ACA & Marketplace Fundamentals Flashcards
7 cards from real CEC practice questions. Tap to flip, then mark Knew It or Still Learning โ missed cards come back until you master them.
Read the first 7 ACA & Marketplace Fundamentals flashcards as text
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.
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.
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.
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.
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.
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.
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.