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Summarize impact of group health plans due to ACA (Mod 3.5) - CORRECT
ANSWER-1: Play or pay rules requiring medium/large ER's to offer health
insurance to ACA-defined FT EE's or pay a penalty (must be affordable**)
2: Establishment of a list of essential health benefits
3: Elimination of lifetime maximums and the capping of out of pocket maximums.
4: Expansion of coverage for preventative services
5: Temporary tax subsidies to small employers who offer group health
6: New administrative/reporting requirements
How do payment methods affect delivery of healthcare? (Mod 3.6) - CORRECT
ANSWER-Affect whether, how and how much care is provided. Ex: Hospital
Length of Stay, diagnostic imaging in phys offices, home health care visits,
coordination among phys/hosp, etc.
,Broad view of Employee Benefits (Mod 1.1) - CORRECT ANSWER-Considers
Employee Benefits to be virtually any form of compensation other than direct
wages paid to Employees (Ex: WC, Unemployment, State DI, SS, Vacation,
Holidays, 401K/Retirement, Employer share of Medical, Severance Pay, Child
Care, etc..)
Narrow view of Employee Benefits (Mod 1.1) - CORRECT ANSWER-Any type of
plan sponsored or initiated by Employees and Employers and engaged in
providing benefits that result from the employment relationship and that are not
underwritten or paid directly by the government; (Ex: Benefits excluded include
those legally mandated - WC, SS).
Impact of Labor Unions on Employee Benefits (Mod 1.2) - CORRECT ANSWER-
Through Collective Bargaining, Employee Benefit Plans have been impacted. In
1948 ruling states that the duty to bargain in good faith over wages also included
insurance and fringes (pension). In WW Cross & Co, NLRB ruled wages included
health and accident plan.
What is the Taft-Hartley Act? (Mod 1.2) - CORRECT ANSWER-The Labor
Management Relations Act of 1947 is a United States federal law that restricts the
activities and power of labor unions. This set forth good-faith collective bargaining
over wages, hours, terms of employment and benefits.
,3 Examples of Tax Advantages of Employee Benefit Plans (Mod 1.2) - CORRECT
ANSWER-1: Employer Contributions are Tax Deductible
2: Employer Contributions are not considered income to Employees
3: Certain Retirement Benefits Accumulate Tax-Free until distributed.
Examples of Questions that should be addressed when creating benefit objectives
(Mod 1.3) - CORRECT ANSWER-Ex: What benefits should be provided? Who
should be covered? Should Employees have options? How should plan be
financed? How should plan be administered? How should plan be communicated
to Employees?
What is the Functional Approach to Employee Benefit Planning? (Mod 1.4) -
CORRECT ANSWER-Application of a systematic method of analysis to an
Employer's Total Employee Benefits Program. It analyzes the organization's EBP as
a whole in terms of its ability to meet various employee's needs and to manage
loss exposures within the overall compensation goals and parameters.
Why is the Functional Approach appropriate when planning, designing and
administering Employee Benefits? (Mod 1.4) - CORRECT ANSWER-1: EE
Benefits Significant Element of EE Comp and are a Tax-Effective Way to
Compensate
, 2: EE Benefit Represent Large Labor Cost, so ER's should effectively plan/cost-
control
3: In the past, EE Benefits were adopted on piece-meal basis; helps to now fill
gaps/overlap
4: Systematic Approach to planning helps to keep the EBP current, competitive
and in compliance with updated requirements (ACA)
5: Benefits to be integrated properly together
Compare Compensation/Service Oriented Benefit Philosophy with the Needs-
Oriented (Mod 1.4) - CORRECT ANSWER-Compensation/Service: EBP
comprised of primarily compensation, service or both. Level of benefits tied to
salary or pay levels/years of service
Needs Orientated: Focuses on Needs of EE's and their dependents
Identify Steps in Applying Functional Approach (Mod 1.4) - CORRECT ANSWER-
1: Classify EE/Dep Needs & Objectives (in logical/functional categories)
2: Classify Categories of EE's to be protected
3: Analyze present benefits in terms of functional categories of needs/objectives,
persons to benefit, and regulatory requirements
4: Determine any gaps or overlap in benefits from all sources in terms of
functional categories of needs & the persons to be protected