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 Feb 22, 2025.

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Question No. 1

The Kayak Company self funds the health plan for its employees. This plan is an example of a type of self-funded plan known as a general asset plan. The fact that this is a completely self-funded plan indicates that

AThe plan has no funding vehicle

BKayak passes to its employees the financial risk of providing healthcare coverage

CThe plan most likely is exempt from ERISA requirements concerning the limits on benefit discrimination for classes of employees

DThe plan is exempt from the state laws and regulations that apply to health insurance policies

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Correct Answer: D

Question No. 2

Most organizations that obtain group healthcare coverage can be classified as one of three types of groups: employer-employee groups, multiple employer groups, and professional associations. One true statement about these types of groups is that

AAnti selection risk is higher for both multiple-employer groups and professional associations than it is for an employer-employee group

BPrivate employers typically present a higher underwriting risk to health plans than do public employers

CIndividual members of a multiple-employer group or a professional association typically are required to obtain healthcare coverage through the group or association

DI health plan is prohibited, when evaluating the risks represented by a professional association, from considering the industry experience of the agent or broker that sells a group plan to the association

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Correct Answer: A

Question No. 3

The goal of the investment department at the Wayfarer Health Plan is to maximize investment return. The investment department executes investments on time and at a low cost. However, these transactions often result in low returns or risks that are deemed too high for Wayfarer. With regard to effectiveness and efficiency, it is correct to say that Wayfarer's investment department is:

Aboth effective and efficient

Befficient, but not effective

Ceffective, but not efficient

Dneither effective nor efficient

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Correct Answer: B

Question No. 4

The Landau health plan will switch from using top-down budgeting to using bottom-up budgeting. One potential advantage to Landau of making this switch is that, compared to top-down budgeting, bottom-up budgeting is more likely to

ARequire little time or labor to complete

BEnable Landau to incorporate key changes in regulatory requirements on a timely basis

CReflect top management's intentions for Landau

DReflect the realities of day-to-day operations

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Correct Answer: B

Question No. 5

Health plans with risk-based Medicare contracts are required to calculate and submit to CMS a Medicare adjusted community rate (Medicare ACR). Medicare ACR can be defined as the:

AEstimated cost of providing services to a beneficiary under Medicare FFS, adjusted for factors such as age and gender

BHealth plan's estimate of the premium it would charge Medicare enrollees in the absence of Medicare payments to the health plan

CAverage amount the health plan expects to receive from CMS per beneficiary covered

DHealth plan's actual costs of providing benefits to Medicare enrollees in a given year

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Correct Answer: B

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