Individual Marketplace UPDATED ACTUAL Questions And Correct Answers
C
Terms in this set (43)
True or False: An agent or broker may sell an individual a False
Marketplace qualified health plan that he or she knows
duplicates the individual's Medicare benefits.
Which of the following is NOT a requirement for an The individual must not have access to a government-sponsored program or
individual seeking coverage through the Individual affordable
Marketplace? employer-sponsored coverage.
The Marketplace verifies data for individuals seeking Health status
coverage and eligibility for insurance affordability
programs. This may include verification of all categories
listed below EXCEPT:
What is the process when the Marketplace determines The Marketplace transfers the information of any applicant assessed or
that an applicant is eligible for Medicaid or the Children's determined eligible
Health Insurance Program (CHIP)? for Medicaid or CHIP to the applicable state Medicaid/CHIP agency, which will
follow up for
either the completion of the eligibility process or plan/delivery system selection.
Which of the following best describes Marketplace Some household members are not eligible for health insurance coverage through
eligibility for members of mixed immigration status the
households? Marketplace, while other household members are eligible for Marketplace
coverage because
they are United States citizens or lawfully present immigrants.
Which of the following is NOT a best practice for assisting You should ask consumers direct questions about their citizenship or immigration
mixed immigration status households? status so
you can quickly determine if they are not eligible for Marketplace coverage.
Your clients have not had health coverage for several You should avoid using acronyms and technical jargon, and give information in
years and have low health insurance literacy. How can small
you provide the most effective assistance to them given chunks.
this challenge?
Which of the following does NOT qualify as a The individual is incarcerated.
circumstance for a hardship exemption for the purpose of
obtaining catastrophic coverage?
How can individuals who are over 30 years old qualify for They must qualify for a hardship or affordability exemption
catastrophic coverage through the Marketplace?
, How long does the Marketplace give a consumer to 95 days
provide additional information to resolve a citizenship or
immigration status data inconsistency before the
consumer loses eligibility for health care coverage or
financial assistance through the Marketplace?
Which of the following is NOT a best practice for assisting You should advise the consumer to wait, as the Marketplace will continue to
a consumer who receives a notice from the Marketplace establish
requesting additional documentation to resolve a data eligibility for the current plan year based on his or her attestation.
inconsistency impacting his or her eligibility?
True or False: If an individual disagrees with the True
Marketplace's final eligibility determination, he or she may
appeal the decision.
Which of the following is NOT a Marketplace eligibility Determination of a qualified health plan's service area or provider network
decision that can be appealed?
Which of the following is true about how to file an appeal A consumer can file an appeal of a Marketplace eligibility determination online,
of a Marketplace eligibility determination? by mail,
or by fax.
The Smith family is eligible for a maximum amount of $200 per month
$800 per month for advance payments of the premium
tax credit. They select a qualified health plan (QHP) with a
premium of $1,000 per month. If they elect to receive the
full amount of the premium tax credit in advance
payments, $800 per month will be paid directly to the
QHP issuer. How much will the Smiths pay each month for
the premium?
True or False: Changes in circumstances (e.g., income, True
family size) must be reported to the Marketplace in order
to avoid excess advance payments of the premium tax
credit that may need to be repaid with the tax filer's
federal income tax return.
Which combination best defines the modified adjusted Adjusted gross income plus any excluded foreign-earned income, tax-exempt
gross income calculation to determine a consumer's interest
eligibility for the premium tax credit and cost-sharing received or accrued during the taxable year, and non-taxable Social Security
reductions? benefits
Which of the following is NOT one of the eligibility The individual is currently enrolled in school, full-time.
criteria for an individual to qualify for the premium tax
credit?
C
Terms in this set (43)
True or False: An agent or broker may sell an individual a False
Marketplace qualified health plan that he or she knows
duplicates the individual's Medicare benefits.
Which of the following is NOT a requirement for an The individual must not have access to a government-sponsored program or
individual seeking coverage through the Individual affordable
Marketplace? employer-sponsored coverage.
The Marketplace verifies data for individuals seeking Health status
coverage and eligibility for insurance affordability
programs. This may include verification of all categories
listed below EXCEPT:
What is the process when the Marketplace determines The Marketplace transfers the information of any applicant assessed or
that an applicant is eligible for Medicaid or the Children's determined eligible
Health Insurance Program (CHIP)? for Medicaid or CHIP to the applicable state Medicaid/CHIP agency, which will
follow up for
either the completion of the eligibility process or plan/delivery system selection.
Which of the following best describes Marketplace Some household members are not eligible for health insurance coverage through
eligibility for members of mixed immigration status the
households? Marketplace, while other household members are eligible for Marketplace
coverage because
they are United States citizens or lawfully present immigrants.
Which of the following is NOT a best practice for assisting You should ask consumers direct questions about their citizenship or immigration
mixed immigration status households? status so
you can quickly determine if they are not eligible for Marketplace coverage.
Your clients have not had health coverage for several You should avoid using acronyms and technical jargon, and give information in
years and have low health insurance literacy. How can small
you provide the most effective assistance to them given chunks.
this challenge?
Which of the following does NOT qualify as a The individual is incarcerated.
circumstance for a hardship exemption for the purpose of
obtaining catastrophic coverage?
How can individuals who are over 30 years old qualify for They must qualify for a hardship or affordability exemption
catastrophic coverage through the Marketplace?
, How long does the Marketplace give a consumer to 95 days
provide additional information to resolve a citizenship or
immigration status data inconsistency before the
consumer loses eligibility for health care coverage or
financial assistance through the Marketplace?
Which of the following is NOT a best practice for assisting You should advise the consumer to wait, as the Marketplace will continue to
a consumer who receives a notice from the Marketplace establish
requesting additional documentation to resolve a data eligibility for the current plan year based on his or her attestation.
inconsistency impacting his or her eligibility?
True or False: If an individual disagrees with the True
Marketplace's final eligibility determination, he or she may
appeal the decision.
Which of the following is NOT a Marketplace eligibility Determination of a qualified health plan's service area or provider network
decision that can be appealed?
Which of the following is true about how to file an appeal A consumer can file an appeal of a Marketplace eligibility determination online,
of a Marketplace eligibility determination? by mail,
or by fax.
The Smith family is eligible for a maximum amount of $200 per month
$800 per month for advance payments of the premium
tax credit. They select a qualified health plan (QHP) with a
premium of $1,000 per month. If they elect to receive the
full amount of the premium tax credit in advance
payments, $800 per month will be paid directly to the
QHP issuer. How much will the Smiths pay each month for
the premium?
True or False: Changes in circumstances (e.g., income, True
family size) must be reported to the Marketplace in order
to avoid excess advance payments of the premium tax
credit that may need to be repaid with the tax filer's
federal income tax return.
Which combination best defines the modified adjusted Adjusted gross income plus any excluded foreign-earned income, tax-exempt
gross income calculation to determine a consumer's interest
eligibility for the premium tax credit and cost-sharing received or accrued during the taxable year, and non-taxable Social Security
reductions? benefits
Which of the following is NOT one of the eligibility The individual is currently enrolled in school, full-time.
criteria for an individual to qualify for the premium tax
credit?
