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Broad view of Employee Benefits (Mod 1.1) - ANSWERConsiders Employee Benefits to be virtually any form of compensation other than direct wages paid to Employees (Ex: WC, Unemployment, State DI, SS, Vacation, Holidays, 401K/Retirement, Employer share of Medical, Severance Pay, Child Care, etc..) N...
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Add to cartBroad view of Employee Benefits (Mod 1.1) - ANSWERConsiders Employee Benefits to be virtually any form of compensation other than direct wages paid to Employees (Ex: WC, Unemployment, State DI, SS, Vacation, Holidays, 401K/Retirement, Employer share of Medical, Severance Pay, Child Care, etc..) N...
Which of the following statements correctly describes minimum requirements that group benefit plans typically must meet in order to be prospectively rated on contract renewal? - ANSWERThe more unpredictable the event that will trigger a claim, the larger the minimum group size and premium requiremen...
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Add to cartWhich of the following statements correctly describes minimum requirements that group benefit plans typically must meet in order to be prospectively rated on contract renewal? - ANSWERThe more unpredictable the event that will trigger a claim, the larger the minimum group size and premium requiremen...
According to the RAND Health Insurance Experiment, which variable has the greatest power in explaining health expenditures? A.) Welfare eligibility B.) Prior utilization C.) Physical health (based on self-reported measures) D.) General health (based on self-reported measures) E.) Ment...
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Add to cartAccording to the RAND Health Insurance Experiment, which variable has the greatest power in explaining health expenditures? A.) Welfare eligibility B.) Prior utilization C.) Physical health (based on self-reported measures) D.) General health (based on self-reported measures) E.) Ment...
Fringe Benefits - ANSWERAddition of benefits as an offset to higher labor Broad View - ANSWER"Virtually any form of compensation other than direct wages" Limited (Narrow) View - ANSWERBenefits that stem from an employment relationship, not underwritten or paid for directly by the governm...
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Add to cartFringe Benefits - ANSWERAddition of benefits as an offset to higher labor Broad View - ANSWER"Virtually any form of compensation other than direct wages" Limited (Narrow) View - ANSWERBenefits that stem from an employment relationship, not underwritten or paid for directly by the governm...
Broad view of Employee Benefits - ANSWERThis view sees employee benefits as virtually any form of compensation other than direct wages. Components of the Broad view of Employee Benefits - ANSWER1. Employer's share of legally required payments (Social Security and Medicare, unemployment insuran...
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Add to cartBroad view of Employee Benefits - ANSWERThis view sees employee benefits as virtually any form of compensation other than direct wages. Components of the Broad view of Employee Benefits - ANSWER1. Employer's share of legally required payments (Social Security and Medicare, unemployment insuran...
Broad View of Employee Benefits - ANSWERAny from of compensation other than direct wages. Includes government mandated plans and private plans (Social Security, paid vacation and pension plans) Narrow View of Employee Benefits - ANSWERAny type of plan sponsored or initiated unilaterally or jointl...
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Add to cartBroad View of Employee Benefits - ANSWERAny from of compensation other than direct wages. Includes government mandated plans and private plans (Social Security, paid vacation and pension plans) Narrow View of Employee Benefits - ANSWERAny type of plan sponsored or initiated unilaterally or jointl...
Employee Benefits - ANSWERAll forms of financial returns and tangible services and benefits employees receive as apart of an employee relationship Broad View of Employee Benefits - ANSWERVirtually any form of compensation other than direct wages, including: 1. Employer's share of legally req...
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Add to cartEmployee Benefits - ANSWERAll forms of financial returns and tangible services and benefits employees receive as apart of an employee relationship Broad View of Employee Benefits - ANSWERVirtually any form of compensation other than direct wages, including: 1. Employer's share of legally req...
______ View is any type of plan sponsored and engaged in providing benefits that result from employment relationship and that are not underwritten or paid directly by government - ANSWERNarrow View A behavioral health care carve-out program usually operates under a separate contract and from a se...
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Add to cart______ View is any type of plan sponsored and engaged in providing benefits that result from employment relationship and that are not underwritten or paid directly by government - ANSWERNarrow View A behavioral health care carve-out program usually operates under a separate contract and from a se...
A prescription drug rebate occurs when: - ANSWERThere is an agreement between a pharmacy benefit manager and a drug manufacturer. The concept designed to make victims of losses whole again reflect the principle of: - ANSWERIndemnification A healthcare plan that has no restrictions on a member...
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Add to cartA prescription drug rebate occurs when: - ANSWERThere is an agreement between a pharmacy benefit manager and a drug manufacturer. The concept designed to make victims of losses whole again reflect the principle of: - ANSWERIndemnification A healthcare plan that has no restrictions on a member...
Employee Benefits - ANSWERAll forms of financial returns and tangible services and benefits employees receive as part of an employment relationship Broad View of Employee Benefits - ANSWEREmployee benefits are virtually any form of compensation other than direct wages What benefits are include...
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Add to cartEmployee Benefits - ANSWERAll forms of financial returns and tangible services and benefits employees receive as part of an employment relationship Broad View of Employee Benefits - ANSWEREmployee benefits are virtually any form of compensation other than direct wages What benefits are include...
Broad View of Employee Benefits - ANSWERAny form of compensation other than direct wages Narrow View of Employee Benefits - ANSWERAny type of plan sponsored or initiated, unilaterally or jointly, by employers and employees engaged in providing benefits that result from the employment relationship...
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Add to cartBroad View of Employee Benefits - ANSWERAny form of compensation other than direct wages Narrow View of Employee Benefits - ANSWERAny type of plan sponsored or initiated, unilaterally or jointly, by employers and employees engaged in providing benefits that result from the employment relationship...
ERISA - ANSWEREmployee Retirement Income Security Act 1974 SOC Reports - ANSWERService Organization Controls: for external vendors SOC 1 - ANSWERInternal Controls & Financial reports; used by auditors SOC 2 - ANSWERSecurity, availability, processing integrity, confidentiality and privacy co...
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Add to cartERISA - ANSWEREmployee Retirement Income Security Act 1974 SOC Reports - ANSWERService Organization Controls: for external vendors SOC 1 - ANSWERInternal Controls & Financial reports; used by auditors SOC 2 - ANSWERSecurity, availability, processing integrity, confidentiality and privacy co...
Categorize the broad approaches to health care reimbursement methodologies. - ANSWERA limited number of payment methodologies are used to reimburse providers. Payment methodologies fall into two broad classifications: fee-for-service and capitation. Under fee-for-service, of which many variations ex...
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Add to cartCategorize the broad approaches to health care reimbursement methodologies. - ANSWERA limited number of payment methodologies are used to reimburse providers. Payment methodologies fall into two broad classifications: fee-for-service and capitation. Under fee-for-service, of which many variations ex...
Integrated Health Systems - ANSWERComprised of physicians, multi-specialty physicians, entire hospitals and ancillary service providers. HIPAA - ANSWERImportant role in protecting sensitive patient information. Delta Dental Plans - ANSWERCover the largest share of the dental benefits populatio...
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Add to cartIntegrated Health Systems - ANSWERComprised of physicians, multi-specialty physicians, entire hospitals and ancillary service providers. HIPAA - ANSWERImportant role in protecting sensitive patient information. Delta Dental Plans - ANSWERCover the largest share of the dental benefits populatio...
3 types of total compensation/benefits policies that an employer could adopt - ANSWER1. follow the company's own prevailing compensation/benefits level in their firms industry or community or both 2. high comp/benefits policies attempt to attract higher levels of managment, technical and general...
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Add to cart3 types of total compensation/benefits policies that an employer could adopt - ANSWER1. follow the company's own prevailing compensation/benefits level in their firms industry or community or both 2. high comp/benefits policies attempt to attract higher levels of managment, technical and general...
Briefly summarize the methods that can be used for handling risk (39-42) - ANSWER1) avoidance : Avoidance means that you avoid the risk altogether. You can't break your leg skiing if you don't go skiing 2) Control: Reducing the risk of something.. ex: reducing your risk of a heart attack by gi...
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Add to cartBriefly summarize the methods that can be used for handling risk (39-42) - ANSWER1) avoidance : Avoidance means that you avoid the risk altogether. You can't break your leg skiing if you don't go skiing 2) Control: Reducing the risk of something.. ex: reducing your risk of a heart attack by gi...
31 day continuation of protection - ANSWERextra days of protection while looking at the conversion privilege or waiting for coverage to start about how many group life policies are in force? - ANSWER46% of all life policies in force. value at $8.7 trillion accelerated benefits - ANSWERplans wi...
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Add to cart31 day continuation of protection - ANSWERextra days of protection while looking at the conversion privilege or waiting for coverage to start about how many group life policies are in force? - ANSWER46% of all life policies in force. value at $8.7 trillion accelerated benefits - ANSWERplans wi...
Adjusted community rating - ANSWERNot giving credit to a plan for favorable risk attributes associated with a healthy population. This makes health insurance more affordable for those with higher risk. Administrative enhancements when opting to self-fund - ANSWERMore transparency and use of bundl...
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Add to cartAdjusted community rating - ANSWERNot giving credit to a plan for favorable risk attributes associated with a healthy population. This makes health insurance more affordable for those with higher risk. Administrative enhancements when opting to self-fund - ANSWERMore transparency and use of bundl...
attraction of private exchanges for employers - ANSWEROne big attraction of private exchanges for employers is the opportunity to change from a traditional premium contribution model, where the employer typically pays 75-80% of the premium, or premium equivalent rate, to a defined contribution mo...
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Add to cartattraction of private exchanges for employers - ANSWEROne big attraction of private exchanges for employers is the opportunity to change from a traditional premium contribution model, where the employer typically pays 75-80% of the premium, or premium equivalent rate, to a defined contribution mo...
31 day continuation of protection - ANSWERextra days of protection while looking at the conversion privilege or waiting for coverage to start about how many group life policies are in force? - ANSWER46% of all life policies in force. value at $8.7 trillion accelerated benefits - ANSWERplans wi...
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Add to cart31 day continuation of protection - ANSWERextra days of protection while looking at the conversion privilege or waiting for coverage to start about how many group life policies are in force? - ANSWER46% of all life policies in force. value at $8.7 trillion accelerated benefits - ANSWERplans wi...
Attorney-client privilege as applied to ee benefit plans - ANSWERAs a general rule, attorney-client privilege applies; however, courts have increasingly recognized that an exception may exist in communications involving fiduciary activities. Categories of company goals for DC retirement plans - A...
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Add to cartAttorney-client privilege as applied to ee benefit plans - ANSWERAs a general rule, attorney-client privilege applies; however, courts have increasingly recognized that an exception may exist in communications involving fiduciary activities. Categories of company goals for DC retirement plans - A...
1.1 - If premium is $1,000 and loading fee is 40%, what is the gross premium? - ANSWERThe gross premium = pure premium divided by (1-loading%). $1000/(1-.40=.60), $1000/.60=$1,666.67. The gross premium is $1,666.67. 1.2 What is included in the loading percentage? - ANSWERit includes objective ris...
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Add to cart1.1 - If premium is $1,000 and loading fee is 40%, what is the gross premium? - ANSWERThe gross premium = pure premium divided by (1-loading%). $1000/(1-.40=.60), $1000/.60=$1,666.67. The gross premium is $1,666.67. 1.2 What is included in the loading percentage? - ANSWERit includes objective ris...
ACA requirements for insurers - ANSWER(a) Insurers may no longer exclude members based on preexisting conditions. (b) Insurers may not place annual or lifetime caps on coverage. (c) All fully insured products must comply with a medical loss ratio (MLR) requirement. It mandates that health insuran...
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Add to cartACA requirements for insurers - ANSWER(a) Insurers may no longer exclude members based on preexisting conditions. (b) Insurers may not place annual or lifetime caps on coverage. (c) All fully insured products must comply with a medical loss ratio (MLR) requirement. It mandates that health insuran...
Sick pay - ANSWERWith the exception of a few jurisdictions that mandate nonoccupational disability insurance, employers have had no statutory responsibility to pay individuals who are sick or injured and missing work for reasons other than those that qualify for workers' compensation benefits....
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Add to cartSick pay - ANSWERWith the exception of a few jurisdictions that mandate nonoccupational disability insurance, employers have had no statutory responsibility to pay individuals who are sick or injured and missing work for reasons other than those that qualify for workers' compensation benefits....
1. Dental Plan Design Features - ANSWERThree factors that affect the cost of a dental plan include: 1. The design of the plan 2. Characteristics of the covered group 3. The employer's approach to plan implementation 10 categories of dental treatments - ANSWER1. Diagnostic- routine oral exam...
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Add to cart1. Dental Plan Design Features - ANSWERThree factors that affect the cost of a dental plan include: 1. The design of the plan 2. Characteristics of the covered group 3. The employer's approach to plan implementation 10 categories of dental treatments - ANSWER1. Diagnostic- routine oral exam...
A plan administrator who is seeking to engage a well-qualified auditor will focus all discussions to matters specific to their own plan(s). To encourage a productive discussion, the plan administrator should provide a potential audit firm with a number of items. List these items. - ANSWERa. Plan doc...
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Add to cartA plan administrator who is seeking to engage a well-qualified auditor will focus all discussions to matters specific to their own plan(s). To encourage a productive discussion, the plan administrator should provide a potential audit firm with a number of items. List these items. - ANSWERa. Plan doc...
3 basic types of funding arrangements of an MBHO - ANSWER1. fully insured -MBHOs assume the financial risk for providing behavioral services paying the claims submitted by providers for behavioral services rendered. Financial risk falls on the MBHO. When overall plan costs exceed expected levels,...
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Add to cart3 basic types of funding arrangements of an MBHO - ANSWER1. fully insured -MBHOs assume the financial risk for providing behavioral services paying the claims submitted by providers for behavioral services rendered. Financial risk falls on the MBHO. When overall plan costs exceed expected levels,...
ACA's guaranteed availability of insurance raise concerns of adverse selection, why? - ANSWERWith the guaranteed availability of insurance, consumers who are most in need of health care may be more likely to purchase insurance. Such an outcome would create an adverse selection problem. It could...
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Add to cartACA's guaranteed availability of insurance raise concerns of adverse selection, why? - ANSWERWith the guaranteed availability of insurance, consumers who are most in need of health care may be more likely to purchase insurance. Such an outcome would create an adverse selection problem. It could...
"taking the expected value" - ANSWERrefers to the process of accounting for the impact of probability abridged financial report - ANSWERan annual report that is provided in the renewal process from non-refund plans. It shows only premiums, claims and waiver of premium and/ or disabled reser...
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Add to cart"taking the expected value" - ANSWERrefers to the process of accounting for the impact of probability abridged financial report - ANSWERan annual report that is provided in the renewal process from non-refund plans. It shows only premiums, claims and waiver of premium and/ or disabled reser...
3 Types of Hazard - ANSWER1. Physical 2. Moral 3. Morale Advantages of Using Insurance for EE Benefit Plan - ANSWER1. Known premium (control over budget) 2. Outside administration (disputes handled by insurance company) 3. Financial backing (employees may prefer outside funding) 4. Cost mana...
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Add to cart3 Types of Hazard - ANSWER1. Physical 2. Moral 3. Morale Advantages of Using Insurance for EE Benefit Plan - ANSWER1. Known premium (control over budget) 2. Outside administration (disputes handled by insurance company) 3. Financial backing (employees may prefer outside funding) 4. Cost mana...
What was the purpose of the Health Maintenance Organization Act of 1973? - ANSWERThe health maintenance organization action of 1973 provided federal initiatives - consisted of federal grants and loans to organizations wishing to investigate the feasibility of "federally qualified HMO" Why d...
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Add to cartWhat was the purpose of the Health Maintenance Organization Act of 1973? - ANSWERThe health maintenance organization action of 1973 provided federal initiatives - consisted of federal grants and loans to organizations wishing to investigate the feasibility of "federally qualified HMO" Why d...
Benefit plan management - ANSWERThe activities of plan design, plan administration, and plan funding. Insurance solvency - ANSWERA regulatory requirement for financial soundness. Single‐employer plan - ANSWERPlans with the most prevalent type of plan sponsor Insurer's market...
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Add to cartBenefit plan management - ANSWERThe activities of plan design, plan administration, and plan funding. Insurance solvency - ANSWERA regulatory requirement for financial soundness. Single‐employer plan - ANSWERPlans with the most prevalent type of plan sponsor Insurer's market...
A global trend taking place in defined contribution retirement plans is: - ANSWERA. Greater reliance on plans with default investments A pension plan investment carries an expense of 2 %. If the expenses are decreased by 50 basis points, what will be the new level of expenses? - ANSWERD. 1.50% ...
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Add to cartA global trend taking place in defined contribution retirement plans is: - ANSWERA. Greater reliance on plans with default investments A pension plan investment carries an expense of 2 %. If the expenses are decreased by 50 basis points, what will be the new level of expenses? - ANSWERD. 1.50% ...
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