RMI 3011 EXAM 3 FSU QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2025/2026
Medical Expense Insurance - Answers Protects an individual or family for covered medical
expenses because of illness or injury
Out-of-Pocket Maximum Limits - Answers 100% of the covered medical expenses in excess of
the deductible are paid after the insured pays a certain amount out-of-pocket
(Health Insurance)
Coinsurance - Answers Percentage of the bill in excess of the deductible, which the insured
must pay out-of-pocket up to some maximum annual dollar limit.
Counts towards deductible and out-of-pocket maximum.
(Health Insurance)
What is the purpose of Coinsurance Provision in health? - Answers Prevents Over-Utilization of
Policy Benefits
Copayment - Answers A flat amount that the insured must pay for certain benefits at each visit
or type of visit
Does not count towards deductible but does count toward out of pocket maximum
(Health insurance)
Individual Market - Answers Health insurance is purchased through state healthcare exchange
Group Market - Answers Health insurance is purchased through employer
Social Insurance - Answers Health insurance is sponsored by government
Individual Medical Expense Insurance Plan - Answers Protects an individual or family for
covered medical expenses because of sickness and injury
No Lifetime Limits or Annual Limits
, Comprehensive plans
Available through healthcare exchanges
Social Security Amendments of 1965 - Answers Created Medicare and Medicaid
Federal Insurance Contributions Act (FICA) Tax - Answers Funds Medicare
Financed by payroll tax paid by:
- Employees and employers
- 7.65% your wages (6.2% to Social Security and 1.45% to Medicare)
Individuals over age 65
Managed Care Plans - Answers Medical expense insurance plans that provide covered services
to members in a cost-effective manner
Types of Managed Care Plans - Answers 1. HMO
2. PPO
3. POS
Health Maintenance Organization (HMO) - Answers Organized system of health care that
provides comprehensive medical services to its members on a prepaid basis
- Limited choice of providers; must be "in-network"
- Payment of fixed premiums
- Cost-sharing includes annual deductibles and copayments
- Gatekeeper physician
- Prior approval to see specialists
Preferred Provider Organization (PPO) - Answers Plan that contracts with health care providers
to provide medical services to plan members at discounted fees
Medical Expense Insurance - Answers Protects an individual or family for covered medical
expenses because of illness or injury
Out-of-Pocket Maximum Limits - Answers 100% of the covered medical expenses in excess of
the deductible are paid after the insured pays a certain amount out-of-pocket
(Health Insurance)
Coinsurance - Answers Percentage of the bill in excess of the deductible, which the insured
must pay out-of-pocket up to some maximum annual dollar limit.
Counts towards deductible and out-of-pocket maximum.
(Health Insurance)
What is the purpose of Coinsurance Provision in health? - Answers Prevents Over-Utilization of
Policy Benefits
Copayment - Answers A flat amount that the insured must pay for certain benefits at each visit
or type of visit
Does not count towards deductible but does count toward out of pocket maximum
(Health insurance)
Individual Market - Answers Health insurance is purchased through state healthcare exchange
Group Market - Answers Health insurance is purchased through employer
Social Insurance - Answers Health insurance is sponsored by government
Individual Medical Expense Insurance Plan - Answers Protects an individual or family for
covered medical expenses because of sickness and injury
No Lifetime Limits or Annual Limits
, Comprehensive plans
Available through healthcare exchanges
Social Security Amendments of 1965 - Answers Created Medicare and Medicaid
Federal Insurance Contributions Act (FICA) Tax - Answers Funds Medicare
Financed by payroll tax paid by:
- Employees and employers
- 7.65% your wages (6.2% to Social Security and 1.45% to Medicare)
Individuals over age 65
Managed Care Plans - Answers Medical expense insurance plans that provide covered services
to members in a cost-effective manner
Types of Managed Care Plans - Answers 1. HMO
2. PPO
3. POS
Health Maintenance Organization (HMO) - Answers Organized system of health care that
provides comprehensive medical services to its members on a prepaid basis
- Limited choice of providers; must be "in-network"
- Payment of fixed premiums
- Cost-sharing includes annual deductibles and copayments
- Gatekeeper physician
- Prior approval to see specialists
Preferred Provider Organization (PPO) - Answers Plan that contracts with health care providers
to provide medical services to plan members at discounted fees
