AHIP AHM-520 Exam - Topic 4 Question 100 Discussion

Actual exam question for AHIP's AHM-520 exam

Question #: 100
Topic #: 4

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:

AA 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.

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

CA health plan is prohibited from canceling a small group's healthcare coverage because of poor claims experience.

DA 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.

Show Suggested Answer

Suggested Answer: B

by Valentin at Sep 17, 2024, 01:48 PM

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Aron

5 months ago

D sounds a bit off, are there really limits on waiting periods?

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Lavonda

5 months ago

C is true, they can't just cancel for claims.

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Cristen

6 months ago

Wait, are you sure about B? I thought it was 2-50 employees.

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Cristen

6 months ago

Totally agree, A is definitely the false one here.

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Annalee

6 months ago

A small group can have as few as 1 employee, not 10!

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Altha

6 months ago

The part about restrictions on waiting periods and pre-existing conditions seems tricky; I thought they could apply those to all individuals, not just high-risk ones.

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Lou

7 months ago

I feel like I read that health plans can't cancel coverage based on claims experience, so that one might be true.

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Kenda

7 months ago

I think the statement about needing more than 10 employees for group underwriting sounds familiar, but I can't recall the exact number.

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Hubert

7 months ago

I remember studying that health plans have to issue contracts to small groups, but I’m not sure if it’s for every employer that requests it.

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Lottie

7 months ago

Okay, I've got a strategy - I'll first identify the 3 true statements, then the remaining one must be the false statement.

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Art

7 months ago

Hmm, I'm a little unsure about the details of HIPAA's small group market requirements. I'll have to think through each option closely.

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Donte

7 months ago

This HIPAA question looks straightforward, but I'll need to carefully read through each statement to determine which one is false.

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Karl

7 months ago

This is a good HIPAA question. I feel confident I can identify the false statement if I apply my knowledge of the small group market regulations.

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Luke

12 months ago

Wait, there's a small group market? I thought HIPAA was just for big corporations. This exam is getting way too specific!

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Shawn

10 months ago

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.

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Blondell

11 months ago

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

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Laurel

11 months ago

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

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Kenda

11 months ago

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.

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