Question 1

Which of the following is a public assistance program that provides health insurance benefits only to those who are unable to pay for health care?

Accepted Answer

A)  Medicare
B)  Medicaid
C)  Blue Cross/Blue Shield
D)  Point-of-service (POS) plan
E)  Workers' compensationF) B) and E)
G) None of the above

Question 2

Blue Cross provides hospital coverage and Blue Shield provides prescription pharmacy coverage.

Accepted Answer

A) True 
 B)False

Question 3

Ben's (aged 40) health coverage charges a low ($15) deductible each time he visits a doctor or hospital.Other than the low per-service deductible,there is very little cost sharing.However,Ben has the advantages lack of deductibles,few or no exclusions,and not having to file insurance claims.Which of the following most likely provides Ben's health coverage?

Accepted Answer

A)  HMO
B)  Blue Cross/Blue Shield association
C)  Commercial insurer (major medical) 
D)  Medicare
E)  Fee-for-service indemnity planF) B) and C)
G) B) and E)

Question 4

Group health insurance premiums are _____.

Accepted Answer

A)  lower than an employer's health insurance plan premiums
B)  paid by the insurer to the insured
C)  designed to cover only comprehensive medical expenses
D)  equal to the reimbursements of medical expenses on claims for medical treatment
E)  only meant to offer coverage for prescription drug,dental,and vision care servicesF) A) and E)
G) A) and C)

Question 5

The community rating approach to health insurance premium pricing _____.

Accepted Answer

A)  advocates offering Social Security Medicare program to all individuals irrespective of their age
B)  favors the government's contribution to the health savings account (HS
A)  
C)  prohibits insurance companies from varying rates based on health status or claims history
D)  considers only medical insurance coverage from a private insurance company
E)  offers consumer directed health plans that go one step beyond a flexible-benefit planF) C) and D)
G) All of the above

Question 6

Long-term-care insurance provides protection against the cost of extended hospital stays.

Accepted Answer

A) True 
 B)False

Question 7

Living a healthy lifestyle is an example of loss prevention and control.

Accepted Answer

A) True 
 B)False

Question 8

The Affordable Care Act (ACA) requires insurance companies to adhere to:

Accepted Answer

A)  the pure community rating approach for individuals and small businesses.
B)  the adjusted community rating approach for individuals and small businesses.
C)  the modified community rating approach for SEC registered corporations.
D)  the unadjusted community rating approach for SEC registered corporations.
E)  the cost-of-living adjustment (COL
A)  for individuals and small businesses.F) B) and E)
G) B) and D)

Question 9

An exclusive provider organization (EPO) is _____.

Accepted Answer

A)  a hybrid form of health maintenance organization (HMO) that reimburses members a specified percentage of the cost
B)  a managed care plan that reimburses members only when affiliated providers are used
C)  a managed care plan in which subscribers receive services from physicians practicing from their own offices
D)  a hybrid form of health maintenance organization (HMO) that allows members to go outside the HMO network for care
E)  a prepaid hospital and medical expense plan that allows members to use nonaffiliated providersF) D) and E)
G) A) and E) B

Question 10

Disability income insurance will provide income to a disabled or ill person ___________. ​

Accepted Answer

A)  without a waiting period
B)  with unlimited funds for years
C)  with a waiting period before income is received
D)  with payments made to the recipient up to age 70E) A) and C)
F) B) and C)

Question 11

Employers set up a salary reduction agreement with the employees if:

Accepted Answer

A)  employees pay hospitalization charges for the pre-existing conditions.
B)  employees pay health care costs due to lapse of insurance coverage.
C)  employees need additional insurance benefits.
D)  employees do not look for ways to avoid exposure to health care loss before it occurs.
E)  employees are injured on the job or become ill through work-related causes.F) All of the above
G) A) and C) C

Question 12

All group insurance plans extend health insurance benefits to retirees.

Accepted Answer

A) True 
 B)False  False

Question 13

You would have a better chance of choosing your own doctor with a preferred provider organizations (PPO)plan than with a health maintenance organizations (HMO)plan.

Accepted Answer

A) True 
 B)False

Question 14

Premiums for workers' compensation insurance are paid by the employees.

Accepted Answer

A) True 
 B)False

Question 15

Which of the following changes would tend to increase the premium on a disability policy?

Accepted Answer

A)  A shorter elimination period
B)  Use of "any occupation" definition of disability instead of "own occupation to which one is reasonably suited"
C)  Decreasing the benefit level to 50% from 66% of prior earnings
D)  Decreasing the payment period until age 65 to a maximum of 2 years
E)  Mandatory disability insurance in which the employer pays the entire premiumF) D) and E)
G) B) and E)

Question 16

Medicare and Medicaid cover ___________. ​

Accepted Answer

A)  more than half of the total cost of long-term care
B)  all the costs related to long-term care
C)  less than half of the total cost of long-term care
D)  the balance between the actual medical cost and the coverage amountE) B) and C)
F) C) and D)

Question 17

During the past few decades,the percentage of our income spent on health care:

Accepted Answer

A)  has increased due to an aging U.S.population.
B)  has decreased due to costly advances in medical technology.
C)  has increased due to advanced demand-and-supply distribution of health care facilities.
D)  has decreased due to increased regulation and decreased administrative costs.
E)  has decreased due to the reduction in the health care costs.F) B) and D)
G) C) and D)

Question 18

Employees should consider risk assumption for certain health risks because:

Accepted Answer

A)  these are covered by Social Security.
B)  they are required to pay health care costs when their insurance coverage lapses.
C)  they would rather pay small amounts from savings than higher premiums to cover them.
D)  they need not look for ways to avoid exposure to risks before they occur.
E)  they will eliminate some or all of the factors from their lifestyle and reduce their chances of becoming ill.F) B) and E)
G) A) and B)

Question 19

Long-term care is a term used to describe _____.

Accepted Answer

A)  the inflation protection riders in the insurance policy
B)  the delivery of medical care to persons with chronic medical conditions in a nursing home
C)  the coverage for a serious illness or accident that prevents an insured person from working for an extended period
D)  an extended period of hospital stay due to a serious illness or accident
E)  compensation provided to the workers who are injured on the job or become ill through work-related causes.F) A) and D)
G) C) and D)

Question 20

Which of the following is true of the health care industry?

Accepted Answer

A)  In the fee-for-service plans,the health care provider is the same as the insurer.
B)  In a traditional indemnity plan,the premium cost is low if it is a high-deductible plan.
C)  In managed care plans,employers contract with the health care service provider.
D)  In traditional indemnity plans,the government waives the doctor's fees or the hospital charges.
E)  A group health insurance is a contract between pharmaceutical companies and the health care provider.F) A) and E)
G) C) and D)

Exam 9: Insuring Your Health

Which of the following is a public assistance program that provides health insurance benefits only to those who are unable to pay for health care?

Correct Answer
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Blue Cross provides hospital coverage and Blue Shield provides prescription pharmacy coverage.

Correct Answer
verified

Correct Answer
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Group health insurance premiums are _____.

Correct Answer
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The community rating approach to health insurance premium pricing _____.

Correct Answer
verified

Long-term-care insurance provides protection against the cost of extended hospital stays.

Correct Answer
verified

Living a healthy lifestyle is an example of loss prevention and control.

Correct Answer
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The Affordable Care Act (ACA) requires insurance companies to adhere to:

Correct Answer
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An exclusive provider organization (EPO) is _____.

Correct Answer
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B

Disability income insurance will provide income to a disabled or ill person ___________.

Correct Answer
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Employers set up a salary reduction agreement with the employees if:

Correct Answer
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C

All group insurance plans extend health insurance benefits to retirees.

Correct Answer
verified
False

You would have a better chance of choosing your own doctor with a preferred provider organizations (PPO)plan than with a health maintenance organizations (HMO)plan.

Correct Answer
verified

Premiums for workers' compensation insurance are paid by the employees.

Correct Answer
verified

Which of the following changes would tend to increase the premium on a disability policy?

Correct Answer
verified

Medicare and Medicaid cover ___________.

Correct Answer
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During the past few decades,the percentage of our income spent on health care:

Correct Answer
verified

Employees should consider risk assumption for certain health risks because:

Correct Answer
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Long-term care is a term used to describe _____.

Correct Answer
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Which of the following is true of the health care industry?

Correct Answer
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Exam 9: Insuring Your Health

Which of the following is a public assistance program that provides health insurance benefits only to those who are unable to pay for health care?

Correct AnswerverifiedShow Answer

Blue Cross provides hospital coverage and Blue Shield provides prescription pharmacy coverage.

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

Group health insurance premiums are _____.

Correct AnswerverifiedShow Answer

The community rating approach to health insurance premium pricing _____.

Correct AnswerverifiedShow Answer

Long-term-care insurance provides protection against the cost of extended hospital stays.

Correct AnswerverifiedShow Answer

Living a healthy lifestyle is an example of loss prevention and control.

Correct AnswerverifiedShow Answer

The Affordable Care Act (ACA) requires insurance companies to adhere to:

Correct AnswerverifiedShow Answer

An exclusive provider organization (EPO) is _____.

Correct AnswerverifiedB

Disability income insurance will provide income to a disabled or ill person ___________. ​

Correct AnswerverifiedShow Answer

Employers set up a salary reduction agreement with the employees if:

Correct AnswerverifiedC

All group insurance plans extend health insurance benefits to retirees.

Correct AnswerverifiedFalse

You would have a better chance of choosing your own doctor with a preferred provider organizations (PPO)plan than with a health maintenance organizations (HMO)plan.

Correct AnswerverifiedShow Answer

Premiums for workers' compensation insurance are paid by the employees.

Correct AnswerverifiedShow Answer

Which of the following changes would tend to increase the premium on a disability policy?

Correct AnswerverifiedShow Answer

Medicare and Medicaid cover ___________. ​

Correct AnswerverifiedShow Answer

During the past few decades,the percentage of our income spent on health care:

Correct AnswerverifiedShow Answer

Employees should consider risk assumption for certain health risks because:

Correct AnswerverifiedShow Answer

Long-term care is a term used to describe _____.

Correct AnswerverifiedShow Answer

Which of the following is true of the health care industry?

Correct AnswerverifiedShow Answer

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Correct Answer
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Correct Answer
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B

Disability income insurance will provide income to a disabled or ill person ___________.

Correct Answer
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C

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False

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Correct Answer
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Correct Answer
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Medicare and Medicaid cover ___________.

Correct Answer
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