Certified Employee Benefit Specialist (CEBS) Group Benefits Associate (GBA) 2 Practice Exam

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• Why would an employer select a fully insured health plan?
• What is typically included in a compliance audit for employee benefits?
• Regarding private long-term disability income (PLTDI), which statement is correct?
• What is the primary purpose of employee benefits legislation enforced by the Department of Labor?
• Which statement about workers' compensation financing is correct?
• Which statement best describes the necessity of a benefits communication strategy?
• Which of the following entities are involved in the risk adjustment program of the Affordable Care Act?
• Which program within the Affordable Care Act dealt with limiting insurer losses and gains beyond an allowable range?
• Which statement correctly describes the Small Business Health Options Program (SHOP) exchanges?
• What is one of the key goals of employee benefit plans?
• According to the Internal Revenue Code, how many activities of daily living must a chronically ill individual be unable to perform for long-term care purposes?
• What is COBRA designed to do?
• What is the benefit of benchmarking employee benefits for an organization?
• What is the health insurance rating system that groups policyholders by loss characteristics called?
• Who is NOT typically a beneficiary of an employer-sponsored group term life insurance contract?
• What is a flexible spending account (FSA)?
• What advantage does the PCMH model offer for patient care?
• Which statement regarding patient-centered medical home (PCMH) recognition is correct?
• Which statement about issues related to in- and out-of-network care is incorrect?
• Which statement about healthcare quality improvement collaboratives (QICs) is false?
• What is a false statement regarding physician employment and compensation in managed care plans?
• In the context of employee health insurance, what does "lasering" refer to?
• Which of the following is the most common reimbursement model for patient-centered medical homes?
• What concept is most closely related to objective risk for health insurers?
• What does "out-of-pocket maximum" refer to in health insurance?
• Under the ACA, what might a large employer be required to do?
• In terms of health plan changes, which employee demographic shows the highest price sensitivity?
• What type of support does an employee assistance program (EAP) typically offer?
• What does the acronym ERISA stand for?
• Which statement is correct regarding physician compensation in managed care plans?
• What defines mandatory state disability insurance?
• What area has been a key focus for improvement efforts in healthcare?
• In the context of employee benefits, what does "portability" mean?
• Which statement about health expenditure prediction models is correct?
• What is the role of a third-party administrator (TPA) in employee benefits?
• Which statement regarding self-insured health plans is incorrect?
• What is a feature of the risk adjustment program included in the Affordable Care Act?
• What major health trend has led to changes in insurance coverage options?
• Which of the following is NOT a major category of employee benefits?
• Which of the following statements on self-insured plans is incorrect?
• Approximately what percentage of total covered health insurance expenses does out-of-network health care account for?
• Which statement about the usual and customary rate (UCR) in health insurer reimbursement is NOT correct?
• Which of the following statements about the Diamond Project is incorrect?
• What requirement does the ACA impose regarding out-of-network emergency care costs?
• How do defined contribution plans differ from defined benefit plans?
• Why have insurance companies been dissatisfied with LTC insurance structures?
• What is reference pricing in managed care health plans?
• Which statement is true about the management of employee benefits?
• What is the significance of HIPAA in the context of employee benefits?
• Which statement about the Affordable Care Act is accurate?
• What is a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)?
• What is true about the Affordable Care Act's risk adjustment program?
• Why is the Silver plan considered a popular choice among Affordable Care Act (ACA) health plans?
• Which type of benefit plan is typically associated with a promise of payout at retirement based on specific calculations?
• What is a major characteristic of a Patient Centered Medical Home?
• What trend has been observed regarding retail healthcare clinics?
• What is a correct statement regarding discounts managed care plans negotiate with hospitals?
• Which element is crucial for benefits competitive benchmarking?
• According to the National Committee For Quality Assurance (NCQA), which criterion is NOT utilized in awarding a "Distinction in Patient Experience Reporting"?
• What does "fully insured" mean in health insurance context?
• What is a statement about patient-centered medical homes (PCMHs) that is incorrect?
• Which statement about legal protection from out-of-network medical bills is incorrect?
• Who meets the vast majority of long-term care needs?
• What primary effect does the Family and Medical Leave Act (FMLA) have on job protection?
• What does the term "voluntary benefits" primarily refer to?
• Which statement about private health insurance exchanges and Small Business Health Options Program (SHOP) exchanges is accurate?
• What is the term for the provision in some group life insurance plans that allows for payment of part of the death benefit in the event of terminal illness?
• How can organizations assess the effectiveness of their employee benefits?
• Which statement regarding health insurance rating systems is correct?
• How is a medical group compensated when paid fee-for-service with a withhold amount?
• During a benefits enrollment period, employees typically have the opportunity to:
• Which statement about state workers' compensation is correct?
• Given a pure premium of $1,300 and a loading percentage of 35 percent, which statement is incorrect?
• Which of the following is considered a taxable fringe benefit?
• All the following are major requirements of a long-term care (LTC) policy EXCEPT:
• What does the employer mandate under the ACA require?
• What type of management is typical for self-insured health plans?
• What was a finding related to health care disparities in the U.S. population?
• Which of the following is NOT a requirement to be eligible for Social Security Disability Insurance benefits?
• Which feature is NOT included in the Affordable Care Act's definition of a Patient Centered Medical Home (PCMH)?
• Pre-existing condition exclusions typically result in what for insured individuals?
• What are compliance audits in relation to employee benefits?
• Which of the following assumptions about long-term care (LTC) policies in the 1980s and 1990s were proven incorrect?
• Why might an employer implement premium sharing?
• Which of the following is true about Medicaid and long-term care?
• Which statement regarding quality improvement (QI) strategies is accurate?
• Which type of service is NOT typically covered by long-term care insurance?
• Which statement about private health insurance exchanges is incorrect?
• Which statement regarding the Age Discrimination in Employment Act (ADEA) on group term life insurance benefits after age 65 is NOT true?
• Which conclusion is NOT supported regarding approaches to quality improvement in healthcare?
• Which statement is true regarding the financial security of primary care practices?
• What is a disadvantage of group term life insurance for employees?
• What is the established waiting period for Social Security Disability Income (SSDI) benefits?
• What is the primary purpose of an employee assistance program (EAP)?
• Which factor contributes to financial insecurity in many primary care practices?
• In the patient-centered medical home (PCMH) model, what is true about primary care visits?
• What is true about reimbursement under SSDI and PLTDI plans?
• Which of the following statements is correct regarding patient-centered medical homes (PCMHs)?
• Which of the following statements about self-funded health care insurance plans is incorrect?
• What is one outcome of managed care plans selectively contracting with providers?
• What is true about the loading percentage for health insurance rates?
• Which of the following statements is an objective of the risk and market stabilization programs in the Affordable Care Act?
• All the following are goals established by the Health and Medicine Division EXCEPT?
• According to IRS regulations, how much group life insurance can be provided to a policyholder without incurring federal income tax liability?
• In what situation are insurers likely to negotiate lower prices with hospitals?
• How do self-funded health plans differ from traditional plans?
• Which of the following measures are typically included in cost-sharing?
• What provision in the Part D Medicare law favors pharmaceutical companies?
• What is a key element of a benefits communication strategy?
• What is the designation for the exchanges that streamline health benefits for small businesses?
• What is one significant policy of the Affordable Care Act regarding medical loss ratios?
• What does aggregate stop-loss reinsurance do?
• How is employee participation in benefit plans typically evaluated?
• When is a policyholder considered "chronically ill" under the Internal Revenue Code for long-term care?
• Which of the following statements about managed health care is accurate?
• Which of the following best describes "voluntary compliance programs"?
• Which of the following statements about quality improvement (QI) in healthcare is incorrect?
• Which factor is NOT considered by a stop-loss insurer when underwriting a health care policy for an employer?
• Regarding stop-loss reinsurance for self-funded health plans, which statement is correct?
• Which of the following is NOT a reason consumers hesitate to purchase long-term care (LTC) insurance?
• What type of life insurance policy aims at providing coverage for a limited payment duration?
• What is the role of the Department of Labor (DOL) in employee benefits?
• What is a requirement for COBRA continuation coverage?
• What is the minimum duration for an impairment to qualify for Social Security Disability Insurance benefits?
• What does the Family and Medical Leave Act (FMLA) allow employees to do?
• Which of the following is a disadvantage of noncontributory financing of group-term life insurance?
• Which statement best describes the Affordable Care Act's impact on insurance premiums for young individuals?
• What is the primary role of an insurance broker in the context of employee benefits?
• What is a major reason believed to contribute to the better quality of healthcare in developed countries other than the U.S.?
• What is a benefit of small firms self-funding health benefits?
• Which healthcare area has recently seen a shift toward managed care?
• What attribute characterizes a "self-funded" health plan?
• What is one effect of moral hazard in the U.S. health care market?
• Which implication regarding hospital price negotiations in selective contracting is valid?
• What may happen to employers who do not offer affordable health coverage under the ACA?
• Which statement is correct regarding out-of-network provider payments?
• How do certain insurers improve their pricing negotiations with hospitals?
• What is a key advantage of private health exchanges?
• For which group of individuals have employers started using defined contribution models for medical benefits?
• Which of the following methods is NOT commonly used in health insurance underwriting?
• Which of the following best describes "cost-sharing" measures in health insurance?
• What is the purpose of employee benefit statements?
• What type of account allows employees to set aside pre-tax income for health care expenses?
• What is the significance of the Section 125 premium conversion plan?
• What does the Affordable Care Act (ACA) state regarding involuntary out-of-network emergency health care?
• What does long-term disability insurance provide?
• Which benefits strategy focus is often prioritized to foster a supportive workplace culture?
• What can be a consequence of the competitive nature of healthcare delivery systems?
• Which benefit provides the most immediate financial support for health-related expenses?
• In what manner can private health exchanges affect self-insured plans' financial risks?
• What has been the largest source of cost savings with private health insurance exchanges?
• What does adverse selection refer to in group insurance?
• What does the Affordable Care Act's "Summary of Benefits and Coverage" aim to simplify?
• Which of the following is considered a disadvantage of conventional group insurance?
• What is an essential feature of specific stop-loss coverage reinsurance?
• What is a misconception about the Affordable Care Act's impact on health insurance?
• In what situation might an employee qualify for COBRA coverage?
• Voluntary compliance programs related to employee benefits aim to:
• What does premium sharing mean in employee benefits?
• What are "voluntary benefits" in the workplace?
• Which of the following factors is essential when designing a benefits strategy?
• Which statement about the services provided by third-party administrators (TPAs) to self-funded health plans is incorrect?
• What change did the Affordable Care Act make regarding Medicare services?
• How do self-insured plans administer liabilities through private health exchanges?
• What does "mgmt" stand for in employee health benefit plans?
• How can benefit plans influence employee retention?
• Which statement about the U.S. health care market is accurate?
• Which reimbursement method is commonly used for patient-centered medical homes (PCMHs)?
• Which statement regarding low-cost retail health care clinics is accurate?
• What is a common limitation of ordinary whole life insurance?
• Which group of employees is least likely to change health plans when facing increased out-of-pocket premiums?
• Which statement regarding salary continuation programs is NOT correct?
• What role does HIPAA play regarding benefits administration?
• What is a key difference between a Health Savings Account (HSA) and a flexible spending account (FSA)?
• Which of the following statements about private health exchanges is incorrect?
• How is the health care cost trend typically calculated?
• Which statement is true about how managed care plans operate?
• What is the result of adverse selection in insurance costs?
• What defines a defined benefit plan?
• What is the primary goal of "desktop medicine," which uses information technology in health care?
• What type of life insurance policy provides lifetime protection with premiums paid for a limited time?
• What is the primary function of ERISA?
• What distinguishes a health maintenance organization (HMO) from a preferred provider organization (PPO)?
• According to the RAND Health Insurance Experiment, which variable has the greatest power in explaining health expenditures?
• What is a significant feature of a benefits enrollment period?
• What is the federal income tax treatment for qualified long-term care (LTC) insurance premiums paid by an S corporation for an employee who is also an owner?
• What does the Americans with Disabilities Act (ADA) require concerning employee benefits?
• Which statement concerning the concept of a free market is incorrect?
• Why did the practice of billing based on charges by commercial insurers and allowable costs by Medicare change?
• What is the primary advantage of term insurance for the policyholder?
• In the context of health care, which statement is correct about consumer-driven health plans?
• Which statement is NOT included in the ten guiding principles of Medicare's current risk adjustment approach?
• What is the primary purpose of employee benefit plans?
• How is the minimum essential coverage defined under the Affordable Care Act?
• Which of the following is true about the incentives created by capitation arrangements?
• Which of the following features is included in the Affordable Care Act's definition of patient-centered medical homes?
• Which of the following statements regarding benefits under private long-term disability income (PLTDI) plans is incorrect?
• Which statement about self-insured health plans is correct?
• Which of the following is a recommendation to address adverse selection in Small Business Health Options Program (SHOP) exchanges?
• Which of the following statements about out-of-network consumer outlay is accurate?
• What are death benefits in the context of life insurance?
• An accountable care organization (ACO) primarily aims to achieve what outcome?
• Which measure of cost is typically used by analysts to examine the impact of insurance premiums on employees' choice of health insurance plans?
• In terms of comparative healthcare expenditure, what is unique about developed countries other than the U.S.?
• What are wellness programs designed to promote?
• Which of the following statements about defined contribution plans is true?
• What best describes the "death spiral" in health insurance premiums?