HCMG EXAM 1 REVIEW QUESTIONS
RATED 100% CORRECT ANSWERS!!
1 of
59
Ter
m
What does it mean for a tax subsidy to be
regressive?
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later!
Higher earners receive less financial The subsidy is only available to
assistance than lower earners individuals with no income
Given progressive income
taxation ,the amount of the
, The subsidy is fixed regardless of subsidy increases with a
income level person's tax bracket
Don't know?
2 of 59
Definition
-guaranteed issue and parital community rrating for
individual and small group markets
-rates for individuals and small groups cannot reflect
health conditions but are allowed to vary within a 3 to 1
age band
-states an allow higher rates for smokers
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Community rating and guaranteed What is a Health Maintenance
issue increase what? organization (HMO) plan?
What are the regulations of What is a Preferred Provider
risk rating post ACA (2014+)? Organization (PPO) plan?
Don't know?
3 of 59
Term
,What is an out of pocket maximum?
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A fee charged for services The total amount an employee must
not covered by insurance pay in premiums each year
Limits the employee's
annual out of pocket for The maximum amount an insurer will
covered expenses pay for any single claim
Don't know?
4 of 59
Term
What is a Point of Service (POS) plan?
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A hybrid of HMO/PPO
Patient selects in network PCP Tax favored arrangement that
referrals are needed for some combines high deductible health
services plan and a medical are savings
account
Access to out of network
care with high cost sharing
excludes coverage for a specified
health condition for some period of
, Limits the employee's annual out time
of pocket for covered expenses
Don't know?
5 of 59
Term
How does variability play a role in insurer's average cost?
Give this one a try later!
declines as more people are insured
spreads the risk of loss over a large number of people
the insurer must offer coverage to applicants as long as they are paying the
premium
Supports "generous" insurance by hospitals, physicians, drug/device
companies, other providers, health insurers
lower income people tend to be sicker and less able to afford coverage
lower income people also have lower WTP for insurance which translate to ability
to pay
WTP increases with a higher income
Don't know?
RATED 100% CORRECT ANSWERS!!
1 of
59
Ter
m
What does it mean for a tax subsidy to be
regressive?
Give this one a try
later!
Higher earners receive less financial The subsidy is only available to
assistance than lower earners individuals with no income
Given progressive income
taxation ,the amount of the
, The subsidy is fixed regardless of subsidy increases with a
income level person's tax bracket
Don't know?
2 of 59
Definition
-guaranteed issue and parital community rrating for
individual and small group markets
-rates for individuals and small groups cannot reflect
health conditions but are allowed to vary within a 3 to 1
age band
-states an allow higher rates for smokers
Give this one a try later!
Community rating and guaranteed What is a Health Maintenance
issue increase what? organization (HMO) plan?
What are the regulations of What is a Preferred Provider
risk rating post ACA (2014+)? Organization (PPO) plan?
Don't know?
3 of 59
Term
,What is an out of pocket maximum?
Give this one a try later!
A fee charged for services The total amount an employee must
not covered by insurance pay in premiums each year
Limits the employee's
annual out of pocket for The maximum amount an insurer will
covered expenses pay for any single claim
Don't know?
4 of 59
Term
What is a Point of Service (POS) plan?
Give this one a try later!
A hybrid of HMO/PPO
Patient selects in network PCP Tax favored arrangement that
referrals are needed for some combines high deductible health
services plan and a medical are savings
account
Access to out of network
care with high cost sharing
excludes coverage for a specified
health condition for some period of
, Limits the employee's annual out time
of pocket for covered expenses
Don't know?
5 of 59
Term
How does variability play a role in insurer's average cost?
Give this one a try later!
declines as more people are insured
spreads the risk of loss over a large number of people
the insurer must offer coverage to applicants as long as they are paying the
premium
Supports "generous" insurance by hospitals, physicians, drug/device
companies, other providers, health insurers
lower income people tend to be sicker and less able to afford coverage
lower income people also have lower WTP for insurance which translate to ability
to pay
WTP increases with a higher income
Don't know?
