AHIP AHM-520 問題集

質問 1：
Juan Ramirez, a licensed social worker, and Dr. Laura Lui, a licensed psychiatrist, are under contract to the Peninsula Health Plan. Peninsula has contracted with CMS to provide services to Medicare and Medicaid beneficiaries. Both Mr. Ramirez and Dr. Lui provide the same type of counseling services to Peninsula's enrollees. With respect to amendments made to the Balanced Budget Act (BBA) of 1997 that impact provider reimbursement, the
amount by which Peninsula will reimburse Mr. Ramirez will be equal to:
A. 75% of Dr. Lui's reimbursement
B. 90% of Dr. Lui's reimbursement
C. 50% of Dr. Lui's reimbursement
D. 100% of Dr. Lui's reimbursement
正解：D

質問 2：
In order to print all of its forms in-house, the Prism health plan isconsidering the purchase of 10 new printers at a total cost of $30,000. Prismestimates that the proposed printers have a useful life of 5 years. Under itscurrent system, Prism spends $10,000 a year to have forms printed by a localprinting company. Assume that Prism selects a 15% discount rate based onits weighted-average costs of capital. The cash inflows for each year,discounted to their present value, are shown in the following chart:

Prism will use both the payback method and the discounted payback methodto analyze the worthiness of this potential capital investment. Prism's decisionrule is to accept all proposed capital projects that have payback periods offour years or less.
Now assume that Prism decides to use the net present value (NPV) method toevaluate this potential investment's worthiness and that Prism will accept theproject if the project's NPV is greater than $4,000. Using the NPV method,Prism would correctly conclude that this project should be
A. Accepted because its NPV is $5,028
B. Rejected because its NPV is $3,520
C. Accepted because its NPV is $16,480
D. Accepted because its NPV is $23,520
正解：B

質問 3：
The following transactions occurred at the Lane Health Plan:
- Transaction 1 - Lane recorded a $25,000 premium prior to receiving the payment - Transaction 2 - Lane purchased $500 in office expenses on account, but did not record the expense until it received the bill a month later - Transaction 3 - Fire destroyed one of Lane's facilities; Lane waited until the facility was rebuilt before assessing and recording the amount of loss - Transaction 4 - Lane sold an investment on which it realized a $14,000 gain; Lane recorded the gain only after the sale was completed.
Of these transactions, the one that is consistent with the accounting principle of conservatism is:
A. Transaction 2
B. Transaction 3
C. Transaction 1
D. Transaction 4
正解：D

質問 4：
The medical loss ratio (MLR) for the Peacock health plan is 80%. Peacock's expense ratio is 16%.
One characteristic of Peacock's MLR is that it
A. Measures Peacock's overall claims levels
B. Includes claims that have been paid but excludes claims that have not yet been reported
C. Is the percentage of Peacock's end-of-period surplus to its earned premiums
D. Cannot adjust for growth in the health plan's business
正解：A

質問 5：
The Norton Health Plan used blended rating to develop a premium rate for the Roswell Company, a large employer group. Norton assigned Roswell a credibility factor of 0.7 (or 70%). Norton calculated Roswell's manual rate to be $200 and its experience claims cost as $180. Norton's retention charge is $3. This information indicates that Roswell's blended rate is:
A. $189
B. $186
C. $194
D. $197
正解：A

質問 6：
The Wallaby Health Plan purchased an asset two years ago for $50,000. At the time of purchase, the asset had an appraised value of $52,000. The asset carries a value on Wallaby's general ledger of $47,000, and its current market value is $80,000. According to the cost concept, Wallaby would report on its financial statements a value for this asset equal to:
A. $52,000
B. $47,000
C. $50,000
D. $80,000
正解：C