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Test - GBA 1 - Practice Exam: Directing Benefits Programs Part 1
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Test - GBA 1 - Practice Exam: DirectingBenefits Programs Part 1
Which risk-handling techniques are being used by a firm that decides to not
produce a dangerous chemical, to purchase insurance with a $10,000
deductible on its assets and to install a fire sprinkler system throughout the
plant? - -Avoidance, retention, insurance and control
-Which of the following statements regarding prescription drug rebates is
correct? - -A rebate occurs when there is an agreement between a
pharmacy benefit manager and a drug manufacturer.
-There are several methods for evaluating health system performance.
Accreditation by the NCQA is an example of which of the following methods?
- -Audit performance evaluation
-When a participant of a cafeteria plan makes a one-time election on
coverage that stays in force from plan year to plan year unless the
participant elects to make a change during the applicable election period, it
is referred to as a(n): - -Evergreen election
-The benefit-oriented philosophy of designing employee benefits tends to
focus on: - -Needs of employees
-The amount of covered medical expenses that a participant must incur
before any medical benefits for non-preventive care services or treatment
become payable under a plan is known as the: - -Deductible
-The Supreme Court decision in National Federation of Independent Business
v. Sebelius had a profound effect on the implementation of the Affordable
Care Act (ACA). Which of the following statements summarizes the impact of
this case? - -The decision made Medicare expansion by the states voluntary.
-The Affordable Care Act (ACA) aimed to make health insurance more
affordable by providing tax credits to individuals ineligible for other
affordable coverage and with income between which of the following limits: -
-100% and 400% of the federal poverty line.
-The concept designed to make victims of losses whole again reflects the
principle of: - -Indemnification
-A mechanism by which one attempts either to prevent or reduce the
probability of a loss taking place or to reduce the severity of the loss if it
does take place is referred to as: - -Control
, -The Affordable Care Act (ACA), in general, defined a full-time employee as
one employed on average at least how many hours per week? - -30
-Dental treatments are placed into ten professional treatment categories. A
restorative treatment is: - -
-If a cafeteria plan fails to pass the required nondiscrimination testing, then:
- -The highly compensated and key employees are taxed based on the value
of their benefits.
-An insured individual has $12,000 of covered medical expenses for in-
network nonpreventive treatment. His plan is a high-deductible health policy
with a $1,500 deductible and a 20% coinsurance arrangement. Also, the plan
reimburses 100% after an individual reaches the plan's $6,000 out-of-pocket
maximum. What will the insured pay out of the total medical expenses if this
is the first claim of the plan year? - -$ 3,600
-A behavioral health care carve-out program usually operates under a
separate contract and from a separate company known as a(n): - -Managed
behavioral health care organization (MBHO)
-A peril as the term applies to the insurance mechanism is defined as: - -
The cause of a loss
-The "managed care backlash" of the late 1990s gave direct rise to which of
the following types of health care organizations? - -Preferred provider
organizations (PPOs)
-Which of the following is a requirement of the Health Insurance Portability
and Accountability Act (HIPAA) as it applies to wellness programs? - -A
program that is offered directly by an employer outside of a group plan is not
subject to HIPAA privacy rules.
-The maximum annual contribution that can be made to a health savings
account (HSA) is: - -A fixed, indexed amount
-Benefits for so-called lifestyle drugs: - -Have been routinely excluded from
all employer plans.
-A dental plan in which certain procedures are reimbursed on a scheduled
basis and others are reimbursed on a nonscheduled basis is called a(n): - -
Combination plan
-A participant in a health care flexible spending account (FSA) elects to
contribute $1,200 to the account for an entire plan year. One month into the
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