CACs Ethics and Impartiality 2

Question 1

A CAC is helping a client who qualifies for both Medicaid and a Marketplace plan with subsidies. The client asks which is better. What is the ethical approach?

Accepted Answer

Explain both options objectively and let the client decide based on their needs

Answer

Recommend Medicaid because it has no premiums

Answer

Recommend the Marketplace plan because it has more providers

Answer

Decline to discuss Medicaid since CACs only assist with Marketplace enrollment

Question 2

A CAC discovers during an enrollment session that a client's employer offers coverage that may be considered affordable under ACA rules. What should the CAC do?

Accepted Answer

Inform the client about the employer offer and explain how it may affect subsidy eligibility

Answer

Ignore employer coverage and proceed with Marketplace enrollment

Answer

Enroll the client in Marketplace and let the IRS sort it out later

Answer

Advise the client to decline employer coverage without explaining the consequences

Question 3

Which of the following actions would constitute a conflict of interest for a CAC?

Accepted Answer

Receiving a commission from an insurer for enrolling clients in their plans

Answer

Helping a client compare two different insurance carriers

Answer

Explaining premium tax credit calculations to a client

Answer

Assisting a client who is a family member

Question 4

A client asks a CAC to recommend the plan with the lowest monthly premium without considering other cost-sharing factors. What is the most ethical response?

Accepted Answer

Explain that total costs include deductibles and copays, then help the client compare all cost factors

Answer

Select the lowest-premium plan as the client requested

Answer

Refuse to assist because the client's approach is unwise

Answer

Select a moderate plan and tell the client it has the lowest premium

Question 5

Under CAC ethical standards, how should a CAC handle a situation where they are not able to answer a client's complex tax question related to the premium tax credit?

Accepted Answer

Acknowledge the limitation and refer the client to a tax professional or IRS resources

Answer

Provide a best guess to avoid seeming unknowledgeable

Answer

Tell the client the question is irrelevant to enrollment

Answer

Proceed with enrollment without addressing the question

Question 6

A CAC's employer instructs them to prioritize enrolling clients in a specific health plan. How should the CAC respond?

Accepted Answer

Report the instruction to CMS as a potential compliance violation

Answer

Follow the employer's instructions since the employer sets the policies

Answer

Enroll clients in that plan only if it genuinely fits their needs after an impartial review

Answer

Resign immediately to avoid the conflict

Question 7

A client shares information during enrollment that suggests potential eligibility fraud. What is the CAC's ethical obligation?

Accepted Answer

Assist the client in accurately reporting their information and advise against false statements

Answer

Complete the enrollment and stay silent to protect client privacy

Answer

Refuse to assist the client and ask them to leave

Answer

Report the client to law enforcement immediately