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AHIP AHM-520 Exam Questions
- Topic 1: Recognize different reserving methodologies used by health insurance providers/ Analyze the role of strategic financial planning in setting a health insurance provider’s future direction
- Topic 2: Learn about the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations compared to risks within the commercial population
- Topic 3: Discover how to identify claim related components of health insurance providers’ financial statements
- Topic 4: Gain an understanding of risk, decisions regarding risk assumption, and how health insurance providers control risk
- Topic 5: Distinguish between fully funded and self-funded plans and the increasing role of self-funding in the marketplace
- Topic 6: Compare the difference between stop-loss insurance and stop-loss reinsurance from the perspective of health insurance providers
Free AHIP AHM-520 Exam Actual Questions
Note: Premium Questions for AHM-520 were last updated On Jun. 20, 2025 (see below)
In the following paragraph, a sentence contains two pairs of words enclosed in parentheses. Determine which word in each pair correctly completes the statement. Then select the answer choice containing the two words that you have selected.
The Igloo health plan recognizes the receipt of its premium income during the accounting period in which the income is earned, regardless of when cash changes hands. However, Igloo recognizes its expenses when it earns the revenues related to those expenses, regardless of when it receives cash for the revenues earned. This information indicates that the (realization/capitalization) principle governs Igloo's revenue recognition, whereas the (matching/initial-recording) principle governs its expense recognition.
The Danube Health Plan's planning activities include tactical planning, which is primarily concerned with
Health plans seeking to provide comprehensive healthcare plans must contract with a variety of providers for ancillary services. One characteristic of ancillary services is that
The Fiesta Health Plan prices its products in such a way that the rates for its products are reasonable, adequate, equitable, and competitive. Fiesta is using blended rating to calculate a premium rate for the Murdock Company, a large employer. Fiesta has assigned a credibility factor of 0.6 to Murdock. Fiesta has also determined that Murdock's manual rate is $200 PMPM and that Murdock's experience rate is $180 PMPM.
According to regulations, Fiesta's premium rates are reasonable if they
The Amethyst Health Plan uses a budgeting approach that requires each line of business within Amethyst's operation to justify its continued operation. Amethyst begins with the premise that no resources will be allocated for the following period unless each dollar to be spent is justified and is shown to be within departmental plans and corporate goals and objectives. The budgeting approach used by Amethyst is known as:
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