Health plans contract - Study guides, Class notes & Summaries

A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as Usual, customary and reasonable What provision would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner? Payment of Claims All of the following are true about gr...

CMIT Exam (200 multiple choice) Questions with Verified Answers A CM's role and responsibilities are governed solely by the Owner/CM Agreement. True False - CORRECT ANSWER True There are two basic forms of CM, agency and at-risk. Each form provides for the basic services of construction management practice. However, there are some key differences. Which of the following do not apply to both CM forms? A) Both forms provide advice to the owner on constructibility, budget and the schedule....

NY Series 17-52 Questions and Answers 100% Pass How many eligible employees must be included in a contributory health insurance plan? 50% A man works for Company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim, The insurance through his company is primary. What is the period of coverage for events such as death or divorce under COBRA? 36 months Twenty-five days after ...

FOUNDATIONS AND ADULT HEALTH NURSING 9TH EDITION COOPER GOOSNELL TEST BANK CHAPTER 1-41 | COMPLETE GUIDE A+ 2023-2024. Which of the following must the nurse recognize regarding the health care delivery system? a. It includes all states. b. It affects the illness of patients. c. Insurance companies are not involved. d. The major goal is to achieve optimal levels of health care. ANS: D The nurse must recognize that in the health care delivery system, the major goal is to achieve optimal lev...

What is the goal of affirmative action? To seek to remedy past practices that innately caused an adverse effect on applicants A female employer is accused of having an employment practice that negatively impacts women. The employer responds that she has the same requirements for male and female applicants and wants to hire other women. Why is this case a potential demonstration of adverse impact? Adverse impact is unintentional and relates to policies applied to all employees. Which prote...

SAFe SPC 6.0 Final Exam Questions & Answers 2024 Update SAFe SPC 6.0 Final Exam Questions & Answers 2024 Update When should a Lean portfolio be established? When it is necessary to operate in a completely decentralized environment When it is part of training the executives When the lack of alignment between strategy and execution impacts value delivery When there is a minimum of six Agile Release Trains (ARTs) that require coordination Which activity is associated with the r...

Community Health ATI Proctor Exam 1. A nurse manager at a community agency is developing an orienta6on program for newly hired nurses. When discussing the differences between community-based and community-oriented nursing, the nurse should include which of the following as examples of community-based nursing? (Select all that apply.) A. A home health nurse care for a client who is immobile B. An occupational health nurse providing classes on body mechanics at a local industrial plant ...

An insurer is REQUIRED to offer which of the following to each long-term care applicant at the time of purchase? Inflation protection Which of these riders will pay a death benefit if the insured's spouse dies? Family term insurance rider Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:15 Full screen Disability income plans which require that the insurer can NEVER change or alter premium rates are usually considered...

PSI Practice Exam - Life Insurance Questions and Answers Rated A+ For an individual long-term care policy there is an annual dollar limit for tax deductions that is based on which of the following? 1. age 2. cost of care 3. policy value 4. premium cost 1 The group conversion option is allowed for all of the following EXCEPT 1. termination of the master policy . 2. loss of group coverage due to termination of employment. 3. upon the loss of eligibility on the part of a class of insureds. ...

Maine Life Insurance Exam Questions With Complete Solutions. Contributory Health Insurance If the employees share a portion of the premium. Often require participation by 75% of eligible members. Noncontributory Health Insurance If the employer pays the entire premium. Most require 100% participation by eligible members. (Funding of Group Insurance) Shared funding Allows employer to self-fund health care expenses, select a deductible and pay covered expenses for any individual incurring ...