Benefits and eligibility Study guides, Class notes & Summaries

The value proposition for the AARP brand is seen in what kinds of benefits for the members? (Select 3) - ANSWERSQuality of products offered. Efforts to improve the lives of members. Security and reputation of the AARP name. Which of the following must you ensure a consumer who is making a plan change understands? (Select 2) - ANSWERSI must make sure the consumer understands the benefits, costs, and limitations of the new plan I must make sure the consumer understands what they are givi...

Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for treatment. How much may Dr. Brennan charge? correct answersDr. Brennan can charge Mary Rogers no more than the cost sharing specified in the PFFS plan's terms and condition of payment which may include balance billing up to 15% of the Medicare rate. Mr. Gomez notes that a Private Fee-for-Service (PFFS) plan available in his area has an at...

Broad view of Employee Benefits - Answer- This view sees employee benefits as virtually any form of compensation other than direct wages. Components of the Broad view of Employee Benefits - Answer- 1. Employer's share of legally required payments (Social Security and Medicare, unemployment insurance, and worker's compensation benefits) 2. Payments for time not worked (e.g. paid rest periods, paid sick leave, paid vacations, holidays, parental leave, etc). 3. Employer's share of medical ...

What kind of retirement plan can a 75-employee for profit corporation establish? - Answer Simple IRA The taxable portion of a monthly income benefit paid during the annuity phase from a nonqualified annuity is calculated using the - Answer Exclusion ratio Unfair claims settlement methods and practices by an insurance company include all of the following acts EXCEPT - Answer failure to pay all claims that are reported within 90 days after a loss occurs The settlement option that al...

ERISA - Answer- Employee Retirement Income Security Act 1974 SOC Reports - Answer- Service Organization Controls: for external vendors SOC 1 - Answer- Internal Controls & Financial reports; used by auditors SOC 2 - Answer- Security, availability, processing integrity, confidentiality and privacy controls;used by management, regulators, and others under an NDA SOC3 - Answer- Same as SOC2, but available for public use. Tribble V Edison - Answer- Landmark court case re fiduciary resp...

EDPNA Exam | 60 Questions with Complete Solutions 100% Correct. The practice items for the Social Security Administration Direct Payment to Non-Attorney Representatives Examination are available below. These items are for practice purposes only and will not appear on the actual examination. All names used in these practice items are purely fictional and do not apply to any real claimants or any other individual. The items are multiple choice and there is only 1 correct answer for each quest...

2023 Medicare Basics Test Questions with Correct Answers In which two parts of Medicare is enrollment generally automatic for eligible consumers who are receiving social security benefits, unless they choose to delay their coverage? - Correct Answer Parts A and B Which statement is true about a member of a Medicare Advantage Plan who wants to enroll in a Medicare Supplement Insurance Plan? - Correct Answer When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automati...

Edward IP suffered from serious kidney disease. As a result. Edward became eligible for Medicare coverage due to end-stage renal disease (ESRD). A close relative donated their kidney and Edward successfully underwent transplant surgery 12 months ago. Edward is now age 50 and asks you if his Medicare coverage will continue, what should you say? - ANSWER Individuals eligible for Medicare based on ESRD generally lose eligibility 36 months after the month in which the individual receives a kidney tr...

WebCE: Long-Term Care: Programs, Policies, and Partnerships 100% Pass What is the Primary Goal of Long Term Care To maintain functionality Which of the following most precisely defines the fundamentals of self-care and the basic tasks of life? Activities of daily living Long Term Care occurs only in nursing facilities. False On what basis are benefits payable under a long term care insurance policy typically triggered? the inability to perform defined ADLs A long-term care ombudsman represen...

Joseph has Original Medicare and was a patient in the hospital last week. What part of Medicare helps cover the costs of his inpatient hospital stay? Part A Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a Medicare Supplement Insurance Plan? The consumer must be in a valid MA election or disenrollment period. 00:46 01:08 Being 65 or older, being under 65 years of age with certain disabilities for more than 24 months, and bein...