Question

multiple choice question

an organization that pays for health insurance directly and sets up a fund from which to pay is called a(n) ______.

health maintenance organization
self-funded health plan
consumer-driven health plan
for-profit health plan

Explanation:

Analyze the question prompt

The question asks for the term used to describe an organization that pays for health insurance directly and sets up a fund from which to pay claims. This is a core concept in Healthcare Insurance Types and Group Health Plans.

Define self-funded health plans

A self-funded (or self-insured) health plan is one in which an employer or organization assumes the financial risk for providing healthcare benefits to its employees. Instead of purchasing a pre-packaged policy from an insurance carrier, the organization pays for medical claims directly out of a designated fund established for this purpose.

Evaluate the given options

• health maintenance organization: A managed care plan that provides coverage through a specific network of providers.
• self-funded health plan: Matches the definition of an organization paying directly and setting up its own fund.
• consumer-driven health plan: A plan combining a high-deductible health policy with a tax-preferred savings account.
• for-profit health plan: A business structure classification, not a funding mechanism.

Select the correct option

The correct term is a self-funded health plan.

Answer:

• health maintenance organization
• self-funded health plan (Correct answer)
• consumer-driven health plan
• for-profit health plan