A Health Plan May Use One of Several Types of Community

question 193

Multiple Choice

A health plan may use one of several types of community rating methods to set premiums for a health plan. The following statements are about community rating. Select the answer choice containing the correct statement.

• A) Standard (pure) community rating is typically used for large groups because it is the most competitive rating method for large groups.
• B) Under standard (pure) community rating, a health plan charges all employers or other group sponsors the same dollar amount for a given level of medical benefits or health plan, without adjusting for factors such as age, gender, or experience.
• C) In using the adjusted community rating (ACR) method, a health plan must consider the actual experience of a group in developing premium rates for that group.
• D) The Centers for Medicare and Medicaid Services (CMS) prohibits health plans that assume Medicare risk from using the adjusted community rating (ACR) me

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