CEC Eligibility Determination Process 2

Question 1

A consumer reports income that fluctuates month to month. How should an enrollment counselor best project annual income for APTC eligibility?

Accepted Answer

Use the consumer's best estimate of expected annual income

Answer

Use only the most recent month's income multiplied by 12

Answer

Average the last 3 months and annualize that figure

Answer

Require the consumer to submit 12 months of pay stubs

Question 2

Which document is generally NOT acceptable as proof of U.S. citizenship for Marketplace enrollment purposes?

Accepted Answer

Voter registration card alone

Answer

U.S. passport

Answer

Birth certificate issued by a U.S. state

Answer

Certificate of Naturalization (N-550)

Question 3

A 28-year-old applicant is offered employer-sponsored insurance that covers only the employee, not dependents. The spouse applies separately through the Marketplace. Which standard applies to the spouse's APTC eligibility?

Accepted Answer

The family glitch rule makes the spouse eligible based on the family premium cost

Answer

The spouse is ineligible because the employee has an offer of employer coverage

Answer

The spouse's APTC eligibility is based on whether the employee-only premium exceeds the affordability threshold

Answer

The spouse is automatically eligible because dependent coverage was not offered

Question 4

During a Special Enrollment Period triggered by loss of MEC, how many days does a consumer generally have to enroll in a Marketplace plan?

Accepted Answer

60 days from the loss event

Answer

30 days from the loss event

Answer

90 days from the loss event

Answer

Until the end of the current calendar year

Question 5

An applicant's household includes a non-citizen spouse who is ineligible for Marketplace coverage. How is household income calculated for APTC purposes?

Accepted Answer

The non-citizen spouse's income is counted but their coverage need is excluded

Answer

The non-citizen spouse's income is excluded entirely

Answer

All household members' income is counted regardless of immigration status

Answer

Only the income of citizens in the household is counted

Question 6

A consumer loses their job on March 15 and their employer coverage ends April 30. When does their 60-day SEP window begin?

Accepted Answer

April 30 (date coverage actually ends)

Answer

March 15 (date of job loss)

Answer

April 1 (first of the following month)

Answer

May 1 (day after coverage ends)

Question 7

Which income is excluded from MAGI-based household income for Marketplace eligibility?

Accepted Answer

Child support received

Answer

Self-employment net profit

Answer

Social Security retirement benefits that are taxable

Answer

Alimony received under pre-2019 divorce decrees