MA 7

James works for a mid-sized company that offers health insurance to employees but limits coverage to only in-network providers. Employees like James who want access to out-of-network providers must pay significantly higher out-of-pocket costs. This model reflects which characteristic of employment-based insurance in the US?

• A. Guaranteed universal coverage for employees and their dependents

• B. Employer-negotiated group plans with cost-sharing mechanisms

• C. Comprehensive coverage for all providers regardless of network affiliation

• D. Government-subsidized insurance plans for private-sector employees

Scarlett, a new employee, joins a company and is offered two insurance plans: one with higher premiums but lower deductibles and another with lower premiums but higher deductibles. What key feature of employment-based insurance in the US does this scenario illustrate?

• A. Flexibility in choosing providers

• B. Cost-sharing options tailored to income levels

• C. Risk pooling and employee choice

• D. Universal health coverage for the workforce

Abigail, an employee working part-time at a large retail chain, is not eligible for the company’s health insurance plan because she does not meet the minimum work hours requirement. This limitation highlights what feature of employment-based insurance in the US?

• A. Comprehensive coverage for all employees

• B. Exclusionary policies for non-full-time employees

• C. Employer-mandated universal health insurance

• D. Automatic enrollment for all staff regardless of hours worked

Isla's company decides to shift from a fully employer-funded insurance model to a high-deductible health plan paired with a Health Savings Account (HSA) to reduce costs. What potential outcome could this decision have on employees?

• A. Increased access to universal healthcare coverage

• B. Greater financial burden on employees for routine medical care

• C. Elimination of employer-provided health insurance benefits

• D. Reduction in government subsidies for employer-sponsored plans

Nora is part of a union that negotiates a contract including health insurance for its members with minimal out-of-pocket costs and coverage for dependents. This reflects which characteristic of employment-based insurance in the US?

• Unionized workers typically have access to universal healthcare

• Employers may negotiate customized group insurance plans

• Dependents are automatically covered under universal mandates

• Out-of-pocket costs are controlled by federal regulations

Elijah, an employee who loses his job, must purchase health insurance through COBRA to maintain continuous coverage. This scenario reflects what gap in the US healthcare system compared to Universal Health Care models?

• Lack of universal coverage independent of employment

• Government-subsidized insurance plans for unemployed individuals

• Automatic enrollment in federal insurance programs for the jobless

• Comprehensive employer obligations for all former employees

Olivia lives in a country with Universal Health Care, which covers all medical services through taxation. She needs elective surgery but must wait six months due to prioritization of urgent cases. What does this highlight about Universal Health Care systems?

• Equitable access to healthcare services for all residents

• The role of employer-sponsored insurance in reducing wait times

• Resource allocation challenges in universal coverage systems

• The elimination of out-of-pocket costs for non-essential procedures

Rohan, an employee covered under a high-deductible health plan, delays necessary medical care due to cost concerns. This highlights what shortcoming of the US employment-based insurance system?

• Lack of universal access to affordable care

• Insufficient coverage for catastrophic illnesses

• Employer-sponsored plans’ limited scope of services

• Overreliance on government subsidies

Kai lives in Canada where Universal Health Care is available, but he opts for private insurance to get faster access to specialized care. What challenge might this create?

• Wealth disparities in access to healthcare services

• Increased administrative costs for public insurance

• Reduced government funding for essential services

• Decreased public participation in universal programs

James works for a small business in the US and lacks employer-sponsored insurance, forcing him to rely on individual marketplaces. How does this situation contrast with Universal Health Care systems?

• Universal systems provide equal coverage regardless of employer size.

• Small businesses are required to provide insurance in universal systems.

• Individual marketplaces are unnecessary in universal systems.

• Government-funded care in universal systems is tied to income levels.