NYSOH (NEW YORK STATE OF HEALTH) ASSISTORS CERTIFICATION EXAM 2026 | REAL EXAM
QUESTIONS AND CORRECT ANSWERS | VERIFIED ANSWERS | UPDATED VERSION | GRADED
A+
Question 1
What is the maximum age for a child to be eligible for the Child Health Plus (CHP) program in
New York State?
A) Under 18
B) Under 19
C) Under 21
D) Under 26
E) There is no age limit
Correct Answer: B) Under 19
Rationale: Child Health Plus is specifically designed for uninsured children who are
residents of New York State. Eligibility ends when the child reaches their 19th birthday, at
which point they may transition to Medicaid or an Essential Plan.
Question 2
Which of the following is a key financial feature of the Child Health Plus (CHP) program?
A) High annual deductibles
B) 20% coinsurance for all services
C) No co-pays, coinsurance, or deductibles
D) Co-pays only for emergency room visits
E) Monthly premiums are always $100 per child
Correct Answer: C) No co-pays, coinsurance, or deductibles
Rationale: Unlike many other health plans, CHP does not require families to pay out-of-
pocket costs at the point of service. There are no deductibles or co-payments for covered
services.
Question 3
What is the income limit for a family to enroll their child in Child Health Plus?
A) 138% of the Federal Poverty Level (FPL)
B) 250% FPL
C) 400% FPL
D) There is no income limit
E) 154% FPL
Correct Answer: D) There is no income limit
Rationale: Any child under 19 in NYS who is uninsured and meets residency/immigration
requirements can join CHP. However, the monthly premium amount varies based on the
family's household size and income relative to the FPL.
Question 4
Under what circumstance is a child considered ineligible for Child Health Plus?
A) If the child is a US Citizen
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B) If the child is eligible for Medicaid
C) If the child’s parents earn $200,000 a year
D) If the child is 12 years old
E) If the child lives in Albany, NY
Correct Answer: B) If the child is eligible for Medicaid
Rationale: By law, if a child is eligible for Medicaid, they must enroll in Medicaid rather
than CHP. Additionally, access to other insurance or enrollment in NYSHIP makes a child
ineligible for CHP.
Question 5
At what Federal Poverty Level (FPL) percentage is a family required to pay $0 in premiums for
Child Health Plus?
A) Below 138%
B) Below 150%
C) Below 160%
D) Below 223%
E) Exactly 250%
Correct Answer: C) Below 160%
Rationale: Children in households with an income below 160% of the FPL qualify for the
"no-premium" tier of CHP, meaning the family pays nothing for the coverage.
Question 6
When is the standard Open Enrollment Period for Qualified Health Plans (QHPs) through the
Marketplace?
A) January 1 – March 31
B) July 1 – August 31
C) November 1 – January 31
D) Year-round
E) Only during a Special Enrollment Period (SEP)
Correct Answer: C) November 1 – January 31
Rationale: While programs like Medicaid and the Essential Plan have year-round
enrollment, Qualified Health Plans (QHPs) have a set Open Enrollment period from
November 1st to January 31st.
Question 7
If a consumer completes their QHP enrollment on December 10th, when will their coverage
officially begin?
A) December 11
B) January 1
C) February 1
D) March 1
E) Immediately
, Page 3
Correct Answer: B) January 1
Rationale: Enrollment in a QHP between November 1 and December 15 results in a January
1st effective date. If they enroll between Dec 16 and Jan 15, the start date is Feb 1st.
Question 8
A consumer enrolls in a QHP on January 20th. When does their coverage start?
A) January 21
B) February 1
C) March 1
D) April 1
E) Retroactive to January 1
Correct Answer: C) March 1
Rationale: Following the Marketplace rules, enrollments from January 16th to January 31st
result in a coverage start date of March 1st.
Question 9
What is the grace period for the first month's payment for a consumer enrolled in a "Full Pay"
Qualified Health Plan?
A) 24 hours
B) 10 days
C) 30 days
D) 60 days
E) 90 days
Correct Answer: B) 10 days
Rationale: For Full Pay QHPs (no subsidies), consumers have a 10-day grace period for the
initial month's payment and a 30-day grace period for every month thereafter.
Question 10
A consumer receiving a subsidy for their QHP has a longer grace period for monthly payments
after the first month. How long is this period?
A) 10 days
B) 30 days
C) 60 days
D) 90 days
E) 1 year
Correct Answer: D) 90 days
Rationale: Subsidized QHP enrollees are granted a 90-day grace period for recurring
monthly payments. This is a federal requirement to prevent loss of coverage due to
temporary financial hardship.
Question 11
Quality ratings for QHPs on the Marketplace must include which of the following metrics?
QUESTIONS AND CORRECT ANSWERS | VERIFIED ANSWERS | UPDATED VERSION | GRADED
A+
Question 1
What is the maximum age for a child to be eligible for the Child Health Plus (CHP) program in
New York State?
A) Under 18
B) Under 19
C) Under 21
D) Under 26
E) There is no age limit
Correct Answer: B) Under 19
Rationale: Child Health Plus is specifically designed for uninsured children who are
residents of New York State. Eligibility ends when the child reaches their 19th birthday, at
which point they may transition to Medicaid or an Essential Plan.
Question 2
Which of the following is a key financial feature of the Child Health Plus (CHP) program?
A) High annual deductibles
B) 20% coinsurance for all services
C) No co-pays, coinsurance, or deductibles
D) Co-pays only for emergency room visits
E) Monthly premiums are always $100 per child
Correct Answer: C) No co-pays, coinsurance, or deductibles
Rationale: Unlike many other health plans, CHP does not require families to pay out-of-
pocket costs at the point of service. There are no deductibles or co-payments for covered
services.
Question 3
What is the income limit for a family to enroll their child in Child Health Plus?
A) 138% of the Federal Poverty Level (FPL)
B) 250% FPL
C) 400% FPL
D) There is no income limit
E) 154% FPL
Correct Answer: D) There is no income limit
Rationale: Any child under 19 in NYS who is uninsured and meets residency/immigration
requirements can join CHP. However, the monthly premium amount varies based on the
family's household size and income relative to the FPL.
Question 4
Under what circumstance is a child considered ineligible for Child Health Plus?
A) If the child is a US Citizen
, Page 2
B) If the child is eligible for Medicaid
C) If the child’s parents earn $200,000 a year
D) If the child is 12 years old
E) If the child lives in Albany, NY
Correct Answer: B) If the child is eligible for Medicaid
Rationale: By law, if a child is eligible for Medicaid, they must enroll in Medicaid rather
than CHP. Additionally, access to other insurance or enrollment in NYSHIP makes a child
ineligible for CHP.
Question 5
At what Federal Poverty Level (FPL) percentage is a family required to pay $0 in premiums for
Child Health Plus?
A) Below 138%
B) Below 150%
C) Below 160%
D) Below 223%
E) Exactly 250%
Correct Answer: C) Below 160%
Rationale: Children in households with an income below 160% of the FPL qualify for the
"no-premium" tier of CHP, meaning the family pays nothing for the coverage.
Question 6
When is the standard Open Enrollment Period for Qualified Health Plans (QHPs) through the
Marketplace?
A) January 1 – March 31
B) July 1 – August 31
C) November 1 – January 31
D) Year-round
E) Only during a Special Enrollment Period (SEP)
Correct Answer: C) November 1 – January 31
Rationale: While programs like Medicaid and the Essential Plan have year-round
enrollment, Qualified Health Plans (QHPs) have a set Open Enrollment period from
November 1st to January 31st.
Question 7
If a consumer completes their QHP enrollment on December 10th, when will their coverage
officially begin?
A) December 11
B) January 1
C) February 1
D) March 1
E) Immediately
, Page 3
Correct Answer: B) January 1
Rationale: Enrollment in a QHP between November 1 and December 15 results in a January
1st effective date. If they enroll between Dec 16 and Jan 15, the start date is Feb 1st.
Question 8
A consumer enrolls in a QHP on January 20th. When does their coverage start?
A) January 21
B) February 1
C) March 1
D) April 1
E) Retroactive to January 1
Correct Answer: C) March 1
Rationale: Following the Marketplace rules, enrollments from January 16th to January 31st
result in a coverage start date of March 1st.
Question 9
What is the grace period for the first month's payment for a consumer enrolled in a "Full Pay"
Qualified Health Plan?
A) 24 hours
B) 10 days
C) 30 days
D) 60 days
E) 90 days
Correct Answer: B) 10 days
Rationale: For Full Pay QHPs (no subsidies), consumers have a 10-day grace period for the
initial month's payment and a 30-day grace period for every month thereafter.
Question 10
A consumer receiving a subsidy for their QHP has a longer grace period for monthly payments
after the first month. How long is this period?
A) 10 days
B) 30 days
C) 60 days
D) 90 days
E) 1 year
Correct Answer: D) 90 days
Rationale: Subsidized QHP enrollees are granted a 90-day grace period for recurring
monthly payments. This is a federal requirement to prevent loss of coverage due to
temporary financial hardship.
Question 11
Quality ratings for QHPs on the Marketplace must include which of the following metrics?
