GBA 2 Practice Exam Questions
and Answers All Correct
Which of the following statements regarding the condition of the delivery of health care
is (are) correct? - Answer-Studies show only incremental improvements in health care
disparities among different segments of the U.S. population.
Most primary care practices are financially insecure.
Which of the following statements regarding the financing of workers' compensation
programs is (are) correct? - Answer-Workers' compensation programs are based on the
principle that the cost of work-related accidents is a business expense.
Which of the following statements regarding the loading percentage for health insurance
rates is (are) correct? - Answer-The loading percentage is lower for group health
insurance rates than it is for individual health insurance rates.
The Affordable Care Act imposes penalties on insurers if their loading fees are too high.
Which of the following statements regarding the methodology used by the Affordable
Care Act's risk adjustment program is (are) correct? - Answer-The risk adjustment
program transfers funds from plans with lower-risk enrollees to plans with higher-risk
enrollees.
If an enrollee is receiving subsidies to reduce his or her cost sharing, an induced
utilization factor is applied to account for induced demand.
Which of the following statements regarding the self-funding of health benefits by small
firms are correct? - Answer-Total costs in self-funded plans are lower relative to fully
insured product options in large part because traditional insurance premiums include
carrier marketing costs and profit margins—factors that are not applicable to self-funded
plans.
With a self-funded plan, a small employer can personalize a benefits package to reflect
the needs of its workers.
A shift to self-insurance may lead to adverse selection in the fully insured market for
small groups.
, Which of the following statements regarding the size of price concessions managed
care plans can negotiate with hospitals is (are) correct? - Answer-Virtually no managed
care plans pay full billed
There apparently is no direct relationship between the size of the discount and the
actual price of hospital services.
Which of the following statements regarding the so-called "death spiral" in health
insurance premiums is (are) correct? - Answer-To counter problems arising from
adverse selection, risk adjustment methods can be used to transfer funds from plans
with below-average costs to plans with above-average costs.
Which of the following statements regarding the strategies that can be used to pursue
quality improvement (QI) is (are) correct? - Answer-One of the top strategies that has
been identified is to delegate authority to the implementation planners.
A study examined the elements that affect health insurer price negotiations in selective
contracting with hospitals. The study concluded that insurers are able to obtain lower
prices in all the following situations EXCEPT: - Answer-When the insurer is small, i.e.,
has assets lower than a certain amount.
After extensive study and research, certain conclusions can be drawn regarding the
various approaches to achieve quality improvements in health care. All the following
statements concerning these conclusions are correct EXCEPT: - Answer-Payment
systems have little impact on quality improvements.
All of the following are criteria utilized by the National Committee For Quality Assurance
(NCQA) in awarding a "Distinction in Patient Experience Reporting" to medical homes
EXCEPT: - Answer-Provider personality ratings
All of the following are factors a stop-loss insurer might consider when underwriting a
health care policy for an employer EXCEPT: - Answer-Anonymized medical surveys of
existing policies' covered employees
All of the following are reasons cited for consumers being reluctant to purchase long-
term care (LTC) insurance EXCEPT: - Answer-Fears of not being able to change
carriers due to the underwriting practice of not accepting policyholders with an existing
five-plus-years policy in force with another carrier.
All of the following are underwriting methods used in health insurance EXCEPT: -
Answer-Consumer choices must be limited for a free market to empower consumers,
regulate producers and operate efficiently.
All of the following statements regarding legal protection from out-of-network medical
bills incurred unknowingly by patients are correct EXCEPT: - Answer-A patient-plaintiff
and Answers All Correct
Which of the following statements regarding the condition of the delivery of health care
is (are) correct? - Answer-Studies show only incremental improvements in health care
disparities among different segments of the U.S. population.
Most primary care practices are financially insecure.
Which of the following statements regarding the financing of workers' compensation
programs is (are) correct? - Answer-Workers' compensation programs are based on the
principle that the cost of work-related accidents is a business expense.
Which of the following statements regarding the loading percentage for health insurance
rates is (are) correct? - Answer-The loading percentage is lower for group health
insurance rates than it is for individual health insurance rates.
The Affordable Care Act imposes penalties on insurers if their loading fees are too high.
Which of the following statements regarding the methodology used by the Affordable
Care Act's risk adjustment program is (are) correct? - Answer-The risk adjustment
program transfers funds from plans with lower-risk enrollees to plans with higher-risk
enrollees.
If an enrollee is receiving subsidies to reduce his or her cost sharing, an induced
utilization factor is applied to account for induced demand.
Which of the following statements regarding the self-funding of health benefits by small
firms are correct? - Answer-Total costs in self-funded plans are lower relative to fully
insured product options in large part because traditional insurance premiums include
carrier marketing costs and profit margins—factors that are not applicable to self-funded
plans.
With a self-funded plan, a small employer can personalize a benefits package to reflect
the needs of its workers.
A shift to self-insurance may lead to adverse selection in the fully insured market for
small groups.
, Which of the following statements regarding the size of price concessions managed
care plans can negotiate with hospitals is (are) correct? - Answer-Virtually no managed
care plans pay full billed
There apparently is no direct relationship between the size of the discount and the
actual price of hospital services.
Which of the following statements regarding the so-called "death spiral" in health
insurance premiums is (are) correct? - Answer-To counter problems arising from
adverse selection, risk adjustment methods can be used to transfer funds from plans
with below-average costs to plans with above-average costs.
Which of the following statements regarding the strategies that can be used to pursue
quality improvement (QI) is (are) correct? - Answer-One of the top strategies that has
been identified is to delegate authority to the implementation planners.
A study examined the elements that affect health insurer price negotiations in selective
contracting with hospitals. The study concluded that insurers are able to obtain lower
prices in all the following situations EXCEPT: - Answer-When the insurer is small, i.e.,
has assets lower than a certain amount.
After extensive study and research, certain conclusions can be drawn regarding the
various approaches to achieve quality improvements in health care. All the following
statements concerning these conclusions are correct EXCEPT: - Answer-Payment
systems have little impact on quality improvements.
All of the following are criteria utilized by the National Committee For Quality Assurance
(NCQA) in awarding a "Distinction in Patient Experience Reporting" to medical homes
EXCEPT: - Answer-Provider personality ratings
All of the following are factors a stop-loss insurer might consider when underwriting a
health care policy for an employer EXCEPT: - Answer-Anonymized medical surveys of
existing policies' covered employees
All of the following are reasons cited for consumers being reluctant to purchase long-
term care (LTC) insurance EXCEPT: - Answer-Fears of not being able to change
carriers due to the underwriting practice of not accepting policyholders with an existing
five-plus-years policy in force with another carrier.
All of the following are underwriting methods used in health insurance EXCEPT: -
Answer-Consumer choices must be limited for a free market to empower consumers,
regulate producers and operate efficiently.
All of the following statements regarding legal protection from out-of-network medical
bills incurred unknowingly by patients are correct EXCEPT: - Answer-A patient-plaintiff
