CEBS - GBA 1: Directing Benefits Programs Part 1 CORRECT 100%
1 view 0 purchase
Course
CEBS - GBA 1:
Institution
CEBS - GBA 1:
______ 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 s...
CEBS - GBA 1: Directing Benefits Programs
Part 1 CORRECT 100%
______ 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
separate company known as a(n): - ANSWERManaged behavioral health care organization (MBHO)
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): - ANSWERCombination plan
A health care plan has no restrictions on a member's choice of provider, there is no "steerage," and
there is no basic utilization management. This type of health care coverage is known as: -
ANSWERIndemnity plan
A healthcare organization is contemplating a possible investment in a new technology and is
conducting a return on investment (ROI) analysis. Which of the following are typically used to define
the returns to be valued?
I. Savings in time
II. Savings in cost
III. Cash returns - ANSWERII and III only
A healthcare organization is contemplating a possible investment in a new technology and is
conducting a return on investment (ROI) analysis. Which of the following are typically used to define
the returns to be valued?I. Savings in timeII. Savings in costIII. Cash returns - ANSWERII and III only
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: - ANSWERControl
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 year, $200 has been contributed to the account
, and the participant incurs $1,200 worth of eligible reimbursable expenses. Which of the following
statements properly describes the maximum allowable claims and payments that can be made on
the account? - ANSWERA claim of $1,200 can be made on the account, and $1,200 will be paid.
A peril as the term applies to the insurance mechanism is defined as: - ANSWERThe cause of a loss
A typical behavioral health specialty network includes which of the following healthprofessionals?
I. Individual practitioners and multispecialty group practices
II. Medical doctors that specialize in addictionology
III. Developmental behavioral pediatricians - ANSWERI, II and III
An employer has only 12 employees, all of whom are full-time. The average annual wage is less than
$50,000. According to the provisions enacted by the Affordable Care Act (ACA):
I. This employer is exempt from the ACA's employer shared responsibility mandate.
II. Tax credits for health coverage might be available to this employer for a limited period if certain
requirements are met.
III. To be eligible for the Small Business Health Options Program (SHOP), insurance must be
purchased for 100% of their full-time employees. - ANSWERI and II only
An example of a healthcare reform that is comprehensive and represents a longer-term set of change
interventions to a range of services is: - ANSWEREnactment of the Affordable Care Act (ACA)
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
$6,000 out-of-pocket maximum. What will the insured pay out of the total medical expenses if this is
the first claim of the plan year? - ANSWER$ 3,600
Are lifestyle drugs covered under prescription benefits? If so, what tier? - ANSWERHave been
routinely excluded from all employer plans.
As wellness programs invest in "total well-being," they are dealing with which of the following types
of issues?
I. Student loan repayment assistance
II. Financial education
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller papersbyjol. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.49. You're not tied to anything after your purchase.
