ACA BUSINESS LAW AND ETHICS IN
ACCOUNTING ASSESSMENT SCRIPT 2026
◉ Premium tax credit (PTC)
Answer: Government financial assistance that lowers monthly
premiums.
◉ Advance Premium Tax Credit (APTC)
Answer: An advance payment of the PTC sent directly to the insurer.
◉ Calculation of Premium Subsidies
Answer: They cap the required premium contribution based on
income using the benchmark Silver plan.
◉ Benchmark Plan
Answer: The second-lowest-cost Silver plan in the rating area.
◉ Cost-sharing reductions (CSRs)
Answer: Subsidies that lower deductibles, copays, and OOP limits.
◉ CSR Silver plans AV calculations
Answer: Silver AV is roughly 73%, 87%, or 94%.
, ◉ Silver Loading
Answer: Increasing Silver premiums to recover unpaid CSR
reimbursement costs, increasing subsidies.
◉ ACA rating rules
Answer: Limits on how insurers may vary premiums.
◉ Insurer's Adjustable Ratings based on these factors
Answer: OK: Age (3:1), geography, family composition, tobacco use,
plan design.
Prohibited: Health status, medical history, gender, claims history.
◉ 3 to 1 Age Band
Answer: Older adults may be charged no more than three times
younger adults.
◉ What is the maximum tobacco surcharge
Answer: Up to 1.5 times the non-tobacco rate.
◉ Process for how children are rated in family premiums
ACCOUNTING ASSESSMENT SCRIPT 2026
◉ Premium tax credit (PTC)
Answer: Government financial assistance that lowers monthly
premiums.
◉ Advance Premium Tax Credit (APTC)
Answer: An advance payment of the PTC sent directly to the insurer.
◉ Calculation of Premium Subsidies
Answer: They cap the required premium contribution based on
income using the benchmark Silver plan.
◉ Benchmark Plan
Answer: The second-lowest-cost Silver plan in the rating area.
◉ Cost-sharing reductions (CSRs)
Answer: Subsidies that lower deductibles, copays, and OOP limits.
◉ CSR Silver plans AV calculations
Answer: Silver AV is roughly 73%, 87%, or 94%.
, ◉ Silver Loading
Answer: Increasing Silver premiums to recover unpaid CSR
reimbursement costs, increasing subsidies.
◉ ACA rating rules
Answer: Limits on how insurers may vary premiums.
◉ Insurer's Adjustable Ratings based on these factors
Answer: OK: Age (3:1), geography, family composition, tobacco use,
plan design.
Prohibited: Health status, medical history, gender, claims history.
◉ 3 to 1 Age Band
Answer: Older adults may be charged no more than three times
younger adults.
◉ What is the maximum tobacco surcharge
Answer: Up to 1.5 times the non-tobacco rate.
◉ Process for how children are rated in family premiums
