Practice Test Geeks(CEC) Certified Enrollment Counselor Practice Test
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Application and Enrollment Procedures 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 Application and Enrollment Procedures flashcards as text

  1. What is the maximum length of a COBRA continuation coverage period for a qualifying event of termination of employment?

    Answer: 18 months

    COBRA provides up to 18 months of continuation coverage for qualifying events such as voluntary or involuntary job loss.

  2. An applicant is unsure whether their household qualifies for Medicaid or a Marketplace plan. What should the enrollment counselor do?

    Answer: Screen the applicant's income against FPL guidelines to determine the appropriate program

    Counselors should compare the household's modified adjusted gross income to the Federal Poverty Level thresholds to determine Medicaid versus Marketplace eligibility.

  3. Under the ACA, what is the maximum out-of-pocket limit for an individual in a plan year for in-network services?

    Answer: $9,450 (2024 figure; indexed annually)

    The ACA sets an annual out-of-pocket maximum that is indexed each year; for 2024 it is $9,450 for individual coverage.

  4. Which metal tier plan has the highest actuarial value under ACA Marketplace rules?

    Answer: Platinum

    Platinum plans have the highest actuarial value of approximately 90%, meaning the plan pays about 90% of covered costs on average.

  5. A consumer wants to enroll in a Marketplace plan after losing Medicaid eligibility. Which SEP applies?

    Answer: Loss-of-minimum-essential-coverage SEP

    Loss of Medicaid qualifies as a loss of minimum essential coverage, triggering a Special Enrollment Period for Marketplace plans.

  6. What information is typically NOT required on a Marketplace health insurance application?

    Answer: Current employer's stock price

    Stock prices are irrelevant to health insurance eligibility; the Marketplace requires income, identity, citizenship/immigration status, and household composition information.

  7. If a consumer does not reconcile their advance premium tax credit on their federal tax return, what consequence may occur?

    Answer: They may be required to repay excess APTC and could lose eligibility for future credits

    Failure to file Form 8962 to reconcile APTC can result in repayment of excess credits and disqualification from future advance payments.