AHIP Healthcare Management: An Introduction AHM-250 Question # 159 Topic 5 Discussion

AHIP Healthcare Management: An Introduction AHM-250 Question # 159 Topic 5 Discussion

AHM-250 Exam Topic 5 Question 159 Discussion:
Question #: 159
Topic #: 5

A health plan may use one of several types of community rating methods to set premiums for a health plan. The following statements are about community rating. Select the answer choice containing the correct statement.


A.

Standard (pure) community rating is typically used for large groups because it is the most competitive rating method for large groups.


B.

Under standard (pure) community rating, a health plan charges all employers or other group sponsors the same dollar amount for a given level of medical benefits or health plan, without adjusting for factors such as age, gender, or experience.


C.

In using the adjusted community rating (ACR) method, a health plan must consider the actual experience of a group in developing premium rates for that group.


D.

The Centers for Medicare and Medicaid Services (CMS) prohibits health plans that assume Medicare risk from using the adjusted community rating (ACR) me


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