ACA Essential Health Benefits & Plan Types 3

Question 1

What is a 'grandfathered' health plan under the ACA?

Accepted Answer

A plan that existed before the ACA was enacted and has not made significant benefit or cost changes

Answer

A plan covering only Medicare-eligible individuals

Answer

A plan offered exclusively to employees with 10+ years of service

Answer

A plan providing coverage across multiple states

Question 2

What is the minimum actuarial value for an employer-sponsored plan to meet the ACA's 'minimum value' standard?

Accepted Answer

60%

Answer

50%

Answer

70%

Answer

80%

Question 3

What is a catastrophic health plan under the ACA?

Accepted Answer

A plan with very high deductibles available to those under 30 or with qualifying hardship exemptions

Answer

A plan with very low deductibles and high premiums

Answer

A plan that only covers emergency room visits

Answer

A plan covering all 10 EHBs with no cost-sharing requirements

Question 4

Which of the following plans are required to cover all 10 Essential Health Benefits?

Accepted Answer

ACA Marketplace individual and small group plans

Answer

Grandfathered plans

Answer

Short-term health insurance plans

Answer

Supplemental insurance plans

Question 5

Under the ACA, the Essential Health Benefits benchmark for each state is typically based on:

Accepted Answer

The largest small group health plan by enrollment in the state

Answer

The second-lowest Silver plan in the state marketplace

Answer

A federally standardized plan applied uniformly to all states

Answer

The most affordable Bronze plan available in the state

Question 6

Which of the following is covered under the 'preventive and wellness services' Essential Health Benefit?

Accepted Answer

Vaccinations recommended by the ACIP

Answer

Elective cosmetic procedures

Answer

Experimental treatments approved by the FDA

Answer

All prescription medications

Question 7

Which of the following best describes 'cost-sharing reductions' (CSRs) under the ACA?

Accepted Answer

Subsidies that lower deductibles and copays for Silver plan enrollees with qualifying incomes

Answer

Reductions in premium costs available to all marketplace enrollees

Answer

Tax deductions for health insurance premiums paid by self-employed individuals

Answer

Employer contributions toward employee health insurance premiums