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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

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

The provider contract that Dr. Timothy Meyer, a pediatrician, has with the Cardigan health plan states that Cardigan will compensate him under a capitation arrangement. However, the contract also includes a typical low enrollment guarantee provision. Statements that can correctly be made about this arrangement include that the low enrollment guarantee provision most likely:

Options:

A.

Causes Dr. Meyer's capitation contract with Cardigan to transfer more risk to him than the contract otherwise would transfer

B.

Specifies that Cardigan will pay Dr. Meyer under an arrangement other than capitation until a specified number of children covered by the plan use him as their PCP

C.

Both A and B

D.

A only

E.

B only

F.

Neither A nor B

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