Most Recent AHIP AHM-520 Exam Questions & Answers

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 Nov 21, 2024.

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Question No. 1

Kevin Olin applied for individual healthcare coverage from the Mercury health plan. Before issuing the policy, Mercury's underwriters attached a rider that excludes from coverage any loss that results from Mr. Olin's chronic knee problem. This information indicates that Mr. Olin's policy includes

Aa moral hazard rider

Ban essential plan rider

Can impairment rider

Dan insurable interest rider

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Correct Answer: C

Question No. 2

Costs that can be defined by behavior are most commonly classified as fixed costs, variable costs and semi-variable costs. Examples of fixed costs include:

ARent, insurance expense, and depreciation on computer equipment

BRent, claims processing costs, and selling expenses

CClaims processing costs, telephone expense, and depreciation on computer equipment

DPremium processing, rent, and selling expenses

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Correct Answer: A

Question No. 3

The Challenger Group is a type of management services organization (MSO) that purchases the assets of physician practices, provides practice management and administrative support services to participating providers, and offers physicians a long-term contract and an equity position in Challenger. This information indicates that Challenger is a type of health plan

AKnown as

BAn integrated delivery system (IDS)

CA medical foundation

DA provider-sponsored organization (PSO)

EA physician practice management (PPM) company

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Correct Answer: D

Question No. 4

Assume that the Lambda, Mesa, and Novella health plans are equal in every way except that the health plans have obtained equal amounts of net cash inflows from different sources, as shown below:

HealthPlan Source

LambdaFinancing activities

Mesa Investing activities

NovellaOperating activities

From the following answer choices, select the response which indicates the health plan that would most likely be the most attractive to a potential plan sponsor, to a potential creditor, and to a potential investor.

APotential Plan Sponsor = Lambda
Potential Creditor = Mesa
Potential Investor = Novella

BPotential Plan Sponsor = Lambda
Potential Creditor = Novella
Potential Investor = Mesa

CPotential Plan Sponsor = Novella
Potential Creditor = Lambda
Potential Investor = Mesa

DPotential Plan Sponsor = Novella
Potential Creditor = Novella
Potential Investor = Novella

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Correct Answer: D

Question No. 5

The Fiesta Health Plan prices its products in such a way that the rates for its products are reasonable, adequate, equitable, and competitive. Fiesta is using blended rating to calculate a premium rate for the Murdock Company, a large employer. Fiesta has assigned a credibility factor of 0.6 to Murdock. Fiesta has also determined that Murdock's manual rate is $200 PMPM and that Murdock's experience rate is $180 PMPM.

According to regulations, Fiesta's premium rates are reasonable if they

Avary only on the factors that affect Fiesta's costs

Bare at a level that balances Fiesta's need to generate a profit against its need to obtain or retain a specified share of the market in which it conducts business

Care high enough to ensure that Fiesta has enough money on hand to pay operating expenses as they come due

Ddo not exceed what Fiesta needs to cover its costs and provide the plan with a fair profit

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Correct Answer: D

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