CACs - Certified Application Counselor Affordable Care Act Basics Questions and Answers 1

Question 1

A consumer loses their employer-sponsored health coverage. Under the Affordable Care Act, this event typically triggers a:

Accepted Answer

Special Enrollment Period (SEP)

Answer

Losing job-based health insurance is considered a Qualifying Life Event (QLE), which makes an individual eligible for a Special Enrollment Period (SEP). This allows them to enroll in a new health plan through the Marketplace outside of the annual Open Enrollment Period.

Question 2

Which of the following is a key role of a Certified Application Counselor (CAC)?

Accepted Answer

Helping consumers understand their eligibility for Marketplace plans, Medicaid, and CHIP.

Answer

The primary role of a CAC is to provide fair, impartial, and accurate information to help consumers understand their options and assist them with the application process for Marketplace coverage, Medicaid, and the Children's Health Insurance Program (CHIP). They are not permitted to sell insurance or recommend specific plans.

Question 3

Under the ACA, what is the primary purpose of the Advanced Premium Tax Credit (APTC)?

Accepted Answer

To lower the monthly health insurance premium for eligible individuals and families.

Answer

The Advanced Premium Tax Credit (APTC) is a subsidy the federal government pays directly to the insurance company to lower the consumer's monthly premium for plans purchased through the Health Insurance Marketplace.

Question 4

A 28-year-old single adult with an annual income of 130% of the Federal Poverty Level (FPL) lives in a state that has expanded Medicaid. Which program are they most likely eligible for?

Accepted Answer

Medicaid

Answer

The ACA allows states to expand Medicaid to cover most low-income adults under age 65 with household incomes up to 138% of the FPL. In a state that has adopted expansion, this individual's income would make them eligible for Medicaid.

Question 5

Which of the following is a fundamental requirement for an individual to be eligible to enroll in a Qualified Health Plan through the Health Insurance Marketplace?

Accepted Answer

They must not be incarcerated.

Answer

To be eligible to enroll in health coverage through the Marketplace, an individual must live in the United States, be a U.S. citizen or national (or be lawfully present), and not be incarcerated. Individuals enrolled in Medicare are not eligible to purchase a Marketplace plan.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs - Certified Application Counselor Affordable Care Act Basics Questions and Answers 1