CEC Application Assistance & Enrollment Procedures 2

Question 1

A consumer submits an application on the last day of open enrollment but makes a payment error. What is the enrollment counselor's best course of action?

Accepted Answer

Assist the consumer in correcting the payment error before the deadline passes

Answer

Enrollment counselors should assist consumers in resolving payment errors before the enrollment deadline to ensure coverage is secured.

Question 2

Which document is typically required when a consumer claims a Special Enrollment Period (SEP) due to loss of employer-sponsored coverage?

Accepted Answer

Letter from the employer confirming loss of coverage and the date it ended

Answer

A letter or notice from the employer documenting coverage termination and the date serves as required proof for an SEP triggered by loss of job-based coverage.

Question 3

When assisting a consumer with a Marketplace application, what must an enrollment counselor do if the consumer is potentially eligible for Medicaid?

Accepted Answer

Screen the consumer for Medicaid eligibility and facilitate a referral to the state Medicaid agency if appropriate

Answer

Enrollment counselors must screen for Medicaid/CHIP eligibility and refer consumers to the appropriate state agency when they may qualify.

Question 4

A family of four applying through the Marketplace includes a non-citizen spouse with a green card. How should the application handle this situation?

Accepted Answer

Include the spouse and enter their immigration status; lawfully present immigrants may qualify for coverage

Answer

Lawfully present immigrants, including green card holders, are generally eligible for Marketplace coverage and should be included on the household application.

Question 5

What is the purpose of the 'advance premium tax credit' (APTC) reconciliation process on Form 8962?

Accepted Answer

To compare the APTC received during the year with the actual credit amount owed based on final income

Answer

Form 8962 reconciles the advance premium tax credits paid on a consumer's behalf with the actual credit they are entitled to based on their final annual income.

(CEC) Certified Enrollment Counselor Practice Test

(CEC) Certified Enrollment Counselor Practice Test

CEC Application Assistance & Enrollment Procedures 2