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

Lets the insured choose any provider and pays a share of charges

Indemnity plans let the insured choose providers and reimburse a share of covered charges.

2. In an HMO, the primary care physician often acts as a gatekeeper to:

Coordinate care and authorize specialist referrals

The PCP gatekeeper coordinates care and controls access to specialists through referrals.

3. Capitation reimburses a provider by paying:

A fixed amount per member regardless of services used

Under capitation a provider receives a set payment per member per period regardless of utilization.

4. A prescription drug formulary is:

A list of covered drugs by tier

A formulary is the plan's list of covered medications, often arranged in cost-sharing tiers.