Your Health Care Coverage Is with a PPO

question 66

Multiple Choice

Your health care coverage is with a PPO.For approved,in-network providers your deductible is $500 and your coinsurance provision is 80%.For out-of-network providers,your deductible is $1,000 and your coinsurance provision is 70%.Assume there is no co-pay provision and you have no other claims this calendar year.You have decided to go to a specialist that is not in the network and the bill is $1,400.How much will you have to pay out-of-pocket?

• A)$1,400
• B)$1,120
• C)$420
• D)$1,320

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Definitions:

Reasonable Reliance

The act of depending on the promise, statement, or action of another on the grounds that it is sensible and justifiable to do so under the circumstances.

Employment Policy Manual

A document provided by employers to employees, outlining workplace rules, policies, and expectations.

Promissory Estoppel

Promissory estoppel is a legal principle that allows a party to recover on a promise made without a formal contract, provided they have relied on that promise to their detriment.

Implied Contract

An agreement created by actions of the parties involved, not written or spoken, but inferred from their conduct.