Marketplace and Exchange Navigation Flashcards
6 cards from real CES practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Marketplace and Exchange Navigation flashcards as text
When an enrollment assister helps a consumer, which action is outside the scope of a Navigator's role?
Answer: Recommending a specific plan and accepting compensation from the insurer
Navigators are prohibited from accepting compensation from insurers and are not permitted to recommend specific plans; they must remain impartial and consumer-focused.
A broker or agent helping with Marketplace enrollment must be:
Answer: State-licensed and registered with the Marketplace
Agents and brokers must hold a state insurance license and register with the federal or state Marketplace to assist clients with Marketplace plan enrollment.
In a Federally Facilitated Marketplace state, the plan selection interface for consumers is hosted at:
Answer: HealthCare.gov
In the 32+ states using the Federally Facilitated Marketplace, consumers apply for coverage and select plans through HealthCare.gov.
What is 'auto-renewal' in the context of Marketplace coverage?
Answer: Automatic re-enrollment in the same or a similar plan if the enrollee takes no action during open enrollment
Auto-renewal re-enrolls consumers in their current plan (or a similar plan if theirs is discontinued) if they do not make an active plan selection during open enrollment.
What does 'minimum essential coverage' (MEC) mean in the context of the ACA?
Answer: A baseline type of health coverage that satisfies the ACA's coverage requirement
MEC is the minimum type of health coverage required under the ACA to avoid the individual mandate penalty; it includes Marketplace QHPs, employer plans, Medicare, Medicaid, and CHIP.
During a Marketplace enrollment session, an assister discovers that a client with income at 110% FPL in a non-expansion state falls into the 'coverage gap.' The assister should:
Answer: Explain that they may be ineligible for both Medicaid and Marketplace subsidies and explore available options
The coverage gap exists in states that didn't expand Medicaid, leaving people below 100% FPL ineligible for Medicaid or Marketplace subsidies; assisters should explain the situation and explore state programs or other options.