CACs Affordable Care Act Basics 2

Question 1

Under the ACA, what is the maximum out-of-pocket limit for an individual in a Marketplace plan for plan year 2024?

Accepted Answer

$9,450

Answer

$5,000

Answer

$7,000

Answer

$12,000

Question 2

Which federal agency administers the Health Insurance Marketplace (Healthcare.gov)?

Accepted Answer

Centers for Medicare & Medicaid Services (CMS)

Answer

Social Security Administration

Answer

Department of Labor

Answer

Office of Personnel Management

Question 3

A consumer's ACA plan covers an emergency visit at an out-of-network hospital. Under the ACA's essential health benefit rules, which statement is TRUE?

Accepted Answer

Plans must cover emergency services without prior authorization

Answer

Emergency services can be denied for out-of-network use

Answer

Cost-sharing for emergencies can be unlimited

Answer

Emergency services are only covered at in-network facilities

Question 4

What does 'creditable coverage' mean in the context of the ACA and Special Enrollment Periods?

Accepted Answer

Prior health insurance that counts toward satisfying waiting periods

Answer

Coverage that is free of charge

Answer

Coverage that includes dental and vision

Answer

A plan with a credit score requirement

Question 5

Under the ACA, which of the following is NOT considered a minimum essential coverage (MEC) type?

Accepted Answer

A short-term limited-duration health plan

Answer

Medicare Part A

Answer

Medicaid

Answer

CHIP

Question 6

What is the income threshold (as a percentage of the Federal Poverty Level) above which individuals are NOT eligible for Medicaid under standard ACA expansion rules for adults?

Accepted Answer

133% FPL (effectively 138% with 5% disregard)

Answer

100% FPL

Answer

150% FPL

Answer

200% FPL

Question 7

A consumer wants to know if a specific drug is covered before enrolling in a Marketplace plan. Which plan document should the CAC direct them to review?

Accepted Answer

Plan Formulary

Answer

Summary of Benefits and Coverage (SBC)

Answer

Certificate of Coverage

Answer

Explanation of Benefits (EOB)