CACs Health Coverage Programs 3 — Questions and Answers
Question 1: Under the ACA, which cost-sharing reduction (CSR) is only available to consumers who enroll in which metal tier?
- Bronze
- Gold
- Silver (Correct answer)
- Platinum
Correct answer: Silver
Cost-sharing reductions are only available on Silver plans; eligible consumers must select a Silver plan to receive CSR benefits.
Question 2: What income threshold (as a percentage of the Federal Poverty Level) generally marks the upper limit for Medicaid eligibility for adults under the ACA expansion?
- 100% FPL
- 133% FPL (effectively 138%) (Correct answer)
- 200% FPL
- 250% FPL
Correct answer: 133% FPL (effectively 138%)
ACA Medicaid expansion covers adults up to 133% FPL, which with a 5% income disregard effectively becomes 138% FPL.
Question 3: What is COBRA continuation coverage?
- A federal program for low-income families
- A law allowing people to temporarily keep employer-sponsored health coverage after losing job-based coverage (Correct answer)
- Medicare's prescription drug benefit
- A Marketplace plan for self-employed workers
Correct answer: A law allowing people to temporarily keep employer-sponsored health coverage after losing job-based coverage
COBRA (Consolidated Omnibus Budget Reconciliation Act) lets qualifying individuals continue their employer-sponsored group health coverage for a limited period after leaving employment.
Question 4: Which group is eligible for Medicare Part A premium-free if they have worked and paid Medicare taxes for at least 40 quarters?
- Children under 19
- Adults aged 65 and older (Correct answer)
- Low-income pregnant women
- Undocumented immigrants
Correct answer: Adults aged 65 and older
Adults 65 and older who or whose spouse paid Medicare taxes for 40 or more quarters qualify for premium-free Medicare Part A.
Question 5: Which term describes the annual amount a consumer must pay out-of-pocket before the health plan begins sharing costs?
- Premium
- Coinsurance
- Deductible (Correct answer)
- Copayment
Correct answer: Deductible
The deductible is the fixed amount a consumer pays for covered services each plan year before the insurance company starts to pay.
Question 6: Premium tax credits under the ACA are available to individuals and families with incomes between what FPL range?
- 0–100% FPL
- 100–400% FPL (or higher under extended provisions) (Correct answer)
- 200–500% FPL
- 138–300% FPL
Correct answer: 100–400% FPL (or higher under extended provisions)
Premium tax credits are generally available to those with incomes from 100% to 400% FPL, though temporary extensions have raised the upper limit.
Question 7: Minimum Essential Coverage (MEC) includes which of the following?
- Vision-only plans
- Short-term limited duration plans
- Medicare Part A (Correct answer)
- Indemnity travel insurance
Correct answer: Medicare Part A
Medicare Part A qualifies as Minimum Essential Coverage; vision-only, dental-only, and short-term plans do not meet the MEC standard.
CACs Health Coverage Programs 3
Under the ACA, which cost-sharing reduction (CSR) is only available to consumers who enroll in which metal tier?