CEC Application and Enrollment Procedures 3

Question 1

When an employee is newly hired, how many days do they typically have to enroll in employer-sponsored coverage without needing a qualifying event?

Accepted Answer

60 days

Answer

Under the ACA and most employer plan rules, newly eligible employees generally have a 60-day enrollment window upon becoming eligible.

Question 2

What is 'auto-enrollment' in the context of employer health plans?

Accepted Answer

Employers automatically enroll new full-time employees in a default plan unless they opt out

Answer

Auto-enrollment means employers enroll newly eligible employees into a default health plan automatically, requiring an affirmative opt-out to decline.

Question 3

For Marketplace plans, when does coverage typically begin if a consumer enrolls between the 1st and 15th of the month?

Accepted Answer

The first of the following month

Answer

Enrollments completed between the 1st and 15th of a month generally result in coverage effective the 1st of the following month.

Question 4

What does 'creditable coverage' mean in health insurance enrollment?

Accepted Answer

Prior health coverage that counts toward satisfying waiting periods or pre-existing condition rules

Answer

Creditable coverage refers to previous health insurance that is at least as comprehensive as Medicare Part D or employer standards, used to avoid waiting periods.

Question 5

A Certified Enrollment Counselor discovers that a client provided incorrect income information on their application. What is the correct course of action?

Accepted Answer

Advise the client to report the correction to the Marketplace immediately

Answer

Incorrect income information must be corrected through the Marketplace to ensure accurate APTC amounts and avoid penalties at tax filing.

(CEC) Certified Enrollment Counselor Practice Test

(CEC) Certified Enrollment Counselor Practice Test

CEC Application and Enrollment Procedures 3