CEBS GBA 2 Practice Exam Questions with Correct Answers

CEBS GBA 2 Practice Exam Questions with Correct Answers 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.) Mental health (based on self-reported measures) - ANSWER-B.) Prior utilization A provision in some group life insurance plans that provides for the payment of all or part of the death benefit in the event of the insured's terminal illness is called: A.) Accelerated death benefits B.) Waiver of premiums C.) Maturity value benefits D.) Continuation-of-protection Copyright © OLIVIAWEST 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 2/47 E.) Assignment - ANSWER-A.) Accelerated death benefits What reasons are given for the Silver plan being a popular choice among all the Affordable Care Act (ACA) health plans? A.) The Silver plan has the greatest actuarial value of all the plans. B.) Cost-sharing subsidies to lower out-of-pocket costs are available only to people who select the Silver plan. C.) The Silver plan has the greatest benefits, even more than the Gold and Platinum plans. D.) The Silver plan has the lowest out-of-pocket costs of any plan even before any subsidies. E.) Many people select the Silver plan because they are not eligible for the Gold or Platinum plans. - ANSWER-B.) Cost-sharing subsidies to lower out-of-pocket costs are available only to people who select the Silver plan. Which of the following measures of cost is generally used by analysts when they are examining the impact of insurance premiums on employees' choice of health insurance plans? A.) The loading percentage B.) The total gross premium C.) The insurer's profit D.) The employee's out-of-pocket price E.) The expected future gross premium - ANSWER-D.) The employee's out-of-pocket price Copyright © OLIVIAWEST 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 3/47 Which of the following statements regarding recognition as a patient-centered medical home (PCMH) is correct? A.) The only organization that can officially recognize a PCMH is the Federally Qualified Health Center Demonstration. B.) The only organization that can officially recognize a PCMH is the National Committee for Quality Assurance (NCQA). C.) No single organization is responsible for recognizing PCMHs. D.) The main organization that recognizes PCMHs is the Joint Commission and the Accreditation Commission for Health Care. E.) A PCMH can be recognized only by the state in which it is domiciled. - ANSWER-C.) No single organization is responsible for recognizing PCMHs. Which of the following statements regarding private health insurance exchanges and Small Business Health Options Program (SHOP) exchanges is correct? A.) A lot of evidence has been produced to show that private exchanges have been designed to make it easier for small business to self-insure. B.) The income tax incentives previously provided to small employers in the SHOP program have expired. C.) Recently states were given the option of making SHOP exchanges mandatory for all employers with fewer than 200 employees. Copyright © OLIVIAWEST 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 4/47 D.) Private exchanges could affect SHOP exchanges by siphoning enrollment from them and thereby reducing revenue (administrative fees) critical to SHOPs' financial viability. E.) Unlike private exchanges, SHOP exchanges do not have the ability to offer small employers a number of plan choices. - ANSWER-D.) Private exchanges could affect SHOP exchanges by siphoning enrollment from them and thereby reducing revenue (administrative fees) critical to SHOPs' financial viability. What is the waiting period for Social Security Disability Income (SSDI) benefits? A.) One month B.) Three consecutive months C.) Five consecutive months D.) Six consecutive months E.) Twelve consecutive months - ANSWER-C.) Five consecutive months "Desktop medicine" is a fully integrated approach using information technology whose primary goal is to: A.) Recruit prospective health plan subscribers B.) Help track patients through their plan of care C.) Encourage patient self-diagnosis using the Internet D.) Gather health status metrics for large patient populations Copyright © OLIVIAWEST 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 5/47 E.) Expedite health provider use of technology - ANSWER-B.) Help track patients through their plan of care Until now, the biggest source of cost savings with private health insurance exchanges has been: A.) Transition to the defined contribution approach B.) Increased use of technology C.) Employees choosing less generous plans D.) Better health education of employees E.) Elimination or reduction in administrative waste - ANSWER-C.) Employees choosing less generous plans Out-of-network health care accounts for approximately what percentage of total covered health insurance expenses? A.) 3 B.) 10 C.) 20 D.) 25 E.) 30 - ANSWER-B.) 10 The major advantage of term insurance for the policyowner is the fact that: Copyright © OLIVIAWEST 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 6/47 A.) A substantial amount of life insurance can be purchased for relatively modest premiums B.) It provides lifetime protection if the insured continues to pay the premiums C.) The premiums remain at the same level for the life of the insured D.) With a policy rider it can be used to provide retirement E.) Premiums are highly competitive especially for those at older ages - ANSWER-A.) A substantial amount of life insurance can be purchased for relatively modest premiums Mr. Smith is insured in his company's group life insurance plan. The plan is noncontributory and meets the requirements of Internal Revenue Code Section 79. How much group life insurance can be provided to Mr. Smith without him incurring a federal income tax liability on the value of his employer's contributions? A.) 0 B.) 25,000 C.) 50,000 D.) 100,000 Copyright © OLIVIAWEST 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 7/47 E.) An unlimited amount - ANSWER-C.) 50,000 Which of the following statements regarding health expenditures and related research is correct? A.) In general, risk adjustment models have been able to predict about 80 percent of total claims. B.) Age and gender account for about 90 percent of explained variation in health care expenditures. C.) Medicare currently pays Medicare Advantage plans on the basis of the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC) model, which uses approximately 70 clinical conditions. D.) Health maintenance organizations (HMOs) that could predict health expenditures only five percentage points better than Medicare would not gain a significant amount of profit per enrollee. E.) Inpatient expenditures are more predictable than outpatient expenditures. - ANSWER-C.) Medicare currently pays Medicare Advantage plans on the basis of the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC) model, which uses approximately 70 clinical conditions. Which of the following has been a key focus of redesign and improvement efforts in healthcare? A.) Hospital care B.) Diagnostic/imaging services C.) Critical care D.) Orthopedic surgery E.) Primary care medicine - ANSWER-E.) Primary care medicine Copyright © OLIVIAWEST 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED Copyright ©Stuvia International BV Page 8/47 Reference pricing used by some managed care health plans: A.) Is an example of center-of-excellence pricing. B.) Is one method of giving subscribers an incentive to use lower-cost but quality providers. C.) Can only be used in a capitation system. D.) Is a model that has not been used in practice. E.) Is designed to attract healthier individuals into the plan. . - ANSWER-B.) Is one method of giving subscribers an incentive to use lower-cost but quality providers The vast majority of long-term care needs are met by: A.) Medicare B.) Medicaid C.) Individual health insurance policie