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AHM-510 – Governance and Regulation

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Showing 1–3 of 10 questions

Question 1

The Tidewater Life and Health Insurance Company is owned by its policy owners, who are entitled to certain rights as owners of the company, and it issues both participating and nonparticipating insurance policies. Tidewater is considering converting to the type of company that is owned by individuals who purchase shares of the company's stock. Tidewater is incorporated under the laws of Illinois, but it conducts business in the Canadian provinces of Ontario and Manitoba.

With regard to the state in which Tidewater is domiciled, it is correct to say that, from the perspective of both Ontario and Manitoba, Tidewater is considered to be the type of corporation known as:

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  • ○

    A foreign corporation
  • ○

    An alien corporation
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    A sister corporation
  • ○

    A domestic corporation
Question 2

The Hanford Health Plan has delegated the credentialing of its providers to the Sienna Group, a credential verification organization (CVO). If the contract between Hanford and Sienna complies with all of the National Committee for Quality Assurance (NCQA) guidelines for delegation of credentialing, then this contract

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  • ○

    Transfers to Sienna all rights to terminate or suspend individual practitioners or providers in Hanford's provider network

    Both A and B
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    Describes the process by which Hanford evaluates Sienna's performance in credentialing providers


    A only
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    B only
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    Neither A nor B
Question 3

The Westchester Health Plan is using a pricing strategy that involves setting a low price in a highly price-sensitive market to stimulate revenue growth. In following this strategy, Westchester is sacrificing short-term profits for fast growth in selected markets. This information indicates that Westchester is following the pricing strategy known as

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  • ○

    Market skimming
  • ○

    Buying market share
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    Price skimming
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    Unitary pricing