CACs - Certified Application Counselor Eligibility and Enrollment Process Questions and Answers

Question 1

A consumer loses their job-based health coverage. How long do they generally have from the date of losing coverage to enroll in a new Marketplace plan through a Special Enrollment Period (SEP)?

Accepted Answer

60 days

Answer

30 days

Answer

90 days

Answer

Until the next Open Enrollment Period

Question 2

Which of the following is a primary eligibility requirement for an individual to purchase a health plan through the Health Insurance Marketplace?

Accepted Answer

Must not be eligible for Medicare

Answer

Must be employed full-time

Answer

Must have a pre-existing condition

Answer

Must be a high-income earner

Question 3

A family is applying for Marketplace coverage. Which of the following documents would generally NOT be required during the application process?

Accepted Answer

A high school diploma or GED certificate

Answer

Social Security numbers for all applicants

Answer

Employer and income information (e.g., pay stubs, W-2s)

Answer

Document information for lawfully present immigrants

Question 4

A Certified Application Counselor (CAC) is assisting a lawfully present immigrant who is a Lawful Permanent Resident (LPR, or 'Green Card' holder) and obtained this status two years ago. The consumer's income is low enough for Medicaid. Why might they be ineligible for Medicaid at this time?

Accepted Answer

Many 'qualified non-citizens' are subject to a 5-year waiting period for Medicaid.

Answer

LPRs are never eligible for Medicaid.

Answer

They must wait until they become a U.S. citizen.

Answer

They can only apply for Marketplace coverage, not Medicaid.

Question 5

Which of the following scenarios would most likely trigger a Special Enrollment Period (SEP) for a consumer to enroll in a Marketplace plan outside of the annual Open Enrollment Period?

Accepted Answer

Moving to a new zip code where different health plans are available.

Answer

Voluntarily cancelling their existing health plan.

Answer

Choosing to not pay their monthly premium.

Answer

Deciding they want a plan with a lower deductible.

Question 6

When a Certified Application Counselor (CAC) helps a consumer fill out a Marketplace application, what information must be collected for every member of the household, even those not applying for coverage?

Accepted Answer

Income information

Answer

Medical history

Answer

Educational background

Answer

Driver's license numbers

A consumer loses their job-based health coverage.How long do they generally have from the date of losing coverage to enroll in a new Marketplace plan through a Special Enrollment Period (SEP)?

A consumer loses their job-based health coverage.
How long do they generally have from the date of losing coverage to enroll in a new Marketplace plan through a Special Enrollment Period (SEP)?