Finance: Chapter 11 Smartbook
Most insurers limit disability benefits from all sources to _______ of your take-home pay.
70%-80%
A "good" health insurance plan pays at least ________ percent of out-of-hospital expenses once a yearly deductible for the individual and family have been met.
80%
The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 requires employers to offer employees and dependents, who would otherwise lose group health insurance, the option to continue their group health coverage for:
A certain amount of time
What might a person who is uninsured experience during times of illness and injury?
A financial burden
A good disability plan would pay you when you:
Are unable to work your regular job Can only work part-time at your regular job
A good health insurance provides which of the following?
At least $1 million lifetime maximum for each family member A provision so the policyholder will pay no more than $6,000 out of pocket a year
Health insurance provides ________ to alleviate the financial burden individuals suffer from illness or injury.
Benefits or Money
Name an independent membership corporation that provides protection against the cost of hospital care:
Blue Cross
Which of the following is not a reason for the high and rising cost of health care?
Built-in deflation of the health care system
In order to contain health care costs, physicians are encouraging consumers to pay with _________ for routine medical care and lab services.
Cash
Administrative costs in the United States are much higher than those in other nations due to activities such as:
Checking eligibility Enrolling beneficiaries in a health plan Filing reimbursement claims Paying health insurance premiums
A provision under which the insured pays a flat dollar amount each time a covered medical service is received is called:
Copayment
Which insurance provides payments to replace income when an insured person is unable to work for a long period of time?
Disability Income Insurance
________ insurance provides regular cash income lost by employees as a result of an accident or illness.
Disability income
The Patient Protection and Affordable Care Act bans insurance companies from ________ coverage when they get sick.
Dropping people from
Identify ways in which you can personally reduce your health care costs.
Eat a balanced diet to keep weight under control Avoid smoking Rest
The federal Consolidated Omnibus Budget Reconciliation Act of 1986 requires many employers to offer group health benefits to:
Employees and dependents who would normally lose group health insurance
What are the sources of disability income coverage?
Employer plans Worker's compensation Social Security
True or false: Administration costs for health care in the United States are less than in nations such as Canada and Mexico.
False
True or false: Most private insurance companies do not provide group policies.
False
Administrative costs in the United States are much higher than those in other nations due to activities such as:
Filing reimbursement claims Paying health insurance premiums Checking eligibility Enrolling beneficiaries in a health plan
Which of the following activities have been undertaken by health care professionals and consumers to keep the overall cost of health care down?
Getting involved in community health planning Offering incentives to encourage preventive care Initiating community health education programs
Most private insurance companies are providers of ________ health insurance policies through employers.
Group
Blue Cross is an independent, nonprofit membership corporation that provides protection against the cost of ________ care.
Health
By exercising, not smoking, getting rest, and driving carefully, individuals can greatly reduce their _________.
Health care costs
________ compiles websites from nonprofits, federal and local websites, and many other sources to present a complete health resources website.
Healthfinder
Rising hospital care costs, new medical technology, and the increasing number of elderly people have helped make ________ one of the fastest-growing areas of the health care industry.
Home health providers
Which type of insurance pays part or all of hospital bills for room, board, and other charges?
Hospital expense insurance
Health insurance is one way people protect themselves against economic losses due to _______.
Illness Disability Accident
A(n) _______ policy provides specified benefits regardless of whether the actual expenses are greater or less than the benefits. A(n) ______ policy provides benefits based on the actual expense.
Indemnity; Reimbursement
________-term care insurance provides day-in day-out care for extended illness or disability.
Long
Match the waiting periods and premiums for disability plans.
Long waiting period -> lower premiums Short waiting period -> higher premiums
Which type of insurance is the fastest growing type of insurance today?
Long-term care
With disability plans, the longer the waiting period, the _______ the premiums.
Lower
Prepaid health plans that provide comprehensive health care to members are called _________.
Managed care
What program was designed to provide medical assistance to low-income individuals and families?
Medicaid
________ was designed to provide medical assistance to groups or categories of persons who are eligible to receive payments under one of the cash assistance programs.
Medicaid
_________ insurance makes up the difference between Medicare payments and medical costs not covered by providing supplemental insurance that can be purchased.
Medigap
Which insurance supplements Medicare by filling the difference between Medicare payments and medical costs not covered by Medicare?
Medigap insurance
The reasons for the increased need for home health care include __________.
Older U.S. population Rising hospital costs New medical technology
A group of doctors and hospitals that agree to provide health care to members at prearranged fees is called ________.
PPO
_________ work like HMOs, except the networks are managed by doctors and hospitals.
PPOs
Self-insurance is an arrangement in which a company collects premiums from employees and ________.
Pays medical benefits as needed
Managed care refers to ________ health plans that provide comprehensive health care to members.
Prepaid
Flexible spending accounts allow you to contribute ________ dollars to an account managed by your employer.
Pretax
Key provisions in the Patient Protection and Affordable Care Act of 2010 include:
Providing tax credits for small businesses to make employee coverage affordable Banning companies from dropping people when they get sick Prohibiting lifetime caps on coverage
Which policy provides benefits based on the actual expense incurred?
Reimbursement
Hospital expense insurance pays part or all of hospital bills for _______, board, and other charges.
Room
The main risk involved with a ________ health plan is the financial burden if the medical bills are greater than the amount covered by premium income.
Self-funded
What are some of the factors that have led to increasing health care costs?
The use of expensive technologies An increased number of crimes and accidents
Copayment is the provision under which the insured pays a flat dollar amount each time a covered medical service is received.
True
Health insurance is one way people protect themselves against economic losses due to illness, accident, or disability.
True
True or false: Healthfinder includes links to more than 1,600 websites operated by government and nonprofit organizations.
True
True or false: Insurers limit benefits from all sources to 70%-80% of your take-home pay because you no longer incur work-related expenses and your taxes are much lower, if not zero.
True
A poor disability plan pays you only when you are ________ to work at any job.
Unable
Disability income insurance may also be provided by your employer, Social Security, or _______.
Worker's compensation
The money in a flexible spending account must be used for health care and used by the end of the _________.
Year
