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Slide 1 - The IAFF

VIEWS: 8 PAGES: 26

									                    Health Care Jeopardy

Traditional                  Consumer
                                           Health Care
Health Care   Terminology     Directed                   Pot Luck
                                             Trends
   Plans                    Health Plans


  100           100            100           100          100

  200           200            200           200          200

  300           300            300           300          300

  400           400            400           400          400

  500           500            500           500          500
What is a PPO?




Traditional Health Care Plans: 100

This plan offers the most flexibility, usually at a higher cost.
What is an indemnity plan?




Traditional Health Care Plans: 200

This plan does not contain a network of doctors.
What is a point of service (POS) plan?




                DAILY DOUBLE !!

Traditional Health Care Plans: 300



This plan is a hybrid of an HMO and a PPO.
What is a fully-funded plan?




Traditional Health Care Plans: 400

This insurance funding option is for employers that want to transfer the risk.
What are consumer directed health plans (CDHP)?




Traditional Health Care Plans: 500

These insurance plans are designed to give consumers greater financial
control over their health care.
What is a summary plan description?




Terminology: 100

This is a booklet containing the benefits, terms and features of a health
insurance plan.
What is a deductible?




Terminology: 200

This is the amount of money a member must pay before insurance benefits
begin.
What is the out-of-pocket maximum?




Terminology: 300

This is the set limit of costs paid by the member that are not covered by
insurance.
What is a pre-existing condition?




Terminology: 400

This is an injury of illness for which a member was treated within the 6 months
prior to obtaining health insurance coverage. This injury or illness might be
excluded from coverage for a designated period of time.
What is Usual, Customary & Reasonable (UCR)?




Terminology: 500

This is the amount commonly charged for a particular medical service by the
physicians within a particular geographic region.
Who are healthy individuals and those who are not on maintenance medication?




Consumer-Directed Health Plans: 100

Consumer-directed health plans benefit these types of individuals.
What is a health savings account (HSA)?




Consumer-Directed Health Plans: 200

This plan is portable and owned by the employee. (i.e., the employee can
take this plan with him/her to another employer).
What is a health reimbursement account (HRA)?




Consumer-Directed Health Plans: 300

This plan is owned by the employer, and contributions are made solely by the
employer.
What is a health reimbursement account (HRA)?




Consumer-Directed Health Plans: 400

This consumer-directed plan can be paired with any type of health insurance
plan (i.e., it does not have to be paired with a high-deductible health plan).
What is $1,100 (single coverage)? or What is $2,200 (family coverage)? Either
answer is sufficient.




Consumer-Directed Health Plans: 500

In 2008, a health insurance plan must have a minimum deductible of this
amount to be considered a High Deductible Plan.
What are indemnity plans?




Health Care Trends: 100

These plans were popular in the ‘80s, but are not commonly offered by
employers today.
What is an increase of nearly double?




            DAILY DOUBLE !!
Health Care Trends: 200



According to a Blue Cross survey, national expenditures are expected to
increase by how much over the next ten years?
What is 3 – 5 times as much?




Health Care Trends: 300

On average, employers spend as much as _____ times as much as
employees on health care.
What is 10% of the employers who offer health insurance?




Health Care Trends: 400

According to the Kaiser survey, this percentage of employers offer a
consumer-directed health plan to their employees.
Increase the amount workers contribute to premiums
Increase deductible amounts
Increase office visit cost sharing




Health Care Trends: 500

According to the Kaiser survey, employers are doing these three things to cut
the cost of health care.
What are educate members and work with management to select a health plan?




Pot Luck: 100

These are two things affiliate leaders can do to be health care activists for
their locals.
What are generic drugs?




Pot Luck: 200

These are FDA-approved, equivalent versions of brand-name drugs that are
offered to consumers when the patent of the brand name drug expires.
What is a formulary?




Pot Luck: 300

This is a list of generic and brand-name drugs that are approved by a health
insurance plan.
What is an explanation of benefits (EOB)?




Pot Luck: 400

This is a document provided to a member in response to filing a claim for a
medical service. This document lists the costs associated with this service.
What is stop loss or reinsurance?




Pot Luck: 500

If an employer decides to self-fund an insurance plan, it must purchase this
type of insurance to cover catastrophic events.

								
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