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AHIP FINAL TEST EXAM (FULL TEST) || 2025
ACTUAL EXAM ALL QUESTIONS AND 100%
CORRECT ANSWERS GRADE A+|| LATEST AND
COMPLETE UPDATED VERSION 2025||
GUARANTEED PASS!!!
Insurer vs Insured ANSWER- - insurer is a company that provides plan
- insured are the people that buy into the plan
Group health insurance ANSWER- Health coverage provided by employers to
members of a group.
Group health insurance - types of coverage ANSWER- You can choose among
several or just one depending on your employer
* dental, vision, medical benefits, managed care, fee-for-service insurance
- dental:
* basic/preventative services, restorative services, comprehensive or stand-
alone, ACA (children, some adults)
- vision:
* basic exams and prescription glasses, ACA (children, some adults)
^ both are employer-sponsored voluntary group plans
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Premium tax-credit ANSWER- a subsidy that reduces the amount that consumers
must pay
* tax credit that will lower monthly premium based on income and household
info
* advanced premium tax-credit (aptc)
self employed workers ANSWER- can deduct health insurance premiums from
their federal taxable income - important tax savings
contracts/health insurance policy ANSWER- between insurer and insured
- consideration: specifically termed agreement w/ promise to do something in
return for a valuable benefit (employer/insured premium payments to the insurer)
Covered services ANSWER- insurance policy will clearly state their covered
services and their exlusions
- proactive, preventative, and reactive services
cost-sharing ANSWER- a situation where insured individuals pay a portion of the
healthcare costs, such as deductibles, coinsurance or co- payments
- insured is reimbursed for some but not all of the costs
- reimbursement depends on policy
Deductible/coinsurance ANSWER- Money paid out of pocket before insurance
covers the remaining costs.
% of medical bill that insured pays out of pocket
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copay ANSWER- a fixed fee you pay for specific medical services
Affordable Care Act (ACA) ANSWER- - group underwriting, some states allow
individual medical underwriting
- insurers are prohibited from discrimination due to pre-existing conditions
Product Development Dept ANSWER- determines type of benefit plans that
members have access to
- determining correct mix of products/benefit plans that company offers
product mix ANSWER- team will design to appeal to potential members
- competitive
market forecasting ANSWER- product development teams keep tabs on how plans
are designing their products and customer preference
- constantly forecast for 1-2 years in future
cross functional teams ANSWER- product development and management of
existing benefit plans involves several cross functional teams with health insurance
plans
- estimate cost
- determine plan approval
- attain regulatory approval
AHIP FINAL TEST EXAM (FULL TEST) || 2025
ACTUAL EXAM ALL QUESTIONS AND 100%
CORRECT ANSWERS GRADE A+|| LATEST AND
COMPLETE UPDATED VERSION 2025||
GUARANTEED PASS!!!
Insurer vs Insured ANSWER- - insurer is a company that provides plan
- insured are the people that buy into the plan
Group health insurance ANSWER- Health coverage provided by employers to
members of a group.
Group health insurance - types of coverage ANSWER- You can choose among
several or just one depending on your employer
* dental, vision, medical benefits, managed care, fee-for-service insurance
- dental:
* basic/preventative services, restorative services, comprehensive or stand-
alone, ACA (children, some adults)
- vision:
* basic exams and prescription glasses, ACA (children, some adults)
^ both are employer-sponsored voluntary group plans
,2|Page
Premium tax-credit ANSWER- a subsidy that reduces the amount that consumers
must pay
* tax credit that will lower monthly premium based on income and household
info
* advanced premium tax-credit (aptc)
self employed workers ANSWER- can deduct health insurance premiums from
their federal taxable income - important tax savings
contracts/health insurance policy ANSWER- between insurer and insured
- consideration: specifically termed agreement w/ promise to do something in
return for a valuable benefit (employer/insured premium payments to the insurer)
Covered services ANSWER- insurance policy will clearly state their covered
services and their exlusions
- proactive, preventative, and reactive services
cost-sharing ANSWER- a situation where insured individuals pay a portion of the
healthcare costs, such as deductibles, coinsurance or co- payments
- insured is reimbursed for some but not all of the costs
- reimbursement depends on policy
Deductible/coinsurance ANSWER- Money paid out of pocket before insurance
covers the remaining costs.
% of medical bill that insured pays out of pocket
, 3|Page
copay ANSWER- a fixed fee you pay for specific medical services
Affordable Care Act (ACA) ANSWER- - group underwriting, some states allow
individual medical underwriting
- insurers are prohibited from discrimination due to pre-existing conditions
Product Development Dept ANSWER- determines type of benefit plans that
members have access to
- determining correct mix of products/benefit plans that company offers
product mix ANSWER- team will design to appeal to potential members
- competitive
market forecasting ANSWER- product development teams keep tabs on how plans
are designing their products and customer preference
- constantly forecast for 1-2 years in future
cross functional teams ANSWER- product development and management of
existing benefit plans involves several cross functional teams with health insurance
plans
- estimate cost
- determine plan approval
- attain regulatory approval
