CORRECT ANSWERS 2026/2027 (100%
VERIFIED)
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? - ANSWER-Avoidance, retention,
insurance and control
Which of the following statements regarding prescription drug rebates is correct? -
ANSWER-A rebate occurs when there is an agreement between a pharmacy benefit
manager and a drug manufacturer.
There are several methods for evaluating health system performance. Accreditation by
the NCQA is an example of which of the following methods? - ANSWER-Audit
performance evaluation
When a participant of a cafeteria plan makes a one-time election on coverage that stays
in force from plan year to plan year unless the participant elects to make a change
during the applicable election period, it is referred to as a(n): - ANSWER-Evergreen
election
The benefit-oriented philosophy of designing employee benefits tends to focus on: -
ANSWER-Needs of employees
The amount of covered medical expenses that a participant must incur before any
medical benefits for non-preventive care services or treatment become payable under a
plan is known as the: - ANSWER-Deductible
The Supreme Court decision in National Federation of Independent Business v.
Sebelius had a profound effect on the implementation of the Affordable Care Act (ACA).
Which of the following statements summarizes the impact of this case? - ANSWER-The
decision made Medicare expansion by the states voluntary.
The Affordable Care Act (ACA) aimed to make health insurance more affordable by
providing tax credits to individuals ineligible for other affordable coverage and with
income between which of the following limits: - ANSWER-100% and 400% of the federal
poverty line.
The concept designed to make victims of losses whole again reflects the principle of: -
ANSWER-Indemnification
, A mechanism by which one attempts either to prevent or reduce the probability of a loss
taking place or to reduce the severity of the loss if it does take place is referred to as: -
ANSWER-Control
The Affordable Care Act (ACA), in general, defined a full-time employee as one
employed on average at least how many hours per week? - ANSWER-30
Dental treatments are placed into ten professional treatment categories. A restorative
treatment is: - ANSWER-
If a cafeteria plan fails to pass the required nondiscrimination testing, then: - ANSWER-
The highly compensated and key employees are taxed based on the value of their
benefits.
An insured individual has $12,000 of covered medical expenses for in-network
nonpreventive treatment. His plan is a high-deductible health policy with a $1,500
deductible and a 20% coinsurance arrangement. Also, the plan reimburses 100% after
an individual reaches the plan's $6,000 out-of-pocket maximum. What will the insured
pay out of the total medical expenses if this is the first claim of the plan year? -
ANSWER-$ 3,600
A behavioral health care carve-out program usually operates under a separate contract
and from a separate company known as a(n): - ANSWER-Managed behavioral health
care organization (MBHO)
A peril as the term applies to the insurance mechanism is defined as: - ANSWER-The
cause of a loss
The "managed care backlash" of the late 1990s gave direct rise to which of the following
types of health care organizations? - ANSWER-Preferred provider organizations (PPOs)
Which of the following is a requirement of the Health Insurance Portability and
Accountability Act (HIPAA) as it applies to wellness programs? - ANSWER-A program
that is offered directly by an employer outside of a group plan is not subject to HIPAA
privacy rules.
The maximum annual contribution that can be made to a health savings account (HSA)
is: - ANSWER-A fixed, indexed amount
Benefits for so-called lifestyle drugs: - ANSWER-Have been routinely excluded from all
employer plans.
A dental plan in which certain procedures are reimbursed on a scheduled basis and
others are reimbursed on a nonscheduled basis is called a(n): - ANSWER-Combination
plan