Question

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QUESTION 21 3 points Save Answer Which of these statements is NOT a criticism of managed care plans: Care is being reduced because of the emphasis on cost control. Preventive care is unlikely to be provided. Restrictions may be placed on physicians' abilities to treat patients. Network physicians may have a financial conflict of interest between providing high-quality medical care and holding down costs. QUESTION 22 3 pointe Save Answer Which of the following term insurance policy statements about conversion is NOT true? Under an attained age conversion, the premium is based on the insured's attained age at the time of conversion Under an original age conversion, the policyowner must pay a financial adjustment in addition to the premium for the new policy Most insurers require original age conversion to take place within a specified period (5 years, for example) of the issue of the term policy. Evidence of insurability is required before a conversion is permitted. QUESTION 23 3 pointe Save Answer If Benz Iron chooses to self-insure for its employee life and health insurance plans and hires Top Agency to manage the plan design, claims processing and record keeping then this type of agreement is called ain) O preferred provider agreement. administrative services only contract. exclusive provider agreement. point-of-service contract.

Answer 1

21. Managed care plans are criticized for the high pricing strategy used for different health plans. There can be a conflict of interest in the managed care providers in providing high quality medical care as well as keeping the costs of the healthcare low. Moreover it has been noticed that preventive care is the first thing to get compromised in managed cares. However there are no restrictions placed on physician’s abilities to treat patients.

Answer: Restrictions may be placed on physician’s abilities to treat patients

22. Under an attained age conversion, the premium is based on the insured’s attained age at the time of conversion. This is known as the attained age method of policy conversion. Under an original age conversion, the policyowner must pay a financial adjustment in addition to the premium for the new policy. This helps in tackling the price difference which may happen due to inflation. Usually it is posed as a condition that original age conversion must take place within a specified time from the issuance date of the policy. However evidence of insurability is not an essential requirement before a conversion gets permitted.

Answer: Evidence of insurability is an essential requirement before a conversion gets permitted.

23. If Benz Iron chooses to self-insure for its employees and hires Top Agency to manage the plan design, claims processing and record keeping, then this type of agreement is called an administrative services only contract. The Top Agency will be third party provider, hired by the company to conduct the administrative functions of the employee insurance in the company.

Answer: Administrative services only contract

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