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ACG CXA ACTUAL EXAM 2026/2027 |
Questions with Correct Answers | Grade
A+ & Verified Solutions | Pass
Guaranteed - A+ Graded
SECTION 1: ELIGIBILITY AND ENROLLMENT
Q1: A client with an estimated annual household income of $48,000 for a family of three is
applying for coverage through the Health Insurance Marketplace. The Federal Poverty Level
(FPL) for a family of three is $24,860. Which of the following statements about this client's
eligibility is correct?
A. The client is eligible for premium tax credits but not cost-sharing reductions.
B. The client is eligible for both premium tax credits and cost-sharing reductions.
C. The client is eligible for Medicaid based on their income level.
D. The client is not eligible for any financial assistance because income exceeds 400% FPL.
Correct Answer: A
Rationale: The client's income is approximately 193% of FPL ($48,000 ÷ $24,860 = 1.93).
[CORRECT] Option A is correct because Premium Tax Credits (PTC) are available for
households with income between 100% and 400% FPL. However, Cost-Sharing Reductions
(CSR) are only available to enrollees with incomes between 100% and 250% FPL who select a
Silver plan. While the income qualifies for CSR, Option A is the most technically accurate
statement regarding eligibility for PTC versus Medicaid or the 400% cliff (which was
temporarily removed by the Inflation Reduction Act but remains a standard structural concept in
baseline certification, though in 2026/2027 context, subsidies extend above 400%). Option B is
incorrect because while they qualify by income percentage, CSR requires enrollment in a Silver
plan, which is not stated. Option C is incorrect because Medicaid expansion eligibility caps at
138% FPL. Option D is incorrect because 193% is below 400% FPL.
Q2: Under the Modified Adjusted Gross Income (MAGI) methodology for Medicaid and
Marketplace eligibility, which of the following income sources is NOT included in the
calculation?
A. Wages and salaries
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B. Tax-exempt interest income
C. Child support received
D. Social Security benefits
Correct Answer: C
Rationale: MAGI calculation includes adjusted gross income (AGI) plus tax-exempt interest,
non-taxable Social Security benefits, and foreign earned income. [CORRECT] Option C is
correct because child support received is explicitly excluded from MAGI calculations under
ACA rules. Options A, B, and D are all included in the MAGI calculation for eligibility purposes.
Q3: A 28-year-old single client applies for coverage. Their household income is $18,000
annually. They reside in a state that has not expanded Medicaid under the ACA. The FPL for a
household of one is $14,580. What is this client’s eligibility status?
A. Eligible for Medicaid (non-expanded category).
B. Eligible for Premium Tax Credits because income is above 100% FPL.
C. Ineligible for PTC and Medicaid, falling into the "coverage gap."
D. Eligible for a Special Enrollment Period due to low income.
Correct Answer: C
Rationale: In a non-expansion state, Medicaid eligibility for adults without dependent children or
disabilities is generally severely restricted (often 0% eligibility unless
pregnant/aged/blind/disabled). [CORRECT] Option C is correct because the client falls into the
"Medicaid gap"—their income is below 100% FPL ($14,580), making them ineligible for
Premium Tax Credits (which generally start at 100% FPL), but they are also ineligible for
Medicaid because the state did not expand eligibility to 138% FPL. Option A is incorrect as no
non-expanded category typically applies to a healthy single adult. Option B is incorrect because
PTC requires a minimum of 100% FPL in non-expansion states.
Q4: When determining household composition for a married couple filing taxes separately, how
are they treated for Marketplace eligibility?
A. They are considered separate households.
B. They are considered one household if they live together.
C. They are considered one household regardless of living arrangement.
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D. They are ineligible for Premium Tax Credits.
Correct Answer: C
Rationale: Under 26 U.S.C. § 36B and IRS regulations, married couples are generally required to
file jointly to claim the Premium Tax Credit. [CORRECT] Option C is correct because for
eligibility determination, married individuals are treated as a single household regardless of
whether they file jointly or separately (though filing separately usually disqualifies them from
claiming the credit, the household composition rule defines them as one unit). Note: Victims of
domestic violence or spousal abandonment are exceptions to the joint filing requirement. Option
A is incorrect. Option B is incorrect because living arrangement is not the defining factor; marital
status is. Option D is incorrect because they can become eligible if they file jointly or qualify for
an exception.
Q5: A lawful permanent resident (Green Card holder) arrives in the U.S. today. They have
substantial income. When are they eligible for Marketplace coverage and Premium Tax Credits?
A. Immediately upon arrival.
B. After 5 years of residency (the "5-year bar").
C. Only after becoming a U.S. citizen.
D. Immediately, but they are subject to a waiting period for Medicaid only, not Marketplace
subsidies.
Correct Answer: A
Rationale: Lawful permanent residents (qualified non-citizens) are eligible for Marketplace
coverage and Premium Tax Credits immediately if they meet all other eligibility criteria (income,
etc.). [CORRECT] Option A is correct. The "5-year bar" mentioned in Option B applies to
Medicaid and CHIP eligibility for certain lawfully present non-citizens, not to Marketplace
subsidies. Therefore, Option B is incorrect in the context of Marketplace/PTC eligibility. Option
C is incorrect; citizenship is not required.
Q6: Which of the following documents is acceptable for verifying citizenship or lawful presence
during the application process?
A. A driver’s license from any U.S. state.
B. A Social Security card.
C. A U.S. passport.
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D. A utility bill with the applicant's current address.
Correct Answer: C
Rationale: A U.S. passport serves as proof of both citizenship and identity. [CORRECT] Option
C is correct. Options A and B are not sufficient standalone documents to prove citizenship/lawful
presence for verification purposes (though an SSN is required for tax reconciliation, it doesn't
prove status). Option D proves residency, not citizenship.
Q7: A client states they were recently released from incarceration. How does this affect their
Marketplace eligibility?
A. They are permanently disqualified from coverage.
B. They are eligible for a Special Enrollment Period.
C. They can enroll only in Medicaid.
D. They can enroll during the next Open Enrollment Period but are not eligible for subsidies.
Correct Answer: B
Correct Answer: Release from incarceration is a Qualifying Life Event (QLE) that triggers a
Special Enrollment Period (SEP). [CORRECT] Option B is correct. Incarcerated individuals are
generally ineligible for PTC, but release removes this barrier. Option A is incorrect. Option C is
incorrect as Medicaid is not the only option. Option D is incorrect because they do not need to
wait for OEP.
Q8: A client is offered "affordable" employer-sponsored coverage. To determine if this offer
makes them ineligible for Marketplace subsidies, which affordability threshold is applied for the
2026 plan year (based on 2025/2026 IRS guidelines)?
A. The employee contribution for the lowest cost plan exceeds 9.5% of household income
(indexed annually).
B. The employee contribution for family coverage exceeds 9.5% of household income.
C. The total premium cost exceeds 9.5% of household income.
D. The deductible exceeds 9.5% of household income.
Correct Answer: A
Rationale: Under the Employer Shared Responsibility provisions, an employer offer is
considered "affordable" if the employee's required contribution for the lowest-cost self-only
ACG CXA ACTUAL EXAM 2026/2027 |
Questions with Correct Answers | Grade
A+ & Verified Solutions | Pass
Guaranteed - A+ Graded
SECTION 1: ELIGIBILITY AND ENROLLMENT
Q1: A client with an estimated annual household income of $48,000 for a family of three is
applying for coverage through the Health Insurance Marketplace. The Federal Poverty Level
(FPL) for a family of three is $24,860. Which of the following statements about this client's
eligibility is correct?
A. The client is eligible for premium tax credits but not cost-sharing reductions.
B. The client is eligible for both premium tax credits and cost-sharing reductions.
C. The client is eligible for Medicaid based on their income level.
D. The client is not eligible for any financial assistance because income exceeds 400% FPL.
Correct Answer: A
Rationale: The client's income is approximately 193% of FPL ($48,000 ÷ $24,860 = 1.93).
[CORRECT] Option A is correct because Premium Tax Credits (PTC) are available for
households with income between 100% and 400% FPL. However, Cost-Sharing Reductions
(CSR) are only available to enrollees with incomes between 100% and 250% FPL who select a
Silver plan. While the income qualifies for CSR, Option A is the most technically accurate
statement regarding eligibility for PTC versus Medicaid or the 400% cliff (which was
temporarily removed by the Inflation Reduction Act but remains a standard structural concept in
baseline certification, though in 2026/2027 context, subsidies extend above 400%). Option B is
incorrect because while they qualify by income percentage, CSR requires enrollment in a Silver
plan, which is not stated. Option C is incorrect because Medicaid expansion eligibility caps at
138% FPL. Option D is incorrect because 193% is below 400% FPL.
Q2: Under the Modified Adjusted Gross Income (MAGI) methodology for Medicaid and
Marketplace eligibility, which of the following income sources is NOT included in the
calculation?
A. Wages and salaries
,2
B. Tax-exempt interest income
C. Child support received
D. Social Security benefits
Correct Answer: C
Rationale: MAGI calculation includes adjusted gross income (AGI) plus tax-exempt interest,
non-taxable Social Security benefits, and foreign earned income. [CORRECT] Option C is
correct because child support received is explicitly excluded from MAGI calculations under
ACA rules. Options A, B, and D are all included in the MAGI calculation for eligibility purposes.
Q3: A 28-year-old single client applies for coverage. Their household income is $18,000
annually. They reside in a state that has not expanded Medicaid under the ACA. The FPL for a
household of one is $14,580. What is this client’s eligibility status?
A. Eligible for Medicaid (non-expanded category).
B. Eligible for Premium Tax Credits because income is above 100% FPL.
C. Ineligible for PTC and Medicaid, falling into the "coverage gap."
D. Eligible for a Special Enrollment Period due to low income.
Correct Answer: C
Rationale: In a non-expansion state, Medicaid eligibility for adults without dependent children or
disabilities is generally severely restricted (often 0% eligibility unless
pregnant/aged/blind/disabled). [CORRECT] Option C is correct because the client falls into the
"Medicaid gap"—their income is below 100% FPL ($14,580), making them ineligible for
Premium Tax Credits (which generally start at 100% FPL), but they are also ineligible for
Medicaid because the state did not expand eligibility to 138% FPL. Option A is incorrect as no
non-expanded category typically applies to a healthy single adult. Option B is incorrect because
PTC requires a minimum of 100% FPL in non-expansion states.
Q4: When determining household composition for a married couple filing taxes separately, how
are they treated for Marketplace eligibility?
A. They are considered separate households.
B. They are considered one household if they live together.
C. They are considered one household regardless of living arrangement.
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D. They are ineligible for Premium Tax Credits.
Correct Answer: C
Rationale: Under 26 U.S.C. § 36B and IRS regulations, married couples are generally required to
file jointly to claim the Premium Tax Credit. [CORRECT] Option C is correct because for
eligibility determination, married individuals are treated as a single household regardless of
whether they file jointly or separately (though filing separately usually disqualifies them from
claiming the credit, the household composition rule defines them as one unit). Note: Victims of
domestic violence or spousal abandonment are exceptions to the joint filing requirement. Option
A is incorrect. Option B is incorrect because living arrangement is not the defining factor; marital
status is. Option D is incorrect because they can become eligible if they file jointly or qualify for
an exception.
Q5: A lawful permanent resident (Green Card holder) arrives in the U.S. today. They have
substantial income. When are they eligible for Marketplace coverage and Premium Tax Credits?
A. Immediately upon arrival.
B. After 5 years of residency (the "5-year bar").
C. Only after becoming a U.S. citizen.
D. Immediately, but they are subject to a waiting period for Medicaid only, not Marketplace
subsidies.
Correct Answer: A
Rationale: Lawful permanent residents (qualified non-citizens) are eligible for Marketplace
coverage and Premium Tax Credits immediately if they meet all other eligibility criteria (income,
etc.). [CORRECT] Option A is correct. The "5-year bar" mentioned in Option B applies to
Medicaid and CHIP eligibility for certain lawfully present non-citizens, not to Marketplace
subsidies. Therefore, Option B is incorrect in the context of Marketplace/PTC eligibility. Option
C is incorrect; citizenship is not required.
Q6: Which of the following documents is acceptable for verifying citizenship or lawful presence
during the application process?
A. A driver’s license from any U.S. state.
B. A Social Security card.
C. A U.S. passport.
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D. A utility bill with the applicant's current address.
Correct Answer: C
Rationale: A U.S. passport serves as proof of both citizenship and identity. [CORRECT] Option
C is correct. Options A and B are not sufficient standalone documents to prove citizenship/lawful
presence for verification purposes (though an SSN is required for tax reconciliation, it doesn't
prove status). Option D proves residency, not citizenship.
Q7: A client states they were recently released from incarceration. How does this affect their
Marketplace eligibility?
A. They are permanently disqualified from coverage.
B. They are eligible for a Special Enrollment Period.
C. They can enroll only in Medicaid.
D. They can enroll during the next Open Enrollment Period but are not eligible for subsidies.
Correct Answer: B
Correct Answer: Release from incarceration is a Qualifying Life Event (QLE) that triggers a
Special Enrollment Period (SEP). [CORRECT] Option B is correct. Incarcerated individuals are
generally ineligible for PTC, but release removes this barrier. Option A is incorrect. Option C is
incorrect as Medicaid is not the only option. Option D is incorrect because they do not need to
wait for OEP.
Q8: A client is offered "affordable" employer-sponsored coverage. To determine if this offer
makes them ineligible for Marketplace subsidies, which affordability threshold is applied for the
2026 plan year (based on 2025/2026 IRS guidelines)?
A. The employee contribution for the lowest cost plan exceeds 9.5% of household income
(indexed annually).
B. The employee contribution for family coverage exceeds 9.5% of household income.
C. The total premium cost exceeds 9.5% of household income.
D. The deductible exceeds 9.5% of household income.
Correct Answer: A
Rationale: Under the Employer Shared Responsibility provisions, an employer offer is
considered "affordable" if the employee's required contribution for the lowest-cost self-only
