America's Benefit Specialist November 2023

CPC QUIZ

6. _____ plans are largely regulated at the state level but are required to meet some federal standards, such as COBRA, HIPAA and the ACA. A. Self-funded B. Medicare C. Fully insured D. Long-term care 7. Self-funded companies can purchase _____ insurance to protect against significant financial losses, pur chased on either a per-employee or covered-group basis. A. E&O B. short-term disability C. stop-loss D. life 8. Employers that _____ gain access to healthcare usage data that can inform future decision making. A. self-fund B. fully insure C. use reference-based pricing D. offer group coverage 9. Which is not a misconception about self-funding? A. Only small companies have self-funded plans. B. Self-funded plans are not cost-effective. C. Self-funded plans are labor-intensive. D. Employees will be confused by a self-funded plan or not understand their responsibilities. 10. Which is not a cost-saving strategy for self-funded plans? A. reduce risk with stop-loss captives B. optimize pharmacy benefits C. implement COBRA D. provide clinical care management for chronic ill nesses 11. A/An _____ under the CAA prohibits restrictions on the disclosure of provider-specific cost or quality-of-care information or data to referring partners, the plan sponsor, participants, beneficiaries or enrollees, or in dividuals eligible to become participants, beneficiaries or enrollees of their plan or coverage.

1. According to the World Health Organization, an es timated 12 billion working days are lost each year to mental health episodes at a cost of _____.

A. $600 billion B. $900 billion C. $1 trillion D. $2 trillion

2. Nearly _____ employers recently changed their bene fits for mental health services, according to a survey conducted by KFF.

A. two out of 10 B. three out of 10 C. four out of 10 D. five out of 10

3. The _____ amended the Mental Health Parity and Addiction Equity Act of 2008, in part by expressly requiring group health plans and health insurance issuers offering group or individual health insurance coverage that offer both medical/surgical benefits and MH/SUD benefits and that impose non-quantitative treatment limitations (NQTLs) on MH/SUD benefits to perform and document their comparative analyses of the design and application of NQTLs. A. Consolidated Appropriations Act of 2021 B. Patient Protection and Affordable Care Act C. Securing the U.S. Organ Procurement and Trans plantation Network Act D. Competitive Health Insurance Reform Act of 2020 4. Which is not a strategy that a benefit professional can take in order to support the employer response to the national mental health crisis? A. acquisition-cost-based pharmacy pricing 5. A/An _____ is a voluntary, work-based program that generally offers free and confidential assessments, short-term counseling, referrals and follow-up services to employees who have personal and/or work-related problems. A. diversity, equity and inclusion training B. employee assistance program C. sales training D. corporate wellness program B. HSA-capable coverage C. reference-based pricing D. self-funding plans

A. gag clause B. attestation C. self-funded plan D. submitter

40 ABS | benefitspecialistmagazine.com