CES Premium and Cost-Sharing

Question 1

The advance premium tax credit (APTC) is based on the cost of which benchmark plan?

Accepted Answer

Second-lowest-cost Silver plan

Answer

Lowest-cost Bronze plan

Answer

Lowest-cost Gold plan

Answer

Lowest-cost plan available in the area

Question 2

Cost-sharing reductions (CSR) on the ACA Marketplace are only available to those who enroll in:

Accepted Answer

A Silver plan

Answer

Any Marketplace plan

Answer

A Bronze plan

Answer

A Gold or Platinum plan

Question 3

For 2025, the ACA out-of-pocket maximum for an individual in a non-grandfathered plan is approximately:

Accepted Answer

$9,200

Answer

$5,000

Answer

$7,000

Answer

$12,000

Question 4

Which income level (as a percentage of the Federal Poverty Level) qualifies for advance premium tax credits in the ACA Marketplace?

Accepted Answer

100–400% FPL

Answer

100–200% FPL

Answer

100–250% FPL

Answer

138–400% FPL

Question 5

If an enrollee chooses a plan other than the benchmark Silver plan, the APTC amount:

Accepted Answer

Stays the same regardless of which plan is selected

Answer

Increases to match the chosen plan's premium

Answer

Is reduced by 10% for non-Silver plans

Answer

Is only applicable to Silver plans

Question 6

What is the 'family glitch' that was fixed by IRS rules effective 2023?

Accepted Answer

Affordability of employer coverage was measured only against the employee's premium, not the family cost

Answer

Dependents could not be added mid-year to employer plans

Answer

Children over 18 could not remain on parents' plans

Answer

Spouses were excluded from premium tax credit calculations