Multiple employer trust

Exam 5: Employer-Sponsored Health-Care Plans

The network model compensates physicians using a fee schedule.(Prepaid Group Practice Model)

Single employees pay a larger percentage of their health care premium than employees with family coverage pay.(Health-Care Coverage and Costs)

Discuss and compare multiple-payer versus single-payer systems.(Defining and Exploring Health-Care Plans)

Briefly discuss how insurers determine premiums.(Defining and Exploring Health-Care Plans)

There has been much controversy over the Patient Protection and Affordable Care Act with arguments focused on the individual mandate.(Patient Protection and Affordable Care Act of 2010)

This consumer-driven health care option contains contributions made by employers and the balance can be carried-over to the next year.(Consumer-Driven Health Care)

Canada,as opposed to the US,has a single-payer health-care system.(Defining and Exploring Health-Care Plans)

Most plans specify the maximum amount a policyholder must pay per calendar year or plan year,known as the out-of-pocket maximum provision.(Out-of-Pocket Maximum)

FAS 106 does not do which of the following? (Retiree Health-Care Benefits)

Coinsurance rates are generally higher in HMOs than in fee-for-service plans.(Features of Health-Care Plans)

Staff model HMOs own the medical facilities and employ the medical and support staffs that work on the premises.(Prepaid Group Practice Model)

This federal law requires group health plans to provide medical and surgical benefits for mastectomies.(The Employee Retirement Income Security Act of 1974 (ERISA) )

The Mental Health Parity Act,which plays a prominent role in establishing parity requirements for mental health plans,was enacted in 2003.(Regulation of Mental Health and Substance Abuse Plans)

IRC does not allow deductions for providing national health coverage.(Tax Regulations)

Generally,health plans pay expenses according to a schedule of usual,customary and reasonable charges.(Surgical Benefits)

What is coinsurance? (Coinsurance)

Under the employer mandate of the Patient Protection and Affordable Care Act,companies with at least 10 employees are required to offer affordable health insurance to its full-time employees.(Patient Protection and Affordable Care Act of 2010)

This consumer-driven health care option allows employees to contribute pre-tax wages annually to pay for qualified medical expenses,but they will lose the balance not used at year's end.(Consumer-Driven Health Care)

Title XVIII of the Social Security Act established the Medicaid program.(Origins of Health-Care Benefits)

This type of group insurance plan is an arrangement made for employers with relatively small workforces.A single master trust holds each employer's contributions,and premiums are paid from the trust.(Exhibit 5.1,Types of Group Plans)