RMIN 4000 UGA Brown Test 4 Questions and Answers (Rated A+)
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RMIN 4000 UGA Brown
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RMIN 4000 UGA Brown
RMIN 4000 UGA Brown Test 4 Questions and Answfee-for-serive - ANSWER-a separate fee is paid for each service
copayment - ANSWER-flat amount the insured must pay each time health services are received
calendar year deductible - ANSWER-an aggregate deductible that has to be satisfied only once ...
RMIN 4000 UGA Brown Test 4 Questions and Answers (Rated A+)
fee-for-serive - ANSWER-a separate fee is paid for each service
copayment - ANSWER-flat amount the insured must pay each time health services are received
calendar year deductible - ANSWER-an aggregate deductible that has to be satisfied only once during the calendar year
coinsurance - ANSWER-the percentage of the medical expenses the policyholder must pay in addition to the deductible amount
Out-of-pocket maximum (stop-loss limit) - ANSWER-the most the insured will have to pay out-of-pocket in a calendar year
managed care plan - ANSWER-a health care plan that is designed to lower costs for both the insurer and the consumer while maintaining a high standard of care
health maintenance organization (HMO) - ANSWER-system that provides healthcare to its members on a prepaid basis in a particular area
capitation fee - ANSWER-a fixed annual payment for each plan member regardless of the frequency or type of service provided
advantages of HMO - ANSWER-low cost sharing, good communication between providers
disadvantages of HMO - ANSWER-no out of network coverage, must get referrals
preferred provider organizations (PPO) - ANSWER-plan that contracts with healthcare providers to provide certain medical services at discounted fees
advantages of PPO - ANSWER-no referral needed, can see out of network providers
disadvantages of PPO - ANSWER-more cost-sharing, less efficient communication, more complicated billing
point of service plan (POS) - ANSWER-hybrid of HMO and PPO consumer directed health care plan (CDHP) - ANSWER-plan that combines a high-
deductible plan with a health savings account
health savings account (HSA) - ANSWER-tax exempt account established exclusively for the purpose of lying medical expenses - high deductible plans only
flexible spending account (FSA) - ANSWER-permits employees to pay for certain unreimbursed medical expenses with before tax dollars - cannot be used with high deductible plan
long-term care insurance - ANSWER-pays a daily/monthly benefit for medical or custodial care received in a nursing facility, hospital, or at home
disability-income insurance - ANSWER-provides income payments when the insured is unable to work because of sickness or injury
total disability - ANSWER-inability to perform the material and substantial duties of your regular occupation
partial disability - ANSWER-you can perform some but not all of the duties of your occupation
residual disability - ANSWER-applies when you are gainfully employed and not totally disabled but, solely because of sickness or injury, our loss of income is at least 15 percent of your prior income
dental insurance - ANSWER-pays the cost of norma dental care, orthodontics not usually covered
vision insurance - ANSWER-coverage for routine eyesore, usually does not cover the full cost of glasses or contacts
types of legal wrongs - ANSWER-crime, breach of contract, tort
tort - ANSWER-a legal wrong for which the court allows a remedy in the form of monetary damages
3 categories of tort - ANSWER-intentional, strict liability, negligence
intentional tort - ANSWER-intentional act or omission resulting in harm or injury to another person or damage to their property
strict liability - ANSWER-liability imposed regardless of negligence or fault (ex: defective
products, workers comp)
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