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 are about the financial risks for health plans in Medicare and Medicaid markets. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.
Answer: C
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The following statements are about the financial risks for health plans in Medicare and Medicaid markets. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.
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Question 2
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Julio Benini is eligible to receive healthcare coverage through a health plan that is under contract to his employer. Mr. Benini is seeking coverage for the following individuals:
Elena Benini, his wife -
Maria Benini, his 18-year-old unmarried daughter
Johann Benini, his 80-year-old father who relies on Julio for support and maintenance
The health plan most likely would consider that the definition of a dependent, for purposes of healthcare coverage, applies to:
Answer: B
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Julio Benini is eligible to receive healthcare coverage through a health plan that is under contract to his employer. Mr. Benini is seeking coverage for the following individuals:
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Question 3
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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 4
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Users of the Fulcrum Health Plan financial information include:
The independent auditors who review Fulcrum's financial statements
Fulcrum's controller (comptroller)
Fulcrum's plan members -
The providers that deliver healthcare services to Fulcrum plan members
Fulcrum's competitors -
Of these users, the ones that most likely can correctly be classified as external users with a direct financial interest in Fulcrum are the:
Answer: D
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Users of the Fulcrum Health Plan financial information include:
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Question 5
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A health plan can use segment margins to evaluate the profitability of its profit centers.
One characteristic of a segment margin is that this margin:
Answer: A
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A health plan can use segment margins to evaluate the profitability of its profit centers.