AHM-510 Free Practice Test

Determine whether the following statement is true or false:
Failing to adopt and implement standards for the prompt investigation and settlement of claims is an example of an activity that would be considered an improper claims practice according to the NAIC Model Unfair Claims Settlement Practices Act.

1. A. True
2. B. False

Correct Answer: A

In the paragraph below, a statement contains two pairs of terms enclosed in parentheses. Determine which term in each pair correctly completes the statement. Then select the answer choice containing the two terms that you have chosen.
Inflation plays a role in the health plan environment by influencing the prices of healthcare services, supplies, and coverage. During an inflationary period, consumers typically have (more / less) purchasing power because the prices of goods and services increase (more / less) quickly than income.

1. A. More / more
2. B. More / less
3. C. Less / more
4. D. Less / less

Correct Answer: C

Health plans typically divide their costs into medical and administrative expenses. Examples of medical expenses are.

1. A. Equipment costs
2. B. Salaries and benefits for executives and for all functional areas
3. C. Sales and marketing costs
4. D. Payments to providers for the delivery of healthcare

Correct Answer: D

State X issued a nonresident license to Tamara Pensky, a sales representative of the Verity Health Plan. In doing so, State X imposed a countersignature requirement, which requires that

1. A. An officer of Verity sign a written statement which indicates that Verity appoints M
2. B. Pensky as an agent who is authorized to market Verity's products
3. C. An officer of Verity sign a written statement which certifies that Verity has investigated M
4. D. Pensky's qualifications and background and believes she is trustworthy and competent
5. E. Applications solicited by M
6. F. Pensky must be signed by an individual who holds a resident License
7. G. Applications solicited by M
8. H. Pensky must be signed by an officer of Verity

Correct Answer: C

Congress enacted three clauses relating to the preemptive effect of the Employee Retirement Income Security Act of 1974 (ERISA). One of these clauses preserves from ERISA preemption any state law that regulates insurance, banking, or securities, with the exception of the exemption for self-funded employee benefit plans. This clause is called the

1. A. Savings clause
2. B. Preemption clause
3. C. Deemer clause
4. D. De novo clause

Correct Answer: A
The savings clause preserves from preemption any state law that regulates insurance, banking or securities except as provided by the deemer clause.