CACs Eligibility and Enrollment 5

Question 1

A consumer receiving unemployment compensation in 2021 or later signs up for Marketplace coverage. What special provision applies?

Accepted Answer

They may qualify for a full premium subsidy (benchmark plan at $0) under unemployment SEP rules

Answer

Under the American Rescue Plan, consumers receiving unemployment compensation in 2021 (and subsequent legislative extensions) were eligible for enhanced APTCs reducing their benchmark Silver plan premium to $0.

Question 2

A consumer's immigration status is 'Deferred Action for Childhood Arrivals' (DACA). What is their Marketplace eligibility?

Accepted Answer

Not eligible for Marketplace enrollment

Answer

DACA recipients are not considered 'lawfully present' under federal ACA rules and are therefore not eligible to enroll in Marketplace plans (though some states have separate programs).

Question 3

Which of the following is NOT considered a qualifying health plan (QHP) for ACA purposes?

Accepted Answer

Short-term limited duration health insurance

Answer

Short-term limited duration insurance (STLDI) is explicitly excluded from the definition of a QHP and does not provide minimum essential coverage.

Question 4

A consumer turns 26 and is dropped from a parent's health plan on their birthday. How long do they have to enroll in their own Marketplace plan?

Accepted Answer

60 days

Answer

Losing coverage due to aging off a parent's plan is a qualifying life event, giving the consumer 60 days to enroll in a Marketplace plan via an SEP.

Question 5

The annual Open Enrollment Period for Marketplace coverage in most states typically runs from:

Accepted Answer

November 1 – January 15 (or January 31 in some states)

Answer

The standard federal OEP runs November 1 through January 15, though some state-based Marketplaces extend their deadlines further.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs Eligibility and Enrollment 5