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AHIP AHM-520 Exam With Confidence Using Practice Dumps

Exam Code:
AHM-520
Exam Name:
Health Plan Finance and Risk Management
Certification:
Vendor:
Questions:
215
Last Updated:
Dec 4, 2025
Exam Status:
Stable
AHIP AHM-520

AHM-520: AHIP Certification Exam 2025 Study Guide Pdf and Test Engine

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Health Plan Finance and Risk Management Questions and Answers

Question 1

One true statement about a type of capitation known as a percent-of-premium arrangement is that this arrangement

Options:

A.

Is the most common type of capitation

B.

Is less attractive to providers when the arrangement sets provisions to limit risk

C.

Sets provider reimbursement at a specific dollar amount per plan member

D.

Transfers some of the risk associated with underwriting and rating from a health plan to a provider

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Question 2

A stop-loss contract may provide that claims are settled using a paid claims method or an incurred claims method. The Concord Company provides health coverage to its employees through a self-funded health plan. On March 17, a Concord employee who is enrolled in this plan underwent surgery, and the surgery was sufficiently expensive to trigger Concord's specific stop-loss coverage. On April 10, Concord paid the medical expenses associated with the surgery. The term of the stop-loss contract ended on April 1. This information indicates that the stop-loss carrier is responsible for paying a portion of the cost of the surgery under

Options:

A.

both the paid claims method and the incurred claims method

B.

the paid claims method but not the incurred claims method

C.

the incurred claims method but not the paid claims method

D.

neither the paid claims method nor the incurred claims method

Question 3

The Coral Health Plan, a for-profit health plan, has two sources of capital:

Debt and equity. With regard to these sources of capital, it can correctly be stated that

Options:

A.

Coral's equity holders have an ownership interest in the health plan

B.

The interest that Coral pays on its debt most likely is not tax deductible to Coral

C.

Coral's debt holders have no legal claim to Coral's assets

D.

Equity is a more risky source of capital, from Coral's perspective, than is debt