1. A point-of-service (POS) plan combines features of:

An HMO and a PPO

A POS plan blends HMO and PPO features, letting members use a gatekeeper network or go out of network at higher cost.

2. Basic hospital and surgical expense coverage differs from major medical because it:

Provides first-dollar benefits up to limited amounts with little or no deductible

Basic coverage pays first-dollar benefits up to modest limits, while major medical adds broad coverage subject to a deductible and coinsurance.

3. The usual, customary, and reasonable (UCR) standard is used to:

Determine the allowable amount payable for a medical service in an area

UCR is used to determine a reasonable allowable charge for a service based on prevailing fees in the geographic area.

4. A formulary in a prescription drug plan is:

The list of drugs the plan covers

A formulary is the list of prescription drugs the plan covers, often arranged in cost tiers.