Chapter 16 - Government Health Insurance Plans

Question 1

Workers compensation is a benefit offered and regulated by who?

Answer 1

The states

Question 2

What are the two types of Flexible Spending Accounts?

Answer 2

• Health Care Account

- Dependent Care Account

Question 3

Under NYS Disability Benefit Law, the weekly benefit that the disabled employee is entitled to receive is what?

Answer 3

50% of weekly wage, not to exceed $170

Question 4

The minimum number of credits required for the partially insured status for Social Security disability benefits is what?

Answer 4

6 credits earned during the last 13-quarter period.

Question 5

To be eligible for an HSA, what is required of an individual? (4)

Answer 5

• Must be covered by a High Deductible Health Plan
• Must not be covered by other insurance except for specific injury, accident, disability, dental care, visions care, ot LTC insurance
• Must not be eligible for Medicare
• Can’t be claimed as a dependent on someone else’s tax return.

Question 6

Who is excluded from the definition of an employee under New York Disability Benefit Law? (4)

Answer 6

• Minor child of the employer
• A domestic or personal worker in a private home who is employed for less than 40 hours per week by any one employer
• A duly ordained, commissioned, or licensed minister, priest or rabbi, a sexton, a Christian Science reader, or member of a religious order
• An executive officer of a corporation who owns all the outstanding stocks and holds all offices of the corporation.

Question 7

What is the calculation of Social Security disability benefit based upon?

Answer 7

The worker’s Primary Insurance Amount (PIA)

Question 8

An insured has Medicare Part D coverage, upon reaching the initial benefit limit, what percentage of the prescription drug cost is the insured responsible for paying?

Answer 8

25%

Question 9

Following an injury, a policyowner covered under Medicare Parts A & N was treated by her physician on an outpatient basis. How much of their doctor’s bill will they be required to pay out-of-pocket?

Answer 9

After the deductible, Part B will pay 80& of covered expenses, subject to Medicare’s standards for reasonable charges, leaving the insured paying the other 20%.

Question 10

Workers Compensation laws provide what four types of benefits?

Answer 10

1. Medical Benefits
2. Income Benefits
3. Death Benefits
4. Rehabilitation Benefits

Question 11

Who is eligible for Medicare Part B?

Answer 11

Part B is optional and offered to everyone who enrolls in Part A.

Question 12

Which Medicare Part has a monthly premium, A or B?

Answer 12

Part B