Question 1

An elimination period is the number of days that must pass after you meet the eligibility requirements before your policy pays the benefits.

Accepted Answer

An elimination period is indeed the number of days that must pass after you meet the eligibility requirements before your policy pays the benefits.

Question 2

Which of the following statements regarding workers' compensation insurance is true?

Accepted Answer

Workers' compensation insurance is designed to provide benefits to employees who suffer work-related injuries or illnesses, covering medical expenses, rehabilitation costs, and lost wages. The other statements are incorrect regarding the general principles of workers' compensation insurance.

Question 3

Social Security disability income benefits are available only when someone is permanently unable to do any job.

Accepted Answer

Social Security disability income benefits are available when an individual is unable to perform their current job or any other job that exists in significant numbers in the national economy, not necessarily permanently unable to do any job.

Question 4

Which of the  following statements regarding private health insurance plans is true?

Accepted Answer

In a traditional indemnity plan, the premium cost is typically lower if it is a high-deductible plan, as the insured pays more out-of-pocket before the insurance coverage begins.

Question 5

You would have a better chance of insurance coverage for medical services not provided by the network with a preferred provider organization (PPO)plan than with a health maintenance organization (HMO)plan.

Accepted Answer

PPO plans typically offer more flexibility than HMO plans, including coverage for services received outside the plan's network, albeit at a higher cost compared to in-network services. HMO plans usually require members to receive care from a network of designated providers and often do not cover services received outside of this network except in emergencies.

Question 6

Which of the following statements regarding medical insurance costs in the United States is true?

Accepted Answer

A poor demand-and-supply distribution of health care facilities and services has increased health care costs in the United States. This is due to a lack of competition, leading to higher prices, and uneven distribution of providers causing some areas to be more expensive than others. Advances in medical technology have actually contributed to higher insurance costs, as new treatments and diagnostic tools can be expensive to develop and implement. Health insurance typically covers routine medical costs, but coverage varies by plan. Increased regulation and decreased administrative costs may help to reduce insurance costs, but it is not clear if these efforts have had a significant impact. While health insurance is financially important, more than 50% of the U.S. population has health insurance, with the uninsured rate declining in recent years.

Question 7

During the past few decades, the percentage of our income spent on health care:

Accepted Answer

The percentage of income spent on health care has increased, largely due to factors such as an aging population in the U.S., which requires more medical care, contributing to higher overall health care spending.

Question 8

Blue Cross\Blue Shield payments for health care services are made directly to the subscriber rather than the hospital or physician.

Accepted Answer

Blue Cross/Blue Shield typically makes payments directly to the hospital or physician for the health care services provided, not to the subscriber. This is known as a direct payment or assignment of benefits.

Question 9

A preferred provider organization has characteristics of both an individual practice association (IPA)and an indemnity plan.

Accepted Answer

A Preferred Provider Organization (PPO) combines features of an Individual Practice Association (IPA), where services are provided within a network of doctors, and an indemnity plan, offering more flexibility in choosing healthcare providers outside of the network.

Question 10

The cost of workers' compensation insurance is usually paid by the employees.

Accepted Answer

Workers' compensation insurance is usually paid by employers, not employees. Employers are required to provide this insurance to their employees in case they are injured or become ill due to their work.

Question 11

Medicare and Medicaid are administered by hospitals and physicians.

Accepted Answer

Medicare and Medicaid are government-run healthcare programs, not administered by hospitals and physicians, but rather by the Centers for Medicare and Medicaid Services (CMS). Hospitals and physicians may participate in these programs as providers, but they do not administer them.

Question 12

Health maintenance organizations (HMOs)provide health care to participants without requiring them to file insurance claims.

Accepted Answer

Health maintenance organizations (HMOs) provide health care to participants without requiring them to file insurance claims.

Question 13

Under the adjusted (modified)community rating approach to health insurance premium pricing, all policyholders in an area pay the same premium without regard to their personal health, age, gender, or other factors.

Accepted Answer

Under the adjusted (modified) community rating approach, premiums can vary based on age and other factors, but not based on personal health status.

Question 14

More than 15% of the working-age population are not covered by health insurance.

Accepted Answer

As of the latest data available up to 2023, more than 15% of the working-age population in the United States and in some other countries are not covered by health insurance, indicating a significant portion of the population lacks health insurance coverage.

Question 15

Long-term-care insurance provides protection against the cost of extended hospital stays.

Accepted Answer

Long-term-care insurance provides protection against the costs of care in a variety of settings, including nursing homes, assisted living facilities, and home health care. It typically does not cover extended hospital stays.

Question 16

Large employers are less likely to offer health insurance to their employees than small employers.

Accepted Answer

Large employers (with 50 or more employees) are required by law to offer health insurance to their full-time employees, while small employers (with fewer than 50 employees) are not required to do so.

Question 17

Living a healthy lifestyle is an example of loss prevention and control.

Accepted Answer

Living a healthy lifestyle can help prevent and control various health issues and diseases, reducing the risk of loss of health and wellbeing.

Question 18

Group insurance plans are legally required to extend health insurance benefits to retirees.

Accepted Answer

Group insurance plans are not legally required to extend health insurance benefits to retirees; this is typically a matter of the employer's policy or the specific plan's provisions.

Question 19

Advances in medical technology, drug prescriptions, and treatments have substantially reduced the cost of health care in recent decades.

Accepted Answer

Advances in medical technology, drug prescriptions, and treatments have actually increased the cost of health care in recent decades. While these advances can improve patient outcomes and quality of life, they often come with a high price tag that contributes to rising health care costs.

Question 20

Generally, group insurance plans cost less than individual policies.

Accepted Answer

Group insurance plans spread the risk across a larger pool of people, leading to lower costs per person compared to individual policies.

Quiz 9: Insuring Your Health