CACs CAC Roles and Responsibilities 2

Question 1

A CAC discovers that a client provided incorrect income information on their Marketplace application. What is the CAC's primary obligation?

Accepted Answer

Advise the client to correct the information and submit an application update

Answer

Ignore it since the application is already submitted

Answer

Report the client to the IRS immediately

Answer

Enroll the client anyway and note the discrepancy internally

Question 2

Which of the following activities is OUTSIDE the scope of a CAC's authorized role?

Accepted Answer

Recommending a specific health plan based on the CAC's commission

Answer

Explaining Marketplace plan options to consumers

Answer

Helping clients complete enrollment applications

Answer

Providing information about tax credits and cost-sharing reductions

Question 3

A CAC is approached by a consumer who speaks limited English. What should the CAC do?

Accepted Answer

Assist the consumer using available language services or interpreter resources

Answer

Decline to assist and refer the consumer to an English-speaking navigator

Answer

Have the consumer bring a family member to translate without any additional steps

Answer

Submit the application on the consumer's behalf without explaining the contents

Question 4

How long must a CAC retain records of consumer assistance activities?

Accepted Answer

At least 3 years

Answer

6 months

Answer

1 year

Answer

10 years

Question 5

A consumer asks a CAC to help them understand the difference between a PPO and an HMO on the Marketplace. This request is:

Accepted Answer

Within a CAC's scope as part of providing educational information about plan options

Answer

Outside a CAC's scope — only licensed agents may explain plan types

Answer

Only permitted if the CAC holds an active insurance license

Answer

Prohibited because it could be construed as plan recommendation

Question 6

A CAC assists a client in enrolling in a Qualified Health Plan (QHP). After enrollment, the client calls with billing questions from the insurer. The CAC should:

Accepted Answer

Direct the client to the insurer's customer service or appropriate state resources

Answer

Handle all billing disputes directly with the insurer on the client's behalf

Answer

Re-enroll the client in a different plan to avoid the billing issue

Answer

File a complaint with CMS on the client's behalf without their knowledge

Question 7

What is a CAC required to do before providing assistance to a consumer?

Accepted Answer

Inform the consumer of the CAC's role, the free nature of services, and confidentiality policies

Answer

Charge a nominal fee for their services

Answer

Obtain written authorization from CMS for each consumer assisted

Answer

Verify the consumer's identity with a government-issued ID