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: Mar 08, 2026

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Question 1

With regard to the financial statements prepared by health plans, it can correctly be stated that:

A : both for-profit, publicly owned health plans and not-for-profit health plans are required by law to provide all interested parties with an annual report

B : a health plan's annual report typically includes an independent auditor's report and notes to the financial statements

C : any health plan that owns more than 20% of the stock of a subsidiary company must compile the financial statements for the health plan's annual report on a consolidated basis

D : a health plan typically must prepare the financial statements included in its annual report according to SAP

Answer: B

Question 2

The following statements are about the Health Insurance Portability and Accountability Act (HIPAA) as it relates to the small group market. Three of these statements are true and one statement is false. Select the answer choice containing the FALSE statement.

A : A health plan that participates in the small group market is required to issue a contract to any employer that requests healthcare benefits, as long as the employer meets the statutory definition of a small group.

B : A small group must consist of more than 10 employees in order to be underwritten on a group, rather than an individual, basis.

C : A health plan is prohibited from canceling a small group’s healthcare coverage because of poor claims experience.

D : A health plan that participates in the small group market is limited in placing restrictions such as waiting periods and pre-existing conditions exclusions to individuals in high risk categories.

Answer: B

Question 3

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

Question 4

The Jasmine Company, which self-funds the health plan for its 200 employees, has established a 501(c)(9) trust as a means of addressing possible claims fluctuations under the health plan. This plan is not a part of a collective bargaining process.

A potential disadvantage to Jasmine of using a 501(c)(9) trust is that:

A : The cost of maintaining the trust may be prohibitive to Jasmine

B : The trust must always maintain enough assets to pay the health plan's claims that have been incurred but not yet paid

C : Jasmine is prohibited from earning any return on the trust assets

D : The contributions to this trust are not deductible for federal income tax purposes

Answer: A

Question 5

If the Ascot health plan's accountants follow the going-concern concept under GAAP, then these accountants most likely:

A : Assume that Ascot will pay its liabilities immediately or in full during the current accounting period

B : Defer certain costs that Ascot has incurred, unless these costs contribute to the health plan's future earnings

C : Assume that Ascot is not about to be liquidated, unless there is evidence to the contrary

D : Value Ascot's assets more conservatively than they would under SAP

Answer: C

Page: 1 / 43

Total 215 Questions | Updated On: Mar 08, 2026

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