Podcast
Questions and Answers
What is the term for the maximum amount an insured person must pay per calendar year?
What is the term for the maximum amount an insured person must pay per calendar year?
- Out-of-pocket maximum (correct)
- Lifetime limit
- Preadmission certification
- Coinsurance
What refers to the maximum amount a health plan would cover each year?
What refers to the maximum amount a health plan would cover each year?
- Second surgical opinion
- Preexisting condition
- Yearly limit (correct)
- Dental care
What does a high-deductible health plan (HDHP) combine with a pretax payment account?
What does a high-deductible health plan (HDHP) combine with a pretax payment account?
- Dental care
- Consumer-driven health-care plan (CDHP) (correct)
- Out-of-pocket maximum
- Coinsurance
What is the term for the contract agreement to provide special health-care services such as dental care and mental health and substance abuse care?
What is the term for the contract agreement to provide special health-care services such as dental care and mental health and substance abuse care?
What reduces unnecessary surgical procedures and costs for health plans?
What reduces unnecessary surgical procedures and costs for health plans?
What does dental fee-for-service plans have in common with medical fee-for-service plans?
What does dental fee-for-service plans have in common with medical fee-for-service plans?
How are dental maintenance organizations (dental HMOs) similar to HMOs?
How are dental maintenance organizations (dental HMOs) similar to HMOs?
What do prescription card programs offer?
What do prescription card programs offer?
Which federal law requires employers to treat pregnancy as other disabilities?
Which federal law requires employers to treat pregnancy as other disabilities?
What does the Newborns’ and Mothers’ Health Protection Act of 1996 set minimum standards for?
What does the Newborns’ and Mothers’ Health Protection Act of 1996 set minimum standards for?
What has contributed to the more than 450% increase in healthcare costs since 1984?
What has contributed to the more than 450% increase in healthcare costs since 1984?
Which federal regulation includes amendments such as COBRA, HIPAA, and the Women’s Health and Cancer Rights Act of 1998?
Which federal regulation includes amendments such as COBRA, HIPAA, and the Women’s Health and Cancer Rights Act of 1998?
What does the Health Maintenance Organization Act of 1973 regulate?
What does the Health Maintenance Organization Act of 1973 regulate?
What does the term 'pay or play' refer to in the context of health-care plans?
What does the term 'pay or play' refer to in the context of health-care plans?
Which type of benefits cover hospital expenses not requiring overnight stays?
Which type of benefits cover hospital expenses not requiring overnight stays?
What is the key difference between fully insured plans and self-funded plans?
What is the key difference between fully insured plans and self-funded plans?
What does individual coverage refer to in the context of health insurance?
What does individual coverage refer to in the context of health insurance?
What do plan providers use to determine terms and premium amounts for health-care plans?
What do plan providers use to determine terms and premium amounts for health-care plans?
Who assumes the risk for paying medical claims in fully insured plans?
Who assumes the risk for paying medical claims in fully insured plans?
What do employers pay to establish and maintain health-care plans under fully insured plans?
What do employers pay to establish and maintain health-care plans under fully insured plans?
What is the condition for companies to take deductions for their contribution to health plan premiums?
What is the condition for companies to take deductions for their contribution to health plan premiums?
What are the four areas of responsibility addressed by state laws regulating fully insured plans?
What are the four areas of responsibility addressed by state laws regulating fully insured plans?
How does a prepaid plan pay health-care providers?
How does a prepaid plan pay health-care providers?
What distinguishes a fee-for-service plan from a managed care plan according to the U.S. Bureau of Labor Statistics?
What distinguishes a fee-for-service plan from a managed care plan according to the U.S. Bureau of Labor Statistics?
What does the IRC allow companies to take deductions for?
What does the IRC allow companies to take deductions for?
In a preferred provider organization (PPO), what do physicians receive in return for providing services at a lower level of reimbursement?
In a preferred provider organization (PPO), what do physicians receive in return for providing services at a lower level of reimbursement?
How is an exclusive provider organization similar to a PPO?
How is an exclusive provider organization similar to a PPO?
What feature does a point-of-service (POS) plan share with HMOs?
What feature does a point-of-service (POS) plan share with HMOs?
What is a common feature shared by health-care plans according to the text?
What is a common feature shared by health-care plans according to the text?
What must employees do before the health-care plan pays for benefits, according to the text?
What must employees do before the health-care plan pays for benefits, according to the text?
What percentage of private-sector employees used some form of employer-sponsored healthcare plans in 2015?
What percentage of private-sector employees used some form of employer-sponsored healthcare plans in 2015?
What is the average monthly premium for family coverage for union members in March 2015?
What is the average monthly premium for family coverage for union members in March 2015?
What percentage of the cost did union workers contribute for single coverage in 2015?
What percentage of the cost did union workers contribute for single coverage in 2015?
What has been a significant change in health care benefits since the 1980s?
What has been a significant change in health care benefits since the 1980s?
What is the primary reason for companies to provide employer-sponsored healthcare?
What is the primary reason for companies to provide employer-sponsored healthcare?
What percentage of the overall cost did the lowest paid workers contribute for family coverage in 2015?
What percentage of the overall cost did the lowest paid workers contribute for family coverage in 2015?
How has the availability of health care benefits changed for unmarried opposite sex or same-sex partners since the 1980s?
How has the availability of health care benefits changed for unmarried opposite sex or same-sex partners since the 1980s?
What is the average monthly premium for single coverage for employees in March 2015?
What is the average monthly premium for single coverage for employees in March 2015?
What is the primary reason for extending coverage to unmarried opposite sex or same-sex partners?
What is the primary reason for extending coverage to unmarried opposite sex or same-sex partners?
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