Module 8: Self-funding By Small Employers

Question 1

The passage of the _____ had restricted certain underwriting factors which can make rates higher for young and healthy workers.

Answer 1

ACA

Question 2

Under ACA, what are the 4 factors insurers may use to set premiums for small groups?

Answer 2

1. Age
2. Geographic area
3. Tobacco use
4. Family composition (tiers)

Question 3

A stop loss carrier targets employees who have had large claims in the past and limits the amounts paid for these high risk individuals.

Answer 3

Lasering

Question 4

An insurance arrangement in which the employer makes a preset premium payment monthly to an insurer or TPA, which funds claims, admin costs, and stop loss coverage.

Answer 4

Level-funded plan

Question 5

Level funded plans offers ______ control over plan design than a self funded program.

Answer 5

Less

Question 6

What is attachment point?

Answer 6

Refers to the amount at which the stop loss insurer begins to pay