AHM-250 Free Practice Test

- (Topic 1)
A health savings account must be coupled with an HDHP that meets federal requirements for minimum deductible and maximum out-of-pocket expenses. Dollar amounts are indexed
annually for inflation. For 2006, the annual deductible for self-only coverage must

1. A. $525
2. B. $1,050
3. C. $2,100
4. D. $5,250

Correct Answer: B

- (Topic 3)
The Koster Company plans to purchase a health plan for its employees from Intuitive HMO. Intuitive will administer the plan and will bear the responsibility of guaranteeing claim payments by paying all incurred covered benefits. Koster will pay for the he

1. A. fully funded plan
2. B. stop-loss plan
3. C. self-pay plan
4. D. self-funded plan

Correct Answer: A

- (Topic 2)
Many of the credentialing standards and criteria used by health plans are often taken from already existing standards established by

1. A. the National Practitioner Data Bank (NPDB)
2. B. the National Association of Insurance Commissioners (NAIC)
3. C. the Centers for Medicare and Medicaid Services (CMS)
4. D. independent accrediting organizations

Correct Answer: D

- (Topic 2)
One true statement about community rating, a rating method commonly used by health plans, is that:

1. A. It requires a health plan to set premiums for financing medical care according to the health plan's expected cost of providing medical benefits to a sub-group within the community.
2. B. A health plan usually uses community rating to set premiums for large groups.
3. C. It tends to lead to greater fluctuations in premium rates than do other rating methods.
4. D. A health plan seldom uses community rating to set premiums for large groups.

Correct Answer: D

- (Topic 2)
Phillip Tsai is insured by both a traditional indemnity health insurance plan, which is his primary plan, and a health plan, which is his secondary plan. Both plans have typical coordination of benefits (COB) provisions, but neither has a nonduplication of

1. A. $0
2. B. $300
3. C. $400
4. D. $900

Correct Answer: C