Free AHIP AHM-520 Exam Questions
Absolute Free AHM-520 Exam Practice for Comprehensive Preparation
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AHIP AHM-520 Exam Questions
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Provided By: AHIP
- Exam: Health Plan Finance and Risk Management (AHM520)
- Certification: AHIP Certification
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Total Questions: 215
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Updated On: Jan 13, 2026
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Rated: 4.9 |
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Online Users: 430
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Question 1
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The following statements illustrate the use of different rating methods by health plans: The Dover health plan established rates for small groups by using a rating method which requires that the average premium in each group cannot be more than 120% of the average premium for any other group. Under this method, all members of each group pay the same premium, which is based on the experience of the group.
Under the rating method used by the Rolling Hills health plan, the health plan calculates the ratio of a group's experience to the group's historical manual rate. Rolling Hills then multiplies this ratio by the group's future manual rate. Rolling Hills cannot consider the group's experience in determining premium rates. From the following answer choices, select the response that correctly indicates the rating methods used by Dover and Rolling Hills.
Answer: D
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The following statements illustrate the use of different rating methods by health plans: The Dover health plan established rates for small groups by using a rating method which requires that the average premium in each group cannot be more than 120% of the average premium for any other group. Under this method, all members of each group pay the same premium, which is based on the experience of the group.
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Question 2
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The Marble Health Plan sets aside a PMPM amount for each specialty.
When a PCP in Marble's provider network refers a Marble plan member to a specialist and the specialist provides medical services to the member, the specialist begins to receive a share of those funds on a monthly basis. Marble determines the monthly payment for each specialist by dividing the number of active patients for that specialty by the total specialty pool for that month.
This form of payment, which is similar to a case rate, is known as:
Answer: C
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The Marble Health Plan sets aside a PMPM amount for each specialty.
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Question 3
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With regard to the financial statements prepared by health plans, it can correctly be stated that:
Answer: B
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With regard to the financial statements prepared by health plans, it can correctly be stated that:
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Question 4
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The Jasmine Company, which self-funds the health plan for its 200 employees, has established a 501(c)(9) trust as a means of addressing possible claims fluctuations under the health plan. This plan is not a part of a collective bargaining process.
A potential disadvantage to Jasmine of using a 501(c)(9) trust is that:
Answer: A
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The Jasmine Company, which self-funds the health plan for its 200 employees, has established a 501(c)(9) trust as a means of addressing possible claims fluctuations under the health plan. This plan is not a part of a collective bargaining process.
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Question 5
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The following statements are about the Health Insurance Portability and Accountability Act (HIPAA) as it relates to the small group market. Three of these statements are true and one statement is false. Select the answer choice containing the FALSE statement.
Answer: B
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The following statements are about the Health Insurance Portability and Accountability Act (HIPAA) as it relates to the small group market. Three of these statements are true and one statement is false. Select the answer choice containing the FALSE statement.