Ch: 6

All of the following statements describe a MEWA except? a) MEWAs can be sponsored by insurance companies b) MEWA employers retain full responsibility for any unpaid claims c) MEWAs can be self-insured d) MEWAs are groups of at least 3 employers

d) MEWAs are groups of at least 3 employers

Can a group that is formed for the sole purpose of obtaining group insurance qualify for group coverage? a) no, a group of individuals cannot apply for group coverage unless represented by an association of trust b) Yes, any group can apply for group coverage c) yes, but only if the group is over 35 people d) no, the group must be formed for a purpose other that obtaining group insurance

d) no, the group must be formed for a purpose other that obtaining group insurance

What is the minimum number of employees that an employer must have in order to be classified as a "small employer"? a) 2 b) 4 c) 5 d) 10

a) 2

COBRA applies to employers with at least a) 20 employees b) 80 employees c) 60 employees d) 50 employees

a) 20 employees

If an employee terminates her employment, which of the following provisions would allow her to continue health coverage under an individual policy, if requested within 31 days? a) conversion b) replacement c) grace period d) renewability

a) conversion

Every small employer carrier must actively offer to small employers at least how many health benefit plans? a) one plan b) 2 plans c) 3 plans d) there is no minimum

b) 2 plans

Which of the following factors would be an underwriting consideration for a small employer carrier? a) medical history of the employees b) percentage of participation c) claims experience d) health status

b) percentage of participation

A small employer must have at least 2 but no more than 50 workers actively engaged in business for at least how many of the working days during the preceding calendar quarter? a) 25% b) 30% c) 50% d) 75%

c) 50%

Which of the following groups seeking health insurance would represent a bad risk for underwriters? a) a group that has a noncontributory plan b) a group that has a large number of members c) a group that changes insurance annually d) a group that pays a low premium

c) a group that changes insurance annually

Which statement best defines a multiple employer welfare arrangement (MEWA)? a) A government health plan that provides health care for the unemployed b) a group health plan that covers medical expenses arising from work related injuries c) a joining together by employers to provide health benefits for employee d) a plan that provides hospice care for terminally ill employees

c) a joining together by employers to provide health benefits for employee

Which of the following options best depicts how the eligibility of members for a group health insurance is determined? a) by the physical conditions of the applicants at the time of employment b) in such a manner as to establish individual selection as to the amounts of insurance c) by conditions of employment d) eligibility is not determined, but simply accepted

c) by conditions of employment

As it pertains to group health insurance, COBRA stipulates that? a) Terminated employees must be allowed to convert their group coverage to individual policies b) group coverage must be extended for terminated employees up to a certain period of time at the employer's expense c) group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense d) retiring employees must be allowed to convert their group coverage to individual policies

c) group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense

When employees are actively at work on the date coverage can be transferred to another insurance carrier, what happens to coinsurance deductibles? a) coinsurance carries over, but deductibles are generally higher b) deductibles carry over, but coinsurance is generally higher c) they carry over from the old plan to the new plan d) they have to be reevaluated

c) they carry over from the old plan to the new plan

A husband and wife are insured under group health insurance plans at their own places of employment, and as dependent under their spouse's coverage. If one of them incurs hospital expenses, how will those expenses likely be paid? a) neither plan would pay b) each plan will pay in equal shares c) the insured will have to select a plan from which to collect benefits d) the benefits will be coordinated

d) the benefits will be coordinated

What is the purpose of cobra? a) To provide coverage for the dependents b) to provide health coverage for people with low income c) to protect the insureds against insolvent insurers d) to provide continuation of coverage for terminated employees

d) to provide continuation of coverage for terminated employees