瑞达 Rejda 保险教材英文练习题16.docx

瑞达 Rejda 保险教材英文练习题16.docx

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瑞达Rejda保险教材英文练习题16

PrinciplesofRiskManagementandInsurance,11e（Rejda）

Chapter16EmployeeBenefits:

GroupLifeandHealthInsurance

1）AllofthefollowingstatementsaboutthecharacteristicsofgroupinsurancearetrueEXCEPT

A）Manypeoplearecoveredunderasinglecontract.

B）Thecostofgroupinsurancemaybelowerthanthecostofindividualinsurance.

C）Theactualexperienceofalargegroupisafactorindeterminingthepremiumthatischarged.

D）Individualevidenceofinsurabilityisusuallyrequired.

Answer:

D

QuestionStatus:

PreviousEdition

2）Whichofthefollowingstatementsaboutgroupinsuranceunderwritingprinciplesis（are）true?

I.Ifaplaniscontributory,100percentoftheeligibleemployeesmustbecovered.

II.Employeesshouldbeallowedtodeterminetheirownlevelofbenefits.

A）Ionly

B）IIonly

C）bothIandII

D）neitherInorII

Answer:

D

QuestionStatus:

PreviousEdition

3）Whichofthefollowingstatementsaboutgroupinsuranceunderwritingprinciplesistrue?

A）Employeesshouldberequiredtoremitpremiumsdirectlytotheinsurancecompany.

B）Theaverageageofthegroupshouldideallyincreaseovertime.

C）Agroupshouldbeformedforthespecificpurposeofobtaininginsurance.

D）Theemployershouldideallyshareinthecostofagroupinsuranceplan.

Answer:

D

QuestionStatus:

PreviousEdition

4）Reasonsforhavingaminimumparticipationrequirementbeforeagroupiseligibleforinsuranceincludewhichofthefollowing?

I.Tolowertheexpenserateperunitofinsurance.

II.Tominimizethepossibilityofinsuringagroupwhichconsistslargelyofunhealthyindividuals.

A）Ionly

B）IIonly

C）bothIandII

D）neitherInorII

Answer:

C

QuestionStatus:

PreviousEdition

5）AllofthefollowingstatementsabouttheeligibilityrequirementsforgroupinsurancearetrueEXCEPT

A）Mostplanscoverbothfull-timeandpart-timeemployees.

B）Anemployeemustbeactivelyatworkonthedaytheemployee'sgrouplifeinsurancebecomeseffective.

C）Anemployeecansign-upforinsuranceduringaneligibilityperiodwithoutfurnishingevidenceofinsurability.

D）Onepurposeofaprobationaryperiodistoloweradministrativecostsbyeliminatingcoverageontransientworkers.

Answer:

A

QuestionStatus:

PreviousEdition

6）Theperiodoftimeduringwhichanemployeecansignupforgroupinsurancecoveragewithoutfurnishingevidenceofinsurabilityiscalleda（n）

A）probationaryperiod.

B）noninsurabilitywindow.

C）waitingperiod.

D）eligibilityperiod.

Answer:

D

QuestionStatus:

PreviousEdition

7）Whichofthefollowingstatementsaboutgrouptermlifeinsuranceistrue?

A）Itusuallyiswrittenintheformof5-yearlevelterminsurance.

B）Anemployeewholeavesthegroupcanusuallyconvertthecoveragetoanindividualtermlifeinsurancepolicy.

C）Manyemployersprovideareducedamountofcoverageonretiredemployees.

D）Itrepresentsonlyabout5percentofthegrouplifeinsuranceinforce.

Answer:

C

QuestionStatus:

PreviousEdition

8）HighdeductiblegrouphealthinsuranceplanshaveallofthefollowingcharacteristicsEXCEPT

A）healthsavingsaccountsorhealthreimbursementaccounts

B）highdollardeductibles

C）lowcoveragelimits

D）majormedicalinsurance

Answer:

C

QuestionStatus:

PreviousEdition

9）Whichofthefollowingstatementsaboutgroupaccidentaldeathanddismemberment（AD&D）insuranceis（are）true?

I.Theprincipalsumispaidiftheemployeediesinanaccident.

II.Theemployerusuallypaysatleast50percentofthecostofvoluntaryAD&Dcoverage.

A）Ionly

B）IIonly

C）bothIandII

D）neitherInorII

Answer:

A

QuestionStatus:

PreviousEdition

10）AllofthefollowingstatementsaboutgroupuniversallifeinsurancearetrueEXCEPT

A）Interestratescreditedtoapolicyvaryovertimebutaresubjecttoaminimumguarantee.

B）Premiumscanbevariedaslongasthecashvalueissufficienttopaycurrentmortalityandexpensecharges.

C）Coverageisissuedonaguaranteedbasisuptocertainlimitswithnoevidenceofinsurability.

D）Atretirement,anemployeemustbeginliquidatinghisorhercashvalueintheformofanannuity.

Answer:

D

QuestionStatus:

PreviousEdition

11）WhichofthefollowingstatementsaboutBlueCrossPlansis（are）true?

I.Theytypicallyprovideservicebenefitsratherthancashbenefitstomembers.

II.Theyusuallyprovideverylimitedbenefitsforhospitalcharges.

A）Ionly

B）IIonly

C）bothIandII

D）neitherInorII

Answer:

A

QuestionStatus:

PreviousEdition

12）Whatisthepurposeofstop-lossinsurancethatisusedwithself-insuredgroupmedicalexpenseplans?

A）torequireemployeestobuyinsuranceforlossesinexcessofsomespecifiedamount

B）tohaveacommercialinsurerpayclaimsthatexceedaspecifiedlimit

C）toobtainadministrativeservicesfromacommercialinsurer

D）toexemptself-insuredplansfromstateinsurancelawsthatrequiremandatedbenefits

Answer:

B

QuestionStatus:

PreviousEdition

13）Allofthefollowingarereasonswhyemployersself-insuremedicalexpenseplansEXCEPT

A）toreducecertaincosts,suchaspremiumtaxesandcommissions.

B）toprovidemandatedstatebenefits.

C）toretainfundsuntilneededtopayclaims.

D）toeliminatetheneedtocomplywithseparatestatelaws.

Answer:

B

QuestionStatus:

PreviousEdition

14）AllofthefollowingstatementsaboutgroupbasicmedicalexpenseinsurancearetrueEXCEPT

A）Benefitsundersurgicalexpenseinsurancemaybebasedonthereasonableandcustomarychargeforthemedicalprocedure.

B）BenefitsareusuallyprovidedfordiagnosticX-rayandlaboratorybenefits.

C）Benefitsaredesignedtocoverthecostofcatastrophicmedicalexpenses.

D）Benefitsareprovidedfornonsurgicalcareprovidedbyaphysician.

Answer:

C

QuestionStatus:

PreviousEdition

15）Whichofthefollowingstatementsaboutsupplementalgroupmajormedicalinsuranceis（are）true?

I.Mostplanshavealifetimelimitof$50,000to$100,000.

II.Mostplanscontainanout-of-pocketmaximumthatplacesadollarlimitonthemaximumamountanindividualmustpayoutofhisorherownpocket.

A）Ionly

B）IIonly

C）bothIandII

D）neitherInorII

Answer:

B

QuestionStatus:

Revised

16）Adeductiblethatmustbesatisfiedafterthebenefitsofabasicmedicalexpenseplanareexhaustedandbeforesupplementalmajormedicalbenefitsarepayableiscalleda（n）

A）calendar-yeardeductible.

B）prospectivedeductible.

C）straightdeductible.

D）corridordeductible.

Answer:

D

QuestionStatus:

Revised

17）Whichofthefollowingis（are）characteristicsofHMOmanagedcareplans?

I.Unlimitedchoiceofphysiciansandhospitals

II.Emphasisoncontrollingthecostofcoveredservices

A）Ionly

B）IIonly

C）bothIandII

D）neitherInorII

Answer:

B

QuestionStatus:

PreviousEdition

18）WhichofthefollowingstatementsaboutHMOmanagedcareplansis（are）true?

I.Thereisanemphasisoncontrollingcosts.

II.Theyusuallyhavehighdeductibles.

A）Ionly

B）IIonly

C）bothIandII

D）neitherInorII

Answer:

A

QuestionStatus:

PreviousEdition

19）AnHMOphysicianwhodeterminesifmedicalcarefromaspecialistisnecessaryiscalleda（n）

A）capitator.

B）internist.

C）networkfacilitator.

D）gatekeeper.

Answer:

D

QuestionStatus:

PreviousEdition

20）AnHMOthatcontractswithtwoormoreindependentgrouppracticestoprovidemedicalservicestocoveredmembersiscalleda（n）

A）groupmodelHMO.

B）networkmodelHMO.

C）staffmodelHMO.

D）independentpracticeassociationHMO.

Answer:

B

QuestionStatus:

Revised

21）Whichofthefollowingstatementsaboutpreferredproviderorganization（PPO）healthplansis（are）true?

I.APPOplancontractswithhealthcareproviderstoprovidemedicalservicestomembersatreducedfees.

II.PlanmembersaregivenafinancialincentivetousePPOprovidersratherthanotherproviders.

A）Ionly

B）IIonly

C）bothIandII

D）neitherInorII

Answer:

C

QuestionStatus:

Revised

22）Amanagedcareplanunderwhichmemberscanreceivemedicalcarefromnon-networkprovidersathigherout-of-pocketcostsisanexampleofa（n）

A）grouppracticeplan.

B）individualpracticeplan.

C）exclusiveproviderorganization.

D）point-of-serviceplan.

Answer:

D

QuestionStatus:

PreviousEdition

23）AllofthefollowingstatementsaboutHMOsaretrueEXCEPT

A）Theyorganizeanddeliverhealthcareservices.

B）HMOsplaceaheavyemphasisoncontrollingthecostofcoveredservices.

C）ComprehensivecoverageisprovidedevenwhenasubscriberisoutsidetheareaservedbytheHMO.

D）TheselectionofphysiciansisusuallylimitedtophysiciansaffiliatedwiththeHMO.

Answer:

C

QuestionStatus:

PreviousEdition

24）AllofthefollowingarecriticismsofmanagedcareplansEXCEPT

A）Thequalityofcaremaybereducedbecauseoftheemphasisoncostcontrol.

B）Preventivecareisunlikelytobeprovided.

C）Restrictionsmaybeplacedonphysicians'abilitiestotreatpatients.

D）Networkphysiciansmayhaveafinancialconflictofinterestbetweenprovidinghigh-qualitymedicalcareandholdingdowncosts.

Answer:

B

QuestionStatus:

PreviousEdition

25）WhichofthefollowingstatementsregardingtheHealthInsurancePortabilityandAccountabilityActistrue?

A）Itguaranteestheavailabilityofgrouphealthinsurancetosmallemployers.

B）Itrequiresemployerstoprovideatleastaminimumlevelofhealthbenefitsprescribedbylaw.

C）Itrequiresgivingcreditforpreviouscoveragewithrespecttoanypreexistingconditionsexclusionfoundinanewhealthplan.

D）Itlimitspreexistingconditionsexclusionsto90days.

Answer:

C

QuestionStatus:

PreviousEdition

26）UndertheHealthInsurancePortabilityand