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Check Your Knowledge - Summary of Benefits & Coverage

Quiz by PHRS Training Team

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16 questions
Show answers
  • Q1

    Match the service with the copay

    linking://Preventive Care|0: Telemedicine|10: Primary Care - non preventative|35: Specialist - non Value-Choice|65

    60s
  • Q2

    Who is responsible to ensure a provider is in-network?

    Patient

    Paychex H&B Rep

    Doctor

    You, the HRP

    60s
  • Q3

    What is the estimated total cost to the patient to have a baby (assume there are no limits or exclusions)?

    13,200

    6,665

    6,600

    65

    60s
  • Q4

    How much can a patient save on their copay if they do a telemedicine visit as opposed to a non Value-Choice primary care visit? 

    20

    25

    10

    35

    60s
  • Q5

    What is the out-of-pocket maximum that a family of 3 may pay in a year?

    13,200

    6,600

    19,800

    60s
  • Q6

    Acupuncture counts towards the out-of-pocket maximum.

    boolean://false

    60s
  • Q7

    What is the copay to see a mental health or substance abuse counselor?

    20

    65

    10

    0

    60s
  • Q8

    With this plan, is it cheaper to get maintenance drugs (such as daily blood pressure medicine) from a retail pharmacy or by mail?

    By mail

    Retail pharmacy

    60s
  • Q9

    How may spinal manipulation/chiropractor visits per year are allowed?

    freetextm://30:thirty

    60s
  • Q10

    One or two? One or two? It’s back to school time, and the entire family needs an eye exam, who is covered?

    No one

    Just the adults

    Just the kids

    The entire family

    60s
  • Q11

    Client question: I’m going to a wedding in Colorado, what happens if I get sick?

    Rub some dirt on it and walk it off

    There is no no coverage, wait until you get home

    multiplem://If it’s not an emergency, you can use the telemedicine option:Out of state urgent care and emergency room visits are covered at the listed copay

    60s
  • Q12

    Florida Blue 62 is an example of what kind of plan?

    POS

    HMO

    MCP

    PPO

    60s
  • Q13

    Client question: How can I save money when visiting a specialist?

    Use a Value-Choice specialist

    There is no cheaper option when visiting a specialist

    Go out of network

    Get a referral

    60s
  • Q14

    Another client question Part 1: I’m having surgery on my foot, the doctor is in-network, so I’m good to go, right?

    You should be, but you won’t know for sure until you get the bill.

    Yes, as long as the doctor in charge is in-network, so are all the other services and providers.

    Never assume anything, you need to check with your provider to ensure things like lab work are done using an in-network provider.

    60s
  • Q15

    Part 2: This service can help a client understand their coverage and benefits for an upcoming procedure, like foot surgery.

    scrambled://BalanceCare

    60s

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