Discuss AHIP AHM-520 Exam Topic 5 Question 91

Most organizations that obtain group healthcare coverage can be classified as one of three types of groups: employer-employee groups, multiple employer groups, and professional associations. One true statement about these types of groups is that

AAnti selection risk is higher for both multiple-employer groups and professional associations than it is for an employer-employee group

BPrivate employers typically present a higher underwriting risk to health plans than do public employers

CIndividual members of a multiple-employer group or a professional association typically are required to obtain healthcare coverage through the group or association

DI health plan is prohibited, when evaluating the risks represented by a professional association, from considering the industry experience of the agent or broker that sells a group plan to the association

Suggested Answer: C

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38 comments · newest first

Naomi 11 months ago

I thought multiple-employer groups had lower risks, guess I was wrong!

Mona 11 months ago

D seems right, they can't just look at the broker's experience.

Yolando 12 months ago

Wait, C sounds a bit off. Can they really force members to get coverage through the group?

Edwin 12 months ago

I disagree with B, public employers can have their own risks too.

Casey 1 year ago

A is definitely true, anti-selection is a big concern for those groups.

Kati 1 year ago

I vaguely recall something about how health plans can consider the broker's experience, but I can't remember the specifics.

Gianna 1 year ago

I practiced a question similar to this where individual members had to get coverage through their group. I think that might be true for multiple-employer groups too.

Maryln 1 year ago

I'm not entirely sure, but I feel like private employers do present higher underwriting risks compared to public ones.

Fairy 1 year ago

I remember discussing anti-selection risk in class, and I think it was mentioned that it's generally higher in multiple-employer groups.

Hester 1 year ago

This question is testing our knowledge of group healthcare coverage, which is an important topic. I'll carefully consider each option and make sure I select the most accurate statement.

Darnell 1 year ago

I feel pretty confident about this one. The differences in anti-selection risk and underwriting between the group types are something we've covered extensively in class. I'm going with option A.

Irma 1 year ago

Okay, I think I've got this. The key is understanding how the underwriting risk differs for the group types. I'm leaning towards option A, but I'll double-check my understanding.

Brynn 1 year ago

This question seems straightforward, but I want to make sure I understand the key differences between the three group types before selecting an answer.

Anika 1 year ago

Hmm, I'm a bit unsure about the anti-selection risk for multiple-employer groups and professional associations compared to employer-employee groups. I'll need to review that concept.

Lavina 1 year ago

Okay, let me think this through. The key things I need to look for are that the consent is in writing, has the right information, and is properly signed.

Rebbecca 1 year ago

I'm a little confused by the options. Channel Account and Commerce Portal don't seem to match the requirements, but I'm not sure if Customer Community or Platform Portal is the better fit. I'll need to review the details again.

Glory 1 year ago

Okay, let me see. Scheduled messages and batched messages seem like they could be supported, but I'm not sure about the others. I'll try to eliminate the ones that don't seem as likely.

Corinne 1 year ago

Ah, the joys of group healthcare coverage. Where the rules are made up and the points don't matter. Time to start my own professional association of professional association experts.

Anna 1 year ago

Wait, so health insurance companies are actually allowed to consider risk factors? I thought they just threw darts at a board to determine premiums.

Elenora 1 year ago

↳ replying to Anna

D) I health plan is prohibited, when evaluating the risks represented by a professional association, from considering the industry experience of the agent or broker that sells a group plan to the association

Suzan 1 year ago

↳ replying to Anna

C) Individual members of a multiple-employer group or a professional association typically are required to obtain healthcare coverage through the group or association

Sabra 1 year ago

↳ replying to Anna

B) Private employers typically present a higher underwriting risk to health plans than do public employers

Tamesha 1 year ago

↳ replying to Anna

A) Anti selection risk is higher for both multiple-employer groups and professional associations than it is for an employer-employee group

Merilyn 1 year ago

Option D is a bit of a head-scratcher. Why would a health plan be prohibited from considering the industry experience of the agent or broker? Seems like that would be relevant information.

Evangelina 1 year ago

Hmm, this one's a tough one. I'm leaning towards option B, but I'd better double-check my understanding of public and private employer risk.

Ciara 1 year ago

↳ replying to Evangelina

C) Individual members of a multiple-employer group or a professional association typically are required to obtain healthcare coverage through the group or association

Marica 1 year ago

↳ replying to Evangelina

B) Private employers typically present a higher underwriting risk to health plans than do public employers

Aaron 1 year ago

↳ replying to Evangelina

A) Anti selection risk is higher for both multiple-employer groups and professional associations than it is for an employer-employee group

Gabriele 2 years ago

Option A seems plausible, but I'm not sure if that's the best answer. The anti-selection risk could vary depending on the specific group.

Shawn 1 year ago

↳ replying to Gabriele

Option A seems plausible, but I'm not sure if that's the best answer. The anti-selection risk could vary depending on the specific group.

Van 1 year ago

↳ replying to Gabriele

B) Private employers typically present a higher underwriting risk to health plans than do public employers

Carisa 1 year ago

↳ replying to Gabriele

A) Anti selection risk is higher for both multiple-employer groups and professional associations than it is for an employer-employee group

Carlene 2 years ago

I'm not sure, but I think the answer might be D. Health plans can't consider the industry experience of the agent or broker when evaluating risks for a professional association.

Marilynn 2 years ago

I think option C is the correct answer. Individual members of a multiple-employer group or a professional association are typically required to obtain healthcare coverage through the group or association.

Alonso 2 years ago

↳ replying to Marilynn

Yeah, that does make sense. It helps with ensuring everyone in the group has access to healthcare benefits.

Galen 2 years ago

↳ replying to Marilynn

I agree, option C seems to be the most accurate. It makes sense for members to get coverage through the group.

Erinn 2 years ago

I disagree, I believe the answer is C. Individual members of those groups are usually required to get coverage through the group.

Beckie 2 years ago

I think the answer is A, because multiple-employer groups and professional associations may have members with higher health risks.

AHIP AHM-520 Exam - Topic 5 Question 91 Discussion