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Exam 16: Employee Benefits: Group Life and Health Insurance

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Question 21

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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.

A) I only
B) II only
C) both I and II
D) neither I nor II

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Question 22

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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

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Question 23

Multiple Choice

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

Which of the following statements about group short-term disability income plans is true?

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 about group long-term disability income plans is true?

Most group health insurance plans have adopted the coordination-of-benefits rules developed by the National Association of Insurance Commissioners.Under these rules,if a dependent child is covered by both of the health insurance plans of the child's married parents,which health plan is primary for the child's medical expenses?

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.

HMOs typically pay network physicians or medical groups a fixed annual or monthly payment for each member,regardless of the frequency or type of service provided.This payment is called a

An HMO that contracts with two or more independent group practices to provide medical services to covered members is called a(n)

Which of the following statements regarding recent developments in employer-sponsored health plans is (are) true? I.Preferred provider organizations (PPOs) continue to dominate group health insurance markets. II.The number of employers offering medical benefits to workers who retire early has increased.

Which of the following statements about Blue Cross and Blue Shield plans is (are) true? I.Most plans combine Blue Cross and Blue Shield into a single entity. II.Some form of managed care plan covers the majority of Blue Cross and Blue Shield enrollees.

Which of the following statements about group insurance underwriting principles is (are) true? I.If a plan is contributory,100 percent of the eligible employees must be covered. II.Ideally,there should be a flow of younger people into the group and older people out of the group.

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

Under older group medical expense plans,physicians were paid a fee for each covered service and were reimbursed on the basis of reasonable and customary charges,up to a maximum limit.These older group medical expense plans were called

Which of the following statements about group accidental death and dismemberment (AD&D) insurance is (are) true? I.The principal sum is paid if the employee dies in an accident. II.A percentage of the principal sum is paid for certain types of dismemberments.

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

An employer-funded plan with favorable tax advantages,which repays employees for medical care not covered by the employer's standard medical plan is a(n)

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.

Marv is covered by a group health insurance plan at work.His employer funds the entire cost of the group health insurance.Because of this characteristic,the group health insurance plan can be described as