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Risk Management

Business

Quiz 22 :

Employment and Individual Health Risk Management

Quiz 22 :

Employment and Individual Health Risk Management

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Maternity benefits are available as a rider, or optional coverage, in group insurance, but they cannot be optional in individual policies.
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True False
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False

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Health maintenance organizations are cheaper than preferred provider organizations and health maintenance organizations with open access.
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True False
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False

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A major criticism of health maintenance organizations is the limited choice of providers for subscribers.
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True False
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True

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Maternity coverage is excluded in group medical expense insurance policies.
True False
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If the health maintenance organization providers overtreat subscribers, they receive extra money.
True False
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A group plan that does not include a coordination of benefits provision is considered the secondary insurer by all insurers that have such provisions.
True False
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In group insurance, the benefit period is usually a calendar year.
True False
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Like most preferred provider organizations, health maintenance organizations give employees and their dependents a broad choice of providers.
True False
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Unlike sick leave, short-term disability income plans do not have the restriction of elimination period to pay benefits to employees.
True False
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The consumer-driven health plans and high-deductible health plans intend to transform the defined contribution plans approach to health insurance into defined benefits as part of an ownership society paradigm.
True False
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With major medical policies, the insured pays most of the cost for medical services.
True False
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Medical savings accounts were used for individuals and large employers only and were not available to small employers or the self-employed.
True False
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Second surgical opinions require that two surgeons agree that surgery needs to be done before the insurer will pay for the procedure.
True False
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When a child is insured under both parents' plans, the policy of the parent whose birthday falls first in the year is the primary policy.
True False
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Contribution to a health savings account can be made by the employer or the individual, or both.If made by the employer, the contribution is not taxable to the employee.If it is made by the individual, it is a before-tax contribution.
True False
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In managed care, capitation is a set amount paid to each health care provider based on the number of subscribers in the provider's plan.
True False
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Dental policies not only cover routine care but also protect insureds against more expensive procedures such as restorative services.
True False
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The doctors in an individual practice association can see both health maintenance organization and non- health maintenance organization patients.
True False
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Health maintenance organizations cover routine checkups even when the employee is not ill.
True False
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Extended care facilities provide basic medical care needed during some recoveries, rather than the intensive and more expensive medical service of a hospital.
True False
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Showing 1 - 20 of 74