HLSA Week 3 Exam Review Questions with
Verified Correct Answers
Employer Sponsored Insurance (ESI) Coverage Share
53.8% of Americans (181 million individuals) get coverage through their job.
ESI Eligibility and Take-Up Rates
75% of workers are eligible; 88% of those with access take it up.
WWII Wage Freeze Impact
Wage controls led employers to offer health insurance as a non-taxed way to attract workers.
1954 IRS Ruling on Tax Exclusion
Ruled that employer and worker contributions to health insurance are untaxed.
Tax Exclusion Progressivity
It is regressive, benefiting higher-income individuals more than lower-income individuals.
The Cadillac Tax
An ACA excise tax on very generous health insurance benefits; later removed.
Self-Insured Plan
Employer bears the financial risk of medical expenses, often using a third-party administrator.
Regulated by the federal government (63% of insured workers)
Fully-Insured Plan
Employer contracts with an insurance company that bears the risk of medical claims. Regulated
by the states (27% of insured workers)
Small vs. Large Group Threshold
Small groups have 50 or fewer employees; large groups have more than 50.
Indemnity Plans
Fee-for-service plans allowing patients to see any provider with standard cost-sharing.
Verified Correct Answers
Employer Sponsored Insurance (ESI) Coverage Share
53.8% of Americans (181 million individuals) get coverage through their job.
ESI Eligibility and Take-Up Rates
75% of workers are eligible; 88% of those with access take it up.
WWII Wage Freeze Impact
Wage controls led employers to offer health insurance as a non-taxed way to attract workers.
1954 IRS Ruling on Tax Exclusion
Ruled that employer and worker contributions to health insurance are untaxed.
Tax Exclusion Progressivity
It is regressive, benefiting higher-income individuals more than lower-income individuals.
The Cadillac Tax
An ACA excise tax on very generous health insurance benefits; later removed.
Self-Insured Plan
Employer bears the financial risk of medical expenses, often using a third-party administrator.
Regulated by the federal government (63% of insured workers)
Fully-Insured Plan
Employer contracts with an insurance company that bears the risk of medical claims. Regulated
by the states (27% of insured workers)
Small vs. Large Group Threshold
Small groups have 50 or fewer employees; large groups have more than 50.
Indemnity Plans
Fee-for-service plans allowing patients to see any provider with standard cost-sharing.
