CEBS GBA 2 Practice Exam 2026|2027 Questions with Detailed Verified
Answers (100% Correct Answers) | Already Graded A+
Reinsurance is especially important in self-funded health insurance plans. Which of the
following statements regarding stop-loss reinsurance for these plans is (are) correct?
I. "Lasering" is the process of excluding selected high-cost employees from reinsurance
coverage.
II. The stop-loss reinsurance contract is almost always limited to one year.
III. Stop-loss reinsurance for self-funded health plans is currently regulated almost exclusively at
the federal level. - Answer -B.) II only
Which of the following entities have participated in the risk adjustment program of the
Affordable Care Act?
I. All qualified health plans offered outside the exchange
II. Self-insured health plans offered on private exchanges
III. Medicare Part D plans - Answer -A.) None
Which of the following statements regarding the Affordable Care Act (ACA) is (are) correct?
I. The ACA puts a limit on the medical loss ratio for large and small groups.
II. The ACA prohibits medical underwriting.
III. The ACA should produce lower health premiums for men and for younger people relative to
the premiums for the same coverage prior to the law. - Answer -D.) I and II only
1|Page
,Studies concerning employees' willingness to change health plans when faced with changes in
out-of-pocket premiums show that not all employees have the same degree of price sensitivity.
Which of the following groups of employees are less likely to change plans for a given increase
in the out-of-pocket premium?
I. Enrollees of point-of-service (POS) plans
II. Enrollees of health maintenance organization (HMO) plans
III. Employees with chronic health conditions - Answer -C.) III only
Which of the following is (are) among the limitations of ordinary whole life insurance?
I. Relatively high cost
II. Limited flexibility
III. No savings fund - Answer -A.) I only
In the patient-centered medical home (PCMH) model, which of the following statements
regarding primary care visits is (are) correct?
I. The first contact person during such visits might be a generalist, a specialist, or a nurse
practitioner.
II. Some medical homes use secure messaging through electronic health records for real-time
specialist consultation during primary care visits.
III. In many practices, it is common to have daily team "huddles" to preview cases. - Answer -E.)
I, II and III
Which of the following statements regarding different approaches by which to compensate
physicians in managed care plans is (are) correct?
I. Some managed care organizations may prefer to use arrangements that provide no direct link
between quality or quantity of physician effort and compensation.
2|Page
,II. Some managed care organizations preferring to provide a link between quantity of physician
effort and compensation will use a fee-for-service arrangement.
III. Some managed care organization will use a capitation arrangement to create incentives for
physicians to provide visits and referrals that cost less than the capitated amount. - Answer -E.)
I, II and III
Which of the following statements regarding insurer payments and consumer out-of-pocket
payments for out-of-network providers is (are) correct?
I. Out-of-network providers are not limited to an insurer fee schedule when setting price and
often charge more than insurers are willing to reimburse.
II. There is evidence that cost-sharing for using an out-of- network provider is decreasing.
III. Some out-of-network providers will accept as full payments reimbursements made by
insurers or they will negotiate with consumers on price. - Answer -D.) I and III only
Which of the following statements regarding the methodology used by the Affordable Care Act's
risk adjustment program is (are) correct?
I. The risk adjustment program transfers funds from plans with lower-risk enrollees to plans with
higher-risk enrollees.
II. Individual risk scores based on an individual's age and sex are specifically prohibited.
III. If an enrollee is receiving subsidies to reduce his or her cost sharing, an induced utilization
factor is applied to account for induced demand. - Answer -C.) I and III only
Which of the following statements regarding the strategies that can be used to pursue quality
improvement (QI) is (are) correct?
I. One of the top strategies that has been identified is to delegate authority to the
implementation planners.
3|Page
, II. It is now believed that a universal implementation approach for the various practice settings
is better than a tailored implementation approach for each practice setting.
III. One of the best strategies is to focus on special projects using a team of volunteers. - Answer
-A.) I only
Which of the following statements regarding the self-funding of health benefits by small firms
are correct?
I. Total costs in self-funded plans are lower relative to fully insured product options in large part
because traditional insurance premiums include carrier marketing costs and profit margins—
factors that are not applicable to self-funded plans.
II. With a self-funded plan, a small employer can personalize a benefits package to reflect the
needs of its workers.
III. A shift to self-insurance may lead to adverse selection in the fully insured market for small
groups. - Answer -E.) I, II and III
Which of the following statements regarding the financing of workers' compensation programs
is (are) correct?
I. Workers' compensation programs are based on the principle that the cost of work-related
accidents is a business expense.
II. Employers can purchase workers' compensation insurance from a private carrier or state fund
but no state allows this exposure to be self-insured.
III. Most state workers' compensation programs rely heavily on the general taxing power of the
state to finance workers' compensation. - Answer -A.) I only
Disadvantages of group term life insurance for employees include which of the following?
I. Coverage is rarely portable
4|Page
Answers (100% Correct Answers) | Already Graded A+
Reinsurance is especially important in self-funded health insurance plans. Which of the
following statements regarding stop-loss reinsurance for these plans is (are) correct?
I. "Lasering" is the process of excluding selected high-cost employees from reinsurance
coverage.
II. The stop-loss reinsurance contract is almost always limited to one year.
III. Stop-loss reinsurance for self-funded health plans is currently regulated almost exclusively at
the federal level. - Answer -B.) II only
Which of the following entities have participated in the risk adjustment program of the
Affordable Care Act?
I. All qualified health plans offered outside the exchange
II. Self-insured health plans offered on private exchanges
III. Medicare Part D plans - Answer -A.) None
Which of the following statements regarding the Affordable Care Act (ACA) is (are) correct?
I. The ACA puts a limit on the medical loss ratio for large and small groups.
II. The ACA prohibits medical underwriting.
III. The ACA should produce lower health premiums for men and for younger people relative to
the premiums for the same coverage prior to the law. - Answer -D.) I and II only
1|Page
,Studies concerning employees' willingness to change health plans when faced with changes in
out-of-pocket premiums show that not all employees have the same degree of price sensitivity.
Which of the following groups of employees are less likely to change plans for a given increase
in the out-of-pocket premium?
I. Enrollees of point-of-service (POS) plans
II. Enrollees of health maintenance organization (HMO) plans
III. Employees with chronic health conditions - Answer -C.) III only
Which of the following is (are) among the limitations of ordinary whole life insurance?
I. Relatively high cost
II. Limited flexibility
III. No savings fund - Answer -A.) I only
In the patient-centered medical home (PCMH) model, which of the following statements
regarding primary care visits is (are) correct?
I. The first contact person during such visits might be a generalist, a specialist, or a nurse
practitioner.
II. Some medical homes use secure messaging through electronic health records for real-time
specialist consultation during primary care visits.
III. In many practices, it is common to have daily team "huddles" to preview cases. - Answer -E.)
I, II and III
Which of the following statements regarding different approaches by which to compensate
physicians in managed care plans is (are) correct?
I. Some managed care organizations may prefer to use arrangements that provide no direct link
between quality or quantity of physician effort and compensation.
2|Page
,II. Some managed care organizations preferring to provide a link between quantity of physician
effort and compensation will use a fee-for-service arrangement.
III. Some managed care organization will use a capitation arrangement to create incentives for
physicians to provide visits and referrals that cost less than the capitated amount. - Answer -E.)
I, II and III
Which of the following statements regarding insurer payments and consumer out-of-pocket
payments for out-of-network providers is (are) correct?
I. Out-of-network providers are not limited to an insurer fee schedule when setting price and
often charge more than insurers are willing to reimburse.
II. There is evidence that cost-sharing for using an out-of- network provider is decreasing.
III. Some out-of-network providers will accept as full payments reimbursements made by
insurers or they will negotiate with consumers on price. - Answer -D.) I and III only
Which of the following statements regarding the methodology used by the Affordable Care Act's
risk adjustment program is (are) correct?
I. The risk adjustment program transfers funds from plans with lower-risk enrollees to plans with
higher-risk enrollees.
II. Individual risk scores based on an individual's age and sex are specifically prohibited.
III. If an enrollee is receiving subsidies to reduce his or her cost sharing, an induced utilization
factor is applied to account for induced demand. - Answer -C.) I and III only
Which of the following statements regarding the strategies that can be used to pursue quality
improvement (QI) is (are) correct?
I. One of the top strategies that has been identified is to delegate authority to the
implementation planners.
3|Page
, II. It is now believed that a universal implementation approach for the various practice settings
is better than a tailored implementation approach for each practice setting.
III. One of the best strategies is to focus on special projects using a team of volunteers. - Answer
-A.) I only
Which of the following statements regarding the self-funding of health benefits by small firms
are correct?
I. Total costs in self-funded plans are lower relative to fully insured product options in large part
because traditional insurance premiums include carrier marketing costs and profit margins—
factors that are not applicable to self-funded plans.
II. With a self-funded plan, a small employer can personalize a benefits package to reflect the
needs of its workers.
III. A shift to self-insurance may lead to adverse selection in the fully insured market for small
groups. - Answer -E.) I, II and III
Which of the following statements regarding the financing of workers' compensation programs
is (are) correct?
I. Workers' compensation programs are based on the principle that the cost of work-related
accidents is a business expense.
II. Employers can purchase workers' compensation insurance from a private carrier or state fund
but no state allows this exposure to be self-insured.
III. Most state workers' compensation programs rely heavily on the general taxing power of the
state to finance workers' compensation. - Answer -A.) I only
Disadvantages of group term life insurance for employees include which of the following?
I. Coverage is rarely portable
4|Page
