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Insurance and Health Care Regulations Quiz

#1

Which government agency oversees insurance regulations in the United States?

Insurance Regulatory Authority (IRA)
Explanation

Regulates insurance industry in the United States

#2

What is a Health Savings Account (HSA) primarily used for?

To save for future medical expenses on a tax-advantaged basis
Explanation

Tax-advantaged savings for medical expenses

#3

Which government agency is responsible for regulating Medicare and Medicaid programs in the United States?

Centers for Medicare & Medicaid Services (CMS)
Explanation

Regulates Medicare and Medicaid programs

#4

What is a 'deductible' in health insurance?

The maximum amount of money the insured person pays out-of-pocket before the insurance company starts paying
Explanation

Maximum out-of-pocket payment before insurance coverage

#5

What is the purpose of a 'copayment' in health insurance?

To share the cost of medical services between the insured individual and the insurance company
Explanation

Cost sharing between insured individual and insurance company

#6

What does COBRA stand for in the context of health insurance?

Consolidated Omnibus Budget Reconciliation Act
Explanation

Allows continuation of group health insurance

#7

Which of the following is NOT a typical feature of a Health Maintenance Organization (HMO)?

No requirement for pre-authorization for medical services
Explanation

Requires pre-authorization for medical services

#8

Which federal law provides protection for employees' health insurance coverage after leaving a job?

Health Insurance Portability and Accountability Act (HIPAA)
Explanation

Protects health insurance coverage after job loss

#9

What is a common method used by insurance companies to manage risk?

Diversification of investments
Explanation

Managing risk through investment diversification

#10

What is the purpose of the 'essential health benefits' provision under the Affordable Care Act (ACA)?

To establish a minimum set of benefits that health insurance plans must cover
Explanation

Establishes minimum benefits for health insurance plans

#11

Which type of insurance plan typically offers the most flexibility in choosing healthcare providers?

Preferred Provider Organization (PPO)
Explanation

Offers flexibility in choosing healthcare providers

#12

What is the purpose of the Medical Loss Ratio (MLR) provision in health insurance?

To ensure a certain percentage of premiums are spent on medical care and quality improvement activities
Explanation

Ensures premiums are used for medical care

#13

In insurance, what does 'underwriting' refer to?

The process of assessing and classifying risks for insurance coverage
Explanation

Assessment of risks for insurance

#14

What does 'guaranteed issue' mean in the context of health insurance?

A requirement for insurers to offer coverage to all applicants regardless of health status
Explanation

Insurers must offer coverage to all applicants

#15

In health insurance, what is 'adverse selection'?

The tendency for higher-risk individuals to seek out or maintain insurance coverage
Explanation

Higher-risk individuals seeking insurance coverage

#16

What is a 'formulary' in the context of health insurance?

A list of preferred prescription drugs covered by a health insurance plan
Explanation

List of preferred drugs covered by insurance

#17

Which of the following statements about the Consolidated Omnibus Budget Reconciliation Act (COBRA) is true?

It allows employees to continue their group health insurance coverage after leaving their job
Explanation

Allows continuation of group health insurance coverage

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