CEBS GBA 2 Practice Exam Questions and Answers |Complete Solutions Graded
A+ |100% Correct
All of the following are factors a stop-loss insurer might consider when underwriting a health
care policy for an employer EXCEPT:
A.) Previous health care experience and anticipated trends going forward for the employer
B.) Anonymized medical surveys of existing policies' covered employees
C.) The employer's preferred physician network
D.) The geographic location of the employer
E.) The third-party administrator selected by the employer B.) Anonymized medical surveys
of existing policies' covered employees
All the following statements regarding private health insurance exchanges are correct EXCEPT:
A.) In private exchanges, the exchange vendor can be relied on to help explain exchanges to
each employee, rather than have employers try to do it on their own.
B.) The technology deployed by most private exchanges renders telephone hotlines and face-
to- face customer service redundant.
C.) Private exchanges typically provide extensive software to aid consumers in decision
support.
D.) The more advanced software of private exchanges allows side-by-side comparisons as the
employee adjusts particular characteristics.
E.) Exchange websites can include pop-up information to explain facets of the benefits as the
employee is looking at a particular item, such as the drug coverage in a health plan. B.) The
technology deployed by most private exchanges renders telephone hotlines and face-to- face
customer service redundant.
All of the following are reasons cited for consumers being reluctant to purchase long-term care
(LTC) insurance EXCEPT:
,A.) Rate increases announced by insurers and the negative publicity that follow such
announcements erode public trust in LTC insurance companies.
B.) 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.
C.) The onerous process required to receive benefits.
D.) The cost is considered too expensive.
E.) The fact that many elderly disabled individuals are unable to satisfy the requirements to be
eligible for LTC benefits. B.) 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 the following statements regarding Medicare Advantage (Medicare Part C) plans are correct
EXCEPT:
A.) These plans give recipients the option to enroll in a health plan with a narrower network of
hospitals and providers than that of Medicare Parts A and B, but with less out-of-pocket costs.
B.) These plans are likely to include their own prescription drug coverage.
C.) These plans are voluntary and beneficiaries always have the option of going back to the
traditional program.
D.) These plans are often chosen because of lower cost and greater care coordination.
E.) These plans have minimal state variation. E.) These plans have minimal state variation.
Studies of physician markets show all the following regarding the employment and
compensation of physicians in managed care plans EXCEPT:
A.) Health maintenance organizations (HMOs) were able to negotiate lower fees than were
preferred provider organizations (PPOs).
B.) Managed care plans paid lower fees when there were more physicians per capita in the
metropolitan area.
,C.) Managed care plans paid lower fees for procedures when there was greater managed care
penetration in the area.
D.) Studies show that the use of the capitation method of compensation has been increasing
for many years.
E.) Managed care leads to somewhat fewer self-employed physicians. D.) Studies show that
the use of the capitation method of compensation has been increasing for many years.
Long-term care insurance may cover all the following types of services EXCEPT:
A.) Custodial care
B.) Home health care
C.) Hospice care
D.) Assisted living care
E.) Short-term hospital stays E.) Short-term hospital stays
All the following statements regarding the usual and customary rate (UCR) used in health
insurer reimbursement practices are correct EXCEPT:
A.) An investigation by one large state alleged conflict of interest between a major insurer and
the entity responsible for managing the database used to calculate UCR.
B.) An independent, nonprofit company has been established to manage the database for
computing UCR.
C.) More and more insurers are abandoning the traditional UCR pay formulas.
D.) Changes involving the UCR have greatly decreased the amount of balance billing.
E.) The use of the Medicare rate has increased recently. D.) Changes involving the UCR have
greatly decreased the amount of balance billing.
The Health and Medicine Division (formerly known as Institute of Medicine) promulgated six
goals following the two landmark reports that identified widespread quality problems within
the U.S. healthcare system. All the following are included among these six goals EXCEPT:
, A.) Equity
B.) Convertibility
C.) Timeliness
D.) Effectiveness
E.) Patient centeredness B.) Convertibility
All the following are advantages cited for noncontributory financing of group-term life
insurance EXCEPT:
A.) Greater control of plan by employer
B.) Economy of installation
C.) Greater employee interest
D.) Simplicity of administration
E.) Coverage of all eligible employees C.) Greater employee interest
All the following statements regarding healthcare quality improvement collaboratives (QICs)
are correct EXCEPT:
A.) QICs are one of the more promising ways to help clinics and medical groups to improve their
quality.
B.) The most well-known QICs are those short-term ones that have been run for specific topics
by the Institute for Healthcare Improvement (IHI).
C.) QICs are very expensive for participants and tend to attract mainly large care delivery
organizations or those paid for by the government.
D.) Enough separate QICs have been implemented in the U.S. that they now have their own
national association, the Network for Regional Healthcare Improvement.
E.) The conclusion, in a systematic review of the evidence of the value of QICs, was that QICs
indeed provide significant value that can be predicted with much certainty. E.) The
A+ |100% Correct
All of the following are factors a stop-loss insurer might consider when underwriting a health
care policy for an employer EXCEPT:
A.) Previous health care experience and anticipated trends going forward for the employer
B.) Anonymized medical surveys of existing policies' covered employees
C.) The employer's preferred physician network
D.) The geographic location of the employer
E.) The third-party administrator selected by the employer B.) Anonymized medical surveys
of existing policies' covered employees
All the following statements regarding private health insurance exchanges are correct EXCEPT:
A.) In private exchanges, the exchange vendor can be relied on to help explain exchanges to
each employee, rather than have employers try to do it on their own.
B.) The technology deployed by most private exchanges renders telephone hotlines and face-
to- face customer service redundant.
C.) Private exchanges typically provide extensive software to aid consumers in decision
support.
D.) The more advanced software of private exchanges allows side-by-side comparisons as the
employee adjusts particular characteristics.
E.) Exchange websites can include pop-up information to explain facets of the benefits as the
employee is looking at a particular item, such as the drug coverage in a health plan. B.) The
technology deployed by most private exchanges renders telephone hotlines and face-to- face
customer service redundant.
All of the following are reasons cited for consumers being reluctant to purchase long-term care
(LTC) insurance EXCEPT:
,A.) Rate increases announced by insurers and the negative publicity that follow such
announcements erode public trust in LTC insurance companies.
B.) 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.
C.) The onerous process required to receive benefits.
D.) The cost is considered too expensive.
E.) The fact that many elderly disabled individuals are unable to satisfy the requirements to be
eligible for LTC benefits. B.) 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 the following statements regarding Medicare Advantage (Medicare Part C) plans are correct
EXCEPT:
A.) These plans give recipients the option to enroll in a health plan with a narrower network of
hospitals and providers than that of Medicare Parts A and B, but with less out-of-pocket costs.
B.) These plans are likely to include their own prescription drug coverage.
C.) These plans are voluntary and beneficiaries always have the option of going back to the
traditional program.
D.) These plans are often chosen because of lower cost and greater care coordination.
E.) These plans have minimal state variation. E.) These plans have minimal state variation.
Studies of physician markets show all the following regarding the employment and
compensation of physicians in managed care plans EXCEPT:
A.) Health maintenance organizations (HMOs) were able to negotiate lower fees than were
preferred provider organizations (PPOs).
B.) Managed care plans paid lower fees when there were more physicians per capita in the
metropolitan area.
,C.) Managed care plans paid lower fees for procedures when there was greater managed care
penetration in the area.
D.) Studies show that the use of the capitation method of compensation has been increasing
for many years.
E.) Managed care leads to somewhat fewer self-employed physicians. D.) Studies show that
the use of the capitation method of compensation has been increasing for many years.
Long-term care insurance may cover all the following types of services EXCEPT:
A.) Custodial care
B.) Home health care
C.) Hospice care
D.) Assisted living care
E.) Short-term hospital stays E.) Short-term hospital stays
All the following statements regarding the usual and customary rate (UCR) used in health
insurer reimbursement practices are correct EXCEPT:
A.) An investigation by one large state alleged conflict of interest between a major insurer and
the entity responsible for managing the database used to calculate UCR.
B.) An independent, nonprofit company has been established to manage the database for
computing UCR.
C.) More and more insurers are abandoning the traditional UCR pay formulas.
D.) Changes involving the UCR have greatly decreased the amount of balance billing.
E.) The use of the Medicare rate has increased recently. D.) Changes involving the UCR have
greatly decreased the amount of balance billing.
The Health and Medicine Division (formerly known as Institute of Medicine) promulgated six
goals following the two landmark reports that identified widespread quality problems within
the U.S. healthcare system. All the following are included among these six goals EXCEPT:
, A.) Equity
B.) Convertibility
C.) Timeliness
D.) Effectiveness
E.) Patient centeredness B.) Convertibility
All the following are advantages cited for noncontributory financing of group-term life
insurance EXCEPT:
A.) Greater control of plan by employer
B.) Economy of installation
C.) Greater employee interest
D.) Simplicity of administration
E.) Coverage of all eligible employees C.) Greater employee interest
All the following statements regarding healthcare quality improvement collaboratives (QICs)
are correct EXCEPT:
A.) QICs are one of the more promising ways to help clinics and medical groups to improve their
quality.
B.) The most well-known QICs are those short-term ones that have been run for specific topics
by the Institute for Healthcare Improvement (IHI).
C.) QICs are very expensive for participants and tend to attract mainly large care delivery
organizations or those paid for by the government.
D.) Enough separate QICs have been implemented in the U.S. that they now have their own
national association, the Network for Regional Healthcare Improvement.
E.) The conclusion, in a systematic review of the evidence of the value of QICs, was that QICs
indeed provide significant value that can be predicted with much certainty. E.) The
