Most Recent AHIP AHM-520 Exam Dumps

Prepare for the AHIP Health Plan Finance and Risk Management exam with our extensive collection of questions and answers. These practice Q&A are updated according to the latest syllabus, providing you with the tools needed to review and test your knowledge.

QA4Exam focus on the latest syllabus and exam objectives, our practice Q&A are designed to help you identify key topics and solidify your understanding. By focusing on the core curriculum, These Questions & Answers helps you cover all the essential topics, ensuring you're well-prepared for every section of the exam. Each question comes with a detailed explanation, offering valuable insights and helping you to learn from your mistakes. Whether you're looking to assess your progress or dive deeper into complex topics, our updated Q&A will provide the support you need to confidently approach the AHIP AHM-520 exam and achieve success.

The questions for AHM-520 were last updated on Mar 31, 2025.

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Question No. 1

Many clinicians are concerned about the development of practice guidelines that seek to define appropriate healthcare services that should be provided to a patient who has been diagnosed with a specific condition. To avoid the risk associated with using such guidelines, health plans should advise clinicians that the existence of such a guideline:

1. Establishes standards of care to be routinely utilized with all patients presenting a specific condition

2. Preempts a physician's judgment when assessing the specific factors related to a patient's condition

ABoth 1 and 2

B1 only

C2 only

DNeither 1 nor 2

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Correct Answer: D

Question No. 2

The traditional financial ratios that analysts use to study a health plan's GAAP-based financial statements include liquidity ratios, activity ratios, leverage ratios, and profitability ratios. Of these categories of ratios, analysts are most likely to use

ALiquidity ratios to measure a health plan's ability to meet its current liabilities

BActivity ratios relate the returns of a health plan to its sales, total revenues, assets, stockholders' equity, capital, surplus, or stock share price

CLeverage ratios to measure how quickly a health plan converts specified financial statement items into premium income or cash

DProfitability ratios to measure the effect that fixed costs have on magnifying a health plan's risk and return

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Correct Answer: A

Question No. 3

With regard to the financial statements prepared by health plans, it can correctly be stated that

Aboth for-profit, publicly owned health plans and not-for-profit health plans are required by law to provide all interested parties with an annual report

Ba health plan's annual report typically includes an independent auditor's report and notes to the financial statements

Cany health plan that owns more than 20% of the stock of a subsidiary company must compile the financial statements for the health plan's annual report on a consolidated basis

Da health plan typically must prepare the financial statements included in its annual report according to SAP

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Correct Answer: B

Question No. 4

The following statements are about federal laws and regulations which affect health plans that offer products and services to the employer group market. Select the answer choice containing the correct statement.

AAmendments to the HMO Act of 1973 require federally qualified HMOs to adjust a group's prior premiums on the basis of the group's experience during the prior rating period.

BThe Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 requires that, if a plan sponsor elects to terminate its group coverage with a health plan, then the health plan must continue its coverage for the COBRA-qualified beneficiaries in the group.

CThe Health Insurance Portability and Accountability Act (HIPAA) of 1996 generally requires the guaranteed renewal of healthcare coverage for certain individuals and for both small and large groups, regardless of the health status of any member.

DThe Mental Health Parity Act (MHPA) of 1996 mandates that all health plans must offer benefits for mental healthcare.

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Correct Answer: C

Question No. 5

Over time, health plans and their underwriters have gathered increasingly reliable information about the morbidity experience of small groups.

Generally, in comparison to large groups, small groups tend to

AHave more frequent and larger claims fluctuations

BGenerate lower administrative expenses as a percentage of the total premium amount the group pays

CMore closely follow actuarial predictions regarding morbidity rates

DAll of the above

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Correct Answer: A

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