Exam (elaborations)
CEBS - GBA 1: Directing Benefits Programs Part 1
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- CEBS - GBA 1: Directing Benefits Programs Part 1
CEBS - GBA 1: Directing Benefits Programs Part 1
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CEBS - GBA 1: Directing BenefitsPrograms 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
-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 - -II and III only
-Which of the following is (are) reasons typically cited for offering carved-out
prescription drug plans?
I. The administration costs of carved-out plans are easier to pass along to
participants.
II. Non-carved-out plans often cost more because some retail chain
pharmacy systems turn off monitoring edits when dispensing prescription
drugs to these plans' participants.
III. Pharmacy benefit managers (PBMs) administering carved-out plans are
willing to pay physicians for dispensing certain drugs in the office while non-
carved-out plans refuse to do so. - -None
-Which of the following entities are eligible to participate in a cafeteria plan?
I. Sole proprietors
II. Partners in a partnership
III. 2% or greater shareholders in an S-corporation - -None
-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 - -I, II and III
-The usual steps in an evaluation of a health reform initiative include which
of the following?
I. Describing the reform instrument and the implementation process
II. Gathering data about changes in health service performance and possibly
also in health data
III. Assessing whether these data really are outcomes of the reform - -I, II
and III
, -Insurance can be distinguished from gambling by which of the following
factors?
I. Insurance handles existing risk while gambling creates a new risk.
II. Insurance is a speculative risk and gambling is pure risk.
III. Insurance is based on a mutual sharing of losses that occur while
gambling involves a gain for one party at the expense of another. - -I and III
only
-Which of the following conditions, if satisfied by a participant's spouse,
would allow the participant to claim benefits under a dependent-care
assistance plan for child-care expenses?
I. Spouse is employed
II. Spouse is traveling outside the country
III. Spouse is in another state caring for aged parents - -I only
-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. - -I and
II only
-Which of the following statements describe(s) reforms enacted by the
Affordable Care Act (ACA)?
I. Precluding insurance companies from denying coverage due to a
preexisting condition
II. In general prohibiting group health plans from offering coverage with any
lifetime or annual limits on the dollar value of essential health benefits
III. Imposing coverage requirements on applicable large employers (ALEs)
defined as those with more than 20 full-time employees (including full-time
equivalent employees) - -I and II only
-Which of the following statements is (are) descriptive of the functional
approach to employee benefit plan design?
I. It involves the evaluation of each benefit plan on a product-oriented basis.
II. Using Social Security integration concepts is inconsistent with this
approach.
III. It is an organized system for classifying and analyzing the risks and needs
of various categories of persons into logical categories of exposure to loss
and employee needs. - -III only
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