AHM-520 AHIP Exam Questions and Free Practice Test

Question 13

- (Topic 2)
Costs that can be defined by behavior are most commonly classified as fixed costs, variable costs, and semi-variable costs. From the following answer choices, select the response that correctly indicates a fixed cost and a variable cost for a health plan.

A. Fixed Cost = depreciation on computer equipment Variable Cost = selling expenses

B. Fixed Cost = premium processing expenses Variable Cost = rent on a regional office

C. Fixed Cost = the cost for building maintenance Variable Cost = the cost for electricity

D. Fixed Cost = the cost for electricityVariable Cost = fire insurance on the home office facility

Correct Answer:A

Question 14

- (Topic 2)
The following statements are about the Health Insurance Portability and Accountability Act (HIPAA) as it relates to the small group market. Three of these statements are true and one statement is false. Select the answer choice containing the FALSE statement:

A. A health plan that participates in the small group market is required to issue a contract to any employer that requests healthcare benefits, as long as the employer meets the statutory definition of a small group.

B. A small group must consist of more than 10 employees in order to be underwritten on a group, rather than an individual, basis.

C. A health plan is prohibited from canceling a small group’s healthcare coverage because of poor claims experience.

D. A health plan that participates in the small group market is limited in placing restrictions such as waiting periods and pre-existing conditions exclusions to individuals in high risk categories.

Correct Answer:B

Question 15

- (Topic 2)
Companies typically produce three types of budgets: operational budgets, cash budgets, and capital budgets. The following statements are about operational budgets. Select the answer choice containing the correct statement.

A. Expense budgets, a type of operational budget, typically describe fixed expenses rather than variable expenses.

B. Operational budgets can only show information by department or by line of business.

C. Operational budgets begin with a forecast of sales revenue and investment income.

D. Revenue budgets, a type of operational budget, indicate the amount of income from operations that a company received from the previous budget period

Correct Answer:C

Question 16

- (Topic 1)
The following statements are about a health plan's underwriting of small groups. Select the answer choice containing the correct statement.

A. Almost all states prohibit health plan s from rejecting a small group because of the nature of the business in which the small business is engaged.

B. Most states prohibit health plans from setting participation levels as a requirement for coverage, even when coverage is otherwise guaranteed issue.

C. In underwriting small groups, a health plan's underwriters typically consider both the characteristics of the group members and of the employer.

D. Generally, a health plan's underwriters require small employers to contribute at least 80% of the cost of the healthcare coverage.

Correct Answer:C

Question 17

- (Topic 2)
The Raven Health Plan is domiciled in a state that requires the health plan to offer small employers and their employees a comprehensive healthcare benefit plan that approximates the healthcare benefits available to large employer-employee groups. This type of uniform benefit plan is known as:

A. A basic plan

B. A low-option plan

C. A standard plan

D. An essential plan

Correct Answer:C

Question 18

- (Topic 2)
The following statement(s) can correctly be made about a health plan's cash receipts and cash disbursements budgets:

A. To predict both the timing and the amount of its cash receipts, a health plan constructs the cash receipts budget using data from its sales forecast and investment forecasts.

B. A health plan uses a cash disbursements budget in order to establish the amount, but not the timing, of all of its cash disbursements.

C. Both A and B

D. A only

E. B only

F. Neither A nor B

Correct Answer:B

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