- (Topic 1)
The following paragraph contains an incomplete statement. Select the answer choice containing the term that correctly completes the statement. Health plans face four contingency risks (C-risks): asset risk (C-1), pricing risk (C-2), interest-rate risk (C-3), and general management risk (C-4). Of these risks, _______ is typically the most important risk that health plans face. This is true because a sizable portion of the total expenses and liabilities faced by a health plan come from contractual obligations to pay for future medical costs, and the exact amount of these costs is not known when the healthcare coverage is priced.
Correct Answer:
B
- (Topic 1)
One true statement about the rate ratios used by a health plan is that the
Correct Answer:
A
- (Topic 2)
The medical loss ratio (MLR) for the Peacock health plan is 80%. Peacock's expense ratio is 16%.
Peacock's MLR and its expense ratio indicate that Peacock
Correct Answer:
A
- (Topic 1)
A health plan that capitates a provider group typically provides or offers to provide stop-loss coverage to that provider group.
Correct Answer:
A
- (Topic 2)
The following information was presented on one of the financial statements prepared by the Rouge Health Plan as of December 31, 1998:
Rouge’s current ratio at the end of 1998 was approximately equal to:
Correct Answer:
C
