CEBS – GBA 1 — Practice Exam Questions and
Answers — 2026 Edition — Complete exam , A+
Graded
Question 1
Which statement best describes the primary purpose of the Employee Retirement Income
Security Act (ERISA) as it applies to group health plans?
A. To mandate that all employers offer health coverage
B. To establish minimum standards for plan design, funding, and fiduciary conduct
C. To require community rating for all fully-insured medical plans
D. To impose a federal excise tax on high-cost health plans
Correct Answer: B
Rationale: ERISA sets uniform federal rules for plan administration, fiduciary responsibility, and
participant protections; it does not force employers to offer coverage (A), set insurance rates (C),
or impose the Cadillac tax (D) (IRC 4980I).
Question 2
Under the ACA’s employer shared-responsibility rules for 2025, an applicable large employer
(ALE) is defined as an employer that employed on average at least how many full-time-
equivalent employees during the preceding calendar year?
A. 10
B. 20
C. 50
D. 100
Correct Answer: C
Rationale: 50 full-time-equivalent employees is the ACA threshold; 100 (D) was a temporary
transition rule that sunset.
Question 3
A fully-insured PPO plan has a $2,000 deductible and 80 % coinsurance. If a participant incurs a
$10,000 covered charge, what is the participant’s total out-of-pocket cost for the claim?
A. $2,000
,B. $3,600
C. $4,000
D. $8,000
Correct Answer: B
Rationale: Deductible ($2,000) + 20 % of remaining $8,000 = $1,600 → total $3,600. Option A
ignores coinsurance; C double-counts; D is insurer’s share.
Question 4
Which of the following services is most commonly covered under a typical group dental plan but
excluded under a standard medical plan?
A. Oral surgery
B. Routine preventive cleanings
C. Anesthesia for extractions
D. TMJ disorder treatment
Correct Answer: B
Rationale: Biannual cleanings are a core dental benefit; medical plans cover oral surgery (A) and
anesthesia (C) only when medically necessary, and TMJ (D) coverage varies.
Question 5
COBRA qualifying events that trigger a loss of coverage for covered employees include all of
the following EXCEPT:
A. Reduction in hours below the plan’s eligibility threshold
B. Voluntary termination of employment
C. Filing for divorce from the plan participant
D. Becoming eligible for Medicare at age 65
Correct Answer: D
Rationale: Medicare entitlement is a qualifying event for spouses/dependents, not for the
employee themselves under COBRA.
Question 6
A high-deductible health plan (HDHP) compatible with an HSA in 2025 must have a minimum
deductible of how much for self-only coverage?
A. $1,000
B. $1,600
, C. $2,000
D. $4,000
Correct Answer: B
Rationale: IRS Rev. Proc. 24-25 sets HDHP minimum deductible at $1,600 self-only for 2025.
Question 7
Which statement best describes a Health Reimbursement Arrangement (HRA)?
A. Employee-funded account with use-it-or-lose-it rule
B. Employer-funded account that can reimburse qualified medical expenses tax-free
C. Account that must be paired with any HDHP
D. Account whose funds are immediately vested and portable upon termination
Correct Answer: B
Rationale: HRA is solely employer-funded and reimburses tax-free expenses; portability (D) is
optional, and HDHP pairing (C) is not mandatory.
Question 8
Under HIPAA’s Privacy Rule, a group health plan may disclose protected health information
(PHI) to the plan sponsor without individual authorization only if which condition is met?
A. The sponsor has fewer than 50 employees
B. The plan document has been amended to include required certifications and the sponsor
agrees to them
C. The disclosure is for marketing wellness products
D. The PHI relates only to dental claims
Correct Answer: B
Rationale: 45 CFR 164.504(f)(2) requires plan-document amendments and certification
language; size (A) and type of claim (D) are irrelevant, and marketing (C) generally requires
authorization.
Question 9
Which cost-containment strategy is classified as a “soft dollar” approach?
A. Increasing employee deductibles
B. Implementing a disease management program
C. Switching to self-funding
D. Adding a spousal surcharge
Answers — 2026 Edition — Complete exam , A+
Graded
Question 1
Which statement best describes the primary purpose of the Employee Retirement Income
Security Act (ERISA) as it applies to group health plans?
A. To mandate that all employers offer health coverage
B. To establish minimum standards for plan design, funding, and fiduciary conduct
C. To require community rating for all fully-insured medical plans
D. To impose a federal excise tax on high-cost health plans
Correct Answer: B
Rationale: ERISA sets uniform federal rules for plan administration, fiduciary responsibility, and
participant protections; it does not force employers to offer coverage (A), set insurance rates (C),
or impose the Cadillac tax (D) (IRC 4980I).
Question 2
Under the ACA’s employer shared-responsibility rules for 2025, an applicable large employer
(ALE) is defined as an employer that employed on average at least how many full-time-
equivalent employees during the preceding calendar year?
A. 10
B. 20
C. 50
D. 100
Correct Answer: C
Rationale: 50 full-time-equivalent employees is the ACA threshold; 100 (D) was a temporary
transition rule that sunset.
Question 3
A fully-insured PPO plan has a $2,000 deductible and 80 % coinsurance. If a participant incurs a
$10,000 covered charge, what is the participant’s total out-of-pocket cost for the claim?
A. $2,000
,B. $3,600
C. $4,000
D. $8,000
Correct Answer: B
Rationale: Deductible ($2,000) + 20 % of remaining $8,000 = $1,600 → total $3,600. Option A
ignores coinsurance; C double-counts; D is insurer’s share.
Question 4
Which of the following services is most commonly covered under a typical group dental plan but
excluded under a standard medical plan?
A. Oral surgery
B. Routine preventive cleanings
C. Anesthesia for extractions
D. TMJ disorder treatment
Correct Answer: B
Rationale: Biannual cleanings are a core dental benefit; medical plans cover oral surgery (A) and
anesthesia (C) only when medically necessary, and TMJ (D) coverage varies.
Question 5
COBRA qualifying events that trigger a loss of coverage for covered employees include all of
the following EXCEPT:
A. Reduction in hours below the plan’s eligibility threshold
B. Voluntary termination of employment
C. Filing for divorce from the plan participant
D. Becoming eligible for Medicare at age 65
Correct Answer: D
Rationale: Medicare entitlement is a qualifying event for spouses/dependents, not for the
employee themselves under COBRA.
Question 6
A high-deductible health plan (HDHP) compatible with an HSA in 2025 must have a minimum
deductible of how much for self-only coverage?
A. $1,000
B. $1,600
, C. $2,000
D. $4,000
Correct Answer: B
Rationale: IRS Rev. Proc. 24-25 sets HDHP minimum deductible at $1,600 self-only for 2025.
Question 7
Which statement best describes a Health Reimbursement Arrangement (HRA)?
A. Employee-funded account with use-it-or-lose-it rule
B. Employer-funded account that can reimburse qualified medical expenses tax-free
C. Account that must be paired with any HDHP
D. Account whose funds are immediately vested and portable upon termination
Correct Answer: B
Rationale: HRA is solely employer-funded and reimburses tax-free expenses; portability (D) is
optional, and HDHP pairing (C) is not mandatory.
Question 8
Under HIPAA’s Privacy Rule, a group health plan may disclose protected health information
(PHI) to the plan sponsor without individual authorization only if which condition is met?
A. The sponsor has fewer than 50 employees
B. The plan document has been amended to include required certifications and the sponsor
agrees to them
C. The disclosure is for marketing wellness products
D. The PHI relates only to dental claims
Correct Answer: B
Rationale: 45 CFR 164.504(f)(2) requires plan-document amendments and certification
language; size (A) and type of claim (D) are irrelevant, and marketing (C) generally requires
authorization.
Question 9
Which cost-containment strategy is classified as a “soft dollar” approach?
A. Increasing employee deductibles
B. Implementing a disease management program
C. Switching to self-funding
D. Adding a spousal surcharge
