Question 1
What is the primary purpose of a Medical Loss Ratio (MLR) requirement under the Affordable Care Act?
Correct Answer:
Cap the share of premium dollars an insurer can spend on administration and profit
Question 2
Under ACA MLR rules, what minimum MLR must individual and small-group health plans achieve before owing rebates?
Correct Answer:
80%
Question 3
Which expense category is generally INCLUDED in the numerator of the ACA MLR calculation?
Correct Answer:
Quality improvement activities (QIA)
Question 4
An actuary estimates Incurred But Not Reported (IBNR) reserves for a health plan. Which method projects ultimate claims by applying historical development factors to paid claims by service month?
Correct Answer:
Chain ladder (loss development) method
Question 5
Why is the Bornhuetter-Ferguson method often preferred over the pure chain ladder method for the most recent two or three months of incurred claims?
Correct Answer:
Recent months have little paid data so development factors are highly leveraged and unstable
Question 1
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Prepare with the FAHM Practice Questions - AHIP Fellow, Academy for Healthcare Management (FAHM) Exam practice quiz. This question bank includes 100 questions covering plan, health, care, program, and medicare. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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FAHM Practice Questions - AHIP Fellow, Academy for Healthcare Management (FAHM) Exam

This practice set contains 100 questions from the matching question bank and focuses on plan, health, care, program, and medicare. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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