AHIP AHM-250 PAHM Exam Practice Test Instant Access

Question 1

The following statements describe individuals who are applying for individual health insurance coverage:

Six months ago, Wilbur Lee lost his health insurance coverage due to a reduction in work hours and has exhausted his coverage under COBR

AMr. Lee has

Aboth Mr. Lee and Mr. Beeker

BMr. Lee only

CMr. Beeker only

Dneither Mr. Lee nor Mr. Beeker

Answer : A, A

Question 2

The following statements are about concepts related to the underwriting function within a health plan. Select the answer choice containing the correct statement.

AAnti selection refers to the fact that individuals who believe that they have a less-than-average likelihood of loss tend to seek healthcare coverage to a greater extent than do individuals who believe that they have an average or greater-than-average like

BFederally qualified HMOs are required to medically underwrite all groups applying for coverage.

CTypically, a health plan guarantees the premium rate for a group health contract for a period of five years.

DWhen evaluating the risk for a group policy, underwriters typically focus on such factors as the size of the group, the stability of the group, and the activities of the group.

Answer : D

Question 3

The following statements apply to flexible spending arrangements. Select the answer choice that contains the correct statement.

AFSAs were designed to help increase health insurance coverage among self-employed individuals.

BOnly employers may contribute funds to FSAs.

CThe popularity of FSAs has been limited because funds may not be rolled over from year to year.

DA popular feature of FSAs is their portability, which allows employees to take the funds with them when they change jobs.

Answer : C

Question 4

The Gable MCO sometimes experience-rates small groups by underwriting a number of small groups as if they constituted one large group and then evaluating the experience of the entire large group. This practice, which allows small groups to take advantage

Aprospective experience rating

Bpooling

Cretrospective experience rating

Dpositioning

Answer : B

Question 5

Dr. Samuel Aldridge's provider contract with the Badger Health Plan includes a typical due process clause. The primary purpose of this clause is to:

AState that Dr. Aldridge's provider contract with Badger will automatically terminate if he loses his medical license or hospital privileges.

BSpecify a time period during which the party that breaches the provider contract must remedy the problem in order to avoid termination of the contract.

CGive Dr. Aldridge the right to appeal Badger's decision if he is terminated with cause from Badger's provider network.

DSpecify that Badger can terminate this provider contract without providing a reason, but only if Badger gives Dr. Aldridge at least 90-days' notice of its intent to terminate the contract.

Answer : C

Question 6

Which of the following is NOT a preventive care initiative often used by health plans?

AScreening for high blood pressure

BMaternity management programs

CVaccines

DPhysical therapy

Answer : D

Question 7

Marlee Whitcomb was covered as a dependent under the group health plan provided by her father's employer. That health plan complied with the provisions of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986. When Ms. Whitcomb married, she c

Acan continue her group coverage for a period not to exceed 48 months

Bcan continue her group coverage for a period not to exceed 36 months

Ccannot continue her group coverage, but has the right to convert the group coverage to an individual health plan

Dcan continue her group coverage indefinitely

Answer : B

AHIP AHM-250 Healthcare Management: An Introduction PAHM Exam Practice Test