AIIM Certified Health Insurance Management
CHIMP Exam
**Question 1. Which historical development marked the shift from fee‑for‑service indemnity
plans to managed care models?**
A) Introduction of Medicare in 1965
B) Creation of Health Maintenance Organizations (HMOs) in the 1970s
C) Passage of the Affordable Care Act in 2010
D) Emergence of telemedicine platforms in the 1990s
Answer: B
Explanation: HMOs pioneered capitation and network‑based care, embodying the core of
managed care and moving away from pure indemnity reimbursement.
**Question 2. In healthcare economics, what does the term “price elasticity of demand” refer
to?**
A) The change in supply when prices rise
B) The responsiveness of quantity demanded to a change in price
C) The fixed cost of providing a service
D) The impact of government subsidies on demand
Answer: B
Explanation: Price elasticity measures how much the quantity demanded changes in response
to price fluctuations; health services often have low elasticity due to necessity.
**Question 3. Which stakeholder primarily performs medical underwriting for an individual
health insurance policy?**
A) Third‑Party Administrator (TPA)
B) Insurance claims adjuster
C) Underwriting medical officer
D) Policyholder’s primary physician
Answer: C
, AIIM Certified Health Insurance Management
CHIMP Exam
Explanation: The underwriting medical officer reviews medical history, evaluates pre‑existing
conditions, and decides on acceptance or exclusions.
**Question 4. The principle of “utmost good faith” (uberrimae fidei) obligates which party to
disclose all material facts?**
A) Only the insurer
B) Only the insured
C) Both insurer and insured
D) Only the broker
Answer: C
Explanation: Both parties must act in good faith and disclose any information that could affect
the risk assessment or claim settlement.
**Question 5. Which type of health plan provides coverage for a single individual and a separate
cover for each dependent, rather than sharing a common sum?**
A) Family Floater plan
B) Individual plan with rider
C) Group health insurance
D) Critical illness plan
Answer: B
Explanation: An individual plan with riders adds separate coverage for spouses or children,
unlike a family floater which shares a single sum insured.
**Question 6. Under a Group Health Insurance (GHI) scheme, who typically bears the risk of
large claim losses?**
A) Individual employees
B) The employer (sponsor)
, AIIM Certified Health Insurance Management
CHIMP Exam
C) The insurance regulator
D) The TPA only
Answer: B
Explanation: The employer pays premiums for the entire group and thus assumes the aggregate
risk, though the insurer bears the underwriting risk.
**Question 7. Which government‑sponsored scheme is classified as Social Health Insurance?**
A) Medicare Advantage
B. Employer‑provided private plan
C) National Health Service (NHS) in the UK
D. Medicaid managed care
Answer: C
Explanation: Social Health Insurance involves mandatory contributions and universal coverage,
exemplified by the NHS.
**Question 8. A senior citizen health plan typically includes which of the following benefits not
found in standard adult plans?**
A) Maternity coverage
B) Pre‑existing disease waiting period waiver
C) Unlimited OPD visits
D) Coverage for age‑related chronic conditions without additional premium
Answer: D
Explanation: Senior citizen plans often waive waiting periods for chronic diseases and provide
enhanced benefits for age‑related ailments.
**Question 9. In the policy lifecycle, which event follows the issuance of a policy?**
, AIIM Certified Health Insurance Management
CHIMP Exam
A) Renewal
B) Cancellation
C) Policy endorsement
D) Premium collection
Answer: D
Explanation: After issuance, the insurer collects the first premium to activate coverage.
**Question 10. What is the primary purpose of risk selection in underwriting?**
A) To increase the insurer’s marketing budget
B) To determine the appropriate premium based on risk profile
C) To meet regulatory capital requirements
D) To assign a claim adjuster to each policyholder
Answer: B
Explanation: Risk selection evaluates the applicant’s health status to set a premium that reflects
the expected cost of claims.
**Question 11. Which factor is most commonly excluded during medical underwriting for a new
health policy?**
A) Family medical history
B) Recent elective cosmetic surgery
C) Current prescription medication usage
D) Chronic disease diagnosed within the last 12 months
Answer: D
Explanation: Recent onset chronic diseases often trigger exclusion periods or higher premiums
due to higher anticipated claim costs.
CHIMP Exam
**Question 1. Which historical development marked the shift from fee‑for‑service indemnity
plans to managed care models?**
A) Introduction of Medicare in 1965
B) Creation of Health Maintenance Organizations (HMOs) in the 1970s
C) Passage of the Affordable Care Act in 2010
D) Emergence of telemedicine platforms in the 1990s
Answer: B
Explanation: HMOs pioneered capitation and network‑based care, embodying the core of
managed care and moving away from pure indemnity reimbursement.
**Question 2. In healthcare economics, what does the term “price elasticity of demand” refer
to?**
A) The change in supply when prices rise
B) The responsiveness of quantity demanded to a change in price
C) The fixed cost of providing a service
D) The impact of government subsidies on demand
Answer: B
Explanation: Price elasticity measures how much the quantity demanded changes in response
to price fluctuations; health services often have low elasticity due to necessity.
**Question 3. Which stakeholder primarily performs medical underwriting for an individual
health insurance policy?**
A) Third‑Party Administrator (TPA)
B) Insurance claims adjuster
C) Underwriting medical officer
D) Policyholder’s primary physician
Answer: C
, AIIM Certified Health Insurance Management
CHIMP Exam
Explanation: The underwriting medical officer reviews medical history, evaluates pre‑existing
conditions, and decides on acceptance or exclusions.
**Question 4. The principle of “utmost good faith” (uberrimae fidei) obligates which party to
disclose all material facts?**
A) Only the insurer
B) Only the insured
C) Both insurer and insured
D) Only the broker
Answer: C
Explanation: Both parties must act in good faith and disclose any information that could affect
the risk assessment or claim settlement.
**Question 5. Which type of health plan provides coverage for a single individual and a separate
cover for each dependent, rather than sharing a common sum?**
A) Family Floater plan
B) Individual plan with rider
C) Group health insurance
D) Critical illness plan
Answer: B
Explanation: An individual plan with riders adds separate coverage for spouses or children,
unlike a family floater which shares a single sum insured.
**Question 6. Under a Group Health Insurance (GHI) scheme, who typically bears the risk of
large claim losses?**
A) Individual employees
B) The employer (sponsor)
, AIIM Certified Health Insurance Management
CHIMP Exam
C) The insurance regulator
D) The TPA only
Answer: B
Explanation: The employer pays premiums for the entire group and thus assumes the aggregate
risk, though the insurer bears the underwriting risk.
**Question 7. Which government‑sponsored scheme is classified as Social Health Insurance?**
A) Medicare Advantage
B. Employer‑provided private plan
C) National Health Service (NHS) in the UK
D. Medicaid managed care
Answer: C
Explanation: Social Health Insurance involves mandatory contributions and universal coverage,
exemplified by the NHS.
**Question 8. A senior citizen health plan typically includes which of the following benefits not
found in standard adult plans?**
A) Maternity coverage
B) Pre‑existing disease waiting period waiver
C) Unlimited OPD visits
D) Coverage for age‑related chronic conditions without additional premium
Answer: D
Explanation: Senior citizen plans often waive waiting periods for chronic diseases and provide
enhanced benefits for age‑related ailments.
**Question 9. In the policy lifecycle, which event follows the issuance of a policy?**
, AIIM Certified Health Insurance Management
CHIMP Exam
A) Renewal
B) Cancellation
C) Policy endorsement
D) Premium collection
Answer: D
Explanation: After issuance, the insurer collects the first premium to activate coverage.
**Question 10. What is the primary purpose of risk selection in underwriting?**
A) To increase the insurer’s marketing budget
B) To determine the appropriate premium based on risk profile
C) To meet regulatory capital requirements
D) To assign a claim adjuster to each policyholder
Answer: B
Explanation: Risk selection evaluates the applicant’s health status to set a premium that reflects
the expected cost of claims.
**Question 11. Which factor is most commonly excluded during medical underwriting for a new
health policy?**
A) Family medical history
B) Recent elective cosmetic surgery
C) Current prescription medication usage
D) Chronic disease diagnosed within the last 12 months
Answer: D
Explanation: Recent onset chronic diseases often trigger exclusion periods or higher premiums
due to higher anticipated claim costs.
