MTEL Business Practice Exam

Category - Business Operations

The yearly deductible for an employee in a company's health insurance plan is $1,200. This is best interpreted to mean that:
  1. The employee must pay $1,200 per year to the insurance company as his or her share of the cost of health insurance.
  2. The maximum yearly amount that the insurance company will pay for routine health care for the employee is $1,200.
  3. The employee must pay the first $1,200 of certain medical bills before the insurance company begins to make payments.
  4. The insurance company will pay the first $1,200 of any individual medical bill and the employee will be liable for the rest.
Explanation
Correct Response: C. A health insurance plan that requires an annual deductible of $1,200 means that this sum must be paid by the employee before the insurance company begins to make payments. Some preventive care benefits do not require a deductible. When care is not preventive, diagnosis care for example, the patient is responsible for paying for the care until the value of $1,200 has been reached. When the $1,200 deductible is met, the insurance plan will pay the additional medical bills. 
The premium, not the deductible, is the amount the employee must pay for insurance (A). The maximum yearly amount that an insurance company will pay for routine health care is called a cap, and is distinct from a deductible (B). Response D is essentially another form of a cap, except it applies to all bills, not just routine bills. This is also distinct from a deductible.
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