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Health Reform Quiz

Health Reform Quiz

General Health Reform

1. New coverage guidelines under the Patient Protection and Affordable Care Act (PPACA) require health plans to cover an expanded list of women's preventive care services with no cost-share (copayment, coinsurance or deductible), beginning in the first plan year that starts on or after August 1, 2012, as long as services are received in the health plan's network. The expanded list of preventive services includes:

 Breast-feeding support, supplies, and counseling
 FDA-approved contraception methods and counseling
 Gestational diabetes screening
 All of the above

That's right. Correct answer is "all of the above"

Sorry, the correct answer is "all of the above"

View a complete list of women's preventive care services, and effective dates for coverage changes.

2. Beginning Jan. 1, 2013, employee contributions to their health Flexible Spending Accounts (FSA) will be limited to:

 $2,000 per plan year
 $2,500 per plan year
 $3,000 per plan year

Correct.

Sorry, the correct answer is $2,500 per plan year

Beginning Jan. 1, 2013, employee contributions to their health Flexible Spending Accounts (FSA) will be limited to $2500 per plan year, with future increases to allow for inflation

3. The Patient Protection and Affordable Care Act imposes a new Patient-Centered Outcomes Research Institute (PCORI) fee on sponsors of self-insured plans and issuers of individual and group policies, effective for policy or plan years ending after Sept. 30, 2012.

 True
 False

Yes, the correct answer is TRUE.

Sorry, the correct answer is TRUE.

The Patient-Centered Outcomes Research Institute (PCORI) fee is effective for policy or plan years ending after Sept. 30, 2012. During the first year, the fee is $1 per covered life per year. The fee adjusts to $2 per covered life the second year, and then it's indexed to national health expenditures thereafter until it ends in 2019.

4. Small businesses may be eligible for a tax credit under the Health Reform law.

 True
 False

Correct

Sorry, that's wrong

Certain small businesses that offer health benefits are eligible for the health care tax credit. The credit amount varies, depending on the tax-exempt status of the organization and the employer contribution toward health benefits. To qualify for the credit:

  • Employers must pay at least half the cost of single coverage for their employees.
  • There must be no more than 25 full-time equivalent (FTE) employees, not counting owners or their family members.
  • Average annual wages of employees must be less than $50,000 per FTE.

5. Which employers are required to report the cost of health care coverage on employees' W-2 forms?

 All employers
 Only employers with more than 250 employees who get a W2
 Only self-funded employers

That's right

Sorry, wrong answer

Employers that file 250 or more W-2 forms must report the total cost of group health benefit plan coverage on their W-2 forms under the Patient Protection and Affordable Care Act. This reporting requirement is effective with the 2012 W-2 forms distributed to employees in January 2013.

6. The health reform law requires plans that offer dependent coverage to cover adult children as dependents. Who is eligible for this coverage?

 Full time students, regardless of their age
 Children who are dependents on their parents' tax returns
 Adult children to age 26

That's right

Sorry, wrong answer

Plans that provide coverage for dependents are required to extend the coverage of dependents (adult children) to age 26, regardless of their eligibility for other insurance coverage. Plans must provide coverage to all eligible dependents, including those who are not enrolled in school, not dependents on their parents' tax returns, and those who are married. Some states may have regulations that require extending the age.

7. The health reform law requires insurers to report plan costs for the purpose of calculating the insurer's Medical Loss Ratio (MLR). Which of the following statements about the MLR requirement is true?

 Large group insurers must achieve at least 85 percent MLR
 Individual and small group insurers must achieve at least 80 percent MLR
 The MLR standard does not apply to self-insured plans
 All of the above

Correct answer

Sorry, that's not right

This law requires insurers to report plan costs for the purpose of calculating the insurer's medical loss ratio (the percentage of insurance premium dollars spent on reimbursement for clinical services and activities to improve health care quality).

Large group insurers must spend at least 85 percent of premium dollars on claims and activities to improve health care quality. Individual and small group insurers must spend at least 80 percent of premium dollars on claims and activities to improve health care quality.

The MLR standard applies to health insurance plans offering group or individual coverage, including those designated "grandfathered plans." It does not apply to self-insured plans.