AHIP Health Plan Finance and Risk Management AHM-520 Question # 120 Topic 6 Discussion

AHIP Health Plan Finance and Risk Management AHM-520 Question # 120 Topic 6 Discussion

AHM-520 Exam Topic 6 Question 120 Discussion:
Question #: 120
Topic #: 6

The Rathbone Company has contracted with the Jarvin Insurance Company to provide healthcare benefits to its employees. Under this contract, Rathbone assumes financial responsibility for paying 80% of its estimated annual claims and for depositing the funds necessary to pay these claims into a bank account. Although Rathbone owns the bank account, Jarvin, acting as Rathbone’s agent, makes the actual claims payments from this account. Claims in excess of Rathbone’s contracted percentage are paid by Jarvin. Rathbone pays to Jarvin a premium for administering the entire plan and bearing the costs of claims in excess of Rathbone’s obligation. This premium is substantially lower than would be charged if Jarvin were providing healthcare coverage under a traditional fully insured group plan. Jarvin is required to pay premium taxes only on the premiums it receives from Rathbone. This information indicates that the type of alternative funding method used by Rathbone is known as a:


A.

Premium-delay arrangement


B.

Reserve-reduction arrangement


C.

Minimum-premium plan


D.

Retrospective-rating arrangement


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