CACs Consumer Education and Assistance 2

Question 1

A consumer asks a CAC about the difference between a premium tax credit and a cost-sharing reduction. Which statement best describes cost-sharing reductions (CSRs)?

Accepted Answer

CSRs lower out-of-pocket costs like deductibles, copays, and coinsurance

Answer

Cost-sharing reductions lower out-of-pocket costs such as deductibles, copayments, and coinsurance, and are only available on Silver plans for eligible consumers.

Question 2

A consumer who is newly employed wants to enroll in Marketplace coverage outside of Open Enrollment. Which qualifying life event would make them eligible for a Special Enrollment Period?

Accepted Answer

Starting a new job that does not offer employer-sponsored insurance

Answer

Losing or gaining access to job-based coverage is a qualifying life event that triggers a Special Enrollment Period.

Question 3

When educating a consumer about the Marketplace's metal tiers, a CAC should explain that actuarial value (AV) represents:

Accepted Answer

The percentage of covered medical costs the plan pays on average for the standard population

Answer

Actuarial value is the average percentage of covered health care costs the plan pays for a standard population, with higher AV meaning lower average out-of-pocket costs.

Question 4

A consumer reports they received a notice that their income-based Medicaid was terminated due to a change in state policy. As a CAC, your first recommended action is to:

Accepted Answer

Advise them to appeal the termination through the Medicaid agency before seeking alternatives

Answer

Consumers should first be advised to appeal a Medicaid termination through the state Medicaid agency, as reinstatement may be possible before pursuing other options.

Question 5

Which of the following best describes the role of a CAC when helping a consumer compare health plans?

Accepted Answer

Presenting objective information about plan options so the consumer can make an informed choice

Answer

CACs must present objective, unbiased information about all available plan options and let the consumer make the final decision.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs Consumer Education and Assistance 2