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Medical Plan Types Medical Plan Terms HSA vs HRA Miscellaneous Medical Stabilizing Costs
100
What is an HMO?
Health Maintainance Organization
100
What is a Co-pay?
A cost-sharing arrangement where participant pays a flat fee for a specified service.
100
What is a Health Savings Account (HSA)?
Tax advantaged account that accepts employer or employee contributions.
100
What is the Affordable Care Act?
Legislative Act designed to make health care more affordable.
100
What is a "Waiting Period"?
Amount of time before an employee is coverage by the company benefits plan?
200
What is Behavioral Health plan?
Type of plan that covers mental health and chemical dependency
200
What is a Deductible?
Amount paid by the plan participant out-of -pocket for covered expenses before the plan pays any anything.
200
What is a Health Reimbursement Account (HRA)?
HRA
200
What is an HMO and PPO?
2 Medical Plan types that have "gatekeepers".
200
What is Coordination of Benefits?
Cost stabilizing approach to manage dual coverage?
300
What is a POS (Point of Service Plan)?
A hybrid of a PPO and an HMO
300
What is and Out-of-Pocket limit?
Maximum amount of covered medical expenses the employee and their dependents are responsble for each year?
300
What is and HSA?
Account balance is portable when an employee leaves his/her company?
300
What are Typical Exclusions?
Cosmetic surgery, nonmedically necessary, experimental procedures and workers compensation expenses.
300
What is Co-insurance?
Percentage that will be paid by plan participant and the employer after the deductible is met.
400
What is and Indemnity Plan?
Plan that allows maximum amount of choice but is no very prevalant in recent years
400
What is Co-insurance?
Percent of coverage paid by the plan participant.
400
What is and HRA?
Provides tax-free funding by employers for general health care expenses.
400
What is Reasonable & Customary (R&C)
The average fee charged by a particular health care practicioner within a geographic area.
400
What is Retiree benefits coverage?
Typically cost 2x the cost of active employee benefits coverage.
500
What is a Consumer Driven Health Plan (CDHP)?
Medical plan type that incentivizes employees to manage their health care costs.
500
What is In-network?
Option for plan participant to utlize providers who have agreed to pre-negotiated rates.
500
What is and HRA?
Account where funds are NOT portable when an employee leaves his/her company?
500
What are Welfare benefit plans?
Sick Leave, STD, LTD, Life and AD&D insurance.
500
What is the Affordable Care Act?
Federal Act impacting benefit plan design decisions.






Benefit Plan Jeopardy- Module 1

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