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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

An actuary for the Noble Health Plan observed that the plan's actual morbidity was lower than its assumed morbidity and that the plan's actual administrative expenses were higher than its assumed administrative expenses. In this situation, Noble's actual underwriting margin was

Options:

A.

larger than its assumed underwriting margin, and the plan's actual expense margin was higher than its assumed expense margin

B.

larger than its assumed underwriting margin, but the plan's actual expense margin was lower than its assumed expense margin

C.

smaller than its assumed underwriting margin, but the plan's actual expense margin was higher than its assumed expense margin

D.

smaller than its assumed underwriting margin, and the plan's actual expense margin was lower than its assumed expense margin

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Question 2

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%

Question 3

The Jade Health Plan used a profitability index (PI) to rank the following capital proposals:

Proposal PI

A0.45

B1.05

This information indicates that, of these two projects, Jade would most likely select:

Options:

A.

Proposal A, and the PI indicates that the net present value (NPV) for this project is less than zero

B.

Proposal A, and the PI indicates that the net present value (NPV) for this project is greater than zero

C.

Proposal B, and the PI indicates that the net present value (NPV) for this project is less than zero

D.

Proposal B, and the PI indicates that the net present value (NPV) for this project is greater than zero

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