Q1. The National Association of Insurance Commissioners (NAIC) developed the Small Group Model Act to enable small groups to obtain accessible, yet affordable, group health benefits. The model law limits the rate spread, which is the difference between the highest and lowest rates that a health plan charges small groups, to a particular ratio. According to the Model Act, for example, if the lowest rate an HMO charges a small group for a given set of medical benefits is $40, then the maximum rate the HMO can charge for the same set of benefits is
A.$60
B. $80
C. $120
D. $160
Correct Answer: B
Q2. The scandent Health Group contracted with the Empire Corporation to provide behavioral healthcare services to. Empire employees. As a condition of providing behavioral healthcare services, scandent required Empire to contract with scandent for basic medical services scandent's actions constituted the type of antitrust violation known as a
A.Horizontal group boycott
B. Price-fixing agreement
C. Horizontal division of markets
D. Tying arrangement
Correct Answer: D
Q3. The National Association of Insurance Commissioners (NAIC) developed the Small Group Model Act to enable small groups to obtain accessible, yet affordable, group health benefits. The model law limits the rate spread, which is the difference between the highest and lowest rates that a health plan charges small groups, to a particular ratio. According to the Model Act, for example, if the lowest rate an HMO charges a small group for a given set of medical benefits is $40, then the maximum rate the HMO can charge for the same set of benefits is
A.$60
B. $80
C. $120
D. $160
Correct Answer: B
Q4. The following statements pertain to the federal requirements for minimum deductible & maximum out of pocket expeses for a high deductible health plan in the year 2006. Select the correct answer from the options given below.
A.Minimum deductible - $ 1,050 for self only coverage ; maximum out of pocket expenses- $ 2,100 for self only coverage
B. Minimum deductible - $ 1,050 for self only coverage ; maximum out of pocket expenses- $ 10.500 for family coverage
C. Minimum deductible - $ 2,100 for self only coverage ; maximum out of pocket expenses- $ 10,500 for self only coverage
D. Minimum deductible - $ 2,100 for self only coverage ; maximum out of pocket expenses- $ 5,250 for self only coverage
Correct Answer: B
$ 39
Reviews
There are no reviews yet.