Podcast
Questions and Answers
What is the main similarity between dental fee-for-service plans and medical fee-for-service plans?
What is the main similarity between dental fee-for-service plans and medical fee-for-service plans?
- Both are managed by HMOs and PPOs
- Both are owned by state dental associations
- Both offer vision insurance plans
- Both cover routine and necessary procedures (correct)
In what way are dental maintenance organizations (dental HMOs) most similar to HMOs?
In what way are dental maintenance organizations (dental HMOs) most similar to HMOs?
- Both have minimum standards for hospital stays
- Both offer prescription drug plans
- Both provide maternity care benefits
- Both focus on cost-effective preventive care (correct)
What do prescription card programs offer?
What do prescription card programs offer?
- Coverage for chronic conditions through mail-order prescription drug programs
- Benefits for maternity care
- Reimbursement of some or all of the medical costs
- Prepaid benefits with nominal copayments (correct)
Which federal law requires employers to treat pregnancy as other disabilities?
Which federal law requires employers to treat pregnancy as other disabilities?
What do dental service corporations represent?
What do dental service corporations represent?
In a fee-for-service plan, who receives the cash benefit?
In a fee-for-service plan, who receives the cash benefit?
What is a key characteristic of managed care plans?
What is a key characteristic of managed care plans?
Which type of managed care plan may cover emergency care outside the network?
Which type of managed care plan may cover emergency care outside the network?
What is a characteristic of a staff model HMO?
What is a characteristic of a staff model HMO?
What do prepaid group practices cover in an open-access HMO?
What do prepaid group practices cover in an open-access HMO?
What is the main reason for the 450% increase in healthcare costs since 1984?
What is the main reason for the 450% increase in healthcare costs since 1984?
What type of benefits cover hospital expenses not requiring overnight stays?
What type of benefits cover hospital expenses not requiring overnight stays?
Which federal regulation oversees the enforcement of the American with Disabilities Act (ADA)?
Which federal regulation oversees the enforcement of the American with Disabilities Act (ADA)?
What is the main action of the Employee Retirement Income Security Act of 1974 (ERISA)?
What is the main action of the Employee Retirement Income Security Act of 1974 (ERISA)?
What is the consequence for companies known to 'pay or play' but fail to offer affordable coverage?
What is the consequence for companies known to 'pay or play' but fail to offer affordable coverage?
In a point-of-service (POS) plan, what is a requirement that distinguishes it from a PPO?
In a point-of-service (POS) plan, what is a requirement that distinguishes it from a PPO?
How is an exclusive provider organization (EPO) different from a PPO?
How is an exclusive provider organization (EPO) different from a PPO?
What do health-care plans commonly require employees to do before paying for benefits?
What do health-care plans commonly require employees to do before paying for benefits?
What is a feature commonly shared by point-of-service (POS) plans and HMOs?
What is a feature commonly shared by point-of-service (POS) plans and HMOs?
What is the main distinguishing factor of preferred provider organizations (PPOs)?
What is the main distinguishing factor of preferred provider organizations (PPOs)?
What distinguishes a prepaid plan from an indemnity plan?
What distinguishes a prepaid plan from an indemnity plan?
What is a key difference in the tax regulations for insurance plans and self-funded plans?
What is a key difference in the tax regulations for insurance plans and self-funded plans?
Which organization addresses issues related to state regulations for health-care plans?
Which organization addresses issues related to state regulations for health-care plans?
Under state regulations, what is one of the four areas of responsibility that every state law addresses for fully insured plans?
Under state regulations, what is one of the four areas of responsibility that every state law addresses for fully insured plans?
What do tax regulations allow companies to take deductions for in relation to health plan premiums?
What do tax regulations allow companies to take deductions for in relation to health plan premiums?
What does coinsurance refer to in health-care plans?
What does coinsurance refer to in health-care plans?
What is meant by 'out-of-pocket maximum' in health-care plans?
What is meant by 'out-of-pocket maximum' in health-care plans?
What is the purpose of preadmission certification of medical necessity for hospitalization in health-care plans?
What is the purpose of preadmission certification of medical necessity for hospitalization in health-care plans?
What is the main characteristic of a high-deductible health insurance plan (HDHP) in consumer-driven health care?
What is the main characteristic of a high-deductible health insurance plan (HDHP) in consumer-driven health care?
What is the purpose of carve-out plans in employer-provided health-care benefits?
What is the purpose of carve-out plans in employer-provided health-care benefits?
What is the main distinction between fully insured and self-funded health-care plans?
What is the main distinction between fully insured and self-funded health-care plans?
In the context of health-care plans, what does 'single coverage' refer to?
In the context of health-care plans, what does 'single coverage' refer to?
In the U.S. healthcare system, what does a multiple-payer system mean?
In the U.S. healthcare system, what does a multiple-payer system mean?
What is the main difference between fee-for-service plans and consumer-driven health care?
What is the main difference between fee-for-service plans and consumer-driven health care?
What do mortality tables indicate in the context of fully insured health-care plans?
What do mortality tables indicate in the context of fully insured health-care plans?
What is the primary factor that makes self-funding sensible for employers in providing health-care coverage?
What is the primary factor that makes self-funding sensible for employers in providing health-care coverage?
What do morbidity tables express in the context of health-care plans?
What do morbidity tables express in the context of health-care plans?
In fully insured plans, what do experience ratings specify?
In fully insured plans, what do experience ratings specify?
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