Chapter 05 – Employer-Sponsored Health Insurance Programs
Chapter 05
Employer-Sponsored Health Insurance Programs
True / False Questions
1. Comprehensive major medical plans usually apply a single deductible for all covered
services. (Major Medical Insurance Plans: Supplemental and Comprehensive)
2. Staff model HMOs own the medical facilities and employ the medical and support staffs
that work on the premises. (Prepaid Group Practice Model)
3. Formularies are lists of drugs proven to be clinically appropriate and cost
effective. (Prescription Drug Benefits)
4. Morbidity tables express annual probabilities of the occurrence of health problems.
(Individual versus Group Insurance Coverage)
5. Individual health insurance coverage can also cover the employee’s dependents. (Individual
Versus Group Insurance Coverage)
6. Exclusive provider organizations are similar to PPOs in that they offer reimbursement for
services provided outside the established network. (Preferred Provider Organizations)
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45. What is coinsurance? (Features of Fee-For-Service Plans)
46. Companies can choose from which four classes of health insurance programs? (Defining
and Exploring Health Insurance Programs)
47. These types of insurance plans are set up to cover things like dental care, vision care and
prescription drugs (Specialized Insurance Benefits)
48. These are the most popular approaches used by employers to offer consumer-driven health
care. (Consumer-Driven Health Care)
49. What are the two types of fee-for-service plans? (Fee-For-Service Plans)
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54. What are the three specific forms of prepaid group practices? (Prepaid Group Practice
Model)
55. State health instructor laws address all BUT which of the following (State Regulations)
56. Medical care has risen about how much since 1984? (Health Insurance Coverage and Costs)
57. Which of the following is not true for medical reimbursement plans? (Prescription Drug
Benefits)
5-12
58. Which of the following does not fall within the scope of the role of a primary care
physician? (Exhibit 5.6, Role of Primary Care Physicians)
59. FASB 106 does not do which of the following? (Retiree Health Care Benefits)
Essay Questions
60. Discuss and compare multiple-payer versus single-payer systems the US. (Defining and
Exploring Health Insurance Programs)
Main Points
5-14
62. Discuss the various FASB rulings associated with retiree health insurance. (Retiree Health
Care Benefits)
Main Points