Free AHIP AHM-520 Exam Questions

Become AHIP Certified with updated AHM-520 exam questions and correct answers

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Total 215 Questions | Updated On: Jan 05, 2026

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Question 1

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

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.

Answer: C

Question 2

The Atoll Health Plan must comply with a number of laws that directly affect the plan's contracts. One of these laws allows Atoll's plan members to receive medical services from certain specialists without first being referred to those specialists by a primary care provider (PCP). This law, which reduces the PCP's ability to manage utilization of these specialists, is known as _________.

A : A due process law

B : An any willing provider law

C : A direct access law

D : A fair procedure law

Answer: C

Question 3

A health plan can use segment margins to evaluate the profitability of its profit centers.

One characteristic of a segment margin is that this margin:

A : Is the portion of the contribution margin that remains after a segment has covered its direct fixed costs

B : Incorporates only the costs attributable to a segment, but it does not incorporate revenues

C : Considers only a segment's costs that fluctuate in direct proportion to changes in the segment's level of operating activity

D : Evaluates the profit center's effective use of assets employed to earn a profit

Answer: A

Question 4

Julio Benini is eligible to receive healthcare coverage through a health plan that is under contract to his employer. Mr. Benini is seeking coverage for the following individuals:

Elena Benini, his wife -

Maria Benini, his 18-year-old unmarried daughter

Johann Benini, his 80-year-old father who relies on Julio for support and maintenance

The health plan most likely would consider that the definition of a dependent, for purposes of healthcare coverage, applies to:

A : Elena, Maria, and Johann

B : Elena and Maria only

C : Elena only

D : Maria only

Answer: B

Question 5

The following statements are about the financial risks for health plans in Medicare and Medicaid markets. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

A : One reason that health plans in the Medicare and Medicaid markets experience financial risk is that government regulations determine which services must be provided to Medicare and Medicaid enrollees.

B : Effective use of hospital utilization is the single most likely factor to contribute to the success of a Medicare-contracting health plan.

C : If a Medicare-contracting health plan is a provider-sponsored organization (PSO), it is prohibited from sharing financial risk with its providers.

D : Typically, providers are more reluctant to accept financial risk in connection with providing services to the Medicaid population than with providing services to the Medicare population.

Answer: C

Page: 1 / 43

Total 215 Questions | Updated On: Jan 05, 2026

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