Group Health Insurance Quiz

How Much Do You Know About Group Health Insurance?

1. A small business with fewer than 50 full time employees will be penalized if they do not offer health insurance.
A. True
B. False
Hint. The answer to this question can be found here: Health Insurance Marketplace for Employers
False. If you run a small business with less than 50 full-time equivalent employees, and choose not to offer coverage, you will NOT be penalized.
2. A small business with more than 50 full time employees will be penalized if they do not offer health insurance.
A. True
B. False
Hint. The answer to this question can be found here: Health Insurance Marketplace for Employers
True. If you have 50 or more full-time equivalent employees, and do not offer Affordable Care Act compliant employer health plans to at least 95% of your full-time employees, and just one of your employees qualifies for subsidized health insurance through a private plan under The Affordable Care Act, then as of 2016 and beyond, you will be penalized $2,260 for each full-time employee employed for the year (minus the first 30 employees).
3. With partially self-funded group plan, an employer contracts with a professional services organization to provide outsourced services in payroll, human resources, employee benefits, and tax compliance.
A. True
B. False
Hint. The answer to this question can be found here: Financial Platforms
False. A partially self-funded plan is administered by an insurance carrier or third party administrator and employers must have more than 50 full time employees to be eligible for coverage.
4. With a self-funded group plan, the employees manages all federal and state employee-related compliance including payroll taxes, human resource assistance, OSHA, and ACA.
A. True
B. False
Hint. The answer to this question can be found here: Financial Platforms
False. The employer pays a variable premium subject to claim utilization, retains a portion of the claim liability, and contracts with a reinsurance carrier to cover the excess claim liability.
5. With a fully insured group health plan, the employer pays a fixed monthly premium.
A. True
B. False
Hint. The answer to this question can be found here: Financial Platforms
True. With a fully insured group health plan, the employer pays a fixed monthly premium and the insurance carrier assumes all claim liability risks. Major insurance carriers (i.e. Blue Cross NC, United HealthCare, or Aetna) administer fully insured health plans for all sizes of employers.
6. A small business can lose out on strong candidates for employment if they do not offer group insurance to employees.
A. True
B. False
Hint. The answer to this question can be found here: Small Business Health Insurance
True. Employers may lose out on strong candidates for employment – candidates who may look elsewhere for a job with a company that offers group insurance.
7. A level funded health plan is a partially self-funded plan with a fixed monthly premium.
A. True
B. False
Hint. The answer to this question can be found here: Financial Platforms
True. A level funded health plan is a partially self-funded plan with a fixed monthly premium. And, if the actual claims for the plan year are lower than expected, then the employer shares the savings with the insurance carrier at the end of the year.
8. For a direct primary care model within a self-funded or partially self-funded group health plan, the employee contracts with primary care providers.
A. True
B. False
Hint. The answer to this question can be found here: Financial Platforms
False. With a hybrid self-funded or partially self-funded plan, an employer contracts directly with primary care providers to achieve additional cost savings on claim utilization. The employer also pays a variable premium subject to claim utilization, retains a portion of the claim liability and contracts with a reinsurance carrier to cover the excess claim liability.
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