#1
What is the primary function of group health insurance?
To provide coverage to individuals only
To cover a group of people under a single policy
To offer coverage for property damage
To insure against natural disasters
#2
Which of the following is typically responsible for paying the premium in group health insurance?
Individual employees
The insurance company
Both employers and employees
Government agencies
#3
What is the Affordable Care Act (ACA) also known as?
Medicare
Obamacare
Medicaid
CHIP
#4
Which of the following is NOT typically covered under a group health insurance plan?
Hospitalization
Prescription drugs
Cosmetic surgery
Routine check-ups
#5
What is 'COBRA' in the context of group health insurance?
A type of insurance plan for retirees
A federal law that allows employees to continue their health insurance coverage for a limited time after leaving their job
An insurance program for children with special healthcare needs
A health savings account for covering medical expenses
#6
What does the term 'deductible' mean in group health insurance?
The maximum amount the insured person will have to pay out-of-pocket during a policy period
The amount an individual pays for healthcare services before the insurance covers any expenses
The percentage of costs an insured person must pay for covered services after the deductible is met
The amount the insurance company pays for covered services
#7
What is 'coinsurance' in the context of group health insurance?
A type of health insurance specifically for coinsurance coverage
The percentage of costs an insured person must pay for covered services after the deductible is met
The amount an individual pays for healthcare services before the insurance covers any expenses
The maximum amount the insured person will have to pay out-of-pocket during a policy period
#8
In group health insurance, what does 'open enrollment' refer to?
A period during which employees can sign up for or make changes to their health insurance coverage
A type of health plan with a high deductible and a health savings account
A plan that allows employees to choose their healthcare providers
A method of determining insurance premiums based on an individual's health status
#9
What is the purpose of a Health Maintenance Organization (HMO) in group health insurance?
To provide financial assistance to individuals with medical bills
To offer flexibility in choosing healthcare providers
To coordinate and provide healthcare services to members for a fixed fee
To exclusively cover preventive care services
#10
What is the main difference between Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs)?
PPOs offer lower premiums than HMOs
PPOs require referrals to see specialists, while HMOs do not
HMOs offer more flexibility in choosing healthcare providers than PPOs
PPOs have a network of preferred providers, but HMOs do not
#11
Which of the following is NOT a factor that influences group health insurance premiums?
Age of employees
Location of the business
Gender of employees
Number of dependents covered
#12
What is the purpose of 'coordination of benefits' in group health insurance?
To ensure that healthcare providers are appropriately compensated for their services
To coordinate medical services for employees with complex healthcare needs
To prevent duplication of benefits when an individual is covered by multiple health insurance plans
To coordinate the payment of premiums between employers and employees
#13
What is 'stop-loss insurance' in the context of group health insurance?
A type of insurance that covers an individual's healthcare costs
Insurance that protects the employer against high claims by reimbursing them for claims that exceed a certain threshold
Insurance that covers healthcare costs for preventive services only
Insurance that covers the costs of long-term care services
#14
What is 'medical underwriting' in the context of group health insurance?
A process of evaluating an individual's health status to determine eligibility and premiums
A type of insurance that covers medical equipment costs
A plan that provides coverage for dental care only
A method of determining insurance premiums based on the individual's age
#15
What is the significance of 'HIPAA' in the context of group health insurance?
It sets standards to protect sensitive patient information
It determines eligibility criteria for Medicaid coverage
It regulates the administration of COBRA benefits
It establishes guidelines for employers to provide health insurance benefits
#16
What is 'cost-sharing' in the context of group health insurance?
The process of comparing prices of different health insurance plans
The practice of dividing healthcare expenses between the insurance company and the insured individual
The premium amount paid by the employer on behalf of the employees
The process of determining the financial stability of an insurance company
#17
What is the role of a 'benefit administrator' in group health insurance?
To manage the financial aspects of the insurance policy
To provide healthcare services to members
To enroll employees in the health insurance plan
To review and process insurance claims