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Question ID 17168

The Wentworth Corporation uses a self-funded plan to provide its employees with
healthcare benefits. One consequence of Wentworth's approach to providing healthcare
benefits is that self-funding

Option A

Requires that Wentworth self-administer its healthcare benefit plan

Option B

Requires that Wentworth pay higher state premium taxes than do insurers and health plans

Option C

Eliminates the need for Wentworth to pay a risk charge to an insurer or health plan

Option D

 Increases the number of benefit and rating mandates that apply to Wentworth's plan

Correct Answer C
Explanation


Question ID 17169

From the following answer choices, choose the term that best corresponds to this
description. The SureQual Group is a group of practicing physicians and other healthcare
professionals paid by the federal government to review services ordered or furnished by
other practitioners in the same medical fields for the purpose of determining whether
medical services provided were reasonable and necessary, and to monitor the quality of
care given to Medicare patients.

Option A

Health insuring organization (HIO)

Option B

 Independent practice association (IPA)

Option C

Physician practice management (PPM) company

Option D

Peer review organization (PRO)

Correct Answer D
Explanation

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