GBA2 - Markets Flashcards
1
Q
Groups of small employers who pool EE’s into larger group to obtain lower premiums. Popular in 1980’s and declined since.
A
Coalitions
2
Q
What % must ACA coverage be offered (what % of actuarial value of cost of benefits)?
A
60%
3
Q
ER pays fixed amount/limits contribution to specific HC service & health plan members must pay difference if more expensive doctor/service is desired
A
Reference Pricing
4
Q
Combines self funded health plans with stop loss insurance
A
Level-funded plans
5
Q
Fully integrated approach of IT that includes outreach, coordination, and follow-up
A
Desktop medicine
6
Q
Develop and implement interprofessional care plans that integrate clinical and community preventative & health promotion services
A
Section 3502 of ACA
