If a Third Party Is Responsible for Injuries to a Plan

question 82

Multiple Choice

If a third party is responsible for injuries to a plan member of the Hope Health Plan, then Hope has a contractual right to file a claim for the resulting healthcare costs against the third party. This contractual right to recovery from the third party is known as

• A) Subrogation
• B) Partial capitation
• C) Coordination of benefits
• D) Aremedy provision

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Definitions:

Total Utility

The overall satisfaction or happiness a consumer derives from consuming a certain quantity of a good or service.

Marginal Utility

is the added satisfaction or benefit a consumer gets from consuming one additional unit of a good or service.

Utility-Maximizing Rule

The principle that to obtain the greatest total utility, a consumer should allocate money income so that the last dollar spent on each good or service yields the same marginal utility (MU). For two goods X and Y, with prices Px and Py, total utility will be maximized by purchasing the amounts of X and Y such that MUx/Px = MUy/Py for the last dollar spent on each good.

Budget Constraint

The limitations on the consumption choices of an individual or family due to limited financial resources.