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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:
Mar 12, 2026
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

An actuary for the Noble Health Plan observed that the plan's actual morbidity was lower than its assumed morbidity and that the plan's actual administrative expenses were higher than its assumed administrative expenses. In this situation, Noble's actual underwriting margin was

Options:

A.

larger than its assumed underwriting margin, and the plan's actual expense margin was higher than its assumed expense margin

B.

larger than its assumed underwriting margin, but the plan's actual expense margin was lower than its assumed expense margin

C.

smaller than its assumed underwriting margin, but the plan's actual expense margin was higher than its assumed expense margin

D.

smaller than its assumed underwriting margin, and the plan's actual expense margin was lower than its assumed expense margin

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Question 2

Geena Falk is eligible for both Medicare and Medicaid coverage. If Ms. Falk incurs a covered expense, then:

Options:

A.

Medicaid will be Ms. Falk’s primary insurer

B.

Medicare will be Ms. Falk’s primary insurer

C.

Either Medicare or Medicaid will be Ms. Falk’s primary insurer depending on her election

D.

Medicare and Medicaid will each be responsible for one-half of Ms. Falk’s covered expense

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