ACA Compliance & Consumer Protections

Question 1

What is one key consumer protection under the ACA?

Accepted Answer

Insurers cannot deny coverage for pre-existing conditions

Answer

The ACA prohibits insurance companies from denying coverage due to pre-existing conditions, ensuring broader access to healthcare.

Question 2

Which entity is responsible for enforcing ACA compliance?

Accepted Answer

Department of Health and Human Services (HHS)

Answer

The Department of Health and Human Services (HHS) ensures that ACA regulations are followed by insurers and healthcare providers.

Question 3

What is the purpose of the ACA’s Medical Loss Ratio rule?

Accepted Answer

To ensure a majority of premiums fund healthcare services

Answer

The Medical Loss Ratio rule requires insurers to spend at least 80% of premium revenues on healthcare services and quality improvements.

Question 4

How does the ACA protect consumers from surprise medical bills?

Accepted Answer

By requiring transparency in coverage and prohibiting surprise billing

Answer

The ACA requires insurers to provide clear explanations of coverage and prohibits unexpected out-of-network charges in emergency situations.

Question 5

What does the ACA require insurers to include in all health plans?

Accepted Answer

Essential health benefits such as preventive care and maternity services

Answer

The ACA mandates that all health plans cover essential health benefits, including preventive care, maternity services, and mental health treatment.

(ACA) Affordable Care Act Certified Practice Test