CEBS GBA 2 Practice Exam Questions with
Complete Solutions| Verified
Out-of-network health care accounts for approximately what percentage of total
covered health insurance expenses?
A.) 3
B.) 10
C.) 20
D.) 25
E.) 30 -✔B.) 10
The major advantage of term insurance for the policyowner is the fact that:
A.) A substantial amount of life insurance can be purchased for relatively modest premiums
B.) It provides lifetime protection if the insured continues to pay the premiums
C.) The premiums remain at the same level for the life of the
insured D.) With a policy rider it can be used to provide retirement
E.) Premiums are highly competitive especially for those at older ages -✔A.) A substantial
amount of life insurance can be purchased for relatively modest premiums
,Mr. Smith is insured in his company's group life insurance plan. The plan is noncontributory and
meets the requirements of Internal Revenue Code Section 79. How much group life insurance
can be provided to Mr. Smith without him incurring a federal income tax liability on the value
of his employer's contributions?
A.) 0
B.) 25,000
C.) 50,000
D.) 100,000
E.) An unlimited amount -✔C.) 50,000
Which of the following statements regarding health expenditures and related research
is correct?
A.) In general, risk adjustment models have been able to predict about 80 percent of
total claims.
B.) Age and gender account for about 90 percent of explained variation in health
care expenditures.
C.) Medicare currently pays Medicare Advantage plans on the basis of the Centers for Medicare
& Medicaid Services Hierarchical Condition Categories (CMS-HCC) model, which uses
approximately 70 clinical conditions.
D.) Health maintenance organizations (HMOs) that could predict health expenditures only
five percentage points better than Medicare would not gain a significant amount of profit per
enrollee.
E.) Inpatient expenditures are more predictable than outpatient expenditures. -✔C.)
Medicare currently pays Medicare Advantage plans on the basis of the Centers for Medicare &
Medicaid Services Hierarchical Condition Categories (CMS-HCC) model, which uses
approximately 70 clinical conditions.
,Which of the following has been a key focus of redesign and improvement efforts
in healthcare?
A.) Hospital care
B.) Diagnostic/imaging services
C.) Critical care
D.) Orthopedic surgery
E.) Primary care medicine -✔E.) Primary care medicine
Reference pricing used by some managed care health plans:
A.) Is an example of center-of-excellence pricing.
B.) Is one method of giving subscribers an incentive to use lower-cost but quality providers.
C.) Can only be used in a capitation system.
D.) Is a model that has not been used in practice.
E.) Is designed to attract healthier individuals into the plan.
. -✔B.) Is one method of giving subscribers an incentive to use lower-cost but quality providers
The vast majority of long-term care needs are met by:
A.) Medicare
B.) Medicaid
C.) Individual health insurance policies
D.) Long-term care insurance policies
, E.) Family members on an unpaid basis -✔E.) Family members on an unpaid basis
The practice of hospitals paid based on billed charges by commercial insurers and
allowable costs by Medicare ended primarily because:
A.) Managed care plans introduced selective contracting into the market.
B.) Hospitals started using more advanced technology.
C.) Patients became less concerned about the cost of services.
D.) Hospitals started to focus more on the quality of services.
E.) Physicians gained a greater voice in the pricing of health care. -✔A.) Managed care plans
introduced selective contracting into the market.
What is the provision in the Part D Medicare law that gives a significant benefit to
pharmaceutical companies?
A.) The law allows only pharmaceutical companies registered with a specified trade association to
market drugs under Part D and virtually all pharmaceutical companies are so registered
B.) The law guarantees a certain profit margin to all pharmaceutical companies that sell
drugs under Part D.
C.) The law prohibits the government from using its purchasing power to negotiate widespread
discounts with drug plans.
D.) The law gives all U.S. pharmaceutical companies special income tax benefits for an
extended period of time.
E.) The law prohibits the widespread dissemination of information regarding specified drugs.
- ✔C.) The law prohibits the government from using its purchasing power to negotiate
widespread discounts with drug plans.
The definition of disability for Social Security Disability Insurance benefits requires the
impairment to be expected to result in death or to last for a continuous period of at least
how many months?
Complete Solutions| Verified
Out-of-network health care accounts for approximately what percentage of total
covered health insurance expenses?
A.) 3
B.) 10
C.) 20
D.) 25
E.) 30 -✔B.) 10
The major advantage of term insurance for the policyowner is the fact that:
A.) A substantial amount of life insurance can be purchased for relatively modest premiums
B.) It provides lifetime protection if the insured continues to pay the premiums
C.) The premiums remain at the same level for the life of the
insured D.) With a policy rider it can be used to provide retirement
E.) Premiums are highly competitive especially for those at older ages -✔A.) A substantial
amount of life insurance can be purchased for relatively modest premiums
,Mr. Smith is insured in his company's group life insurance plan. The plan is noncontributory and
meets the requirements of Internal Revenue Code Section 79. How much group life insurance
can be provided to Mr. Smith without him incurring a federal income tax liability on the value
of his employer's contributions?
A.) 0
B.) 25,000
C.) 50,000
D.) 100,000
E.) An unlimited amount -✔C.) 50,000
Which of the following statements regarding health expenditures and related research
is correct?
A.) In general, risk adjustment models have been able to predict about 80 percent of
total claims.
B.) Age and gender account for about 90 percent of explained variation in health
care expenditures.
C.) Medicare currently pays Medicare Advantage plans on the basis of the Centers for Medicare
& Medicaid Services Hierarchical Condition Categories (CMS-HCC) model, which uses
approximately 70 clinical conditions.
D.) Health maintenance organizations (HMOs) that could predict health expenditures only
five percentage points better than Medicare would not gain a significant amount of profit per
enrollee.
E.) Inpatient expenditures are more predictable than outpatient expenditures. -✔C.)
Medicare currently pays Medicare Advantage plans on the basis of the Centers for Medicare &
Medicaid Services Hierarchical Condition Categories (CMS-HCC) model, which uses
approximately 70 clinical conditions.
,Which of the following has been a key focus of redesign and improvement efforts
in healthcare?
A.) Hospital care
B.) Diagnostic/imaging services
C.) Critical care
D.) Orthopedic surgery
E.) Primary care medicine -✔E.) Primary care medicine
Reference pricing used by some managed care health plans:
A.) Is an example of center-of-excellence pricing.
B.) Is one method of giving subscribers an incentive to use lower-cost but quality providers.
C.) Can only be used in a capitation system.
D.) Is a model that has not been used in practice.
E.) Is designed to attract healthier individuals into the plan.
. -✔B.) Is one method of giving subscribers an incentive to use lower-cost but quality providers
The vast majority of long-term care needs are met by:
A.) Medicare
B.) Medicaid
C.) Individual health insurance policies
D.) Long-term care insurance policies
, E.) Family members on an unpaid basis -✔E.) Family members on an unpaid basis
The practice of hospitals paid based on billed charges by commercial insurers and
allowable costs by Medicare ended primarily because:
A.) Managed care plans introduced selective contracting into the market.
B.) Hospitals started using more advanced technology.
C.) Patients became less concerned about the cost of services.
D.) Hospitals started to focus more on the quality of services.
E.) Physicians gained a greater voice in the pricing of health care. -✔A.) Managed care plans
introduced selective contracting into the market.
What is the provision in the Part D Medicare law that gives a significant benefit to
pharmaceutical companies?
A.) The law allows only pharmaceutical companies registered with a specified trade association to
market drugs under Part D and virtually all pharmaceutical companies are so registered
B.) The law guarantees a certain profit margin to all pharmaceutical companies that sell
drugs under Part D.
C.) The law prohibits the government from using its purchasing power to negotiate widespread
discounts with drug plans.
D.) The law gives all U.S. pharmaceutical companies special income tax benefits for an
extended period of time.
E.) The law prohibits the widespread dissemination of information regarding specified drugs.
- ✔C.) The law prohibits the government from using its purchasing power to negotiate
widespread discounts with drug plans.
The definition of disability for Social Security Disability Insurance benefits requires the
impairment to be expected to result in death or to last for a continuous period of at least
how many months?
