CACs Special Enrollment Periods and Life Events 3

Question 1

A consumer turns 26 and ages off their parent's health plan. How many days do they have to enroll in a Marketplace plan?

Accepted Answer

60 days

Answer

Aging off a parent's plan at 26 is a qualifying life event that provides a 60-day Special Enrollment Period for Marketplace coverage.

Question 2

What is the Open Enrollment Period for Marketplace health plans?

Accepted Answer

November 1 – January 15

Answer

The federal Marketplace Open Enrollment Period runs from November 1 through January 15, with coverage starting as early as January 1.

Question 3

Which of the following is a 'permanent' SEP available year-round regardless of a recent life event?

Accepted Answer

SEP for income below 150% FPL

Answer

Consumers with household income at or below 150% of the federal poverty level qualify for a year-round SEP allowing continuous Marketplace enrollment.

Question 4

A natural disaster displaces a consumer and they miss Open Enrollment. What SEP may apply?

Accepted Answer

An exceptional circumstances SEP may be granted by CMS

Answer

CMS may grant an exceptional circumstances SEP for consumers affected by natural disasters, system errors, or other hardships beyond their control.

Question 5

Which action should a CAC avoid when helping a consumer claim a SEP?

Accepted Answer

Submitting false qualifying event information to gain enrollment

Answer

Submitting false qualifying event information is fraudulent, violates CAC ethical standards, and could result in decertification.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs Special Enrollment Periods and Life Events 3