CEC ACA & Marketplace Fundamentals 2

Question 1

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

Accepted Answer

Centers for Medicare & Medicaid Services (CMS)

Answer

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

Question 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?

Accepted Answer

No upper income limit (through 2025 under enhanced subsidies)

Answer

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.

Question 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?

Accepted Answer

60 days

Answer

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

Question 4

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

Accepted Answer

Bronze

Answer

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

Question 5

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

Accepted Answer

Silver

Answer

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

(CEC) Certified Enrollment Counselor Practice Test

(CEC) Certified Enrollment Counselor Practice Test

CEC ACA & Marketplace Fundamentals 2