瑞达 Rejda 保险教材英文练习题16.docx

1、瑞达 Rejda 保险教材英文练习题16Principles of Risk Management and Insurance, 11e (Rejda)Chapter 16 Employee Benefits: Group Life and Health Insurance1) All of the following statements about the characteristics of group insurance are true EXCEPTA) Many people are covered under a single contract.B) The cost of gr

2、oup insurance may be lower than the cost of individual insurance.C) The actual experience of a large group is a factor in determining the premium that is charged.D) Individual evidence of insurability is usually required.Answer: DQuestion Status: Previous Edition2) Which of the following statements

3、about group insurance underwriting principles is (are) true?I. If a plan is contributory, 100 percent of the eligible employees must be covered.II. Employees should be allowed to determine their own level of benefits.A) I onlyB) II onlyC) both I and IID) neither I nor IIAnswer: DQuestion Status: Pre

4、vious Edition3) Which of the following statements about group insurance underwriting principles is true?A) Employees should be required to remit premiums directly to the insurance company.B) The average age of the group should ideally increase over time.C) A group should be formed for the specific p

5、urpose of obtaining insurance.D) The employer should ideally share in the cost of a group insurance plan.Answer: DQuestion Status: Previous Edition4) Reasons for having a minimum participation requirement before a group is eligible for insurance include which of the following?I. To lower the expense

6、 rate per unit of insurance.II. To minimize the possibility of insuring a group which consists largely of unhealthy individuals.A) I onlyB) II onlyC) both I and IID) neither I nor IIAnswer: CQuestion Status: Previous Edition5) All of the following statements about the eligibility requirements for gr

7、oup insurance are true EXCEPTA) Most plans cover both full-time and part-time employees.B) An employee must be actively at work on the day the employees group life insurance becomes effective.C) An employee can sign-up for insurance during an eligibility period without furnishing evidence of insurab

8、ility. D) One purpose of a probationary period is to lower administrative costs by eliminating coverage on transient workers.Answer: AQuestion Status: Previous Edition6) The period of time during which an employee can sign up for group insurance coverage without furnishing evidence of insurability i

9、s called a(n)A) probationary period.B) noninsurability window.C) waiting period.D) eligibility period.Answer: DQuestion Status: Previous Edition7) Which of the following statements about group term life insurance is true?A) It usually is written in the form of 5-year level term insurance.B) An emplo

10、yee who leaves the group can usually convert the coverage to an individual term life insurance policy.C) Many employers provide a reduced amount of coverage on retired employees.D) It represents only about 5 percent of the group life insurance in force.Answer: CQuestion Status: Previous Edition8) Hi

11、gh deductible group health insurance plans have all of the following characteristics EXCEPTA) health savings accounts or health reimbursement accounts B) high dollar deductibles C) low coverage limitsD) major medical insuranceAnswer: CQuestion Status: Previous Edition9) Which of the following statem

12、ents about group accidental death and dismemberment (AD&D) insurance is (are) true?I. The principal sum is paid if the employee dies in an accident.II. The employer usually pays at least 50 percent of the cost of voluntary AD&D coverage.A) I onlyB) II onlyC) both I and IID) neither I nor IIAnswer: A

13、Question Status: Previous Edition10) All of the following statements about group universal life insurance are true EXCEPTA) Interest rates credited to a policy vary over time but are subject to a minimum guarantee.B) Premiums can be varied as long as the cash value is sufficient to pay current morta

14、lity and expense charges.C) Coverage is issued on a guaranteed basis up to certain limits with no evidence of insurability.D) At retirement, an employee must begin liquidating his or her cash value in the form of an annuity.Answer: DQuestion Status: Previous Edition11) Which of the following stateme

15、nts about Blue Cross Plans is (are) true?I. They typically provide service benefits rather than cash benefits to members.II. They usually provide very limited benefits for hospital charges.A) I onlyB) II onlyC) both I and IID) neither I nor IIAnswer: AQuestion Status: Previous Edition12) What is the

16、 purpose of stop-loss insurance that is used with self-insured group medical expense plans?A) to require employees to buy insurance for losses in excess of some specified amountB) to have a commercial insurer pay claims that exceed a specified limitC) to obtain administrative services from a commerc

17、ial insurerD) to exempt self-insured plans from state insurance laws that require mandated benefitsAnswer: BQuestion Status: Previous Edition13) All of the following are reasons why employers self-insure medical expense plans EXCEPTA) to reduce certain costs, such as premium taxes and commissions.B)

18、 to provide mandated state benefits.C) to retain funds until needed to pay claims.D) to eliminate the need to comply with separate state laws.Answer: BQuestion Status: Previous Edition14) All of the following statements about group basic medical expense insurance are true EXCEPTA) Benefits under sur

19、gical expense insurance may be based on the reasonable and customary charge for the medical procedure.B) Benefits are usually provided for diagnostic X-ray and laboratory benefits.C) Benefits are designed to cover the cost of catastrophic medical expenses.D) Benefits are provided for nonsurgical car

20、e provided by a physician.Answer: CQuestion Status: Previous Edition15) Which of the following statements about supplemental group major medical insurance is (are) true?I. Most plans have a lifetime limit of $50,000 to $100,000.II. Most plans contain an out-of-pocket maximum that places a dollar lim

21、it on the maximum amount an individual must pay out of his or her own pocket.A) I onlyB) II onlyC) both I and IID) neither I nor IIAnswer: BQuestion Status: Revised16) A deductible that must be satisfied after the benefits of a basic medical expense plan are exhausted and before supplemental major m

22、edical benefits are payable is called a(n)A) calendar-year deductible.B) prospective deductible.C) straight deductible.D) corridor deductible.Answer: DQuestion Status: Revised17) Which of the following is (are) characteristics of HMO managed care plans?I. Unlimited choice of physicians and hospitals

23、II. Emphasis on controlling the cost of covered servicesA) I onlyB) II onlyC) both I and IID) neither I nor IIAnswer: BQuestion Status: Previous Edition18) Which of the following statements about HMO managed care plans is (are) true?I. There is an emphasis on controlling costs.II. They usually have

24、high deductibles.A) I onlyB) II onlyC) both I and IID) neither I nor IIAnswer: AQuestion Status: Previous Edition19) An HMO physician who determines if medical care from a specialist is necessary is called a(n)A) capitator.B) internist.C) network facilitator.D) gatekeeper.Answer: DQuestion Status: P

25、revious Edition20) An HMO that contracts with two or more independent group practices to provide medical services to covered members is called a(n)A) group model HMO.B) network model HMO.C) staff model HMO.D) independent practice association HMO.Answer: BQuestion Status: Revised21) Which of the foll

26、owing statements about preferred provider organization (PPO) health plans is (are) true?I. A PPO plan contracts with health care providers to provide medical services to members at reduced fees. II. Plan members are given a financial incentive to use PPO providers rather than other providers. A) I o

27、nlyB) II onlyC) both I and IID) neither I nor IIAnswer: CQuestion Status: Revised22) A managed care plan under which members can receive medical care from non-network providers at higher out-of-pocket costs is an example of a(n)A) group practice plan.B) individual practice plan.C) exclusive provider

28、 organization.D) point-of-service plan.Answer: DQuestion Status: Previous Edition23) All of the following statements about HMOs are true EXCEPTA) They organize and deliver health care services.B) HMOs place a heavy emphasis on controlling the cost of covered services. C) Comprehensive coverage is pr

29、ovided even when a subscriber is outside the area served by the HMO.D) The selection of physicians is usually limited to physicians affiliated with the HMO.Answer: CQuestion Status: Previous Edition24) All of the following are criticisms of managed care plans EXCEPTA) The quality of care may be redu

30、ced because of the emphasis on cost control.B) Preventive care is unlikely to be provided.C) Restrictions may be placed on physicians abilities to treat patients.D) Network physicians may have a financial conflict of interest between providing high-quality medical care and holding down costs.Answer:

31、 BQuestion Status: Previous Edition25) Which of the following statements regarding the Health Insurance Portability and Accountability Act is true?A) It guarantees the availability of group health insurance to small employers.B) It requires employers to provide at least a minimum level of health ben

32、efits prescribed by law.C) It requires giving credit for previous coverage with respect to any preexisting conditions exclusion found in a new health plan.D) It limits preexisting conditions exclusions to 90 days.Answer: CQuestion Status: Previous Edition26) Under the Health Insurance Portability and