CACs Marketplace Plan Options 3

Question 1

A client is eligible for both a premium tax credit and Cost-Sharing Reductions. To receive BOTH benefits, which plan must they select?

Accepted Answer

A Silver plan

Answer

While premium tax credits can be applied to any metal tier, CSRs are only available when the enrollee selects a Silver plan.

Question 2

Which of the following is NOT a standard metal tier offered in the Health Insurance Marketplace?

Accepted Answer

Diamond

Answer

The standard Marketplace metal tiers are Bronze, Silver, Gold, and Platinum; Diamond is not an ACA plan category.

Question 3

A Silver plan with Cost-Sharing Reductions for a consumer at 150% FPL will have an actuarial value closest to which percentage?

Accepted Answer

94%

Answer

At 100–150% FPL, CSR-enhanced Silver plans can reach an actuarial value of approximately 94%, providing very rich coverage.

Question 4

Which cost-sharing feature do Catastrophic plans require enrollees to meet before coverage kicks in for most services?

Accepted Answer

A very high deductible equal to the annual out-of-pocket maximum

Answer

Catastrophic plans have a very high deductible that equals the annual out-of-pocket limit, meaning enrollees pay nearly all costs until the maximum is reached.

Question 5

What must ALL Marketplace plans cover regardless of metal tier?

Accepted Answer

The 10 Essential Health Benefits (EHBs)

Answer

All Marketplace qualified health plans must cover the 10 Essential Health Benefits as required by the ACA.

(CACs) Certified Application Counselor Practice Test

(CACs) Certified Application Counselor Practice Test

CACs Marketplace Plan Options 3