1. A point-of-service (POS) managed care plan is best described as one that:

Combines in-network care with the option to go out of network at higher cost

A POS plan blends HMO features with the option to use out-of-network providers at greater cost.

2. An Exclusive Provider Organization (EPO) generally:

Covers care only within its network except in emergencies

An EPO generally covers only in-network care except emergencies, with no benefits for out-of-network services.

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

Determine the allowable charge for a service in a geographic area

UCR establishes the allowable amount for a service based on customary charges in the area.

4. Under a capitation arrangement, a provider is paid:

A set amount per member per period regardless of services used

Capitation pays the provider a fixed amount per enrolled member per period regardless of the services actually rendered.