CEBS GBA 2 Practice Exam Questions and Answers Rated A
According to the RAND Health Insurance
Experiment, which variable has the greatest
power in explaining health expenditures? Which of the following measures of cost is
generally used by analysts when they are
A.) Welfare eligibility examining the impact of insurance premiums on
B.) Prior utilization employees' choice of health insurance plans?
C.) Physical health (based on self-reported
measures) A.) The loading percentage
D.) General health (based on self-reported B.) The total gross premium
measures) C.) The insurer's profit
E.) Mental health (based on self-reported D.) The employee's out-of-pocket price
measures) - ANSWER -B.) Prior utilization E.) The expected future gross premium -
ANSWER -D.) The employee's out-of-
pocket price
A provision in some group life insurance plans
that provides for the payment of all or part of the
death benefit in the event of the insured's Which of the following statements regarding
terminal illness is called: recognition as a patient-centered medical home
(PCMH) is correct?
A.) Accelerated death benefits
B.) Waiver of premiums A.) The only organization that can officially
C.) Maturity value benefits recognize a PCMH is the Federally Qualified
D.) Continuation-of-protection Health Center Demonstration.
E.) Assignment - ANSWER -A.) B.) The only organization that can officially
Accelerated death benefits recognize a PCMH is the National Committee for
Quality Assurance (NCQA).
C.) No single organization is responsible for
What reasons are given for the Silver plan being recognizing PCMHs.
a popular choice among all the Affordable Care D.) The main organization that recognizes
Act (ACA) health plans? PCMHs is the Joint Commission and the
Accreditation Commission for Health Care.
A.) The Silver plan has the greatest actuarial E.) A PCMH can be recognized only by the state
value of all the plans. in which it is domiciled. - ANSWER -C.) No
B.) Cost-sharing subsidies to lower out-of-pocket single organization is responsible for recognizing
costs are available only to people who select the PCMHs.
Silver plan.
C.) The Silver plan has the greatest benefits,
even more than the Gold and Platinum plans. Which of the following statements regarding
D.) The Silver plan has the lowest out-of-pocket private health insurance exchanges and Small
costs of any plan even before any subsidies. Business Health Options Program (SHOP)
E.) Many people select the Silver plan because exchanges is correct?
they are not eligible for the Gold or Platinum
plans. - ANSWER -B.) Cost-sharing A.) A lot of evidence has been produced to show
subsidies to lower out-of-pocket costs are that private exchanges have been designed to
available only to people who select the Silver make it easier for small business to self-insure.
plan. B.) The income tax incentives previously
,CEBS GBA 2 Practice Exam Questions and Answers Rated A
provided to small employers in the SHOP
program have expired. A.) Transition to the defined contribution
C.) Recently states were given the option of approach
making SHOP exchanges mandatory for all B.) Increased use of technology
employers with fewer than 200 employees. C.) Employees choosing less generous plans
D.) Private exchanges could affect SHOP D.) Better health education of employees
exchanges by siphoning enrollment from them E.) Elimination or reduction in administrative
and thereby reducing revenue (administrative waste - ANSWER -C.) Employees choosing
fees) critical to SHOPs' financial viability. less generous plans
E.) Unlike private exchanges, SHOP exchanges
do not have the ability to offer small employers a
number of plan choices. - ANSWER -D.) Out-of-network health care accounts for
Private exchanges could affect SHOP exchanges approximately what percentage of total covered
by siphoning enrollment from them and thereby health insurance expenses?
reducing revenue (administrative fees) critical to
SHOPs' financial viability. A.) 3
B.) 10
C.) 20
What is the waiting period for Social Security D.) 25
Disability Income (SSDI) benefits? E.) 30 - ANSWER -B.) 10
A.) One month
B.) Three consecutive months The major advantage of term insurance for the
C.) Five consecutive months policyowner is the fact that:
D.) Six consecutive months
E.) Twelve consecutive months - A.) A substantial amount of life insurance can be
ANSWER -C.) Five consecutive months purchased for relatively modest premiums
B.) It provides lifetime protection if the insured
continues to pay the premiums
"Desktop medicine" is a fully integrated approach C.) The premiums remain at the same level for
using information technology whose primary goal the life of the insured
is to: D.) With a policy rider it can be used to provide
retirement
A.) Recruit prospective health plan subscribers E.) Premiums are highly competitive especially
B.) Help track patients through their plan of care for those at older ages - ANSWER -A.) A
C.) Encourage patient self-diagnosis using the substantial amount of life insurance can be
Internet purchased for relatively modest premiums
D.) Gather health status metrics for large patient
populations
E.) Expedite health provider use of technology - Mr. Smith is insured in his company's group life
ANSWER -B.) Help track patients through insurance plan. The plan is noncontributory and
their plan of care meets the requirements of Internal Revenue
Code Section 79. How much group life insurance
can be provided to Mr. Smith without him
Until now, the biggest source of cost savings with incurring a federal income tax liability on the
private health insurance exchanges has been: value of his employer's contributions?
, CEBS GBA 2 Practice Exam Questions and Answers Rated A
D.) Orthopedic surgery
A.) 0 E.) Primary care medicine - ANSWER -E.)
Primary care medicine
B.) 25,000
C.) 50,000 Reference pricing used by some managed care
health plans:
D.) 100,000
A.) Is an example of center-of-excellence pricing.
E.) An unlimited amount - ANSWER -C.) B.) Is one method of giving subscribers an
50,000 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
Which of the following statements regarding practice.
health expenditures and related research is E.) Is designed to attract healthier individuals
correct? into the plan.
A.) In general, risk adjustment models have been . - ANSWER -B.) Is one method of giving
able to predict about 80 percent of total claims. subscribers an incentive to use lower-cost but
B.) Age and gender account for about 90 quality providers
percent of explained variation in health care
expenditures.
C.) Medicare currently pays Medicare Advantage The vast majority of long-term care needs are
plans on the basis of the Centers for Medicare & met by:
Medicaid Services Hierarchical Condition A.) Medicare
Categories (CMS-HCC) model, which uses
approximately 70 clinical conditions. B.) Medicaid
D.) Health maintenance organizations (HMOs)
that could predict health expenditures only five C.) Individual health insurance policies
percentage points better than Medicare would
not gain a significant amount of profit per D.) Long-term care insurance policies
enrollee.
E.) Inpatient expenditures are more predictable E.) Family members on an unpaid basis -
than outpatient expenditures. - ANSWER - ANSWER -E.) Family members on an
C.) Medicare currently pays Medicare Advantage unpaid basis
plans on the basis of the Centers for Medicare &
Medicaid Services Hierarchical Condition
Categories (CMS-HCC) model, which uses The practice of hospitals paid based on billed
approximately 70 clinical conditions. charges by commercial insurers and allowable
costs by Medicare ended primarily because:
Which of the following has been a key focus of A.) Managed care plans introduced selective
redesign and improvement efforts in healthcare? contracting into the market.
B.) Hospitals started using more advanced
A.) Hospital care technology.
B.) Diagnostic/imaging services C.) Patients became less concerned about the
C.) Critical care cost of services.
According to the RAND Health Insurance
Experiment, which variable has the greatest
power in explaining health expenditures? Which of the following measures of cost is
generally used by analysts when they are
A.) Welfare eligibility examining the impact of insurance premiums on
B.) Prior utilization employees' choice of health insurance plans?
C.) Physical health (based on self-reported
measures) A.) The loading percentage
D.) General health (based on self-reported B.) The total gross premium
measures) C.) The insurer's profit
E.) Mental health (based on self-reported D.) The employee's out-of-pocket price
measures) - ANSWER -B.) Prior utilization E.) The expected future gross premium -
ANSWER -D.) The employee's out-of-
pocket price
A provision in some group life insurance plans
that provides for the payment of all or part of the
death benefit in the event of the insured's Which of the following statements regarding
terminal illness is called: recognition as a patient-centered medical home
(PCMH) is correct?
A.) Accelerated death benefits
B.) Waiver of premiums A.) The only organization that can officially
C.) Maturity value benefits recognize a PCMH is the Federally Qualified
D.) Continuation-of-protection Health Center Demonstration.
E.) Assignment - ANSWER -A.) B.) The only organization that can officially
Accelerated death benefits recognize a PCMH is the National Committee for
Quality Assurance (NCQA).
C.) No single organization is responsible for
What reasons are given for the Silver plan being recognizing PCMHs.
a popular choice among all the Affordable Care D.) The main organization that recognizes
Act (ACA) health plans? PCMHs is the Joint Commission and the
Accreditation Commission for Health Care.
A.) The Silver plan has the greatest actuarial E.) A PCMH can be recognized only by the state
value of all the plans. in which it is domiciled. - ANSWER -C.) No
B.) Cost-sharing subsidies to lower out-of-pocket single organization is responsible for recognizing
costs are available only to people who select the PCMHs.
Silver plan.
C.) The Silver plan has the greatest benefits,
even more than the Gold and Platinum plans. Which of the following statements regarding
D.) The Silver plan has the lowest out-of-pocket private health insurance exchanges and Small
costs of any plan even before any subsidies. Business Health Options Program (SHOP)
E.) Many people select the Silver plan because exchanges is correct?
they are not eligible for the Gold or Platinum
plans. - ANSWER -B.) Cost-sharing A.) A lot of evidence has been produced to show
subsidies to lower out-of-pocket costs are that private exchanges have been designed to
available only to people who select the Silver make it easier for small business to self-insure.
plan. B.) The income tax incentives previously
,CEBS GBA 2 Practice Exam Questions and Answers Rated A
provided to small employers in the SHOP
program have expired. A.) Transition to the defined contribution
C.) Recently states were given the option of approach
making SHOP exchanges mandatory for all B.) Increased use of technology
employers with fewer than 200 employees. C.) Employees choosing less generous plans
D.) Private exchanges could affect SHOP D.) Better health education of employees
exchanges by siphoning enrollment from them E.) Elimination or reduction in administrative
and thereby reducing revenue (administrative waste - ANSWER -C.) Employees choosing
fees) critical to SHOPs' financial viability. less generous plans
E.) Unlike private exchanges, SHOP exchanges
do not have the ability to offer small employers a
number of plan choices. - ANSWER -D.) Out-of-network health care accounts for
Private exchanges could affect SHOP exchanges approximately what percentage of total covered
by siphoning enrollment from them and thereby health insurance expenses?
reducing revenue (administrative fees) critical to
SHOPs' financial viability. A.) 3
B.) 10
C.) 20
What is the waiting period for Social Security D.) 25
Disability Income (SSDI) benefits? E.) 30 - ANSWER -B.) 10
A.) One month
B.) Three consecutive months The major advantage of term insurance for the
C.) Five consecutive months policyowner is the fact that:
D.) Six consecutive months
E.) Twelve consecutive months - A.) A substantial amount of life insurance can be
ANSWER -C.) Five consecutive months purchased for relatively modest premiums
B.) It provides lifetime protection if the insured
continues to pay the premiums
"Desktop medicine" is a fully integrated approach C.) The premiums remain at the same level for
using information technology whose primary goal the life of the insured
is to: D.) With a policy rider it can be used to provide
retirement
A.) Recruit prospective health plan subscribers E.) Premiums are highly competitive especially
B.) Help track patients through their plan of care for those at older ages - ANSWER -A.) A
C.) Encourage patient self-diagnosis using the substantial amount of life insurance can be
Internet purchased for relatively modest premiums
D.) Gather health status metrics for large patient
populations
E.) Expedite health provider use of technology - Mr. Smith is insured in his company's group life
ANSWER -B.) Help track patients through insurance plan. The plan is noncontributory and
their plan of care meets the requirements of Internal Revenue
Code Section 79. How much group life insurance
can be provided to Mr. Smith without him
Until now, the biggest source of cost savings with incurring a federal income tax liability on the
private health insurance exchanges has been: value of his employer's contributions?
, CEBS GBA 2 Practice Exam Questions and Answers Rated A
D.) Orthopedic surgery
A.) 0 E.) Primary care medicine - ANSWER -E.)
Primary care medicine
B.) 25,000
C.) 50,000 Reference pricing used by some managed care
health plans:
D.) 100,000
A.) Is an example of center-of-excellence pricing.
E.) An unlimited amount - ANSWER -C.) B.) Is one method of giving subscribers an
50,000 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
Which of the following statements regarding practice.
health expenditures and related research is E.) Is designed to attract healthier individuals
correct? into the plan.
A.) In general, risk adjustment models have been . - ANSWER -B.) Is one method of giving
able to predict about 80 percent of total claims. subscribers an incentive to use lower-cost but
B.) Age and gender account for about 90 quality providers
percent of explained variation in health care
expenditures.
C.) Medicare currently pays Medicare Advantage The vast majority of long-term care needs are
plans on the basis of the Centers for Medicare & met by:
Medicaid Services Hierarchical Condition A.) Medicare
Categories (CMS-HCC) model, which uses
approximately 70 clinical conditions. B.) Medicaid
D.) Health maintenance organizations (HMOs)
that could predict health expenditures only five C.) Individual health insurance policies
percentage points better than Medicare would
not gain a significant amount of profit per D.) Long-term care insurance policies
enrollee.
E.) Inpatient expenditures are more predictable E.) Family members on an unpaid basis -
than outpatient expenditures. - ANSWER - ANSWER -E.) Family members on an
C.) Medicare currently pays Medicare Advantage unpaid basis
plans on the basis of the Centers for Medicare &
Medicaid Services Hierarchical Condition
Categories (CMS-HCC) model, which uses The practice of hospitals paid based on billed
approximately 70 clinical conditions. charges by commercial insurers and allowable
costs by Medicare ended primarily because:
Which of the following has been a key focus of A.) Managed care plans introduced selective
redesign and improvement efforts in healthcare? contracting into the market.
B.) Hospitals started using more advanced
A.) Hospital care technology.
B.) Diagnostic/imaging services C.) Patients became less concerned about the
C.) Critical care cost of services.
