CEBS GBA EXAM 2 LATEST
Differentiate among the various disabilities and benefits of workers
compensation systems and identify the most prevalent (Mod 10.6) -
ANSWERS-a) Temporary Total Disability: Most compensation cases
that involve cash payments are for temporary total disability. In these
cases, EE is temporarily precluded from performing the preinjury job or
another job with the ER the EE could have performed prior to the injury.
Most workers who receive these benefits fully recover and return to
work, at which time benefits end. Most states pay weekly for temporary
total disability that replace 2/3rds of the worker's preinjury wage (tax
free), subject to a dollar maximum that varies from state to state.
b) Temporary Partial Disability: In some cases, workers RTW before
they reach maximum medical improvement and have reduced
responsibilities and a lower salary. In these cases, they receive
temporary partial disability benefits.
c) Permanent Total Disability: If EE has significant impairments that are
judged to be permanent after he or she reaches maximum medical
improvement, worker receives permanent total disability; very few
workers comp cases are found to have permanent total disability.
d) Permanent Partial Disability: When EE has impairment that, although
permanent, does not completely limit the worker's ability to work,
permanent partial disability benefits are paid. The system for
determining benefits in these cases is complex and varies across states.
END OF
PAGE
1
, CEBS GBA EXAM 2 LATEST
e) Death Benefits: Generally, compensation is related to earnings and to
the number of dependents eligible as survivors of workers who die from
a work related illness/injury.
f) Medical Benefits: Most cases do not involve lost work time greater
than the 3 to 7 day waiting period for cash benefits. In these cases, only
medical costs are paid. Medical only cases are quite common in workers
comp, but only represent a small share of overall payments.
How are WC programs financed? (Mod 10.6) - ANSWERS-Almost
exclusively by ERs and are based on the principle that the cost of work
related accidents is a business expense. Depending on state laws, ERs
can purchase insurance from a private carrier or state fund, or they can
self-insure. No program relies on general taxing power to finance
workers comp.
What are disadvantages of an ER using a silo approach in managing
occupation and nonoccupational claims? (Mod 10.6) - ANSWERS-The
silo approach many lead to missed opportunities to identify EEs who are
at a high risk for future lost work time and to develop
prevention/intervention strategies for costly recurrences of
illness/injuries from crossing over from one disability system to the
other.
END OF
PAGE
2
, CEBS GBA EXAM 2 LATEST
What are the findings of an analysis of a large dataset of STD and
workers compensation claim systems and the implications for
employers? (Mod 10.6) - ANSWERS-Study reveals that claimants
w/multiple claims are common and they cross over from one system to
the other more often than risk and benefits managers may realize.
Implications of these findings for ERs is that coordinated strategies to
identify EEs with a high risk of repeat disabilities is necessary; must also
cultivate their sustained engagement with remedial and preventative care
efforts as they may yield various benefits.
Regardless if claim was initially occupational or nonoccupational,
remedial and preventative interventions could help mitigate costly
medical treatments and lost productivity. Coordinated strategies valuable
for management of costly occupational illness and injury claims.
Nonetheless, managers of nonoccupational disability benefits stand to
gain from the occupational system's depth of experience in RTW
strategies.
Risk and benefits professionals must recognize their mutual position as
stakeholders in workforce health more generally. This will entail
developing better info about the types of demographic and health risk
factors that indicate a high risk for claims in either system. Encouraging
risk and benefit professionals' involvement in their development,
implementation and evaluation of preventative and remedial
END OF
PAGE
3
, CEBS GBA EXAM 2 LATEST
interventions could also help professionals recognize the advantages of a
coordinated, organization-wide health and productivity strategy.
What are the major demographic and societal reasons that US citizens
should save for (LTC) long term care? (Mod 11.1) - ANSWERS--As
baby boomer generation is aging out, there is a growing demand for
services that provide care for the elderly.
-Numerous improvements in both science and medicine have
contributed to increased life expectancies; however much of this
increase is spent in disabled years.
-Other reasons include: birth rates falling, avg family sizes are
decreasing, geographic distances among family members increasing and
proportion of women in labor force is increasing.
These trends suggest there is less availability of informal, family based
support to provide in home healthcare to elderly. With rising incidence
of dementia, LTC service needs will increase dramatically.
Why are Medigap policies a significant reason for the rising cost of
Medicare? (Mod 11.1) - ANSWERS-Medicare spending has increased
significantly in absolute dollar amounts and as a % of GDP due to the
fact many individuals buy Medigap policies to fill in coverage gaps in
basic Medicare (Parts A & B) so as to reduce their out of pocket costs -
END OF
PAGE
4
Differentiate among the various disabilities and benefits of workers
compensation systems and identify the most prevalent (Mod 10.6) -
ANSWERS-a) Temporary Total Disability: Most compensation cases
that involve cash payments are for temporary total disability. In these
cases, EE is temporarily precluded from performing the preinjury job or
another job with the ER the EE could have performed prior to the injury.
Most workers who receive these benefits fully recover and return to
work, at which time benefits end. Most states pay weekly for temporary
total disability that replace 2/3rds of the worker's preinjury wage (tax
free), subject to a dollar maximum that varies from state to state.
b) Temporary Partial Disability: In some cases, workers RTW before
they reach maximum medical improvement and have reduced
responsibilities and a lower salary. In these cases, they receive
temporary partial disability benefits.
c) Permanent Total Disability: If EE has significant impairments that are
judged to be permanent after he or she reaches maximum medical
improvement, worker receives permanent total disability; very few
workers comp cases are found to have permanent total disability.
d) Permanent Partial Disability: When EE has impairment that, although
permanent, does not completely limit the worker's ability to work,
permanent partial disability benefits are paid. The system for
determining benefits in these cases is complex and varies across states.
END OF
PAGE
1
, CEBS GBA EXAM 2 LATEST
e) Death Benefits: Generally, compensation is related to earnings and to
the number of dependents eligible as survivors of workers who die from
a work related illness/injury.
f) Medical Benefits: Most cases do not involve lost work time greater
than the 3 to 7 day waiting period for cash benefits. In these cases, only
medical costs are paid. Medical only cases are quite common in workers
comp, but only represent a small share of overall payments.
How are WC programs financed? (Mod 10.6) - ANSWERS-Almost
exclusively by ERs and are based on the principle that the cost of work
related accidents is a business expense. Depending on state laws, ERs
can purchase insurance from a private carrier or state fund, or they can
self-insure. No program relies on general taxing power to finance
workers comp.
What are disadvantages of an ER using a silo approach in managing
occupation and nonoccupational claims? (Mod 10.6) - ANSWERS-The
silo approach many lead to missed opportunities to identify EEs who are
at a high risk for future lost work time and to develop
prevention/intervention strategies for costly recurrences of
illness/injuries from crossing over from one disability system to the
other.
END OF
PAGE
2
, CEBS GBA EXAM 2 LATEST
What are the findings of an analysis of a large dataset of STD and
workers compensation claim systems and the implications for
employers? (Mod 10.6) - ANSWERS-Study reveals that claimants
w/multiple claims are common and they cross over from one system to
the other more often than risk and benefits managers may realize.
Implications of these findings for ERs is that coordinated strategies to
identify EEs with a high risk of repeat disabilities is necessary; must also
cultivate their sustained engagement with remedial and preventative care
efforts as they may yield various benefits.
Regardless if claim was initially occupational or nonoccupational,
remedial and preventative interventions could help mitigate costly
medical treatments and lost productivity. Coordinated strategies valuable
for management of costly occupational illness and injury claims.
Nonetheless, managers of nonoccupational disability benefits stand to
gain from the occupational system's depth of experience in RTW
strategies.
Risk and benefits professionals must recognize their mutual position as
stakeholders in workforce health more generally. This will entail
developing better info about the types of demographic and health risk
factors that indicate a high risk for claims in either system. Encouraging
risk and benefit professionals' involvement in their development,
implementation and evaluation of preventative and remedial
END OF
PAGE
3
, CEBS GBA EXAM 2 LATEST
interventions could also help professionals recognize the advantages of a
coordinated, organization-wide health and productivity strategy.
What are the major demographic and societal reasons that US citizens
should save for (LTC) long term care? (Mod 11.1) - ANSWERS--As
baby boomer generation is aging out, there is a growing demand for
services that provide care for the elderly.
-Numerous improvements in both science and medicine have
contributed to increased life expectancies; however much of this
increase is spent in disabled years.
-Other reasons include: birth rates falling, avg family sizes are
decreasing, geographic distances among family members increasing and
proportion of women in labor force is increasing.
These trends suggest there is less availability of informal, family based
support to provide in home healthcare to elderly. With rising incidence
of dementia, LTC service needs will increase dramatically.
Why are Medigap policies a significant reason for the rising cost of
Medicare? (Mod 11.1) - ANSWERS-Medicare spending has increased
significantly in absolute dollar amounts and as a % of GDP due to the
fact many individuals buy Medigap policies to fill in coverage gaps in
basic Medicare (Parts A & B) so as to reduce their out of pocket costs -
END OF
PAGE
4
