Quiz 5

Question 1

Applies when each member of an insurance pool pays the same premium per person or per family for the same coverage.

Answer 1

community rating

Question 2

Occurs when insurance companies base premiums on past levels of payouts, which is often done in the case of car or homeowner’s insurance.

Answer 2

Experience rating

Question 3

____________ refers to the level of expenditure that must be incurred before any benefits are paid out.

Answer 3

Deductible

Question 4

One problem in modeling the optimal insurance contract is that the degree of moral hazard may vary by type of illness or type of healthcare service

Answer 4

True

Question 5

____________________ refers to increased use of health care services by those who have health insurance.

Answer 5

moral hazard

Question 6

______________ is a medical condition that is excluded from coverage by an insurance company because the condition was believed to exist prior to the individual obtaining a policy from the particular insurance company

Answer 6

Pre-existing condition

Question 7

Which of the following is a desirable characteristics of an insurance arrangement?

1. The number of insured should be large and they should be independently exposed to potential loss
2. The losses covered should be definite in time, place, and amount
3. The chance of loss should be measurable.
4. ALL

Answer 7

ALL

Question 8

True or False? HMO members are assigned a primary care provider who serves as a gate keeper and authorize any health care provided

Answer 8

true

Question 9

True or False? While the goals are not finance driven, the efficiency, quality, and safety objectives of the In Patient Centered Medical Homes lead to lower costs in healthcare delivery.

Answer 9

true

Question 10

Seeking to attract more healthy patients who will use services less than their premiums

Answer 10

Creaming