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

Grandfathered plans existed before March 23, 2010 (the ACA's enactment date), and are exempt from certain ACA requirements as long as they haven't made significant changes to coverage or cost-sharing.

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

An employer plan must have an actuarial value of at least 60% to satisfy the minimum value requirement and protect employers from applicable ACA penalties.

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

Catastrophic plans feature very high deductibles and are only available to individuals under age 30 or those with a qualifying hardship or affordability exemption.

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

ACA Marketplace plans in the individual and small group markets must cover all 10 Essential Health Benefits as a condition of marketplace participation.

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

States select their EHB benchmark from approved options, most commonly the largest small group health plan by enrollment in that state, giving states some flexibility in defining EHBs.

(ACA) Affordable Care Act Certified Practice Test

(ACA) Affordable Care Act Certified Practice Test

ACA Essential Health Benefits & Plan Types 3