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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

The following information relates to the Hardcastle Health Plan for the month of June:

  • Incurred claims (paid and IBNR) equal $100,000
  • Earned premiums equal $120,000
  • Paid claims, excluding IBNR, equal $80,000
  • Total health plan expenses equal $300,000

This information indicates that Hardcastle’s medical loss ratio (MLR) for the month of June was approximately equal to:

Options:

A.

40%

B.

67%

C.

83%

D.

120%

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Question 2

A health plan most likely would use benchmarking in order to

Options:

A.

Measure its performance and practices against those of other companies to help identify those practices that will lead to superior performance in a variety of financial and non-financial areas

B.

Calculate the percentage changes in its financial statement items over several consecutive accounting periods

C.

Determine both the direction and velocity of trends in its financial statements

D.

Display only percentage relationships in its financial statements

Question 3

Mandated benefit laws are state or federal laws that require health plans to arrange for the financing and delivery of particular benefits. Within a market, the implementation of mandated benefit laws is likely to cause __________.

Options:

A.

A reduction in the number of self-funded healthcare plans

B.

An increase in the cost to the health plans

C.

A reduction in the size of the provider panels of health plans

D.

A reduction in the uniformity among the healthcare plans of competing health plans

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