Update Questions with Correct Answers
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A coverage offered through a restricted provider network, like a managed care plan is known as
A. medicaid
B. medicare SELECT
C. medicare part C
D. medicare part D
- Answer -B
A dental plan tat pays on a usual, customary, and reasonable basis (UCR) is also known as a
A. scheduled plan
B. nonscheduled plan
C. maximum plan
D. first dollar coverage plan
- Answer -B
A dental plan that has benefits limited to specified maximums per procedure with first dollar coverage is
considered to be
A. schedules
B. nonscheduled
C. combined
D. predetermined
- Answer -A
A health insurance plan where the employees pay part of the cost and at least 75% of those eligible must
participate in is known as
A. a contributory plan
B. a noncontributory plan
C. an association plan
,D. an administrative plan
- Answer -A
A health plan that offers relatively low premiums but requires taht the insured pay a high deductible is a
A. health savings account
B. health reimbursement account
C. flexible spending account
D. high deductible health plan
- Answer -D
A lender, or creditor may sponsor a group health insurance plan for its group of debtors. This is known as
A multiple employer welfare arrangement
B group credit disability insurance
C association group plans
D credit life insurance
- Answer -B
A limitation or exclusion of benefits based on a physical or mental condition that was present before the
effective date of coverage is also known as
A. a grandfather exclusion
B. a pre-existing condition
C. a conditional exclusion
D. a preventative limitation
- Answer -B
A method of establishing the premium of a group based on the group's previous claim experience is
known as
A. community rating
B. experience rating
C. premium rating
D. group rating
- Answer -B
A need for medical care due to a cause other than an accident is known as
,A. Accident
B. Sickness
C. Peril
D. Loss
- Answer -B
A pro rata return is one in which the insurer returns
A. less than the proportionate amount of the unearned premium
B. the proportionate amount of the unearned premium
C. both earned and unearned premium
D. neither earned nor unearned premium
- Answer -B
A reinstated policy will cover
A. sickness immediately and accidents after 10 days
B. both sickness and accidents after 10 days
C. accidents after 10 days and sickness after 30 days
D. accidents immediately and sickness after 10 days
- Answer -D
A root canal is an example of which of the following types of dental treatment
A. periodontics
B. oral surgery
C. restorative
D. endodontic
- Answer -D
A state law that requires benefits that began to be paid while a health insurance policy was in force to
continue to be paid after the policy is terminated is known as
A. continuation of benefits
B. extension of benefits
C. qualified benefits
D. COBRA
, - Answer -B
A type of group insurance where the group members are identified as all the persons engaged in a
similar activity is known as:
A. An accident-only plan
B. A critical illness plan
C. Blanket coverage
D. Workers Compensation - Answer -C
A type of health insurance that provides a much broader range of medical expenses and higher benefit
amounts is a
A. basic medical expense policy
B. major medical expense policy
C. simple medical expense policy
D. prepaid medical expense policy - Answer -B
A type of HMO that does not have a gatekeeper and allows subscribers to obtain care from either
providers that do or not belong to the HMO is called a
A. point-of-service plan
B. traditional insurance plan
C. preferred provider plan
D. cost containment plan - Answer -A
A written treatment plan provided to patients showing the estimated charge for each service to be
performed, along with a breakdown or how much of the cost is expected to be paid by the dental plan is
known as a
A. predetermination of benefits
B. combination plan
C. scheduled benefit
D. nonscheduled benefit - Answer -A
ABC Printing, a small tax nonexempt company, can get tax credits to help offset the cost of the
company's health plan premium contribution for it's employees. The maxiumum credit is
A. 75% of premium paid
B. 50% of premium paid
C. 25% of premium paid