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16 Cards in this Set
- Front
- Back
What are the the three major types of managed care plans
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Health maintenance organization, PPO, preferred provider and point of service plans. All managed care plans provide a primary care physician or gatekeeper
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What is a health reimbursement arrangements?
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Employees are reimbursed for medical expenses by employer
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What are the qualifying events under COBRA?
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18 months=terminated employees or conv to part tieme
29 months= disabled 36 months=MDs; medicare eligibility; Death; Dependents;; Deletion of plan; Divorce |
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How long does an employee have to elect COBRA
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60 days. Once elected, the employee or beneficiary has 45 days to pay the premium
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Which employers must offer COBRA
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All employers with 20 or more employees
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What is HIPPA
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Health Insurance Portability and Accountability Act of 1996-provides that there cannot be enforcement of a preexisting medical condition if employee was covered by the prior employer's health insurance plan for at least 12 months; fewer than 63 days have elapsed since the loss of coverage
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What is Obamacare, PPACA
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beginning in 2014, people who are not eligible for other insurance must maintain certain minimum levels of health care coverage or be subject to a penalty., prohibits lifetime coverage limits for essential health benefits, and requires plans to provide preventive services without charging deductibles, copayments or coinsurance.
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What is Medicare
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federal government health insurance plan that covers individuals 65 and over, who have been receiving SS disability benefits for at least 24 months, who are on kidney dialysis treatment
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What is the breakpoint in a major medical policy?
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This is the dollar amount of covered expenses after which the insurer pays 100% up to the maximum limit of the policy. It is a combination of the deductible and stop-loss limit.
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What is first-dollar coverage?
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Also called basic coverage-hospital and surgical expense coverage that requires the insurance company to pay the first costs that are insured without being subject to a deductible.
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Are health care premiums deductible?
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Yes Included in Sch A and deductible if all medical expenses exceed 10% or 7.% % of AGI Self employed persons can deduct 100% of the cost of health insurance from their gross income for federal tax purposes.
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How does contributions to a health savings account appear on tax return
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Above the line deduction
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Is there a premium for Medicare part A
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Yes but if you have 40 or more quarters of medicare covered employment you do not have to pay for it. The premium is $248 for 30-39 quarters and $451 for less than 30 quarters.
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What is not covered under Medicare Part B
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routine immunizations, cosmetic surgerys unless needed due to an accident, dental care, eyeglasses, hearing aids, orthopedic shoes and routine foot care.
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Name some types of medical insurance
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physicians, surgical, and hospital
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What is the max contribution for an HSA for single and for mfj
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$3250 and $6450
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