Find Your Perfect Health Insurance Plan

Find Your Perfect Health Insurance Plan

Created by
@ReverentTourmaline

Questions and Answers

Who is the third-party administrator (TPA) for health plans and employers?

Clearwater Benefits Administrators

Which company sells Major Medical and supplemental insurance plans and healthshare memberships?

Boomy Health

Which of the following is NOT a characteristic of Healthshare?

Providers submit claims

Which type of plan offers more comprehensive coverage for everyday care like doctor visits, prescriptions, and diagnostics including out-of-network?

<p>Advanced</p> Signup and view all the answers

What is the age cap for primary members in ClearShare?

<p>65 years old</p> Signup and view all the answers

What is the monthly tobacco surcharge for ClearShare?

<p>$50 per household</p> Signup and view all the answers

Which membership type offers the most comprehensive coverage for day-to-day care, including out-of-network services?

<p>Advanced</p> Signup and view all the answers

What is the maximum benefit per pre-membership medical condition in Year Two?

<p>$50,000</p> Signup and view all the answers

Which type of ClearShare membership is often paired with a Trident MEC plan?

<p>ClearShare-only</p> Signup and view all the answers

For maternity needs, what is the maximum benefit limit?

<p>There is no maximum limit</p> Signup and view all the answers

Which service does Care Coordination for ClearShare provide?

<p>Finding local providers</p> Signup and view all the answers

What is the main purpose of Care Coordination?

<p>To recommend fair-priced, high quality providers</p> Signup and view all the answers

Who can access their own unique Lyric accounts through their own Health Wallet account?

<p>All of the above</p> Signup and view all the answers

Which of the following ClearShare Membership types offers a more comprehensive plan with set amounts for everyday care including out-of-network services?

<p>Advanced</p> Signup and view all the answers

Which ClearShare Membership type offers set amounts for doctor visits and prescriptions in network?

<p>Basic</p> Signup and view all the answers

Which type of plan allows you to pay for day-to-day needs with a tax deductible Health Savings Account (HSA)?

<p>HSA</p> Signup and view all the answers

Which ClearShare Membership type offers more comprehensive coverage for major health incidents and allows you to choose the amount you want to pay for dental, accident, vision, and critical illness?

<p>Advanced</p> Signup and view all the answers

Which of the following best describes a healthshare?

<p>A non-profit organization that helps members cover each other's medical costs</p> Signup and view all the answers

What is the purpose of ClearShare?

<p>To offer healthshare memberships</p> Signup and view all the answers

What role does Clearwater Benefits Administrators play in the healthshare plans?

<p>They handle billing and claims for ClearShare</p> Signup and view all the answers

How are healthshares different from insurance?

<p>Healthshares require members to contribute towards each other's medical costs, while insurance does not</p> Signup and view all the answers

Which of the following is NOT included in the ClearShare community's annual maximum?

<p>Medical expenses shared by the ClearShare community</p> Signup and view all the answers

If a family has a ClearShare 1000 Annual Max and a Family Annual Max of $3,000, how much does the primary member have to pay before the ClearShare community shares in eligible medical expenses?

<p>$1,000</p> Signup and view all the answers

If a family of four has a ClearShare 1000 Annual Max and a Family Annual Max of $3,000, how much does the household have to pay before the ClearShare community shares in eligible medical expenses at 100%?

<p>$2,000</p> Signup and view all the answers

Which of the following conditions would NOT be considered a pre-membership medical condition?

<p>Cancer</p> Signup and view all the answers

Which entity owns the agency and TPA, and houses shared services such as finance, technology, and marketing?

<p>Clearwater Benefits Holdings, LLC</p> Signup and view all the answers

Which company provides virtual assistant services?

<p>Trident</p> Signup and view all the answers

Which company sells Major Medical and supplemental insurance plans and healthshare memberships?

<p>Trident</p> Signup and view all the answers

What is the previous name of the third-party administrator (TPA) for health plans and employers?

<p>Boomy Health</p> Signup and view all the answers

Which of the following is NOT a major incident covered by ClearShare Membership Options?

<p>Prescriptions</p> Signup and view all the answers

What is the monthly cost or monthly contribution for an Advanced ClearShare Membership?

<p>$1,000</p> Signup and view all the answers

Which of the following is NOT a supplemental insurance offered by ClearShare?

<p>Life</p> Signup and view all the answers

What is the maximum benefit per pre-membership medical condition in Year Two for ClearShare Memberships?

<p>$5,000</p> Signup and view all the answers

Which ClearShare Membership type offers set amounts for doctor visits and prescriptions in network?

<p>Basic</p> Signup and view all the answers

What is the maximum benefit per pre-membership medical condition in Year Two?

<p>$25,000</p> Signup and view all the answers

Which of the following is NOT a role played by Clearwater in the healthshare plans?

<p>Third-party administrator</p> Signup and view all the answers

Which type of ClearShare membership is often paired with a Trident MEC plan?

<p>ClearShare-only</p> Signup and view all the answers

Which of the following is a characteristic of healthshares?

<p>They provide medical cost sharing</p> Signup and view all the answers

Which type of plan offers more comprehensive coverage for everyday care like doctor visits, prescriptions, and diagnostics including out-of-network?

<p>Advanced</p> Signup and view all the answers

Which ClearShare Membership type offers more comprehensive coverage for major health incidents and allows you to choose the amount you want to pay for dental, accident, vision, and critical illness?

<p>Advanced ClearShare 1000</p> Signup and view all the answers

Which of the following is included in the ClearShare community's annual maximum?

<p>Dental and vision expenses</p> Signup and view all the answers

Which of the following is NOT a primary level of personal responsibility in ClearShare?

<p>$10000</p> Signup and view all the answers

If a family of four has a ClearShare 1000 Annual Max and a Family Annual Max of $3,000, how much does the household have to pay before the ClearShare community shares in eligible medical expenses at 100%?

<p>$3000</p> Signup and view all the answers

Which of the following conditions would be considered a pre-membership medical condition in ClearShare?

<p>Cancer</p> Signup and view all the answers

What is the maximum benefit limit for maternity needs in ClearShare?

<p>$5000</p> Signup and view all the answers

Which ClearShare Membership type offers set amounts for doctor visits and prescriptions in network?

<p>Basic</p> Signup and view all the answers

What is the purpose of ClearShare?

<p>To provide day-to-day coverage for everyday care</p> Signup and view all the answers

Which ClearShare Membership type offers more comprehensive coverage for major health incidents and allows you to choose the amount you want to pay for dental, accident, vision, and critical illness?

<p>Advanced</p> Signup and view all the answers

Which type of ClearShare membership is often paired with a Trident MEC plan?

<p>HSA</p> Signup and view all the answers

Which service does Care Coordination for ClearShare provide?

<p>Finding and recommending fair-priced, high quality providers</p> Signup and view all the answers

What is the main purpose of Care Coordination?

<p>To find and recommend fair-priced, high quality providers</p> Signup and view all the answers

Who can access their own unique Lyric accounts through their own Health Wallet account?

<p>Primary members, spouses, and dependents aged 18-26</p> Signup and view all the answers

What is the maximum benefit per pre-membership medical condition in Year Two?

<p>$150,000</p> Signup and view all the answers

Which ClearShare Membership type offers more comprehensive coverage for major health incidents and allows you to choose the amount you want to pay for dental, accident, vision, and critical illness?

<p>Supplemental Plan</p> Signup and view all the answers

What role does Clearwater Benefits Administrators play in the healthshare plans?

<p>Third-party administrator (TPA) for health plans and employers</p> Signup and view all the answers

Trident sponsors several insurance plans for Limited Partners.

<p>True</p> Signup and view all the answers

The agency or healthcare brokerage that does the selling is Clearwater Benefits Holdings, LLC.

<p>False</p> Signup and view all the answers

ClearShare Merge Memberships offer more comprehensive coverage for major health incidents and allow you to choose the amount you want to pay for dental, accident, vision, and critical illness.

<p>True</p> Signup and view all the answers

A healthshare is a type of insurance that is bound by state and federal government laws and regulations.

<p>False</p> Signup and view all the answers

ClearShare-only memberships are often paired with a Trident MEC plan.

<p>True</p> Signup and view all the answers

Clearwater Benefits Administrators handles billing for ClearShare plans.

<p>False</p> Signup and view all the answers

Healthshares are not-for-profit organizations that provide an organized structure for members to contribute towards each other's medical costs.

<p>True</p> Signup and view all the answers

ClearShare-only memberships are often paired with a Trident MEC plan.

<p>True</p> Signup and view all the answers

ClearShare Membership types offer set amounts for doctor visits and prescriptions in network.

<p>True</p> Signup and view all the answers

The ClearShare community's annual maximum includes dental, accident, vision, and critical illness coverage.

<p>False</p> Signup and view all the answers

Clearwater is the third-party administrator (TPA) for health plans and employers.

<p>True</p> Signup and view all the answers

Care Coordination can help you find local providers if the primary and secondary network doesn’t provide the coverage you need in your area.

<p>True</p> Signup and view all the answers

Care Coordination works to find and recommend you a fair-priced, high quality provider.

<p>True</p> Signup and view all the answers

Primary members, spouses, and dependents aged 18-26 can access their own unique Lyric accounts through their own Health Wallet account.

<p>True</p> Signup and view all the answers

True or false: Pre-membership medical conditions are not shareable in the first year of membership?

<p>False</p> Signup and view all the answers

True or false: Expenses related to pre-membership medical conditions can be shareable at a maximum of $125,000 after year four of membership?

<p>True</p> Signup and view all the answers

True or false: Maternity needs are treated differently and are not shareable like any other medical need?

<p>False</p> Signup and view all the answers

True or false: Conception that occurs prior to membership or within the first 60 days of membership is eligible for sharing with a $50,000 limit?

<p>True</p> Signup and view all the answers

True or false: The annual maximum is the amount that a member will pay before the ClearShare community shares in medical expenses.

<p>True</p> Signup and view all the answers

True or false: Service copays or service costs that apply to a member’s deductible are included in the annual maximum.

<p>False</p> Signup and view all the answers

True or false: If a family has a ClearShare 1000 Annual Max and a Family Annual Max of $3,000, the primary member has to pay $1,000 before the ClearShare community shares in eligible medical expenses.

<p>True</p> Signup and view all the answers

True or false: High blood pressure, high cholesterol, and diabetes (types 1 and 2) will be considered pre-membership medical conditions even if the member has not been hospitalized for the condition in the 12 months prior to the effective date.

<p>False</p> Signup and view all the answers

True or false: ClearShare-only membership offers more comprehensive coverage for major health incidents compared to Basic membership?

<p>False</p> Signup and view all the answers

True or false: The HSA portion of the plan is a Trident Minimum Essential Coverage (MEC) plan?

<p>True</p> Signup and view all the answers

True or false: ClearShare membership options include Advanced, Basic, and HSA?

<p>True</p> Signup and view all the answers

True or false: Care Coordination for ClearShare helps members lower their healthcare costs by connecting them with lower cost, high quality providers for labs, imaging, and major procedures?

<p>True</p> Signup and view all the answers

Use Quizgecko on...
Browser
Browser