CEBS GBA 2 Test Questions and Answers Fully Solved Graded A+
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 - Answers C.) 50,000
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 - Answers E. Family members on an unpaid basis
"Desktop Medicine" is a fully integrated approach using information technology whose primary goal is
to:
A. Recruit prospective health plan subscribers
B. Help track patients through their plan of care
C. Encourage patient self-diagnosis using the internet
D. Gather health status metrics for large patient populations
E. Expedite health provider use of technology - Answers B. Help track patients through their plan of care
,Objective risk for health insurers is most closely related to which of the following concepts?
A. Expense rations
B. Carve out coverage such as prescription drug benefits
C. Dispersion (which is often measured by stand deviation)
D. Investment underwriting
E. Subjective risk - Answers C. Dispersion (which is often measured by stand deviation)
A life insurance policy in which the insurance provides lifetime protection, the premiums are level, but
they are paid only for a certain period is referred to as:
A. Endowment insurance
B. Term to age 65
C. Straight life
D. Limited payment life
E. Variable life - Answers D. Limited payment life
Which of the following measures of cost is generally used by analysts when they are examining the
impact of insurance premiums on employees' choice of health insurance plans?
A. The loading percentage
B. The total gross premium
C. The insurer's profit
D. The employee's out of pocket price
E. The expected future gross premium - Answers D. The employee's out of pocket price
Which of the following statements regarding reimbursement methods for patient-centered medical
homes (PCMHs) is correct?
A. The most popular approach, by far, is fee for service
,B. The most common approach is a capitation system
C. Typically, reimbursement is based on a pay for performance approach
D. A negotiated, or modified, fee for service is the most common
E. Nearly all approaches utilize a blend of pay for performance, monthly per enrollee payments and fee
for service - Answers E. Nearly all approaches utilize a blend of pay for performance, monthly per
enrollee payments and fee for service.
The Affordable Care Act (ACA) does not require employers with fewer than a certain number or full time
employees to offer health insurance coverage. The number is:
A. 25
B. 50
C. 75
D. 80
E. 100 - Answers B. 50
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 - Answers A. Managed care plans
introduced selective contracting into the market
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 - Answers B. is one method of giving
subscribers an incentive to use lower cost but quality providers
"Lasering" by stop loss insurance carriers refers to the practice of:
A. Severely limiting the amount that will be paid for high risk individuals
B. Refusing to provide coverage for high risk individuals
C. Limiting the number of covered perils for certain specified individuals
D. Seeking bids from a number of insurance carriers
E. Refining the rates the insurance carrier will charge the plan sponsor - Answers A. Severely limiting the
amount that will be paid for high risk individuals
Which of the following statements regarding important provisions in the Affordable Care Act (ACA) is
correct?
A. Lifetime limits are permissible for almost all new health care benefits
B. Insurers are allowed to charge higher premiums for females
C. Children are permitted to remain on their parents insurance plans until their thirtieth birthday
D. Insurers must spend at least 80 percent of premium dollars on health costs and claims instead of
administration costs
E. Insurers can deny coverage for certain specified preexisting conditions - Answers D. Insurers must
spend at least 80 percent of premium dollars on health costs and claims instead of administration costs
A small employer has a self funded health plan with reinsurance coverage. Which of the following
statements regarding this type of reinsurance is correct?
A. Aggregate stop loss reinsurance limits the dollar amount of coverage on each employee's health care
costs
B. Reinsurers often help small employers revise their health plans
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 - Answers C.) 50,000
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 - Answers E. Family members on an unpaid basis
"Desktop Medicine" is a fully integrated approach using information technology whose primary goal is
to:
A. Recruit prospective health plan subscribers
B. Help track patients through their plan of care
C. Encourage patient self-diagnosis using the internet
D. Gather health status metrics for large patient populations
E. Expedite health provider use of technology - Answers B. Help track patients through their plan of care
,Objective risk for health insurers is most closely related to which of the following concepts?
A. Expense rations
B. Carve out coverage such as prescription drug benefits
C. Dispersion (which is often measured by stand deviation)
D. Investment underwriting
E. Subjective risk - Answers C. Dispersion (which is often measured by stand deviation)
A life insurance policy in which the insurance provides lifetime protection, the premiums are level, but
they are paid only for a certain period is referred to as:
A. Endowment insurance
B. Term to age 65
C. Straight life
D. Limited payment life
E. Variable life - Answers D. Limited payment life
Which of the following measures of cost is generally used by analysts when they are examining the
impact of insurance premiums on employees' choice of health insurance plans?
A. The loading percentage
B. The total gross premium
C. The insurer's profit
D. The employee's out of pocket price
E. The expected future gross premium - Answers D. The employee's out of pocket price
Which of the following statements regarding reimbursement methods for patient-centered medical
homes (PCMHs) is correct?
A. The most popular approach, by far, is fee for service
,B. The most common approach is a capitation system
C. Typically, reimbursement is based on a pay for performance approach
D. A negotiated, or modified, fee for service is the most common
E. Nearly all approaches utilize a blend of pay for performance, monthly per enrollee payments and fee
for service - Answers E. Nearly all approaches utilize a blend of pay for performance, monthly per
enrollee payments and fee for service.
The Affordable Care Act (ACA) does not require employers with fewer than a certain number or full time
employees to offer health insurance coverage. The number is:
A. 25
B. 50
C. 75
D. 80
E. 100 - Answers B. 50
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 - Answers A. Managed care plans
introduced selective contracting into the market
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 - Answers B. is one method of giving
subscribers an incentive to use lower cost but quality providers
"Lasering" by stop loss insurance carriers refers to the practice of:
A. Severely limiting the amount that will be paid for high risk individuals
B. Refusing to provide coverage for high risk individuals
C. Limiting the number of covered perils for certain specified individuals
D. Seeking bids from a number of insurance carriers
E. Refining the rates the insurance carrier will charge the plan sponsor - Answers A. Severely limiting the
amount that will be paid for high risk individuals
Which of the following statements regarding important provisions in the Affordable Care Act (ACA) is
correct?
A. Lifetime limits are permissible for almost all new health care benefits
B. Insurers are allowed to charge higher premiums for females
C. Children are permitted to remain on their parents insurance plans until their thirtieth birthday
D. Insurers must spend at least 80 percent of premium dollars on health costs and claims instead of
administration costs
E. Insurers can deny coverage for certain specified preexisting conditions - Answers D. Insurers must
spend at least 80 percent of premium dollars on health costs and claims instead of administration costs
A small employer has a self funded health plan with reinsurance coverage. Which of the following
statements regarding this type of reinsurance is correct?
A. Aggregate stop loss reinsurance limits the dollar amount of coverage on each employee's health care
costs
B. Reinsurers often help small employers revise their health plans
