Free AHM-520 Exam Braindumps

- (Topic 2)
The Jamal Health Plan operates in a state that mandates that a health plan either allow providers to become part of its network or reimburse those providers at the health plan’s negotiated-contract rate, so long as the non-contract provider is willing to perform the services at the contract rate. This type of law is known as:

1. A. A fair procedure law
2. B. A direct access law
3. C. An any willing provider law
4. D. A due process law

Correct Answer: C

- (Topic 2)
The following statements are about the option for health plan funding known as a self- funded plan. Select the answer choice containing the correct response:

1. A. In a self-funded plan, an employer is relieved of all risk associated with paying for the healthcare costs of its employees.
2. B. Self-funded plans are subject to the same state laws and regulations that apply to health insurance policies.
3. C. Employers electing to self-fund a health plan are required to pay claims from a separate trust established for that purpose.
4. D. An employer electing to self-fund a health plan has the option of purchasing stop-loss insurance to transfer part of the financial risk to an insurer.

Correct Answer: D

- (Topic 2)
In a comparison of small employer-employee groups to large employer-employee groups, it is correct to say that small employer-employee groups tend to:

1. A. More closely follow actuarial predictions with respect to morbidity rates
2. B. Generate more administrative expenses as a percentage of the total premium amount the group pays
3. C. Have less frequent and smaller claims fluctuations
4. D. Expose an health plan to a lower risk of anti selection

Correct Answer: B

- (Topic 2)
Health plans have access to a variety of funding sources depending on whether they are operated as for-profit or not-for-profit organizations. The Verde Health Plan is a for-profit health plan and the Noir Health Plan is a not-for-profit health plan. From the answer choices below, select the response that correctly identifies whether funds from debt markets and equity markets are available to Verde and Noir:

1. A. Funds from Debt Markets: available to Verde and Noir Funds from Equity Markets: available to Verde and Noir
2. B. Funds from Debt Markets: available to Verde and Noir Funds from Equity Markets: available to Verde only
3. C. Funds from Debt Markets: available to Verde only Funds from Equity Markets: available to Noir only
4. D. Funds from Debt Markets: available to Noir only Funds from Equity Markets: available to Verde only

Correct Answer: B

- (Topic 1)
The McGwire Health Plan is a for-profit health plan that issues stock. Events that will cause the owners' equity account of McGwire to change include

1. A. McGwire's retention of net income
2. B. McGwire's payment of cash dividends on the stock it issued
3. C. McGwire's purchase of treasury stock
4. D. All of the above

Correct Answer: D