AHM 250 Fall 2026 Part 1 QUESTIONS AND ANSWERS
A health plan can best be described as an organization that - CORRECT ANSWER✅✅Integrates the
delivery and financing of health care and seeks to manage health care costs, access, and quality
The earliest versions of health plans appeared - CORRECT ANSWER✅✅In the early 1900s
Which is a very early type of health plan? - CORRECT ANSWER✅✅Prepaid group practice
Which was a provision of the hmo act of 1973? - CORRECT ANSWER✅✅Federally qualified HMOs had
access to federal funding
In the 1990s, HMOs were - CORRECT ANSWER✅✅Popular because they held down costs, but people
objected to the lack of provider choice
To receive benefits from her plan, Janine must first go to here PCP and remain within her plan's network
for other health services. Janine is most likely covered by a - CORRECT ANSWER✅✅Traditional HMO
plan
Jacob must pay $5,000 in health care expenses each year before he receives benefits from his health
plan, but he can use money from a tax-advantaged savings account. Jacob has a - CORRECT
ANSWER✅✅Consumer Directed Health Plan
What is the involvement of the state and federal government in health plans? - CORRECT
ANSWER✅✅They legislate and regulate in this area and purchase health coverage
Under the fee-for-service compensation method, healthcare providers have a financial incentive to
provide - CORRECT ANSWER✅✅More services
Which of these do health plans generally seek to replace? - CORRECT ANSWER✅✅Fee for service
compensation
,A consumer directed health plan seeks to lower premiums through - CORRECT ANSWER✅✅A high
deductible
In relation to health plans, over the years the definition of quality - CORRECT ANSWER✅✅Has become
broader
Which is an organization accrediting health plans? - CORRECT ANSWER✅✅NCQA
Why is it useful in studying health plans to learn about indemnity insurance? - CORRECT
ANSWER✅✅Some features of today's health plans are inherited from indemnity insurance or
designated to address its problems
Andy and his family are cover by his employer's group health insurance policy. Who is the (are) the
policy holder(s) of this policy? - CORRECT ANSWER✅✅The employer
Who pays the premium of an employer sponsored group policy? - CORRECT ANSWER✅✅Employees
may pay part or all of the premium, but they do so through the employer.
What happens in adverse selection? - CORRECT ANSWER✅✅People who need health care enroll in
greater numbers than average people
Which employee group is most likely to have a higher than average loss rate? - CORRECT ANSWER✅✅A
group made up of mostly women
Which employee group presents a high risk of adverse selection? - CORRECT ANSWER✅✅In Company
A, a small percentage of employees enroll
In traditional indemnity health insurance, insureds - CORRECT ANSWER✅✅Can go to any provider they
choose
In traditional indemnity health insurance, how are providers compensated? - CORRECT
ANSWER✅✅Fee-for-service
, Owen pays 20% of the cost of health care services covered by his policy. This describes - CORRECT
ANSWER✅✅Coinsurance
Which is not common in traditional indemnity health insurance? - CORRECT ANSWER✅✅Copayment
Coordination of Benefits is designed to - CORRECT ANSWER✅✅Prevent duplication of benefits when a
person is covered by more than one health insurance policy
Increased cost sharing - CORRECT ANSWER✅✅All of the above (shifts cost from insurer to insured, can
help to lower the level of premium increases, helps hold down health care expenditures through insured
incentives)
According to the text, cost containment helps hold down death insurance premiums primarily by -
CORRECT ANSWER✅✅Reducing unnecessary health car services
Coverage of preventative care is - CORRECT ANSWER✅✅Cost effective in the long run
In this course, "health plan" is defined as any entity that - CORRECT ANSWER✅✅Uses certain concepts
of techniques to manage the cost, access, and quality of health care
What is the trend in health plan products? - CORRECT ANSWER✅✅More types are being offered and
the distinctions between them are becoming more blurred
Members do not have to select how to receive services until they use them. This describes a - CORRECT
ANSWER✅✅Point of Service product
A health savings account is combined with a high deductible health plan. This describes a - CORRECT
ANSWER✅✅Consumer Directed Health Plan
Which of these health plan types uses a managed care techniques and concepts the most? - CORRECT
ANSWER✅✅HMOs
A health plan can best be described as an organization that - CORRECT ANSWER✅✅Integrates the
delivery and financing of health care and seeks to manage health care costs, access, and quality
The earliest versions of health plans appeared - CORRECT ANSWER✅✅In the early 1900s
Which is a very early type of health plan? - CORRECT ANSWER✅✅Prepaid group practice
Which was a provision of the hmo act of 1973? - CORRECT ANSWER✅✅Federally qualified HMOs had
access to federal funding
In the 1990s, HMOs were - CORRECT ANSWER✅✅Popular because they held down costs, but people
objected to the lack of provider choice
To receive benefits from her plan, Janine must first go to here PCP and remain within her plan's network
for other health services. Janine is most likely covered by a - CORRECT ANSWER✅✅Traditional HMO
plan
Jacob must pay $5,000 in health care expenses each year before he receives benefits from his health
plan, but he can use money from a tax-advantaged savings account. Jacob has a - CORRECT
ANSWER✅✅Consumer Directed Health Plan
What is the involvement of the state and federal government in health plans? - CORRECT
ANSWER✅✅They legislate and regulate in this area and purchase health coverage
Under the fee-for-service compensation method, healthcare providers have a financial incentive to
provide - CORRECT ANSWER✅✅More services
Which of these do health plans generally seek to replace? - CORRECT ANSWER✅✅Fee for service
compensation
,A consumer directed health plan seeks to lower premiums through - CORRECT ANSWER✅✅A high
deductible
In relation to health plans, over the years the definition of quality - CORRECT ANSWER✅✅Has become
broader
Which is an organization accrediting health plans? - CORRECT ANSWER✅✅NCQA
Why is it useful in studying health plans to learn about indemnity insurance? - CORRECT
ANSWER✅✅Some features of today's health plans are inherited from indemnity insurance or
designated to address its problems
Andy and his family are cover by his employer's group health insurance policy. Who is the (are) the
policy holder(s) of this policy? - CORRECT ANSWER✅✅The employer
Who pays the premium of an employer sponsored group policy? - CORRECT ANSWER✅✅Employees
may pay part or all of the premium, but they do so through the employer.
What happens in adverse selection? - CORRECT ANSWER✅✅People who need health care enroll in
greater numbers than average people
Which employee group is most likely to have a higher than average loss rate? - CORRECT ANSWER✅✅A
group made up of mostly women
Which employee group presents a high risk of adverse selection? - CORRECT ANSWER✅✅In Company
A, a small percentage of employees enroll
In traditional indemnity health insurance, insureds - CORRECT ANSWER✅✅Can go to any provider they
choose
In traditional indemnity health insurance, how are providers compensated? - CORRECT
ANSWER✅✅Fee-for-service
, Owen pays 20% of the cost of health care services covered by his policy. This describes - CORRECT
ANSWER✅✅Coinsurance
Which is not common in traditional indemnity health insurance? - CORRECT ANSWER✅✅Copayment
Coordination of Benefits is designed to - CORRECT ANSWER✅✅Prevent duplication of benefits when a
person is covered by more than one health insurance policy
Increased cost sharing - CORRECT ANSWER✅✅All of the above (shifts cost from insurer to insured, can
help to lower the level of premium increases, helps hold down health care expenditures through insured
incentives)
According to the text, cost containment helps hold down death insurance premiums primarily by -
CORRECT ANSWER✅✅Reducing unnecessary health car services
Coverage of preventative care is - CORRECT ANSWER✅✅Cost effective in the long run
In this course, "health plan" is defined as any entity that - CORRECT ANSWER✅✅Uses certain concepts
of techniques to manage the cost, access, and quality of health care
What is the trend in health plan products? - CORRECT ANSWER✅✅More types are being offered and
the distinctions between them are becoming more blurred
Members do not have to select how to receive services until they use them. This describes a - CORRECT
ANSWER✅✅Point of Service product
A health savings account is combined with a high deductible health plan. This describes a - CORRECT
ANSWER✅✅Consumer Directed Health Plan
Which of these health plan types uses a managed care techniques and concepts the most? - CORRECT
ANSWER✅✅HMOs
