Health Insurance Providers - Ch. 5

Question 1

Capitation

Answer 1

The payment (per patient) the physician recieves

Question 2

What type of payment model does an HMO use?

Answer 2

Pre-payment model

Question 3

What type of payment model does a PPO use?

Answer 3

Fee-for-service model

Question 4

What makes an individual eligible for Social Security Disability Benefits?

Answer 4

Mental or physical disability preventing substantial work, expected to last at least 12 months or result in death. (5 month waiting period)

Question 5

Multiple Employer Trusts

Answer 5

Used to offer group benefits to employers with a small workforce.

Question 6

Multiple Employer Welfare Arrangement

Answer 6

A type of MET that is tax-exempt when employees share an employment-related bond.

Question 7

TRICARE

Answer 7

A federal accident and health plan for military service members and their
families

Question 8

3 main types of commercial insurance providers

Answer 8

Life Insurance, Casualty insurance, and Monoline insurance - mostly operating on a reimbursement model