The National Association of Insurance Commissioners (NAIC) Managed Care Plan

question 95

Multiple Choice

The National Association of Insurance Commissioners (NAIC) Managed Care Plan Network Adequacy Model Act defines specific adequacy and accessibility standards that health plans must meet. In addition, the Model Act requires health plans to

• A) Hold plan members responsible for unreimbursed charges or unpaid claims
• B) Allow providers to develop their own standards of care
• C) Adhere to specified disclosure requirements related to provider contract termination
• D) File written access plans and sample contracts with the Centers for Medicaid and Medicare Services (CMS)

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Definitions:

Early Majority

A segment of consumers adopting new products or innovations just before the average person, following the innovators and early adopters.

Consumer Adoption Process

The stages consumers go through in accepting and becoming loyal users of a new product or service, including awareness, interest, evaluation, trial, and adoption.

Simulated Test Market

A market analysis tool where a new product is introduced to a sample of consumers in a controlled environment to forecast its success.

Product Launch

The introduction of a new product into the market, involving promotional strategies to create awareness and sales.