Under one type of HMO, the physicians are employees of the HMO and are paid a salary and sometimes an incentive bonus to hold down costs. This type of HMO is called a(n)
A) individual practice association (IPA).
B) staff model.
C) group model.
D) network model.
Question 2
Maria is covered under a group medical expense plan as an employee. She is also covered under her husband's plan as a dependent.
If Maria is hospitalized, how will each plan respond to her medical bills if both plans have the typical coordination-of-benefits provision?
A) Maria's plan is primary, and her husband's plan is excess.
B) Her husband's plan is primary, and Maria's plan is excess.
C) The primary plan is determined by which birthday, Maria's or her husband's, occurs first in the year.
D) Both plans will pay benefits on a pro rata basis.
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