1. In a traditional HMO, the primary care physician often acts as a 'gatekeeper,' meaning the PCP:

Coordinates care and provides referrals to specialists

In a gatekeeper HMO model, the primary care physician coordinates care and must refer members to specialists.

2. Precertification (prior authorization) in a managed care plan requires that:

Certain services be approved in advance to confirm medical necessity

Precertification requires advance approval of certain services to confirm medical necessity before they are provided.

3. A health reimbursement arrangement (HRA) is:

An employer-funded account that reimburses employees for qualified medical expenses

An HRA is funded by the employer to reimburse employees for qualified medical expenses under the plan's terms.

4. A stop-loss feature in a major medical plan is designed to:

Limit the insured's out-of-pocket costs after which the plan pays 100%

A stop-loss provision caps the insured's out-of-pocket expense, after which the plan pays 100% of covered charges.