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AHIP AHM-520 Health Plan Finance and Risk Management Exam Practice Test

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Total 215 questions

Health Plan Finance and Risk Management Questions and Answers

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Question 1

The following statements are about 501(c)(9) trusts. Select the answer choice containing the correct statement:

Options:

A.

In the event a 501(c)(9) trust is terminated, any funds remaining in the trust revert back to the employer.

B.

In order to satisfy Internal Revenue Code (IRC) requirements, membership in a 501(c)(9) trust is mandatory for all employees.

C.

Contributions made by an employer to a 501(c)(9) trust are deductible for federal income tax purposes.

D.

Typically, a 501(c)(9) trust is controlled solely by the employer that established the trust.

Question 2

The traditional financial ratios that analysts use to study a health plan's GAAP-based financial statements include liquidity ratios, activity ratios, leverage ratios, and profitability ratios. Of these categories of ratios, analysts are most likely to use

Options:

A.

Liquidity ratios to measure a health plan's ability to meet its current liabilities

B.

Activity ratios relate the returns of a health plan to its sales, total revenues, assets, stockholders' equity, capital, surplus, or stock share price

C.

Leverage ratios to measure how quickly a health plan converts specified financial statement items into premium income or cash

D.

Profitability ratios to measure the effect that fixed costs have on magnifying a health plan's risk and return

Question 3

The Norton Health Plan used blended rating to develop a premium rate for the Roswell Company, a large employer group. Norton assigned Roswell a credibility factor of 0.7 (or 70%). Norton calculated Roswell’s manual rate to be $200 and its experience claims cost as $180. Norton’s retention charge is $3. This information indicates that Roswell’s blended rate is:

Options:

A.

$186

B.

$189

C.

$194

D.

$197

Question 4

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:

Options:

A.

A fair procedure law

B.

A direct access law

C.

An any willing provider law

D.

A due process law

Question 5

The Rathbone Company has contracted with the Jarvin Insurance Company to provide healthcare benefits to its employees. Under this contract, Rathbone assumes financial responsibility for paying 80% of its estimated annual claims and for depositing the funds necessary to pay these claims into a bank account. Although Rathbone owns the bank account, Jarvin, acting as Rathbone’s agent, makes the actual claims payments from this account. Claims in excess of Rathbone’s contracted percentage are paid by Jarvin. Rathbone pays to Jarvin a premium for administering the entire plan and bearing the costs of claims in excess of Rathbone’s obligation. This premium is substantially lower than would be charged if Jarvin were providing healthcare coverage under a traditional fully insured group plan. Jarvin is required to pay premium taxes only on the premiums it receives from Rathbone. This information indicates that the type of alternative funding method used by Rathbone is known as a:

Options:

A.

Premium-delay arrangement

B.

Reserve-reduction arrangement

C.

Minimum-premium plan

D.

Retrospective-rating arrangement

Question 6

The goal of the investment department at the Wayfarer Health Plan is to maximize investment return. The investment department executes investments on time and at a low cost. However, these transactions often result in low returns or risks that are deemed too high for Wayfarer. With regard to effectiveness and efficiency, it is correct to say that Wayfarer’s investment department is:

Options:

A.

both effective and efficient

B.

efficient, but not effective

C.

effective, but not efficient

D.

neither effective nor efficient

Question 7

In order to print all of its forms in-house, the Prism health plan is considering the purchase of 10 new printers at a total cost of $30,000. Prism estimates that the proposed printers have a useful life of 5 years. Under its current system, Prism spends $10,000 a year to have forms printed by a local printing company. Assume that Prism selects a 15% discount rate based on its weighted-average costs of capital. The cash inflows for each year, discounted to their present value, are shown in the following chart:

Prism will use both the payback method and the discounted payback method to analyze the worthiness of this potential capital investment. Prism's decision rule is to accept all proposed capital projects that have payback periods of four years or less.

Now assume that Prism decides to use the net present value (NPV) method to evaluate this potential investment's worthiness and that Prism will accept the project if the project's NPV is greater than $4,000. Using the NPV method, Prism would correctly conclude that this project should be

Options:

A.

Rejected because its NPV is $3,520

B.

Accepted because its NPV is $5,028

C.

Accepted because its NPV is $16,480

D.

Accepted because its NPV is $23,520

Question 8

The Puma health plan uses return on investment (ROI) and residual income (RI) to measure the performance of its investment centers. Two of these investment centers are identified as X and Y. Investment Center X earns $10,000,000 in operating income on controllable investments of $50,000,000, and it has total revenues of $60,000,000. Investment Center Y earns $2,000,000 in operating income on controllable investments of $8,000,000, and it has total revenues of $10,000,000. Both centers have a minimum required rate of return of 15%.

The following statements are about Puma's evaluation of these investment centers. Select the answer choice containing the correct statement.

Options:

A.

Investment Center Y's RI is greater than Investment Center X's RI.

B.

The ROI for Investment Center X is 16.7%, and the ROI for Investment Center Y is 20.0%.

C.

Because Investment Centers X and Y are different sizes, Puma should not use ROI to compare these investment centers.

D.

According to the evaluation of ROI, Investment Center Y achieves a higher return on its available resources than does Investment Center X.

Question 9

Residual trend is the difference between total trend and the portion of the total trend caused by changes in provider reimbursement levels.

Consider the following events that could affect an health plan’s provider reimbursement levels:

Event 1 — The disenrollment of a large group with unusually high utilization rates

Event 2 — The introduction of a new treatment for infertility

Event 3 — A serious flu epidemic

Event 4 — A shift in inpatient medical services from obstetrical care to neonatal intensive care

One cause of residual trend is change in intensity, which would be represented by:

Options:

A.

Event 1

B.

Event 2

C.

Event 3

D.

Event 4

Question 10

Juan Ramirez, a licensed social worker, and Dr. Laura Lui, a licensed psychiatrist, are under contract to the Peninsula Health Plan. Peninsula has contracted with CMS to provide services to Medicare and Medicaid beneficiaries. Both Mr. Ramirez and Dr. Lui provide the same type of counseling services to Peninsula's enrollees. With respect to amendments made to the Balanced Budget Act (BBA) of 1997 that impact provider reimbursement, the amount by which Peninsula will reimburse Mr. Ramirez will be equal to:

Options:

A.

50% of Dr. Lui's reimbursement

B.

75% of Dr. Lui's reimbursement

C.

90% of Dr. Lui's reimbursement

D.

100% of Dr. Lui's reimbursement

Question 11

The following transactions occurred at the Lane Health Plan:

  • Transaction 1 — Lane recorded a $25,000 premium prior to receiving the payment
  • Transaction 2 — Lane purchased $500 in office expenses on account, but did not record the expense until it received the bill a month later
  • Transaction 3 — Fire destroyed one of Lane’s facilities; Lane waited until the facility was rebuilt before assessing and recording the amount of loss
  • Transaction 4 — Lane sold an investment on which it realized a $14,000 gain; Lane recorded the gain only after the sale was completed.

Of these transactions, the one that is consistent with the accounting principle of conservatism is:

Options:

A.

Transaction 1

B.

Transaction 2

C.

Transaction 3

D.

Transaction 4

Question 12

The Landau health plan will switch from using top-down budgeting to using bottom-up budgeting. One potential advantage to Landau of making this switch is that, compared to top-down budgeting, bottom-up budgeting is more likely to

Options:

A.

Require little time or labor to complete

B.

Enable Landau to incorporate key changes in regulatory requirements on a timely basis

C.

Reflect top management's intentions for Landau

D.

Reflect the realities of day-to-day operations

Question 13

In evaluating the claims experience during a given rating period of the Lucky Company, the Calaway Health Plan determined that the claims incurred by Lucky were lower than Calaway anticipated when it established Lucky’s premium rate for the rating period. Calaway, therefore, refunded a portion of Lucky’s premium to reflect the better-than-anticipated claims experience. This rating method is known as:

Options:

A.

durational rating

B.

retrospective experience rating

C.

blended rating

D.

prospective experience rating

Question 14

Ways in which a company can increase its return on investment (ROI) include:

1. Reducing expenses to increase operating income

2. Increasing controllable investment

Options:

A.

Both 1 and 2

B.

1 only

C.

2 only

D.

Neither 1 nor 2

Question 15

Contingency risks, or C-risks, are general categories of risk that have a direct bearing on both the cash flow and solvency of a health plan. One of these C-risks, pricing risk (C-2 risk), is typically the most important risk a health plan faces. Pricing risk is crucial to a health plan’s solvency because:

Options:

A.

A sizable portion of any health plan’s assets are held in long-term investments and any shift in interest rates can significantly impact a health plan’s ability to pay medical benefits

B.

A health plan relies heavily on the sound judgment of its management, and poor management decisions can result in financial losses for the health plan

C.

A situation in which actual expenses exceed the amounts budgeted for those expenses may result in the health plan failing to retain assets sufficient to cover current obligations

D.

A sizable portion of the total expenses and liabilities faced by a health plan come from contractual obligations to pay future medical costs, and the exact amounts of those costs are not known at the time a product’s premium is established

Question 16

The following statements are about the capital budgeting technique known as the payback method. Select the answer choice containing the correct statement:

Options:

A.

The main benefit of the payback method is that it is simple to use.

B.

The payback method measures the profitability of a given capital project.

C.

The payback method considers the time value of money.

D.

The payback method states a proposed project’s cash flow in terms of present value for the life of the entire project.

Question 17

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

Options:

A.

vary only on the factors that affect Fiesta's costs

B.

are at a level that balances Fiesta's need to generate a profit against its need to obtain or retain a specified share of the market in which it conducts business

C.

are high enough to ensure that Fiesta has enough money on hand to pay operating expenses as they come due

D.

do not exceed what Fiesta needs to cover its costs and provide the plan with a fair profit

Question 18

The Sanford Group, a provider group, entered into a risk contract with a health plan. Sanford has purchased aggregate stop-loss coverage with an attachment point of 115% of the group's predicted healthcare costs of $2,000,000 for the year. Sanford has a copayment of 10% for any costs above the attachment point. If Sanford's actual costs for the year are $2,800,000, then, according to the terms of the aggregate stop-loss agreement, the amount that Sanford is responsible for is

Options:

A.

$2,080,000

B.

$2,300,000

C.

$2,350,000

D.

$2,380,000

Question 19

For each of its products, the Wisteria Health Plan monitors the provider reimbursement trend and the residual trend. One true statement about these trends is that

Options:

A.

The provider reimbursement trend probably is more difficult for Wisteria to quantify than is the residual trend

B.

Wisteria's residual trend is the difference between the total trend and the portion of the total trend caused by changes in Wisteria's provider reimbursement levels

C.

The residual trend most likely has more impact on Wisteria's total trend than does the provider reimbursement trend

D.

An example of a residual trend would be a 5% increase in the capitation rate paid to a PCP by Wisteria

Question 20

The following statements illustrate the use of different rating methods by health plans:

  • The Dover health plan established rates for small groups by using a rating method which requires that the average premium in each group cannot be more than 120% of the average premium for any other group. Under this method, all members of each group pay the same premium, which is based on the experience of the group.
  • Under the rating method used by the Rolling Hills health plan, the health plan calculates the ratio of a group's experience to the group's historical manual rate. Rolling Hills then multiplies this ratio by the group's future manual rate. Rolling Hills cannot consider the group's experience in determining premium rates.

From the following answer choices, select the response that correctly indicates the rating methods used by Dover and Rolling Hills.

Options:

A.

Dover = modified community rating

Rolling Hills = factored rating

B.

Dover = modified community rating

Rolling Hills = adjusted community rating (ACR)

C.

Dover = community rating by class (CRC)

Rolling Hills = factored rating

D.

Dover = community rating by class (CRC)

Rolling Hills = adjusted community rating (ACR)

Question 21

The Eagle health plan wants to limit the possibility that it will be held vicariously liable for the negligent acts of providers. Dr. Michael Chan is a member of an independent practice association (IPA) that has contracted with Eagle. One step that Eagle could take in order to limit its exposure under the theory of vicarious liability is to

Options:

A.

Supply Dr. Chan with office space

B.

Employ nurses, laboratory technicians, and therapists to support Dr.Chan

C.

Be responsible for keeping Dr. Chan's medical records updated

D.

Ensure that documents provided to Dr. Chan's patients describe him as an independent practitioner

Question 22

The Caribou health plan is a for-profit organization. The financial statements that Caribou prepares include balance sheets, income statements, and cash flow statements. To prepare its cash flow statement, Caribou begins with the net income figure as reported on its income statement and then reconciles this amount to operating cash flows through a series of adjustments. Changes in Caribou's cash flow occur as a result of the health plan's operating activities, investing activities, and financing activities.

The basic formula for Caribou's income statement is

Options:

A.

Cash Inflows – Cash Outflows = Net Cash Inflow (Outflow)

B.

Revenues – Expenses = Net Income (Net Loss)

C.

Sources of Funds – Uses of Funds = Net Change in Cash

D.

Assets = Liabilities + Owners' Equity

Question 23

Experience rating and manual rating are two rating methods that the Cheshire health plan uses to determine its premium rates. One difference between these two methods is that, under experience rating, Cheshire

Options:

A.

Uses a purchaser's actual experience to estimate the group's expected experience, whereas, under manual rating, Cheshire uses its own average experience—and sometimes the experience of other plans—to estimate the group's expected experience

B.

can establish rates for groups that have no previous plan experience, whereas, under manual rating, Cheshire cannot establish rates for groups with no previous plan experience

C.

charges each group in the same class the same premium whereas, under manual rating, Cheshire charges lower premiums to groups that have experienced lower utilization rates

D.

can use group demographics to help determine the rate for a block of business, whereas, under manual rating, Cheshire cannot use group demographics when determining the rate for a block of business

Question 24

The Challenger Group is a type of management services organization (MSO) that purchases the assets of physician practices, provides practice management and administrative support services to participating providers, and offers physicians a long-term contract and an equity position in Challenger. This information indicates that Challenger is a type of health plan

Options:

A.

Known as

B.

An integrated delivery system (IDS)

C.

Amedical foundation

D.

Aprovider-sponsored organization (PSO)

E.

Aphysician practice management (PPM) company

Question 25

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

Options:

A.

Physician behavior typically does not impact the utilization rates for these services

B.

Package pricing is the preferred reimbursement method for ancillary service providers

C.

These services include physical therapy, behavior therapy, and home healthcare, but not diagnostic services such as laboratory tests

D.

Few plan members seek these services without first being referred to the ancillary provider by a physician

Question 26

Three general strategies that health plans use for controlling types of risk are risk avoidance, risk transfer, and risk acceptance. The following statements are about these strategies. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

Options:

A.

Generally, the smaller the likely benefits of accepting a risk, and the lower the costs of avoiding that risk, the greater the likelihood that a health plan will elect to avoid the risk.

B.

A health plan is seldom able to transfer any of the risk that utilization rates will be higher than expected and that its cost of providing healthcare will exceed the revenues it receives.

C.

If a risk is a pure risk from the point of view of a health plan, then the health plan most likely will attempt to avoid the risk.

D.

A health plan would most likely transfer some or all of its utilization risk if it pays a provider a rate that is based on the number of plan enrollees that choose the provider as their primary care provider (PCP).

Question 27

The Kayak Company self funds the health plan for its employees. This plan is an example of a type of self-funded plan known as a general asset plan. The fact that this is a completely self-funded plan indicates that

Options:

A.

The plan has no funding vehicle

B.

Kayak passes to its employees the financial risk of providing healthcare coverage

C.

The plan most likely is exempt from ERISA requirements concerning the limits on benefit discrimination for classes of employees

D.

The plan is exempt from the state laws and regulations that apply to health insurance policies

Question 28

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.

Options:

A.

realization / matching

B.

realization / initial-recording

C.

capitalization / matching

D.

capitalization / initial-recording

Question 29

With regard to the major risk factors associated with group underwriting, it can correctly be stated that, typically,

Options:

A.

The age and gender of group plan members are not predictors of utilization of health services by group members

B.

A health plan's product design or delivery system has an impact on member selection of the health plan, unless the members are in an environment in which employees have at least two benefit options or health plans from which to choose

C.

A health plan should track demographic factors of groups only if the plan specifically adjusts for demographic factors on a group basis

D.

A large group is more likely to exhibit a consistent claims pattern, level of healthcare cost, or utilization of services than is a small group

Question 30

The Health Maintenance Organization (HMO) Model Act, developed by the National Association of Insurance Commissioners (NAIC), represents one approach to developing solvency standards. One drawback to this type of solvency regulation is that it

Options:

A.

Uses estimates of future expenditures and premium income to estimate future risk

B.

Fails to adjust the solvency requirement to account for the size of an HMO's premiums and expenditures

C.

Assumes that the amount of premiums an HMO charges always directly corresponds to the level of the risk that the HMO faces

D.

Fails to mandate a minimum level of capital and surplus that an HMO must maintain

Question 31

The Violin Company offers its employees a triple option of health plans: an HMO, an HMO with a point of service (POS) option, and an indemnity plan.

Premiums are lowest for the HMO option and highest for the indemnity plan. Violin employees who anticipate that they will be individual low utilizes of healthcare services are most likely to enroll in the

Options:

A.

HMO and are least likely to enroll in the HMO with the POS option

B.

HMO and are least likely to enroll in the indemnity plan

C.

Indemnity plan and are least likely to enroll in the HMO

D.

Indemnity plan and are least likely to enroll in the HMO with the POS option

Question 32

The following statements illustrate common forms of capitation:

1. The Antler Health Plan pays the Epsilon Group, an integrated delivery system (IDS), a capitated amount to provide substantially all of the inpatient and outpatient services that Antler offers. Under this arrangement, Epsilon accepts much of the risk that utilization rates will be higher than expected. Antler retains responsibility for the plan's marketing, enrollment, premium billing, actuarial, underwriting, and member services functions.

2. The Bengal Health Plan pays an independent physician association (IPA) a capitated amount to provide both primary and specialty care to Bengal's plan members. The payments cover all physician services and associated diagnostic tests and laboratory work. The physicians in the IPA determine as a group how the individual physicians will be paid for their services.

From the following answer choices, select the response that best indicates the form of capitation used by Antler and Bengal.

Options:

A.

Antler = subcapitation

Bengal = full-risk capitation

B.

Antler = subcapitation

Bengal = full professional capitation

C.

Antler = global capitation

Bengal = subcapitation

D.

Antler = global capitation

Bengal = full professional capitation

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Total 215 questions