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RMIN 4000 UGA Brown Test 4 Questions Graded A+ $14.49   Add to cart

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RMIN 4000 UGA Brown Test 4 Questions Graded A+

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RMIN 4000 UGA Brown Test 4

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  • November 12, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • RMIN 4000 UGA
  • RMIN 4000 UGA
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julianah420
RMIN 4000 UGA Brown Test 4

fee-for-serive - answer a separate fee is paid for each service

copayment - answer flat amount the insured must pay each time health services are
received

calendar year deductible - answer an aggregate deductible that has to be satisfied only
once during the calendar year

coinsurance - answer the percentage of the medical expenses the policyholder must
pay in addition to the deductible amount

Out-of-pocket maximum (stop-loss limit) - answer the most the insured will have to pay
out-of-pocket in a calendar year

managed care plan - answera health care plan that is designed to lower costs for both
the insurer and the consumer while maintaining a high standard of care

health maintenance organization (HMO) - answer system that provides healthcare to its
members on a prepaid basis in a particular area

capitation fee - answera fixed annual payment for each plan member regardless of the
frequency or type of service provided

advantages of HMO - answerlow cost sharing, good communication between providers

disadvantages of HMO - answerno out of network coverage, must get referrals

preferred provider organizations (PPO) - answerplan that contracts with healthcare
providers to provide certain medical services at discounted fees

advantages of PPO - answerno referral needed, can see out of network providers

disadvantages of PPO - answermore cost-sharing, less efficient communication, more
complicated billing

point of service plan (POS) - answerhybrid of HMO and PPO

consumer directed health care plan (CDHP) - answerplan that combines a high-
deductible plan with a health savings account

, health savings account (HSA) - answertax exempt account established exclusively for
the purpose of lying medical expenses - high deductible plans only

flexible spending account (FSA) - answerpermits employees to pay for certain
unreimbursed medical expenses with before tax dollars - cannot be used with high
deductible plan

long-term care insurance - answerpays a daily/monthly benefit for medical or custodial
care received in a nursing facility, hospital, or at home

disability-income insurance - answerprovides income payments when the insured is
unable to work because of sickness or injury

total disability - answerinability to perform the material and substantial duties of your
regular occupation

partial disability - answeryou can perform some but not all of the duties of your
occupation

residual disability - answerapplies when you are gainfully employed and not totally
disabled but, solely because of sickness or injury, our loss of income is at least 15
percent of your prior income

dental insurance - answerpays the cost of norma dental care, orthodontics not usually
covered

vision insurance - answercoverage for routine eyesore, usually does not cover the full
cost of glasses or contacts

types of legal wrongs - answercrime, breach of contract, tort

tort - answera legal wrong for which the court allows a remedy in the form of monetary
damages

3 categories of tort - answerintentional, strict liability, negligence

intentional tort - answerintentional act or omission resulting in harm or injury to another
person or damage to their property

strict liability - answerliability imposed regardless of negligence or fault (ex: defective
products, workers comp)

negligence - answerfailure to exercise the standard of care required by law to protect
others from an unreasonable risk of harm

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