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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

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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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

The Jamal Health Plan operates in a state that mandates that a health plan either allow providers to become part of its network or reimburse those providers at the health plan’s negotiated-contract rate, so long as the non-contract provider is willing to perform the services at the contract rate. This type of law is known as:

Options:

A.

A fair procedure law

B.

A direct access law

C.

An any willing provider law

D.

A due process law