AHIP PHIAS study plan

Map the full structure of medical plan types (indemnity, HMO, PPO, POS, EPO) and write a one-line differentiator for each

Define core managed-care cost-control mechanisms (networks, gatekeeping, prior authorization, utilization review, case management) in your own words

Explain how deductibles, coinsurance, copays, and out-of-pocket maximums interact to determine member cost sharing

Diagram the flow of a claim from service to adjudication, labeling each stakeholder's role

Distinguish network types and provider-contracting models, including HMO/PPO/EPO network rules and tiered networks

Compare funding arrangements (fully insured vs. self-funded/ASO) and identify which ERISA and state-mandate rules apply to each

Describe pharmacy benefit management basics: formularies, tiers, and utilization management tools

Apply coordination-of-benefits and subrogation concepts to a multi-plan scenario

Break down Medicare Parts A, B, C, and D and state what each covers, how it is financed, and its enrollment rules

Sequence Original Medicare eligibility, initial enrollment periods, general and special enrollment periods, and late-enrollment penalties

Explain Medigap standardization (lettered plans) and how Medigap interacts with Medicare Advantage enrollment

Calculate a Part B late-enrollment penalty and a Part D late-enrollment penalty from given dates

Compare Medicare Advantage plan types (HMO, PPO, PFFS, SNP, MSA) on network rules and cost sharing

Explain MA payment concepts at a high level: benchmarks, bids, rebates, and star ratings' effect on quality bonuses

Identify MA and Part D marketing and enrollment-compliance rules, including permitted and prohibited agent conduct

Contrast MA vs. Original Medicare + Medigap on cost, network, and flexibility tradeoffs

Define consumer-directed health plans and explain how HSAs, HRAs, and FSAs differ in ownership, portability, and eligibility

State HSA contribution, eligibility, and qualified-expense rules and apply them to edge cases (e.g., Medicare enrollment, dependent coverage)

Categorize supplemental products (dental, vision, critical illness, accident, hospital indemnity, cancer) by benefit trigger and payout structure

Explain how supplemental and indemnity benefits coordinate with major medical coverage

Distinguish short-term disability from long-term disability and describe typical benefit formulas, elimination periods, and definitions of disability

Explain long-term care insurance features: benefit triggers, elimination periods, benefit periods, inflation protection, and nonforfeiture options

Identify key worksite-benefits concepts, including voluntary benefits, payroll deduction, and employer group vs. individual portability

Describe statutory and regulatory touchpoints for disability and LTC products, such as tax treatment of premiums and benefits at a conceptual level

Re-review your error logs from weeks 1-6 and re-teach the three weakest concepts in writing

Build 40 original mixed-domain practice questions weighted to Domains 1 and 2

Complete a timed 60-question mixed set and analyze misses by domain

Close knowledge gaps flagged as uncertain by verifying each against a primary or authoritative source

Drill high-yield facts for Domains 1 and 2 using spaced-repetition flashcards until recall is automatic

Re-take a full-length timed practice exam under test conditions

Review every missed item and write a one-sentence rule for each to prevent repeat errors

Finalize a one-page formula and rules cheat sheet covering enrollment periods, penalties, and cost-sharing math