Anda di halaman 1dari 71

AHM 520 - Tests

Page 1 of 71

Learn More Scribd Upload a Document


Search Books, Presentations, Business, Academics... Search Documents

Explore

Documents
Books - Fiction Books - Non-fiction Health & Medicine Brochures/Catalogs Government Docs How-To Guides/Manuals Magazines/Newspapers Recipes/Menus School Work + all categories Featured Recent

People
Authors Students Researchers Publishers Government & Nonprofits Businesses Musicians Artists & Designers Teachers + all categories Most Followed Popular Sign Up | Log In
Health Insurance Plans Compare Features, Benefits & Quotes Apply For The Plan That Suits You!
MyInsuranceClub.com/Health_Plan www.perfios.com/managingyourmoney

Financial Planning Companies A Free, Safe & Simplified Tool for Managing Your Money. Try It Now! Star Health Insurance Cashless Hospitalization at 4800+ Hospitals & Tax Benefits.Apply Now!

www.Starhealth.in/Health_Insurance

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 2 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 3 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 4 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 5 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 6 of 71

Shell Marine Products Supplier of Marine Fuels/Lubricants For Marine Industry Worldwide

www.shell.com/marine MaxNewYorkLife.com/Comprehensive InsuranceKaFunda.com/HealthIns

Max New York Life Plans A range of Health, Pension, Child & Life Insurance plans for the future

Best Health Insurance 14 Companies, Multiple Quotes, Best Insurance Policy - Compare & Apply!

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 7 of 71

Physicians Money Digest Free Financial Education & News For Medical Professionals.

PhysiciansMoneyDigest.com paisabazaar.com/Health-Insurance Maxbupa.in/Health-Insurance

Individual Health Plan 13 Lac Health Insurance Cover for Just Rs.750 Per Month. Buy Now!

Max Bupa Health Insurance For us, what comes 1st in Health Insurance, is Health. Know more!

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 8 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 9 of 71

Protect Family: Term Plan Secure Your Family. Get 50Lac Life Cover & Invest Rs.561 pm.Get it Now ICICI Lombard Insurance Get Unmatched Insurance Deals for Health, Motor & Travel. Apply Now ! Tata AIG Travel Insurance Covers Medical, Accident & Baggage Loss Benefits. Buy Online in 2 mins

www.policybazaar.com/termICICILombard.com/GeneralInsurance TravelInsurance-TataAIG.com

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 10 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 11 of 71

e-health symposium October 20-21, Boston Ehealth, IT innovation and more

www.connected-health.org KayaClinic.com HDFCERGO.com/Health_Insurance

Tips for Beautiful Skin Get the right beauty tips for your skin from the Experts. Apply Now!

HDFCERGO Health Insurance Cashless Claims across India at 3800+ network hospital. Apply Now!

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 12 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 13 of 71

HDFC ERGO Car Insurance Comprehensive Cover-All Policy. No Claim Bonus & Discounts. Buy Now! Tata AIG Health Insurance Health Insurance + Huge Tax Savings Instant Policy. No Paperwork. Apply

HDFCERGO.com Healthcare-TataAIG.com www.bimadeals.com/Healthinsurance

Cashless Health Insurance 2 lakh Family cover @ Rs 300 Pm. Check Premiums,Covers From 20 Plans

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 14 of 71

Need Life Insurance? Quote From 6 Life Insurance Companies Instantly. Fast & Free.

Yellowpages.sulekha.com/Insurance www.utsglobal.edu.in

PG Diploma in Risk Mgmt. Online material backed by Textbooks E-Library,Student Care.Enrol Now! RMSS - Risk Management Enterprise Risk Intelligence Risk / Events / Compliance
www.rmss.com.au

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 15 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 16 of 71

TataAIG Medical Insurance Misfortune Never Announce Arrivals Insure Your Family with Tata AIG! SBI Life - Flexi Smart No Pain. Only Gain. Know more details today!
www.sbilife.co.in

HealthInsurance-TataAIG.com

Life Insurance Research We provide Life Insurance Research Based on High Quality Research Tool

www.ethicalfinancial.in

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 17 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 18 of 71

>---------- End of the Test ----------<

1 2 3 4 5 6

B C C C A C

LIC ULIP Plan NAV Compare Past returns of All Ulips Choose Max,Assured Returns Plans IndianMoney.com/ULIPs Smart Healthcare Learn how communities use ICT to improve healthcare servics smartconnectedcommunities.org Earn the Rice MBA Learn more about improving your career from a top program in the US business.rice.edu

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 19 of 71

Assignment 5: Fully Funded and Self-Funded Health Plans

Reading 5A: Health Plan Funding Distinguish between fully funded and self-funded health plans Identify and describe the two main types of self-funded health plans

Instructions:

1.
2.

Select or enter the best answer for each of the 3 questions. Answer all the questions. Remember to scroll down if necessary.
Complete the Test

3.

Click Complete the Test to score your answers and view a report.

1. The Poplar Company and a Blue Cross/Blue Shield organization have contracted to provide a typical fully funded health plan for Poplar's employees. One true statement about this health plan for Poplar's employees is that Poplar bears the entire financial risk if, during a given period, the dollar amount of services rendered to Poplar plan members exceeds the dollar amount of premiums collected for this health plan Poplar and the Blue Cross/Blue Shield organization share the financial risk of paying for claims under Poplar's health plan the Blue Cross/Blue Shield organization, upon acceptance of a premium, becomes the group plan sponsor for Poplar's health plan the Blue Cross/Blue Shield organization, upon acceptance of a premium, bears the entire financial risk of paying for the administrative expenses associated with health plan operations 2. The Kayak Company self funds the health plan for its employees. This plan is an example of a type of self-funded plan known as a general asset plan. The fact that this is a completely self-funded plan indicates that the plan has no funding vehicle Kayak passes to its employees the financial risk of providing healthcare coverage the plan most likely is exempt from ERISA requirements concerning the limits on benefit discrimination for classes of employees the plan is exempt from the state laws and regulations that apply to health insurance policies 3. The Kayak Company self funds the health plan for its employees. This plan is an example of a type of self-funded plan known as a general asset plan. Because Kayak's plan is a general asset plan, the funds that Kayak sets aside for the health plan are subject to the claims of Kayak's creditors

Go to question 2.

Go to question 3.

Back to Top

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 20 of 71

available to Kayak solely for the purpose of paying for the healthcare expenses of Kayak's covered employees placed in a trust fund established by Kayak to pay for the health plan considered separate from Kayak's current operating funds
>---------- End of the Test ----------<

1 2 3

D D A

LIC's Jeevan Aarogya A comprehensive health plan that takes care of your extended family

LICIndia.in/Jeevan-Aarogya

Life Insurance Plans Get quotes from 9 insurance cos Evaluate benefits and premiums ApnaPaisa.com/Life-Insurance Professional Doctorate Renowed online healthcare doctorate Gain research expertise in practice
www.bath.ac.uk/health

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 21 of 71

Reading 5B: Alternative Funding Methods Distinguish between a contributory plan and a noncontributory plan

Describe the individual components of a premium, including the interest charge, the risk charge, and the retention charge List the key characteristics of premium-delay arrangements, reserve-reduction arrangements, minimum-premium plans, retrospective-rating arrangements, and administrative-services-only contracts

Instructions:

1.
2.

Select or enter the best answer for each of the 6 questions. Answer all the questions. Remember to scroll down if necessary.
Complete the Test

3.

Click Complete the Test to score your answers and view a report.

1. The methods of alternative funding for health coverage can be divided into the following general categories:

Category AThose methods that primarily modify traditional fully insured group insurance contracts Category BThose methods that have either partial or total selffunding

Go to question 2.

Typically, small employers are able to use some of the alternative funding methods in both Category A and Category B Category A only Category B only neither Category A nor Category B 2. Under the alternative funding method used by the Flair Company, Flair assumes financial responsibility for paying claims up to a specified level and deposits the funds necessary to pay these claims into a bank account that belongs to Flair. However, an insurer, which acts as an agent of Flair, makes the actual payment of claims from this account. When claims exceed the specified level, the insurer pays the balance from its own funds. No state premium tax is levied on the amounts that Flair deposits into this bank account. From the following answer choices, choose the name of the alternative funding method described. Retrospective-rating arrangement Premium-delay arrangement Reserve-reduction arrangement Minimum-premium plan

Go to question 3.

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 22 of 71

3. Under the alternative funding method used by the Trilogy Company, the insurer charges Trilogy an initial premium that is based on the assumption that claims will be 93% of the expected claims for the year. If claims exceed 93% of expected claims, then Trilogy must reimburse the insurer for any additional claims paid, up to 112% of expected claims. The insurer bears the responsibility for paying claims in excess of 112% of expected claims. From the following answer choices, choose the name of the alternative funding method described. Retrospective-rating arrangement Premium-delay arrangement Reserve-reduction arrangement Minimum-premium plan 4. The purest form of a self-funded benefit plan is one in which the employer pays benefits from current revenue, administers all aspects of the plan, and bears the risk that actual benefit payments will exceed the expected amount of payments. A decision to use this kind of self-funding is generally considered most desirable when certain conditions are present. These conditions most likely include that the benefit plan is a contributory plan is subject to collective bargaining is unable to secure discounts from the physicians who provide medical services to the plan members has a relatively high frequency of low severity claims 5. The Harp Company self-funds the health plan for its employees. The plan is administered under a typical administrative-services-only (ASO) arrangement. One true statement about this ASO arrangement is that this arrangement prevents Harp from purchasing stop-loss coverage for its health plan the amount that Harp pays the administrator to provide the ASO services is not subject to state premium taxes the administrator is responsible for paying claims from its own assets if Harp's account is insufficient the charges for the ASO services must be stated as a percentage of the amount of claims paid for medical expenses incurred by Harp's covered employees and their dependents 6. The Jasmine Company, which self funds the health plan for its 200 employees, has established a 501(c)(9) trust as a means of addressing possible claims fluctuations under the health plan. This plan is not a part of a collective bargaining process. A potential disadvantage to Jasmine of using a 501(c)(9) trust is that the cost of maintaining the trust may be prohibitive to Jasmine

Go to question 4.

Go to question 5.

Go to question 6.

Back to Top

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 23 of 71

the trust must always maintain enough assets to pay the health plan's claims that have been incurred but not yet paid Jasmine is prohibited from earning any return on the trust assets the contributions to this trust are not deductible for federal income tax purposes
>---------- End of the Test ----------<

1 2 3 4 5 6

C D A D B A

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 24 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 25 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 26 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 27 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 28 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 29 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 30 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 31 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 32 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 33 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 34 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 35 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 36 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 37 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 38 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 39 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 40 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 41 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 42 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 43 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 44 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 45 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 46 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 47 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 48 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 49 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 50 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 51 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 52 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 53 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 54 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 55 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 56 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 57 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 58 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 59 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 60 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 61 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 62 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 63 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 64 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 65 of 71

/ 75

ithin document...

d this Document for Free

AHM 520 - Tests


http://www.scribd.com/doc/36909386/AHM-520-Tests 11-08-2011

AHM 520 - Tests

Page 66 of 71

Download this Document for FreePrintMobileCollectionsReport Document This is a private document.

Info and Rating


praveen1510
Like Sign Up to see what your friends like.

Follow

citi.com/world_money_card

Ads by Google

Share & Embed Related Documents


PreviousNext

p.

p.

1. p.

p. / 75

ithin document...

1. d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 67 of 71

p.

1. p.

p.

p.

1. p.

p.

p.

1. p.

More from this user


PreviousNext

/ 75 1. p.

67

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 68 of 71

470 p.

59 1. p.

550 p.

75 p.

159 1. p.

24 p.

13 p.

3 1. p.

/ 75 9 1. p.

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 69 of 71

8 1. p.

Add a Comment

Submit

Characters: 400

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 70 of 71

Upload a Document
Search Books, Presentations, Business, Academics... Search Documents

Follow Us! scribd.com/scribd twitter.com/scribd facebook.com/scribd About Press Blog Partners Scribd 101 Web Stuff Scribd Store Support FAQ Developers / API Jobs Terms Copyright Privacy / 75

Copyright ithin document...

2011 Scribd Inc. Language: English d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011

AHM 520 - Tests

Page 71 of 71

/ 75

ithin document...

d this Document for Free

http://www.scribd.com/doc/36909386/AHM-520-Tests

11-08-2011