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AHM-520 Exam Dumps : Health Plan Finance and Risk Management

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Health Plan Finance and Risk Management Questions and Answers

Question 1

One true statement about a type of capitation known as a percent-of-premium arrangement is that this arrangement

Options:

A.

Is the most common type of capitation

B.

Is less attractive to providers when the arrangement sets provisions to limit risk

C.

Sets provider reimbursement at a specific dollar amount per plan member

D.

Transfers some of the risk associated with underwriting and rating from a health plan to a provider

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Question 2

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

Options:

A.

a moral hazard rider

B.

an essential plan rider

C.

an impairment rider

D.

an insurable interest rider

Question 3

With regard to alternative funding arrangements, the part of a health plan premium that is intended to contribute to the claims reserve that a health plan maintains to pay for unusually high utilization is known as the:

Options:

A.

Interest charge

B.

Retention charge

C.

Risk charge

D.

Surplus