Health Insurance Fundamentals
Fundamentals of Health Insurance, Part A (Basics of Health Insurance)—NEWLY UPDATED
This online course is the place to start to master basic concepts and terminology of the health insurance industry. You’ll get a comprehensive overview of the business environment of insurance companies; learn about the various kinds of health insurance; and develop a working knowledge of how the insurance industry works, including contract provisions, underwriting, sales and marketing. This course is essential for anyone who is new to the industry.
What You’ll Learn:
- The definition of insurance and how it works
- The major types of insurance, including medical expense, supplemental, long-term care, and disability coverage
- Needs met by health insurance
- The importance of the life and health insurance industry in the United States
- Types of organizations
- Advantages and disadvantages of flexible benefit plans
- Contract provisions and underwriting of individual and group plans
- Selling and marketing of insurance products
- The role of reinsurance
- Relevant terms and key concepts
Who Should take this Course:
- Employees of health insurance plans, especially newcomers to the industry who need a basic orientation in health insurance principles and operations
- Agents and brokers who specialize in group and individual health plans
- Case managers and medical directors who seek a broader administrative background
- Technical business solutions advisors who seek more knowledge in client operations
- Consumers and others in related fields who seek expertise in this area
Enrollment
$165 AHIP Members; $215 Non-members
To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.
Publications
The Health Insurance Primer: An Introduction to How Health Insurance Works
$40 AHIP Members; $50 Non-members
The Health Insurance Primer Study Manual
$15 AHIP Members; $15 Non-members
Earn a Designation
This course is good towards earning the following Center designations:
- Health Insurance Associate (HIA®)
- Disability Healthcare Professional (DHP)
- Healthcare Customer Service Associate (HCSA)
- Managed Healthcare Professional (MHP)
Continuing Education Credits
- Many state insurance departments have approved the course for continuing education (CE) credits. You can check the Center's CE website at https://www.ahipresearch.org/ciepd/cemap/ to see if CE credits have been approved by your state.
- The Commission for Case Manager Certification (CCMC) grants 24 contact hours for this course.
Fundamentals of Health Insurance, Part B (Basics of Company Operations)
This online course is a survival guide when it comes to understanding health insurance operations. You’ll gain a thorough introduction to business basics, including issuance and installation of policies; policy renewal and changes; premium billing and payment; claims administration; pricing; and state and federal regulation of insurance. Recently expanded and now offered in a convenient online format, this course brings you up to date on new developments, such as wellness programs, the medical home concept, health information technology, price and quality transparency, and landmark health care reform initiatives. To facilitate study and review, short quizzes are included in each section of the course.
What You’ll Learn:
- The administration of group health insurance plans
- Procedures for issuance and installation of policies
- Policy renewal processes
- Premium billing and payment
- How to manage, submit, and process claims
- How to control operational costs
- How to promote cost-effective health care
- The definition, detection, and prevention of health insurance fraud and abuse
- Product pricing strategies
- Insurance regulation, including roles of federal and state government
- Improvements in health care quality and efficiency associated with health information technology
- How the medical home concept helps lower costs by focusing on preventive care
- Elements, implementation, and expected return from wellness programs
- Who buys and sells health care and at what prices
- Federal role in advancing health cost and quality transparency
- Relevant terms and key concepts
Who Should take this Course:
- Employees of health insurance companies, especially those who need a basic orientation to health insurance principles and operations
- Agents and brokers who specialize in group and individual health plans
- Case managers and medical directors who seek a broader administrative background
- Technical business solutions advisors who seek more knowledge in client operations
- Consumers and others in related fields who seek expertise in this area
Enrollment
$165 AHIP Members; $215 Non-members
To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.
Publications
Health Insurance Nuts and Bolts: An Introduction to Health Insurance Operations
$40 AHIP Members; $50 Non-members
Health Insurance Nuts and Bolts Study Manual
$15 AHIP Members; $15 Non-members
Earn a Designation
This course applies toward the following Center designations:
- Health Insurance Associate (HIA®)
- Disability Healthcare Professional (DHP)
- Healthcare Customer Service Associate (HCSA)
- Managed Healthcare Professional (MHP)
Continuing Education Credits
- Many state insurance departments have approved the course for continuing education (CE) credits. You can check the Center's CE website at https://www.ahipresearch.org/ciepd/cemap/ to see if CE credits have been approved by your state.
- The Commission for Case Manager Certification (CCMC) grants 16 contact hours for this course.
Health Insurance Advanced Studies, Part A
You understand the health insurance industry and continuously work to stay ahead of the trends and changes. This online course advances your knowledge on a full range of topics within health insurance including health insurance plan structures and alternatives, prescription drugs and pharmacy benefit news, Medicare and Part D, Medicaid, tax treatment of medical expenses and high-benefit plans, consumer driven plans and HSAs, and planning tools including fraud detection.
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Who Should take this Course:
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Enrollment
$195 AHIP Members; $255 Non-members
To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.
Publications
Health Insurance Advanced Studies, Part A
Available in electronic format only. Supplied free of charge to students enrolling in the Health Insurance Advanced Studies, Part A course.
Earn a Designation
Upon completion of this course, you will earn the following Center designation:
Health Insurance Advanced Studies, Part B
Delve into some of the most important health insurance products and trends in this course. You’ll add to your knowledge and expertise in disability, long-term care, supplemental, and dental insurance with information on policy structuring, options, and placement.
Who Should take this Course:
- Health insurance plan employees
- Agents and brokers
- Others in related fields who seek more knowledge of health insurance
Enrollment
$195 AHIP Members; $255 Non-members
To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.
Publications
Health Insurance Advanced Studies, Part B
Available in electronic format only. Supplied free of charge to students enrolling in the Health Insurance Advanced Studies, Part B course.
Earn a Designation
This course is good towards earning the following Center designation:
Medical Expense Insurance
This self-study course addresses forms of insurance coverage that provide reimbursement for various medical care expenses, such as group major medical insurance and individual hospital-surgical insurance. You’ll learn about the process of marketing and selling, pricing, contract provisions, and underwriting, as well as policy and claims administration.
What You’ll Learn:
- The descriptions of the two most common coverages in the United States—group major medical and individual hospital-surgical insurance
- Policy administration
- Underwriting and pricing procedures
- Methods of selling and marketing
- Claims administration
- Relevant terms, industry issues, and key concepts
Who Should take this Course:
- Employees of health insurance plans who need a solid understanding of medical expense insurance
- Agents and brokers who specialize in group and individual health insurance plans
- Financial planners who seek more knowledge of products to meet client needs
- Case managers and medical directors who seek more knowledge of insurance products
- Consumers and others in related fields who seek expertise in this area
Enrollment
$110 AHIP Members; $150 Non-members
To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.
Publications
Medical Expense Insurance
$40 AHIP Members; $50 Non-members
Medical Expense Insurance Study Manual
$15 AHIP Members; $15 Non-members
Earn a Designation
This course is good towards earning the following Center designations:
Continuing Education Credits
- The Commission for Case Manager Certification (CCMC) grants 24 contact hours for this course.
Supplemental Health Insurance
Newly updated, this online course examines the impact of the most recent Medigap legislation. You’ll explore in detail critical illness insurance, as well as the administration of supplemental coverage for vision, dental, hearing, specified disease and cancer, special risks, accidents, Medicare, and hospital services. You’ll also learn the latest on benefit plans to get a clearer perspective on what is likely to happen in the supplemental health insurance market in the future.
What You’ll Learn:
- The facts and features of major supplemental products in the marketplace, including hospital indemnity coverage, specified disease insurance, Medicare supplements, accident coverage, dental plans, and prescription drug plans
- The impact of the most recent legislation on Medigap
- How to identify gaps in basic health insurance that create the need for additional coverage
- How supplemental products protect individuals from financial risk
- The administration of supplemental policies
- Relevant terms, industry issues, and key concepts
Who Should take this Course:
- Employees of health insurance plans who need a solid understanding of supplemental health insurance and Medigap
- Agents and brokers who specialize in group and individual health plans
- Financial planners who seek more knowledge of products to meet client needs
- Case managers and medical directors who seek more knowledge of insurance products
- Consumers and others in related fields who seek expertise in this area
Enrollment
$150 AHIP Members; $200 Non-members
To enroll in a course, or purchase a text book, please log in, and browse our Center’s online catalog. If you are a new user, please register for an account to get started.
Publications
Supplemental Health Insurance
$40 AHIP Members; $50 Non-members
Earn a Designation
This course is good towards earning the following Center designation:
Continuing Education Credits
- The Commission for Case Manager Certification (CCMC) grants 20 contact hours for this course.