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In the health insurance and claims data model, employees of Penumbra's account are called a:

A. Policyholders
B. Subscribers
C. Beneficiaries
D. Insured members

1 Answer

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Final answer:

In health insurance and claims data models, employees of Penumbra's account who are covered by the health insurance plan are called Subscribers. They may choose to enroll in Part B for additional healthcare coverage beyond hospital stays, for which they pay monthly fees and copayments, with government support. The correct option is B.

Step-by-step explanation:

In the context of health insurance and claims data models, particularly for an account like Penumbra's, the correct term for employees covered by the health insurance plan would be B. Subscribers. Subscribers are the individuals who have an agreement with the health insurance company to provide coverage.

The term policyholder often refers to the one who owns the policy, which in many cases, could be the employer or the individual. Beneficiaries are generally the ones who receive benefits from the policy, often including dependents of the subscriber.

Insured members could be a generic term that includes policyholders, subscribers, and beneficiaries but in this specific context, 'Subscribers' is the most appropriate term to describe the employees under Penumbra's health insurance plan.

As part of their cover, subscribers may choose to enroll in Part B, which is an optional insurance system covering health-care costs that are not included in hospital stays, such as physician services, medical tests, and outpatient visits. They are typically required to pay a monthly fee, deductible charges, and copayments, with the government subsidizing a significant portion of the costs.

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