2: Under the New York State Disability Benefit Law, no employee may be entitled to benefits for more than how many weeks after 52 consecutive calendar weeks or during any one period of disability?
A 12 weeks
B 16 weeks
C 26 weeks
D 48 weeks
Employees are not entitled to benefits for more than 26 weeks during 52 consecutive calendar weeks or during any one period of disability.
8: How do employer contributions to a Health Savings Account affect the insured’s taxes?
A The employer contributions are taxed at the same rate as the Social Security tax rate.
B The employer contributions are taxed to the individual insured as earned income.
C The employer contributions are deducted from the individual insured’s tax calculations.
D The employer contributions are not included in the individual insured’s taxable income.
HSA contributions made by an employer are not included in the determination of an individual's taxable income.
10: Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?
A 80
B 3
C 20
D 100
Following hospitalization for at least three days, if medically necessary, Medicare pays for all covered services during the first 20 days in a skilled nursing facility. Days 21 through 100 require a daily copayment.
14: Concerning Medicare Part B, which statement is INCORRECT?
A It offers limited prescription drug coverage.
B It provides partial coverage for medical expenses not fully covered by Part A.
C It is fully funded by Social Security taxes (FICA).
D It is known as medical insurance.
Part B is funded by monthly premiums and from the general revenues of the federal government.
A 80
B 3
C 20
D 100
Following hospitalization for at least three days, if medically necessary, Medicare pays for all covered services during the first 20 days in a skilled nursing facility. Days 21 through 100 require a daily copayment.
10: Hospice care is intended for
A People in need of acute care.
B Home health visits from a participating home health agency.
C The caregiver.
D The terminally ill.
Under certain conditions, hospital insurance can help pay for hospice care for terminally ill insureds, if the care is provided by a Medicare-certified hospice.
7: To sign up for a Medicare prescription drug plan, individuals must first be enrolled in
A Medicare Part B and C.
B Medicare Parts A and C.
C Medicare Part D.
D Medicare Part A.
To receive Medicare prescription drug benefits, beneficiaries must sign up with a plan offering this coverage in their area and must be enrolled in Medicare Part A or in Parts A and B.
8: Concerning Medicare Part B, which statement is INCORRECT?
A It is fully funded by Social Security taxes (FICA).
B It is known as medical insurance.
C It offers limited prescription drug coverage.
D It provides partial coverage for medical expenses not fully covered by Part A.
Part B is funded by monthly premiums and from the general revenues of the federal government.
13: All of the following are covered by Part A of Medicare EXCEPT
A Post-hospital nursing care.
B Home health services.
C Physician's and surgeon's services.
D In-patient hospital services.
Physician's and surgeon's services are covered under Part B.
12: What is the amount a physician or supplier bills for a particular service or supply?
A Assignment
B Coinsurance
C Approved amount
D Actual charge
Actual Charge is the amount a physician or supplier bills for a particular service or supply.
A Sickness in old age.
B Premature death.
C Disability.
D Bad investment choices.
Social Security is a Federal program enacted in 1935, that is designed to provide protection, for eligible workers and their dependents, against financial loss due to death, disability, superannuation (retirement income), and sickness in old age.
13: Workers Compensation benefits are regulated by which entity?
A Insurer
B Federal government
C State government
D Employer
The state government offers and regulates Workers Compensation benefits, which vary slightly from state to state.4: Which of the following must the patient pay under Medicare Part B?
A 80% of covered charges above the deductible
B All reasonable charges above the deductible according to Medicare standards
C A per benefit deductible
D 20% of covered charges above the deductible
As established by Medicare, the patient must pay 20% of covered charges above the deductible.
6: All of the following are requirements of eligibility for Social Security disability income benefits EXCEPT
A Fully insured status.
B Waiting period of 5 months.
C Being age 65.
D Inability to perform any gainful work.
The term fully insured refers to someone who has earned 40 quarters of coverage (the equivalent of 10 years of work), and is therefore entitled to receive Social Security retirement, Medicare, and survivor benefits. The waiting, or elimination period for Social Security disability benefits is 5 months.
10: Which of the following statements is correct?
A All HMOs and PPOs charge premiums beyond what is paid by Medicare.
B HMOs may pay for services not covered by Medicare.
C HMOs do not pay for services covered by Medicare.
D Medicare Advantage is Medicare provided by an approved Health Maintenance Organization only.
The advantages of an HMO or PPO for a Medicare recipient may be that there are no claims forms required, almost any medical problem is covered for a set fee so health care costs can be budgeted, and the HMO or PPO may pay for services not usually covered by Medicare or Medicare supplement policies, such as prescriptions, eye exams, hearing aids, or dental care.
11: Which of the following is NOT true regarding a flexible spending account?
A It does not have limits on contributions.
B It operates on “use-or-lose” basis.
C It provides an opportunity to receive benefits on a pretax basis.
D It is a cafeteria plan.
A Flexible Spending Account (FSA) is a form of cafeteria plan benefit funded by salary reduction. The employees are allowed to deposit a certain amount of their paycheck into an account before paying income taxes. FSA benefits are subject to annual maximum and "use-or-lose" rule.
12: Which of the following statements is INCORRECT concerning Medicare Part B coverage?
A Part B coverage is provided free of charge when an individual turns age 65.
B Participants under Part B are responsible for an annual deductible.
C Part B will pay 80% of covered expenses, subject to Medicare's standards for reasonable charges.
D It is a voluntary program designed to provide supplementary medical insurance to cover physician services, medical services and supplies not covered under Part A.
Those who desire Part B coverage must enroll and pay a monthly premium.
Questions
2: Medicaid provides all of the following benefits EXCEPT
A Eyeglasses.
B Family planning services.
C Income assistance for work-related injury.
D Home health care services.
Medicaid covers a variety of medical costs, from eyeglasses to hospitalization.
8: Under the New York State Disability Benefit Law, for an employed individual, disability benefits will be payable after a waiting period of
A 7 days.
B 31 days.
C 60 days.
D 3 days.
New York State Disability Benefits are only paid when the individual cannot collect unemployment because of disability. If the employee’s weekly average wage is less than $20.00, the benefit is such average weekly wage.
13: All of the following are covered by Part A of Medicare EXCEPT
A Post-hospital nursing care.
B Home health services.
C Physician's and surgeon's services.
D In-patient hospital services.
Physician's and surgeon's services are covered under Part B.
14: Workers Compensation benefits are regulated by which entity?
A State government
B Employer
C Insurer
D Federal government
The state government offers and regulates Workers Compensation benefits, which vary slightly from state to state.
15: How do employer contributions to a Health Savings Account affect the insured’s taxes?
A The employer contributions are not included in the individual insured’s taxable income.
B The employer contributions are taxed at the same rate as the Social Security tax rate.
C The employer contributions are taxed to the individual insured as earned income.
D The employer contributions are deducted from the individual insured’s tax calculations.
HSA contributions made by an employer are not included in the determination of an individual's taxable income.
15: What is a penalty tax for nonqualified distributions from a health savings account?
A 8%
B 10%
C 12%
D 20%
An HSA holder who uses the money for a nonhealth expenditure pays tax on it, plus a 20% penalty.
Q: Under a fully contributory health plan, how are benefits received by the employee?
A: Income tax free
Q: How are excess funds in an employee's health savings account (HSA) handled?
A: The funds can be carried forward to the next year
Q: In order to be eligible for coverage by an HSA, an individual must also be covered by what type of health plan?
A: High Deductible Health Plan (HDHP)
Q: In group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense?
A: 100%
Q: Under what employer-provided plan are the benefits taxable to an employee in proportion to the amount of premium paid by the employer?
A: Disability income
Q: How are individually-owned disability income benefits taxed once received by the insured?
A: Disability benefits are not taxed; they are received income tax free
Q: How are the benefits of group accidental death and dismemberment policy received?
A: Income tax free
Q: What are the tax implications for employer contributions to Health Reimbursement Accounts?
A: Employer contributions are tax deductible as business expenses
Q: How are benefits received by the business from a key person disability insurance?
A: Income tax free
Q: What is the tax advantage of the employer paying premiums for its employees for disability income insurance?
A: Premiums are deductible as a business expense
Q: How long do short-term disability group plans pay benefits?
A: For a period of less than 2 years
A: Income tax free
A: The funds can be carried forward to the next year
A: High Deductible Health Plan (HDHP)
A: 100%
A: Disability income
A: Disability benefits are not taxed; they are received income tax free
A: Income tax free
A: Employer contributions are tax deductible as business expenses
A: Income tax free
A: Premiums are deductible as a business expense
A: For a period of less than 2 years
Questions
2: Medicaid provides all of the following benefits EXCEPT
A Eyeglasses.
B Family planning services.
C Income assistance for work-related injury.
D Home health care services.
Medicaid covers a variety of medical costs, from eyeglasses to hospitalization.
8: Under the New York State Disability Benefit Law, for an employed individual, disability benefits will be payable after a waiting period of
A 7 days.
B 31 days.
C 60 days.
D 3 days.
New York State Disability Benefits are only paid when the individual cannot collect unemployment because of disability. If the employee’s weekly average wage is less than $20.00, the benefit is such average weekly wage.
13: All of the following are covered by Part A of Medicare EXCEPT
A Post-hospital nursing care.
B Home health services.
C Physician's and surgeon's services.
D In-patient hospital services.
Physician's and surgeon's services are covered under Part B.
14: Workers Compensation benefits are regulated by which entity?
A State government
B Employer
C Insurer
D Federal government
The state government offers and regulates Workers Compensation benefits, which vary slightly from state to state.
15: How do employer contributions to a Health Savings Account affect the insured’s taxes?
A The employer contributions are not included in the individual insured’s taxable income.
B The employer contributions are taxed at the same rate as the Social Security tax rate.
C The employer contributions are taxed to the individual insured as earned income.
D The employer contributions are deducted from the individual insured’s tax calculations.
HSA contributions made by an employer are not included in the determination of an individual's taxable income.
1: Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?
A 20
B 100
C 80
D 3
Following hospitalization for at least three days, if medically necessary, Medicare pays for all covered services during the first 20 days in a skilled nursing facility. Days 21 through 100 require a daily copayment.
2: If one takes Social Security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare?
A Nothing
B Apply for coverage through the state
C Appear for a physical at the Social Security office
D Apply at a local Social Security office
Nothing needs to be done in this case. Medicare Part A and B will automatically be effective the month you turn 65.
3: Under the New York State Disability Benefit Law, the weekly benefit that the disabled employee is entitled to receive is
A 35% of weekly wage
B 40% of weekly wage
C 50% of weekly wage
D 70% of weekly wage
The weekly benefit that a disabled employee will receive is one-half of the employee’s weekly wage; however, the benefit cannot exceed $170.
4: How is the amount of Social Security disability benefits calculated?
A It is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over their highest 30 years.
B It is based on age, number of quarters worked in the last 25 years (minimum of 80) and the number of health claims made during that period of time.
C It is based on age, number of quarters worked in the last 20 years (minimum of 60) and the number of health claims made during that period of time.
D It is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over their highest 35 years.
The amount of Social Security disability benefits is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over their highest 35 years. The lowest 5 years of income may be deleted from calculation.
5: What are the 2 types of Flexible Spending Accounts?
A Health Care Accounts and Health Reimbursement Accounts
B Medical Savings Accounts and Dependent Care Accounts
C Medical Savings Accounts and Health Reimbursement Accounts
D Health Care Accounts and Dependent Care Accounts
There are 2 types of Flexible Spending Accounts: a Health Care Account for out-of-pocket health care expenses, and a Dependent Care Account to help pay for dependent care expenses which make it possible for an employee and his or her spouse, if applicable, to work.
8: What is the difference between the Medicare approved amount for a service or supply and the actual charge?
A Excess charge
B Actual charge
C Limiting charge
D Coinsurance
Excess Charge is the difference between the Medicare approved amount for a service or supply and the actual charge.
9: What is the official name for the Social Security program?
A Social Insurance Program
B Defined Benefit Retirement Insurance
C Qualified Pension Plan
D Old Age Survivors Disability Insurance
Social Security is formally called Old Age Survivors Disability Insurance - OASDI.
11: Which of the following is a type of covered employment under the New York State Disability Benefit Law?
A Maritime employment
B Casual employment
C Trade organization employment
D Services performed for a state agency
Services performed for the state (and other governmental agencies as specified) and services subject to the Federal Railroad and Unemployment Insurance Act are excluded from employment coverage under this law.
12: Assuming that all of the following people are covered by a High Deductible Health Plan and are not claimed as dependents on anyone's tax returns, which would NOT be eligible for a Health Savings Account?
A Joe is 40 and is not covered by any other health insurance
B Amanda is 67 and is covered by a basic medical expense policy
C Andy is 55 and is covered under a dental care policy
D Jenny is 60 and also has a long-term care insurance plan
To be eligible for a Health Savings Account, an individual must be covered by a High Deductible Health Plan (HDHP), must not be covered by other health insurance except for specific injury, accident, disability, dental care, vision care, or long-term care insurance, must not be eligible for Medicare (usually age 65), and can't be claimed as a dependent on someone else's tax return.
13: Which of the following is INCORRECT concerning Medicaid?
A It is solely a federally administered program.
B It provides medical assistance to low-income people who cannot otherwise provide for themselves.
C It pays for hospital care, outpatient care, and laboratory and X-ray services.
D The federal government provides about 56 cents for every Medicaid dollar spent.
Medicaid is assistance program for persons with insufficient income and/or resources to pay for health care. States administer the program that is financed by federal and state funds.
A 4 credits
B 6 credits
C 10 credits
D 40 credits
To be considered currently (or partially) insured, an individual must have earned 6 credits during the last 13-quarter period.
2: At what age may an individual make withdrawals from an HSA for nonhealth purposes without being penalized?
A 55
B 59 1/2
C 62
D 65
After age 65, a withdrawal from an HSA used for a nonhealth purposes will be without a penalty, although taxed.
3: If an insured worker has earned 40 quarters of coverage, the worker’s status under Social Security disability is
A Correctly insured.
B Permanently insured.
C Fully insured.
D Partially insured.
A worker is fully insured under Social Security if the worker has accumulated the required number of credits based on his/her age.
4: Which of the following is NOT true regarding Workers Compensation?
A Benefits are regulated by the state government.
B Benefits are offered by the insurer.
C Benefits are not regulated by the federal government.
D Benefits vary from state to state.
The state government regulates Workers Compensation benefits, which vary slightly from state to state.
5: The primary eligibility requirement for Medicaid benefits is based upon
A Number of dependents.
B Need.
C Whether the claimant is insurable on the private market.
D Age.
Medicaid is a program operated by the state, with some federal funding, to provide medical care for those in need.
6: All of the following statements concerning workers compensation are correct EXCEPT
A All states have workers compensation.
B Benefits include medical, disability income, and rehabilitation coverage.
C A worker receives benefits only if the work related injury was not his/her fault.
D Workers compensation laws are established by each state.
Workers Compensation benefits are payable when a worker is injured by a work-related injury, regardless of fault or negligence.
7: All of the following statements concerning Medicaid are correct EXCEPT
A Individual states design and administer the Medicaid program under broad guidelines established by the federal government.
B Individuals claiming benefits must prove they do not have the ability or means to pay for their own medical care.
C Persons, at least 65 years of age, who are blind or disabled and financially unable to pay, may qualify for Medicaid Nursing Home Benefits.
D Medicaid is a state funded program that provides health care to persons over age 65, only.
Medicaid is a government funded (both state and federal) program designed to provide health care to poor people of all ages.
8: In order for an insured under Medicare Part A to receive benefits for care in a skilled nursing facility, which of the following conditions must be met?
A There is no benefit provided under Medicare Part A for skilled nursing care.
B The insured must cover daily copayments.
C The insured must have first been hospitalized for 3 consecutive days.
D The insured must have a Medicare supplement insurance policy.
Part A covers the cost of care in a skilled nursing facility as long as the patient was first hospitalized for 3 consecutive days, and the services are medically necessary and only up to amounts deemed.
10: Medicare Advantage is also known as
A Medicare Part B.
B Medicare Part C.
C Medicare Part D.
D Medicare Part A.
Medicare consists of Hospital Insurance protection (Part A), Medical Insurance protection (Part B), and Medicare Advantage (Part C) (formerly known as Medicare+Choice). Medicare Part D is a "stand alone" drug insurance policy for persons who need the coverage and are eligible for Medicare Part A and/or Part B.
13: The annual contribution limit of a Dependent Care Flexible Spending Account is set by
A The employer.
B The insurer.
C The insured.
D The IRS.
The IRS sets limits for the annual contribution for Dependent Care Accounts.
14: Which New York program specifically provides health insurance for children under the age of 19 whose families meet income guidelines?
A Timothy’s Law
B Child Health Plus
C Taft-Hartley Trust
D Healthy New York
The Child Health Plus program provides health insurance for child under the age of 19 if their families meet income guidelines.
15: The amount of Social Security disability benefits is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over which years? Which years of income may be deleted from calculation?
A Their highest 20; lowest 2
B Their highest 35; lowest 5
C Their highest 40; lowest 5
D Their highest 15; lowest 4
The amount of Social Security disability benefits is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over their highest 35 years. The lowest 5 years of income may be deleted from calculation.