GBA 1 Exam : Directing Benefits Programs
Part 1 2024 Questions & Answers | 100%
Correct | Verified
Which risk-handling techniques are being used by a firm that decides to not produce a dangerous
chemical, to purchase insurance with a $10,000 deductible on its assets and to install a fire sprinkler
system throughout the plant? - ✔✔Avoidance, retention, insurance and control
Which of the following statements regarding prescription drug rebates is correct? - ✔✔A rebate occurs
when there is an agreement between a pharmacy benefit manager and a drug manufacturer.
There are several methods for evaluating health system performance. Accreditation by the NCQA is an
example of which of the following methods? - ✔✔Audit performance evaluation
When a participant of a cafeteria plan makes a one-time election on coverage that stays in force from
plan year to plan year unless the participant elects to make a change during the applicable election
period, it is referred to as a(n): - ✔✔Evergreen election
The benefit-oriented philosophy of designing employee benefits tends to focus on: - ✔✔Needs of
employees
The amount of covered medical expenses that a participant must incur before any medical benefits for
non-preventive care services or treatment become payable under a plan is known as the: -
✔✔Deductible
The Supreme Court decision in National Federation of Independent Business v. Sebelius had a profound
effect on the implementation of the Affordable Care Act (ACA). Which of the following statements
summarizes the impact of this case? - ✔✔The decision made Medicare expansion by the states
voluntary.
The Affordable Care Act (ACA) aimed to make health insurance more affordable by providing tax credits
to individuals ineligible for other affordable coverage and with income between which of the following
limits: - ✔✔100% and 400% of the federal poverty line.
, The concept designed to make victims of losses whole again reflects the principle of: -
✔✔Indemnification
A mechanism by which one attempts either to prevent or reduce the probability of a loss taking place or
to reduce the severity of the loss if it does take place is referred to as: - ✔✔Control
The Affordable Care Act (ACA), in general, defined a full-time employee as one employed on average at
least how many hours per week? - ✔✔30
Dental treatments are placed into ten professional treatment categories. A restorative treatment is: -
✔✔
If a cafeteria plan fails to pass the required nondiscrimination testing, then: - ✔✔The highly
compensated and key employees are taxed based on the value of their benefits.
An insured individual has $12,000 of covered medical expenses for in-network nonpreventive treatment.
His plan is a high-deductible health policy with a $1,500 deductible and a 20% coinsurance arrangement.
Also, the plan reimburses 100% after an individual reaches the plan's $6,000 out-of-pocket maximum.
What will the insured pay out of the total medical expenses if this is the first claim of the plan year? -
✔✔$ 3,600
A behavioral health care carve-out program usually operates under a separate contract and from a
separate company known as a(n): - ✔✔Managed behavioral health care organization (MBHO)
A peril as the term applies to the insurance mechanism is defined as: - ✔✔The cause of a loss
The "managed care backlash" of the late 1990s gave direct rise to which of the following types of health
care organizations? - ✔✔Preferred provider organizations (PPOs)
Which of the following is a requirement of the Health Insurance Portability and Accountability Act
(HIPAA) as it applies to wellness programs? - ✔✔A program that is offered directly by an employer
outside of a group plan is not subject to HIPAA privacy rules.
Part 1 2024 Questions & Answers | 100%
Correct | Verified
Which risk-handling techniques are being used by a firm that decides to not produce a dangerous
chemical, to purchase insurance with a $10,000 deductible on its assets and to install a fire sprinkler
system throughout the plant? - ✔✔Avoidance, retention, insurance and control
Which of the following statements regarding prescription drug rebates is correct? - ✔✔A rebate occurs
when there is an agreement between a pharmacy benefit manager and a drug manufacturer.
There are several methods for evaluating health system performance. Accreditation by the NCQA is an
example of which of the following methods? - ✔✔Audit performance evaluation
When a participant of a cafeteria plan makes a one-time election on coverage that stays in force from
plan year to plan year unless the participant elects to make a change during the applicable election
period, it is referred to as a(n): - ✔✔Evergreen election
The benefit-oriented philosophy of designing employee benefits tends to focus on: - ✔✔Needs of
employees
The amount of covered medical expenses that a participant must incur before any medical benefits for
non-preventive care services or treatment become payable under a plan is known as the: -
✔✔Deductible
The Supreme Court decision in National Federation of Independent Business v. Sebelius had a profound
effect on the implementation of the Affordable Care Act (ACA). Which of the following statements
summarizes the impact of this case? - ✔✔The decision made Medicare expansion by the states
voluntary.
The Affordable Care Act (ACA) aimed to make health insurance more affordable by providing tax credits
to individuals ineligible for other affordable coverage and with income between which of the following
limits: - ✔✔100% and 400% of the federal poverty line.
, The concept designed to make victims of losses whole again reflects the principle of: -
✔✔Indemnification
A mechanism by which one attempts either to prevent or reduce the probability of a loss taking place or
to reduce the severity of the loss if it does take place is referred to as: - ✔✔Control
The Affordable Care Act (ACA), in general, defined a full-time employee as one employed on average at
least how many hours per week? - ✔✔30
Dental treatments are placed into ten professional treatment categories. A restorative treatment is: -
✔✔
If a cafeteria plan fails to pass the required nondiscrimination testing, then: - ✔✔The highly
compensated and key employees are taxed based on the value of their benefits.
An insured individual has $12,000 of covered medical expenses for in-network nonpreventive treatment.
His plan is a high-deductible health policy with a $1,500 deductible and a 20% coinsurance arrangement.
Also, the plan reimburses 100% after an individual reaches the plan's $6,000 out-of-pocket maximum.
What will the insured pay out of the total medical expenses if this is the first claim of the plan year? -
✔✔$ 3,600
A behavioral health care carve-out program usually operates under a separate contract and from a
separate company known as a(n): - ✔✔Managed behavioral health care organization (MBHO)
A peril as the term applies to the insurance mechanism is defined as: - ✔✔The cause of a loss
The "managed care backlash" of the late 1990s gave direct rise to which of the following types of health
care organizations? - ✔✔Preferred provider organizations (PPOs)
Which of the following is a requirement of the Health Insurance Portability and Accountability Act
(HIPAA) as it applies to wellness programs? - ✔✔A program that is offered directly by an employer
outside of a group plan is not subject to HIPAA privacy rules.
