ACA Cheat Sheet 2026

The 30 highest-yield ACA facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. What is the recommended frequency for reviewing and updating compliance & consumer protections protocols? → Monitoring outcomes through regular data collection and trend analysis
2. What is the ACA's requirement for health plans regarding coverage of preventive services rated 'A' or 'B' by the U.S. Preventive Services Task Force? → Plans must cover them without cost-sharing
3. Which of the following is an Essential Health Benefit mandated by the ACA? → Prescription drug coverage
4. What is the most common mistake professionals make when implementing tax credits & subsidies strategies? → Developing contingency plans for high-probability risk scenarios
5. Which communication approach is most appropriate when discussing a sensitive health topic with a client during ACA enrollment assistance? → Use plain language, ensure privacy, and follow the client's lead
6. Under the ACA, an insurer that fails to meet the 80% MLR threshold in the individual market must: → Pay rebates to policyholders
7. Which factor determines eligibility for ACA premium subsidies? → Household income and federal poverty level
8. Which of the following is a key performance indicator (KPI) for measuring ACA outreach effectiveness? → Number of completed enrollments or applications assisted
9. A stakeholder questions the value of quality assurance & compliance initiatives. Which response best demonstrates ROI? → Building a culture of accountability with transparent reporting
10. A health plan's Medical Loss Ratio (MLR) report must be submitted to CMS by what deadline each year? → June 1 following the end of the calendar year
11. Which document must QHP issuers provide to enrollees that summarizes the key features of their health plan in plain language? → Summary of Benefits and Coverage (SBC)
12. Under the ACA, how long must health insurers retain records related to MLR calculations and rebate payments? → Ten years
13. Under the ACA, an insurer offering plans in a state that has NOT established its own reinsurance program (state innovation waiver) must: → Participate in the federal reinsurance framework if applicable
14. Under ACA exchange regulations, what is the consequence for a QHP issuer that repeatedly fails to meet network adequacy standards? → Decertification from the exchange
15. When explaining cost-sharing reductions (CSRs) to a client, which statement is accurate? → CSRs are only available on Silver plans purchased through the marketplace
16. Under the ACA's guaranteed issue requirement, which risk management tool do insurers use INSTEAD of medical underwriting to manage their risk pool? → Annual open enrollment periods with limited special enrollment
17. Which ACA mechanism allows states to waive certain ACA requirements to implement alternative coverage approaches if they meet specific waiver criteria? → Section 1332 State Innovation Waivers
18. Which ACA reporting requirement asks insurers to justify premium rate increases of 10% or more? → Rate Review Program
19. Which scenario would require a affordable care act certified professional to escalate a health insurance coverage & enrollment concern? → Creating feedback mechanisms that encourage continuous improvement
20. A health insurer that significantly over-priced premiums relative to actual claims in the individual market will MOST likely face which ACA consequence? → Obligation to pay MLR rebates to policyholders
21. Under ACA quality compliance standards, what is the primary purpose of HEDIS (Healthcare Effectiveness Data and Information Set)? → To measure health plan performance on dimensions of care and service
22. Under the ACA, which enrollee action most directly triggers a Special Enrollment Period that could pose adverse selection risk to insurers? → Loss of minimum essential coverage
23. Which employer size is exempt from the ACA's employer shared responsibility provisions (employer mandate)? → Employers with fewer than 50 full-time equivalent employees
24. Which population group was newly eligible for Medicaid under ACA expansion that was not previously covered in most states? → Low-income adults without dependent children
25. During an outreach event at a community health center, which message best motivates uninsured individuals to explore marketplace plans? → Financial assistance may reduce monthly premiums to near zero for eligible individuals
26. Which metal tier has the HIGHEST actuarial value under the ACA? → Platinum
27. Which plan type typically offers the MOST provider flexibility but usually has higher monthly premiums? → PPO
28. What is the look-back measurement method used by ALEs to determine employee full-time status? → A measurement period of 3–12 months used to average hours and project status forward
29. A Certified Application Counselor (CAC) is ethically prohibited from doing which of the following during client communications? → Recommending a specific plan based on personal commission incentives
30. Under the ACA, which entity is responsible for training and certifying Navigators to assist consumers? → The state or federal exchange that awards Navigator grants