What service/s is/or not included in the annual deductible of an OFF EXCHANGE plan?
Preventive care and prescription drugs do not apply to the member's annual deductible.
100
Who will administer dental benefits for off exchange members in 2017?
DentaQuest
100
How many counties are in the service area for EmblemHealth's Individual Direct Pay HMO plans
28 counties
200
When does coinsurance apply to a service?
Coinsurance costs are applied after your deductible has been met, if a deductible applies.
200
EmblemHealth Small Group plan members have access to Telemedicine? TRUE or FALSE
TRUE
200
All EmblemHealth Individual Direct Pay HMO plan have deductibles. TRUE or FALSE
FALSE
300
What OFF SHOP plan has $0 deductible?
EmblemHealth HMO 15/35
300
John has had his current plan for 3 months now is calling to find out when his payment is due. He calls EmblemHealth on the first of the month. How will you answer this query?
Payment MUST be received and posted by the end of the month
300
Can members of Direct Pay Plans be terminated for nonpayment? YES or NO
YES
400
If an individual would like to a plan that offers free PCP visits and adult vision and dental are included which plan/s will you offer?
Select Care Bronze Value D
Select Care Silver Value D
400
A Tax Credit is available to low income individuals regardless the plan is purchased directly through EmblemHealth or the New York State of Health. TRUE or FALSE
FALSE. Tax credits do not apply to plans directly purchased through EH.
400
Sam would like to enroll into an EmblemHealth direct pay plan because he makes too much to qualify for an Exchange plan. Where would Kyle go to enroll into an EmblemHealth direct pay plan?
EmblemHealth's Customer Acquisition Tool
500
What are the changes to a Select Care Platinum D plan?
Telemedicine at $0 copay
Pediatric dental now included
500
Mary wants to know up to what age is covered if she will get an Adult Child coverage for her daughter.
Until the end of the month of the 30th birthday
500
Name the Off Exchange Small Group plans that are
non-standard plans?
Select Care Silver Value S
Select Care Bronze Value S
EH HMO 40/60