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Section 12.3 Quiz

1
Section 12.3 Review

An HMO can offer only HMO contracts approved by the Office of Insurance Regulation and cannot engage in any other type of activity, including insurance.

a)
b)
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2

HMOs work with a network of doctors who use HMOs on a part-time basis in their private offices. HMOs consist of a group of physicians who operate out of an HMO facility as HMO employees.


Word bank: Closed-Panel, Open-Panel

Open-Panel HMOs work with a network of doctors who use HMOs on a part-time basis in their private offices. Closed-Panel HMOs consist of a group of physicians who operate out of an HMO facility as HMO employees.

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3

HMOs must hold an open enrollment period of not less than ______ every 18-month period.

a)
b)
c)
d)
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4

HMOs operate almost exclusively through group enrollment plans.

a)
b)
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5

HMOs are required to file a report of its activities within three months of the end of each fiscal year. A complete examination of an HMO's affairs is conducted at least once every:

a)
b)
c)
d)
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6

HMOs and agents are prohibited from using the HMO Consumer Assistance Plan (CAP) in any of its sales advertisements or marketing procedures.

a)
b)
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7

Penalties in Florida for violating the Unfair Trade Practices Act are probation, suspension, or revocation of licensure or HMO Certificate of Authority and a fine up to:

a)
b)
c)
d)
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8

Under an HMO group policy, new dependents are eligible to enroll within _____ of marriage, birth, or adoption.

a)
b)
c)
d)
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