CEC Application and Enrollment Procedures 4

Question 1

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

Accepted Answer

18 months

Answer

12 months

Answer

24 months

Answer

36 months

Question 2

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

Accepted Answer

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

Answer

Enroll them in both programs simultaneously

Answer

Refer them only to their employer

Answer

Tell them to call 911

Question 3

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

Accepted Answer

$9,450 (2024 figure; indexed annually)

Answer

$5,000

Answer

$7,000

Answer

$12,000

Question 4

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

Accepted Answer

Platinum

Answer

Bronze

Answer

Silver

Answer

Gold

Question 5

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

Accepted Answer

Loss-of-minimum-essential-coverage SEP

Answer

Birth/adoption SEP

Answer

Marriage SEP

Answer

Move SEP

Question 6

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

Accepted Answer

Current employer's stock price

Answer

Social Security number (or explanation of why unavailable)

Answer

Household income estimate

Answer

Immigration status for non-citizen applicants

Question 7

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

Accepted Answer

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

Answer

They lose their plan retroactively

Answer

The IRS automatically adjusts their subsidy with no penalty

Answer

They receive a larger refund