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AHIP AHM-520 Exam Questions
- Topic 1: Recognize different reserving methodologies used by health insurance providers/ Analyze the role of strategic financial planning in setting a health insurance provider’s future direction
- Topic 2: Learn about the financial risks for health insurance provider organizations that provide health care services to Medicare and/or Medicaid populations compared to risks within the commercial population
- Topic 3: Discover how to identify claim related components of health insurance providers’ financial statements
- Topic 4: Gain an understanding of risk, decisions regarding risk assumption, and how health insurance providers control risk
- Topic 5: Distinguish between fully funded and self-funded plans and the increasing role of self-funding in the marketplace
- Topic 6: Compare the difference between stop-loss insurance and stop-loss reinsurance from the perspective of health insurance providers
Free AHIP AHM-520 Exam Actual Questions
Note: Premium Questions for AHM-520 were last updated On Sep. 27, 2026 (see below)
The Caribou health plan is a for-profit organization. The financial statements that Caribou prepares include balance sheets, income statements, and cash flow statements. To prepare its cash flow statement, Caribou begins with the net income figure as reported on its income statement and then reconciles this amount to operating cash flows through a series of adjustments. Changes in Caribou's cash flow occur as a result of the health plan's operating activities, investing activities, and financing activities.
Caribou is engaged in an operating activity when it
In the following paragraph, a sentence contains two pairs of words enclosed in parentheses. Determine which word in each pair correctly completes the statement. Then select the answer choice containing the two words that you have selected.
The Igloo health plan recognizes the receipt of its premium income during the accounting period in which the income is earned, regardless of when cash changes hands. However, Igloo recognizes its expenses when it earns the revenues related to those expenses, regardless of when it receives cash for the revenues earned. This information indicates that the (realization/capitalization) principle governs Igloo's revenue recognition, whereas the (matching/initial-recording) principle governs its expense recognition.
The Fairway health plan is a for-profit health plan that issues stock. The following data was taken from Fairway's financial statements:
Current assets.....$5,000,000
Total assets.....6,000,000
Current liabilities.....2,500,000
Total liabilities.....3,600,000
Stockholders' equity.....2,400,000
Fairway's total revenues for the previous financial period were $7,200,000, and its net income for that period was $180,000.
For the previous financial period, Fairway's net profit margin was
The Puma health plan uses return on investment (ROI) and residual income (RI) to measure the performance of its investment centers. Two of these investment centers are identified as X and Y. Investment Center X earns $10,000,000 in operating income on controllable investments of $50,000,000, and it has total revenues of $60,000,000. Investment Center Y earns $2,000,000 in operating income on controllable investments of $8,000,000, and it has total revenues of $10,000,000. Both centers have a minimum required rate of return of 15%.
One difference between the RI method and the ROI method is that
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