LESSON 12: HEALTH INSURANCE PROVIDERS
The following subjects are contained within Lesson 12:
Commercial Insurance Providers - Reimbursement Approach; Right of Assignment
Service Providers - Health Maintenance Organizations (Purpose, Open-Panel HMOs, Closed-Panel HMOs); HMO Operation; Florida Laws and Regulations Regarding HMOs; Unfair Trade Practice Activities by HMOs (Unfair Trade Practices Act, Comprehensive Health Care, Florida HMO Contract Requirements)
Preferred Provider Organizations (PPOs)
Government Health Insurance Programs - Medicare Part A (Lifetime Reserve); Medicare Part B (Income-Related Premiums for Higher-Income Participants; Primary Payor, Secondary Payor); Medicare Part C (Participating PPOs, Private Fee-For-Service Plans); Medicare Part D; Medicaid (Medicaid Reform, The Deficit Reduction Act); Workers' Compensation
Alternative Methods - Self-Insurance; Multiple Employer Trusts (METs); Multiple Employer Welfare Arrangements (MEWAs)
Lesson Review - Key Concepts, Quiz
The information contained in Lesson 12 can be found in
Units 16 and 20 of the Florida study manual.
