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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 16, 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

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%

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Question 2

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

Question 3

The amount of risk for health plan products is dependent on the degree of influence and the relationships that the health plan maintains with its providers. Consider the following types of managed care structures:

  • Preferred provider organization (PPO)
  • Group model HMO
  • Staff model health maintenance organization (HMO)
  • Traditional health insurance

Of these health plan products, the one that would most likely expose a health plan to the highest risk is the:

Options:

A.

preferred provider organization (PPO)

B.

group model HMO

C.

staff model health maintenance organization (HMO)

D.

traditional health insurance