CACs Special Enrollment Periods and Life Events 2

Question 1

Which qualifying life event allows a consumer to enroll in a Marketplace plan even if they previously had coverage?

Accepted Answer

Loss of minimum essential coverage

Answer

Losing minimum essential coverage involuntarily — such as a job loss — qualifies a consumer for a Special Enrollment Period.

Question 2

A couple gets divorced and one spouse loses coverage. When does their SEP begin?

Accepted Answer

On the date the divorce is finalized and coverage is lost

Answer

The SEP begins on the date coverage is lost due to divorce, not when the divorce is merely filed.

Question 3

Which government program losing eligibility can trigger a SEP for Marketplace coverage?

Accepted Answer

Medicaid or CHIP

Answer

Losing eligibility for Medicaid or CHIP is a qualifying life event that opens a Special Enrollment Period for Marketplace plans.

Question 4

What documentation might a CAC help a consumer gather to verify a qualifying life event for a SEP?

Accepted Answer

A letter showing loss of prior coverage or a birth certificate

Answer

Consumers may be asked to provide documents like a coverage termination letter or birth certificate to verify their qualifying life event.

Question 5

A consumer's employer stops offering health insurance. How soon should the consumer contact a CAC to use their SEP?

Accepted Answer

As soon as possible within the 60-day window

Answer

Consumers should act as soon as possible within their 60-day window to ensure they have enough time to select and enroll in a plan.

(CACs) Certified Application Counselor Practice Test