CACs Consumer Education and Assistance 3

Question 1

A consumer who enrolled in a Marketplace plan wants to add their newborn to their coverage. A CAC should advise them that a birth triggers a SEP and the consumer must report the birth within:

Accepted Answer

60 days of the birth

Answer

A newborn must be added to Marketplace coverage within 60 days of the birth, which is the standard SEP window for birth, adoption, or placement.

Question 2

When explaining the Marketplace's network types to a consumer, which plan type generally requires referrals to see specialists but may offer lower premiums?

Accepted Answer

HMO (Health Maintenance Organization)

Answer

HMO plans typically require members to get referrals from a primary care physician before seeing specialists and generally have lower premiums.

Question 3

A consumer asks a CAC whether they can keep their doctor after enrolling in a Marketplace plan. The BEST advice the CAC can provide is to:

Accepted Answer

Tell them to call their doctor to confirm participation in the specific plan's network before enrolling

Answer

Consumers should verify their preferred doctors and facilities are in-network for a specific plan before enrolling, as networks vary by plan.

Question 4

During Open Enrollment, a consumer who received advance premium tax credits (APTC) last year wants to re-enroll. A CAC must remind them to:

Accepted Answer

Update their household income and family size information each year

Answer

Consumers receiving APTC must update their income and household information annually during Open Enrollment to ensure their tax credit amount is accurate.

Question 5

A CAC is assisting a consumer who speaks limited English. Under federal civil rights requirements, the CAC or their organization must:

Accepted Answer

Provide language assistance services free of charge to individuals with limited English proficiency

Answer

Federal civil rights law (Title VI) requires covered entities to provide meaningful access, including free language assistance, to individuals with limited English proficiency.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs Consumer Education and Assistance 3