CEBS GBA Exam 2 Complete Study Questions with Correct Answers

CEBS GBA Exam 2 Complete Study Questions with Correct Answers 1. According to the RAND Health Insurance Experiment, which variable has the greatest power in explaining health expenditures? A.) Welfare eligibility B.) Prior utilization C.) Physical health (based on self-reported measures) D.) General health (based on self-reported measures) E.) Mental health (based on self-reported measures) - ANSWER B.) Prior utilization 2. 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 terminal illness is called: A.) Accelerated death benefits B.) Waiver of premiums C.) Maturity value benefits D.) Continuation-of-protection E.) Assignment - ANSWER A.) Accelerated death benefits 3. Out-of-network health care accounts for approximately what percentage of total covered health insurance expenses? A.) 3 B.) 10 C.) 20 D.) 25 E.) 30 - ANSWER B.) 10 4. The major advantage of term insurance for the policyowner is the fact that: A.) A substantial amount of life insurance can be purchased for relatively modest premiums B.) It provides lifetime protection if the insured continues to pay the premiums C.) The premiums remain at the same level for the life of the insured D.) With a policy rider it can be used to provide retirement E.) Premiums are highly competitive especially for those at older ages - ANSWER A.) A substantial amount of life insurance can be purchased for relatively modest premiums 5. 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 - ANSWER C.) 50,000 6. Which of the following statements regarding health expenditures and related research is correct? A.) In general, risk adjustment models have been able to predict about 80 percent of total claims. B.) Age and gender account for about 90 percent of explained variation in health care expenditures. C.) Medicare currently pays Medicare Advantage plans on the basis of the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC) model, which uses approximately 70 clinical conditions. D.) Health maintenance organizations (HMOs) that could predict health expenditures only five percentage points better than Medicare would not gain a significant amount of profit per enrollee. E.) Inpatient expenditures are more predictable than outpatient expenditures. - ANSWER C.) Medicare currently pays Medicare Advantage plans on the basis of the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC) model, which uses approximately 70 clinical conditions. 7. Which of the following has been a key focus of redesign and improvement efforts in healthcare? A.) Hospital care B.) Diagnostic/imaging services C.) Critical care D.) Orthopedic surgery E.) Primary care medicine - ANSWER E.) Primary care medicine 8. 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. . - ANSWER B.) Is one method of giving subscribers an incentive to use lower-cost but quality providers 9. 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 - ANSWER E.) Family members on an unpaid basis 10.What reasons are given for the Silver plan being a popular choice among all the Affordable Care Act (ACA) health plans? A.) The Silver plan has the greatest actuarial value of all the plans. B.) Cost-sharing subsidies to lower out-of-pocket costs are available only to people who select the Silver plan. C.) The Silver plan has the greatest benefits, even more than the Gold and Platinum plans. D.) The Silver plan has the lowest out-of-pocket costs of any plan even before any subsidies. E.) Many people select the Silver plan because they are not eligible for the Gold or Platinum plans. - ANSWER B.) Cost-sharing subsidies to lower out-of-pocket costs are available only to people who select the Silver plan.