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ACA & Marketplace Fundamentals Flashcards

7 cards from real CEC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 ACA & Marketplace Fundamentals flashcards as text

  1. Which federal agency oversees the Health Insurance Marketplace established under the ACA?

    Answer: Centers for Medicare & Medicaid Services (CMS)

    CMS is the federal agency responsible for administering and overseeing the ACA's Health Insurance Marketplace.

  2. What is the maximum income level (as a percentage of the Federal Poverty Level) at which individuals can qualify for premium tax credits on the Marketplace?

    Answer: No upper income limit (through 2025 under enhanced subsidies)

    The American Rescue Plan Act temporarily eliminated the 400% FPL cap on premium tax credits, and this was extended through 2025 by the Inflation Reduction Act.

  3. A consumer who loses job-based coverage on June 15 has how many days to enroll in a Marketplace plan using a Special Enrollment Period?

    Answer: 60 days

    Loss of minimum essential coverage triggers a 60-day Special Enrollment Period during which the consumer can enroll in a Marketplace plan.

  4. Which metal tier plan typically has the lowest monthly premium but highest out-of-pocket costs when care is used?

    Answer: Bronze

    Bronze plans have the lowest premiums but highest cost-sharing (deductibles, copays, coinsurance), covering about 60% of average medical costs.

  5. Cost-sharing reductions (CSRs) are available exclusively with which Marketplace metal tier?

    Answer: Silver

    CSRs are only available when a consumer enrolls in a Silver plan, automatically reducing deductibles, copays, and out-of-pocket maximums.

  6. What document serves as the primary legal authority establishing the Health Insurance Marketplace?

    Answer: Patient Protection and Affordable Care Act (ACA)

    The Patient Protection and Affordable Care Act, signed in 2010, established the Health Insurance Marketplace as a key component of health reform.

  7. Which of the following is NOT a type of health plan available through the ACA Marketplace?

    Answer: Indemnity Plan

    Traditional indemnity (fee-for-service) plans are generally not offered through the ACA Marketplace; plans are typically HMO, PPO, EPO, or POS.