CEBS-GBA 2, Module 7 Exam
questions 2026 Exam Questions and
verified Answers
Relationship of health care insurance to firm size - CORRECT ANSWERS Small firms are much
less likely than larger firms to offer health care insurance to
their employees. According to one source, approximately 54% of firms under 200
full-time equivalents (FTEs) offer some type of health care policy to their employees,
while about 98% of firms above 100 FTEs offer health care insurance to their
employees
Relationship of self-funding to firm size - CORRECT ANSWERS Self-funding is not common
among small firms. Only about 8% of employers with
fewer than 50 FTEs self-fund their health benefits. However, the percentage of
firms that self-fund health insurance plans increases along with the number of
employees—58% of firms with 200-299 employees self-fund, with the figure rising
to 79% in employers with 3,000-4,999 employees and 94% in employers with over
Affordable Care Act (ACA) requirements for employers - CORRECT ANSWERS ACA requires
companies with 50 or more FTEs to offer health care policies that
meet specific criteria—or pay penalties. Although ACA does not impose this
requirement on firms below 50 FTEs, it does establish minimum conditions for
policies sold by health insurers to the firms under 50 FTEs. Also, employers under
50 FTEs are not required to contribute toward employee health care insurance costs.
Small Business Health Options Program (SHOP) exchanges - CORRECT ANSWERS Small
Business Health Options Program (SHOP) exchanges are marketplaces that
, are essentially online portals enabling small employers to select from a range of fully
insured plans and contribution arrangements for their employees. ACA established
these exchanges to allow small employers better access to health care insurance
plans.
Plans marketed on SHOP exchanges, like those sold in the small group market
outside the exchanges, must comply with federal requirements for insurers.
However, other elements of SHOP exchanges are determined by individual states.
Most states have established minimum participation requirements, specifying the
percentage of employees within any small group that must enroll in SHOP coverage.
States have also set minimum contribution requirements, which specify that
employers must contribute at least 50-75% of employee premium costs.
ACA requirements for insurers - CORRECT ANSWERS (a) Insurers may no longer exclude
members based on preexisting conditions.
(b) Insurers may not place annual or lifetime caps on coverage.
(c) All fully insured products must comply with a medical loss ratio (MLR)
requirement. It mandates that health insurance issuers in the individual and
small group markets and in the large group market spend at least 80% and 85%
of premiums, respectively, on health care activities (as opposed to administrative
functions).
(d) Coverage must be available to dependents until the age of 26.
(e) Benefits that discriminate in favor of highly compensated employees are
prohibited.
Two important ACA provisions that deal with essential health benefits and community rating. - CORRECT
ANSWERS Fully insured plans sold to employer groups under 50 FTEs (either on SHOP
questions 2026 Exam Questions and
verified Answers
Relationship of health care insurance to firm size - CORRECT ANSWERS Small firms are much
less likely than larger firms to offer health care insurance to
their employees. According to one source, approximately 54% of firms under 200
full-time equivalents (FTEs) offer some type of health care policy to their employees,
while about 98% of firms above 100 FTEs offer health care insurance to their
employees
Relationship of self-funding to firm size - CORRECT ANSWERS Self-funding is not common
among small firms. Only about 8% of employers with
fewer than 50 FTEs self-fund their health benefits. However, the percentage of
firms that self-fund health insurance plans increases along with the number of
employees—58% of firms with 200-299 employees self-fund, with the figure rising
to 79% in employers with 3,000-4,999 employees and 94% in employers with over
Affordable Care Act (ACA) requirements for employers - CORRECT ANSWERS ACA requires
companies with 50 or more FTEs to offer health care policies that
meet specific criteria—or pay penalties. Although ACA does not impose this
requirement on firms below 50 FTEs, it does establish minimum conditions for
policies sold by health insurers to the firms under 50 FTEs. Also, employers under
50 FTEs are not required to contribute toward employee health care insurance costs.
Small Business Health Options Program (SHOP) exchanges - CORRECT ANSWERS Small
Business Health Options Program (SHOP) exchanges are marketplaces that
, are essentially online portals enabling small employers to select from a range of fully
insured plans and contribution arrangements for their employees. ACA established
these exchanges to allow small employers better access to health care insurance
plans.
Plans marketed on SHOP exchanges, like those sold in the small group market
outside the exchanges, must comply with federal requirements for insurers.
However, other elements of SHOP exchanges are determined by individual states.
Most states have established minimum participation requirements, specifying the
percentage of employees within any small group that must enroll in SHOP coverage.
States have also set minimum contribution requirements, which specify that
employers must contribute at least 50-75% of employee premium costs.
ACA requirements for insurers - CORRECT ANSWERS (a) Insurers may no longer exclude
members based on preexisting conditions.
(b) Insurers may not place annual or lifetime caps on coverage.
(c) All fully insured products must comply with a medical loss ratio (MLR)
requirement. It mandates that health insurance issuers in the individual and
small group markets and in the large group market spend at least 80% and 85%
of premiums, respectively, on health care activities (as opposed to administrative
functions).
(d) Coverage must be available to dependents until the age of 26.
(e) Benefits that discriminate in favor of highly compensated employees are
prohibited.
Two important ACA provisions that deal with essential health benefits and community rating. - CORRECT
ANSWERS Fully insured plans sold to employer groups under 50 FTEs (either on SHOP
