RMI 3501 EXAM 3 QUESTIONS WITH
100% SOLVED ANSWERS!!
1 of 75
Term
What is direct regulation under the pre-emption clause?
Give this one a try later!
plans that are funded through an insurance contract
ERISA plans
subject to state regulation
2. plans that are self-funded
- ERISA plans
-completely beyond state control`
, 1. An improved cash flow for the ER
2.Minimization of premium taxes
authority to pay claims from a bank account that belongs to the ER or from
segregated funds in the admins hands
any state that tries to pass a law such as an employer-mandate at the state
level is usually found to be pre-empted by ERISA
with the exception of the San Francisco Ordinance
Don't know?
2 of 75
Term
What is the deemer clause?
Give this one a try later!
Prohibits states from
regulating self-funded plans in
Services may be handled more
their state
cost-effectively by 3rd party than if
it were handled by ER
states cannot "deem" a self
insured plan to be an insurer
uniform standard of conduct or
regulation on a national level for Er- ER purchases specific adminstrative
sponsored plans services from an insurance
company or from an independent
third party adminstrator
, especially important for multi-
state ERs
Don't know?
3 of 75
Term
What impact did the McCarran Ferguson Act have on regulation?
Give this one a try later!
the plan must exist to benefit the
EE must act in the best interest of Makes void all state laws to the
plan participants extent that they relate to an
an ER must subordinate its own employer sponsored plan
interests
Settled who has regulatory
authroity over insurers EE is walked through plan choices
and spends "Credits" assigned to EE
exempt insurers from federal
regulation
good way to market voluntary
fed can only regulate the
benefits
"business aspects" of insurers
Don't know?
, 4 of 75
Term
What are the types of groups eligible for group insurance?
Give this one a try later!
1. High deductible health plan (HDHP) + MUCH higher OOP Max
2. Account - EE controlled, EE owned (HSA) or ER owned (HRA)
3.Consumer information to elp insureds be better consumers of HCGS
Summary Plan description (SPD) - must be offered by paper
Summary of benefits and coverages (SBC)
Makes void all state laws to the extent that they relate to an employer
sponsored plan
ER-EE group
Taft-Hartley Plans (unions, trust funds)
Trade associations
Creditor-Debtor Group
Alumni Associations, Professional Associations
MEWAs
Don't know?
100% SOLVED ANSWERS!!
1 of 75
Term
What is direct regulation under the pre-emption clause?
Give this one a try later!
plans that are funded through an insurance contract
ERISA plans
subject to state regulation
2. plans that are self-funded
- ERISA plans
-completely beyond state control`
, 1. An improved cash flow for the ER
2.Minimization of premium taxes
authority to pay claims from a bank account that belongs to the ER or from
segregated funds in the admins hands
any state that tries to pass a law such as an employer-mandate at the state
level is usually found to be pre-empted by ERISA
with the exception of the San Francisco Ordinance
Don't know?
2 of 75
Term
What is the deemer clause?
Give this one a try later!
Prohibits states from
regulating self-funded plans in
Services may be handled more
their state
cost-effectively by 3rd party than if
it were handled by ER
states cannot "deem" a self
insured plan to be an insurer
uniform standard of conduct or
regulation on a national level for Er- ER purchases specific adminstrative
sponsored plans services from an insurance
company or from an independent
third party adminstrator
, especially important for multi-
state ERs
Don't know?
3 of 75
Term
What impact did the McCarran Ferguson Act have on regulation?
Give this one a try later!
the plan must exist to benefit the
EE must act in the best interest of Makes void all state laws to the
plan participants extent that they relate to an
an ER must subordinate its own employer sponsored plan
interests
Settled who has regulatory
authroity over insurers EE is walked through plan choices
and spends "Credits" assigned to EE
exempt insurers from federal
regulation
good way to market voluntary
fed can only regulate the
benefits
"business aspects" of insurers
Don't know?
, 4 of 75
Term
What are the types of groups eligible for group insurance?
Give this one a try later!
1. High deductible health plan (HDHP) + MUCH higher OOP Max
2. Account - EE controlled, EE owned (HSA) or ER owned (HRA)
3.Consumer information to elp insureds be better consumers of HCGS
Summary Plan description (SPD) - must be offered by paper
Summary of benefits and coverages (SBC)
Makes void all state laws to the extent that they relate to an employer
sponsored plan
ER-EE group
Taft-Hartley Plans (unions, trust funds)
Trade associations
Creditor-Debtor Group
Alumni Associations, Professional Associations
MEWAs
Don't know?
