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AHIP AHM-520 Exam - Topic 5 Question 85 Discussion

The Poplar Company and a Blue Cross/Blue Shield organization have contracted to provide a typical fully funded health plan for Poplar's employees. One true statement about this health plan for Poplar's employees is that
B) Poplar and the Blue Cross/Blue Shield organization share the financial risk of paying for claims under Poplar's health plan
A) Poplar bears the entire financial risk if, during a given period, the dollar amount of services rendered to Poplar plan members exceeds the dollar amount of premiums collected for this health plan
C) The Blue Cross/Blue Shield organization, upon acceptance of a premium, becomes the group plan sponsor for Poplar's health plan
D) The Blue Cross/Blue Shield organization, upon acceptance of a premium, bears the entire financial risk of paying for the administrative expenses associated with health plan operations

AHIP AHM-520 Exam - Topic 5 Question 85 Discussion

Actual exam question for AHIP's AHM-520 exam
Question #: 85
Topic #: 5
[All AHM-520 Questions]

The Poplar Company and a Blue Cross/Blue Shield organization have contracted to provide a typical fully funded health plan for Poplar's employees. One true statement about this health plan for Poplar's employees is that

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Suggested Answer: B

by Willard at Apr 23, 2024, 03:06 AM

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Alonzo
7 months ago
Just to clarify, fully funded means Poplar pays premiums, right?
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Margot
7 months ago
D sounds surprising, are they really covering all admin costs?
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Annamae
7 months ago
C seems off, Blue Cross isn't the sponsor.
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Kerrie
7 months ago
I think B is more accurate, they share the risk.
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Patti
8 months ago
A is definitely true, Poplar takes all the risk!
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Ivan
8 months ago
I don't think the insurer becomes the sponsor just by accepting premiums, so option C seems off to me. I might go with A or D instead.
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Kip
8 months ago
I recall a practice question that mentioned shared risk in some plans, but I thought fully funded meant the employer takes all the risk, so I'm confused about option B.
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Carry
8 months ago
I'm not entirely sure, but I feel like we discussed how the insurer typically takes on the risk in these arrangements, which makes me lean towards option D.
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Justine
8 months ago
I think I remember that in a fully funded plan, the employer usually bears the financial risk, so option A might be correct?
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Leota
8 months ago
I've seen similar questions before, so I have a general idea of how to approach this. Time to put my knowledge to the test.
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Micah
8 months ago
The wording of the options is tricky, I'll have to read them closely to determine the correct answer.
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Crista
8 months ago
Okay, I need to focus on the key details about the contract between Poplar and Blue Cross/Blue Shield.
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France
8 months ago
Hmm, I'm a bit unsure about the financial risk aspect here. Let me think this through carefully.
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Jackie
9 months ago
This question seems straightforward, I think I can handle it.
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Deeann
9 months ago
Okay, I've got this. Tier 2 providers typically have a public transit relationship with Tier 1 providers, so I'm going to go with option A.
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Lettie
9 months ago
Okay, let's see here. I think it has something to do with how the system handles creating vulnerability groups, but I'm not entirely sure which property controls that.
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Tresa
9 months ago
I remember we talked about needing a data file in CSV format for BAT. I think that might be one of the steps.
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Rolf
1 year ago
Option B seems like the most logical choice to me. I mean, if Poplar was bearing all the risk, why would they need to contract with Blue Cross/Blue Shield in the first place?
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Eva
1 year ago
Haha, this question is a real brain-teaser! I bet the test writers are just trying to trip us up. But I think I've got it - the answer is B.
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Tamesha
1 year ago
Hmm, I'm not sure. I was leaning towards option A, but now I'm second-guessing myself. I guess I'll have to review the material again.
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Nickie
1 year ago
I'm not sure either. Let's review the material together to figure out the correct answer.
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Han
1 year ago
I believe option B is the right choice. Poplar and Blue Cross/Blue Shield share the financial risk.
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Sheron
1 year ago
I think option A is correct. Poplar bears the entire financial risk if services exceed premiums.
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Ludivina
1 year ago
I think the correct answer is B. Poplar and the Blue Cross/Blue Shield organization share the financial risk of paying for claims under Poplar's health plan. This makes sense since it's a fully funded plan.
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Shala
1 year ago
That's true, sharing the financial risk would benefit both Poplar and the Blue Cross/Blue Shield organization.
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Shelia
1 year ago
Yes, it makes sense that both parties would share the financial risk.
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Paris
1 year ago
I agree, option B seems like the most logical choice.
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Stanford
1 year ago
But if Poplar bears the entire financial risk, wouldn't that mean option A is correct?
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Trina
1 year ago
I disagree, I believe the answer is B.
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Stanford
1 year ago
I think the answer is A.
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