1. A traditional fee-for-service (indemnity) health plan generally:

Reimburses covered services without requiring a provider network

A fee-for-service indemnity plan reimburses covered charges without requiring the insured to use a network, unlike managed care.

2. A point-of-service (POS) plan combines features of an HMO and a PPO by letting members:

Choose in-network or out-of-network care at the time service is needed

A POS plan blends HMO and PPO features, allowing members to decide whether to use network or out-of-network care when they seek treatment.

3. Capitation is a payment method in which a provider receives:

A fixed amount per enrolled member per period regardless of services used

Under capitation, the provider is paid a set amount per member per period regardless of how many services that member uses.

4. Usual, customary, and reasonable (UCR) charges are used by a health plan to:

Determine the allowable amount the plan will pay for a service

UCR charges establish the allowable amount a plan will recognize for a given service based on prevailing charges in the area.