Question 1

Paige's organization provides group health insurance.The plan covers "major medical" costs for each employee in any given year that total more than $10,000.Her group health insurance is a ________.

Accepted Answer

The plan described in the scenario is a high-deductible health plan (HDHP) because it has a threshold of $10,000 before major medical costs are covered.

Question 2

Benefits from group long-term policies will generally continue until the employee reaches his or her eligible retirement age under Social Security or until he or she is able to return to work.

Accepted Answer

Benefits from group long-term policies typically do continue until the employee reaches their eligible retirement age or is able to return to work, making statement A true.

Question 3

Social Security benefits are designed to replace 100 percent of an employee's preretirement income.

Accepted Answer

Social Security benefits are not designed to replace 100 percent of an employee's preretirement income. The amount of benefits received depends on several factors, such as the individual's earnings history and age at the time of retirement.

Question 4

Tamera's organization provides group health insurance.She has a primary care physician who is her first point of contact for all preventative care and routine medical situations.Her primary care physician can provide her with referrals to specialists,if needed.However,to be covered,the specialists must be within her plan's network.Her group health insurance is a ________.

Accepted Answer

Tamera's health insurance plan is described as one where she has a primary care physician who acts as her first point of contact and can refer her to specialists within the plan's network for coverage. This model is characteristic of a Health Maintenance Organization (HMO), where care is coordinated through a primary care physician and services are typically covered only if they are provided by doctors and hospitals within the HMO's network.

Question 5

Myra's organization provides group health insurance.Under her coverage,Myra can see any physician or go to any medical facility.However,if she goes to a physician or facility outside those identified by her plan,she will have to pay a larger percentage of the costs.Her group health insurance is a ________.

Accepted Answer

Myra's plan allows her to see any physician or medical facility, but she will have to pay a larger percentage of the costs if she goes out of network. This is a characteristic of a preferred provider organization (PPO) plan. In a PPO, members have access to a network of preferred providers who offer discounted rates for services, but they can still choose to go out of network and receive care from non-preferred providers at a higher cost.

Question 6

Shannon recently quit her job at Acme Global.Under ________,Shannon can continue to pay for her group health insurance through Acme Global to avoid having a gap in her coverage.

Accepted Answer

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allows employees to continue their group health insurance coverage for a limited period of time after leaving their job. Shannon can elect to continue her coverage under COBRA to avoid a gap in her insurance coverage.

Question 7

Alexander's organization offers flexible benefits.The plan has five packages from which Alexander can choose.His organization is offering a _______ flexible benefits plan.

Accepted Answer

A modular flexible benefits plan allows employees to choose from a set of pre-designed packages, which fits the description given.

Question 8

Federal law requires unpaid vacation time.

Accepted Answer

Federal law in the United States does not require employers to provide unpaid vacation time. Vacation policies are typically determined by the employer.

Question 9

Rachel's organization offers flexible benefits.Rachel receives some of the same benefits as everyone else in the organization,such as health,dental,and life insurance.However,Rachel was also able to add tuition reimbursement and elder care assistance to her benefits package.Rachel's organization is offering a _______ flexible benefits plan.

Accepted Answer

Rachel's organization is offering a core-plus flexible benefits plan because there is a core set of benefits that everyone receives (health, dental, and life insurance), but employees can also add on additional benefits like tuition reimbursement and elder care assistance. A modular plan would offer pre-set packages of benefits to choose from, a full-choice plan would allow employees to select any benefits they want with little or no pre-set options, and a defined benefit plan is a specific type of retirement plan.

Question 10

Most long-term disability polities do not provide replacement income until the employee completes a 180-day elimination period.

Accepted Answer

Most long-term disability policies have an elimination period, which is the amount of time that must elapse after the disability occurs and before the benefit payments begin. The elimination period is typically 90 or 180 days, and the policyholder must wait until the end of the elimination period to begin receiving benefits. Therefore, most long-term disability policies do not provide replacement income until the employee completes a 180-day elimination period.

Question 11

Chelsea's organization offers flexible benefits.During the open enrollment period,Chelsea can choose any benefits she wants.She selects several benefits,including elder care coverage to help her care for her mother and extra dental coverage because she knows her daughter will need braces this year.Chelsea's organization is offering a _______ flexible benefits plan.

Accepted Answer

Chelsea's ability to choose any benefits she wants during the open enrollment period indicates that the organization is offering a full-choice flexible benefits plan, which allows employees to tailor their benefits package to their individual needs and preferences. The other answer choices do not accurately describe the level of flexibility in Chelsea's benefits plan.

Question 12

Macy's organization provides group health insurance to its employees.According to the ________,the organization must issue a "Summary Plan Description" that describes the plan and how it works in plain language.

Accepted Answer

The Employee Retirement Income Security Act of 1974 (ERISA) requires employers to issue a "Summary Plan Description" that describes their employee benefit plans, including group health insurance, in plain language. The other options listed are not relevant to this requirement.

Question 13

Heather quit her job at one organization with a group health insurance plan and was hired at another organization with a group insurance plan.According to the _________,Heather's new employer is required to provide her with the opportunity to participate in the plan.

Accepted Answer

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) ensures that individuals who change jobs are provided the opportunity to participate in the new employer's group health plan without being denied coverage due to pre-existing conditions. This act enhances the portability of health insurance coverage.

Question 14

Ashley's business has 150 employees.By 2015,the organization needs to make the "pay or play" decision to be in compliance with __________.

Accepted Answer

The "pay or play" decision refers to the employer mandate of the Affordable Care Act, which requires businesses with 50 or more full-time equivalent employees to provide health insurance or face penalties. Since Ashley's business has 150 employees, they would be subject to this mandate and need to make the decision by 2015. The other options (A, C, and D) are not related to the employer mandate of the Affordable Care Act.

Question 15

Erin knows exactly what benefits she will receive when she retires.She has worked for the organization for 20 years and will receive 65 percent of the average of her two highest years of pay.Erin's retirement plan is a ________ plan.

Accepted Answer

Erin's retirement plan is a defined benefit plan, which promises a specific payout amount upon retirement based on factors such as years of service and salary history. The fact that she knows exactly what benefits she will receive indicates that she is in a defined benefit plan rather than a defined contribution plan, which does not guarantee a specific payout amount. Vesting refers to the point at which an employee becomes entitled to employer contributions to a retirement plan, and experience is not a relevant term in this context.

Question 16

While not required,many U.S.employers provide employees with some paid holidays,sick leave,and/or vacation time.These voluntary benefits fall under the category of ________.

Accepted Answer

These sorts of benefits usually fall under the umbrella of "paid time off."

Question 17

Michelle puts $17,500 into her 401(k) retirement plan each year.This type of retirement plan is a ________.

Accepted Answer

Michelle's 401(k) retirement plan is a defined contribution plan, where she contributes a fixed amount each year. The opposite is defined benefit plans, where the retirement benefit is predetermined based on factors such as years of service and salary. Vesting refers to the employee's right to the employer's contribution to the retirement plan over time, and experience is not related to retirement plans.

Question 18

Meghan's organization offers several sets of benefits.One set would appeal to young single employees because it provides more paid time off for personal activities and no reimbursements for child care expenses.Another set would likely appeal parents with young children because it does provide child care reimbursements and other benefits important to parents such as life insurance.Meghan's organization is offering a _______ flexible benefits plan.

Accepted Answer

Meghan's organization is offering a modular flexible benefits plan, where different sets or modules of benefits are designed to meet the needs of different groups of employees, such as young single employees and parents with young children.

Question 19

Abigail runs a small business of 55 employees.She is working hard to find a way to provide health benefits to all her employees by 2016 to be in compliance with __________.

Accepted Answer

The Affordable Care Act (also known as Obamacare) requires employers with 50 or more full-time employees to provide affordable health insurance coverage to their employees or face penalties. Abigail's business has 55 employees, which means she is subject to this requirement.

Question 20

Laura's organization provides group health insurance that covers a set percentage of fees for medical services such as doctors or in-patient care.It allows her to go to any doctor or provider.Her group health insurance is a ________.

Accepted Answer

A fee-for-service plan is a type of health insurance where the insurer pays a set percentage of fees for medical services such as doctors or in-patient care. This plan allows the insured person to go to any doctor or provider.

Quiz 13: Employee Benefits