CES Benefits Plans and Coverage

Question 1

Which health plan type requires members to choose a primary care physician (PCP) and get referrals to see specialists?

Accepted Answer

HMO

Answer

PPO

Answer

EPO

Answer

POS

Question 2

What does PPO stand for in health insurance?

Accepted Answer

Preferred Provider Organization

Answer

Primary Provider Option

Answer

Participating Plan Option

Answer

Premium Payment Obligation

Question 3

An EPO plan differs from a PPO primarily because an EPO:

Accepted Answer

Does not cover out-of-network care except emergencies

Answer

Requires a PCP referral

Answer

Covers out-of-network care at higher costs

Answer

Has no deductible

Question 4

A High Deductible Health Plan (HDHP) is typically paired with which savings vehicle?

Accepted Answer

Health Savings Account (HSA)

Answer

Flexible Spending Account (FSA)

Answer

Health Reimbursement Arrangement (HRA)

Answer

401(k)

Question 5

Under the ACA, which metal tier plan covers approximately 80% of expected healthcare costs on average?

Accepted Answer

Gold

Answer

Bronze

Answer

Silver

Answer

Platinum

Question 6

A formulary in a health insurance plan refers to:

Accepted Answer

The list of covered prescription drugs

Answer

The network of approved hospitals

Answer

The schedule of copayments

Answer

The plan's deductible structure