Câu 47: AHM-520: Health Plan Finance and Risk Management

The Longview Hospital contracted with the Carlyle Health Plan to provide inpatient services to Carlyle’s enrolled members. Carlyle provides Longview with a type of stop-loss coverage that protects, on a claims incurred and paid basis, against losses arising from significantly higher than anticipated utilization rates among Carlyle’s covered population. The stop-loss coverage specifies an attachment point of 130% of Longview’s projected $2,000,000 costs of treating Carlyle plan members and requires Longview to pay 15% of any costs above the attachment point. In a given plan year, Longview incurred covered costs totaling $3,000,000. For the year in which Longview’s incurred covered costs were $3,000,000, the amount for which Longview will be responsible is:

1. A. $2,000,000
2. B. $2,600,000
3. C. $2,660,000 — đáp án hiện tại
4. D. $3,900,000