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: May 23, 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 Fairway health plan is a for-profit health plan that issues stock. The following data was taken from Fairway's financial statements:
Current assets.....$5,000,000 -
Total assets.....$6,000,000 -
Current liabilities.....$2,500,000
Total liabilities.....$3,600,000
Stockholders' equity.....$2,400,000
Fairway's total revenues for the previous financial period were $7,200,000, and its net income for that period was $180,000.
For the previous financial period, Fairway's net profit margin was:
Answer: A
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The Fairway health plan is a for-profit health plan that issues stock. The following data was taken from Fairway's financial statements:
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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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Under GAAP, three approaches to expense recognition are generally allowed: associating cause and effect, systematic and rational allocation, and immediate recognition.
A health plan most likely would use the approach of systematic and rational allocation in order to:
Answer: D
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Under GAAP, three approaches to expense recognition are generally allowed: associating cause and effect, systematic and rational allocation, and immediate recognition.
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Question 5
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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.