AHIP AHM-250 Quiz 1 Topic 5 Questions 1-5

Question: 1

When determining the premium rates it will charge a particular group, the Blue Jay Health Plan used a rating method known as community rating by class (CRC). Under this rating method, Blue Jay,

Awas allowed to use no more than four rating classes when determining how much to charge the group for health coverage

Bwas required to make the average premium in each class no more than 105% of the average premium for any other class

Cdivided its members into rating classes based on demographic factors, experience, or industry characteristics, and then charged each member in a rating class the same premium

Dcharged all employers or other group sponsors the same dollar amount for a given level of medical benefits, without adjustments for age, gender, industry, or experience

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Question: 2

Several marketplace factors helped fuel the movement toward consumer choice. Which one of the following statements is NOT accurate with regard to these factors?

AAfter a period of relative stability, annual growth in private health spending per capita began to increase rapidly in 2002.

BDuring the height of the recent cost upswing, insurance premiums were increasing by more than 13% annually.

CIncreased utilization was the largest factor contributing to the rise in premiums, accounting for 43% of the increase.

DEmployer payers began seeking ways to control spiraling utilization rates and provide lower cost health coverage options.

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Question: 3

Phillip Tsai is insured by both a 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 benefits p

A$0

B$300

C$400

D$900

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Question: 4

Medicare Advantage product options include:

ACoordinated care plans, medical savings accounts and national PPOs.

BPrivate Fee for Service plans, health care prepayment plans and medical savings accounts

CCoordinated care plans, regional PPOs and private fee for service plans

DCost contracts, coordinated care programs and medical savings accounts.

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Question: 5

Parable Healthcare Providers, a health plan, recently segmented the market for a new healthcare service. Parable began the process by dividing the healthcare market into two broad categories: non-group and group. Next, Parable further segmented the non-gr

Achannel segmentation

Bgeographic segmentation

Cdemographic segmentation

Dproduct segmentation

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AHIP AHM-250 Quiz:1 Topic:5 Questions:1-5