Estimating current medical claim liabilities

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Reference no: EM132241260

1. The market segments for an MCO as defined by ACA are:

Group and individual.

Individual, employer group and private purchase.

Individual, small employer group and large employer group.

None of the above.

2. Estimating current medical claim liabilities and future medical expenses are the most important task of actuaries.

True

False

3. Private insurance exchanges are the same as under the ACA.

True

False

4. Under the ACA, no group or individual can be denied coverage as long as they enroll during open enrollment period or based on a "life event" as long as they have paid previous premiums and not committed fraud.

True

False

5. An underwriter considers all of the following factors in calculating a premium EXCEPT:

actuarial projections

risk level assessment

type of product (HMO, PPO, etc.)

None of the above. All of the above are considered in a premium calculations.

Reference no: EM132241260

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