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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

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Question 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

Options:

A.

a moral hazard rider

B.

an essential plan rider

C.

an impairment rider

D.

an insurable interest rider

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Question 2

One difference between the internal and external analysis of a health plan's financial information is that

Options:

A.

Internal analysis of the health plan can be more detailed and more specific than can external analysis

B.

Internal analysts are more likely than external analysts to want comparative financial data about the health plan

C.

Only internal analysts use trend analysis to analyze the health plan's financial statements

D.

Only internal analysts typically conduct the financial analysis of the health plan themselves

Question 3

Provider reimbursement methods that transfer some utilization risk from a health plan to providers affect the health plan's RBC formula. A health plan's use of these reimbursement methods is likely to result in

Options:

A.

An increase the health plan's underwriting risk

B.

A decrease the health plan's credit risk

C.

A decrease the health plan's net worth requirement

D.

All of the above

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