CEC - Certified Enrollment Counselor Application and Enrollment Procedures Questions and Answers

Question 1

When assisting a consumer with a Marketplace application, which of the following pieces of information is required for every member of the household, even those not applying for coverage?

Accepted Answer

Social Security numbers

Answer

The Marketplace application requires Social Security numbers for everyone in the household, including those not seeking coverage, to verify income and household information for eligibility determinations.

Question 2

A consumer reports a loss of job-based health coverage that will take effect in 45 days. As a Certified Enrollment Counselor, what should you advise them regarding their enrollment options?

Accepted Answer

They can apply for a Special Enrollment Period now, as they expect to lose coverage within the next 60 days.

Answer

A consumer who expects to lose qualifying health coverage within the next 60 days is eligible to apply for a Special Enrollment Period (SEP). This allows them to enroll in a new Marketplace plan before their current coverage ends, preventing a gap in coverage.

Question 3

Which of the following life events would typically NOT trigger a Special Enrollment Period (SEP) for Marketplace coverage?

Accepted Answer

Voluntarily dropping existing employer-sponsored coverage

Answer

Voluntarily dropping existing health coverage, such as an employer-sponsored plan, does not qualify an individual for a Special Enrollment Period. SEPs are generally triggered by involuntary loss of coverage or specific life changes like marriage, birth, or a qualifying move.

Question 4

A Certified Enrollment Counselor is helping a family complete their Marketplace application. The household consists of two parents and their 20-year-old child, who is a college student and claimed as a tax dependent. The child has coverage through their university and is not seeking Marketplace coverage. How should the counselor advise the parents to proceed?

Accepted Answer

The child must be included on the application, along with their income, even though they are not applying for coverage.

Answer

For Marketplace eligibility, a household includes the tax filer, their spouse, and their tax dependents. Therefore, the dependent child must be included on the application, and their income must be reported to accurately determine the household's eligibility for financial assistance, even if the child is not applying for coverage.

Question 5

What is the primary purpose of the Open Enrollment Period?

Accepted Answer

It provides a specific window each year for anyone to apply for new health coverage or change their existing plan for any reason.

Answer

The Open Enrollment Period is the annual window during which individuals can enroll in a new health insurance plan or change their current plan through the Marketplace for any reason, without needing a qualifying life event.

(CEC) Certified Enrollment Counselor Practice Test

(CEC) Certified Enrollment Counselor Practice Test

CEC - Certified Enrollment Counselor Application and Enrollment Procedures Questions and Answers