ACA MANAGEMENT ACCOUNTING AND
COST CONTROL PRACTICE TEST 2026
◉ What is actuarial value (AV)
Answer: The average percentage of EHB costs a plan pays for a
standard population.
◉ Why do metal levels exist
Answer: To standardize plan generosity, improve consumer
comparison, and prevent under-insurance.
◉ What does cost-sharing mean
Answer: The portion the member pays when using care—
deductible, copays, and coinsurance.
◉ What are cost-sharing levers
Answer: Deductibles, copays, coinsurance, out-of-pocket maximums,
and pre/post-deductible coverage rules used to shape AV.
◉ Why are cost-sharing tradeoffs required
Answer: If you make one benefit richer, you usually must make
another leaner to stay AV-compliant.
, ◉ Aggregate deductible
Answer: The entire family deductible must be met before coverage
begins for anyone.
◉ Which deductible type is typical in ACA plans
Answer: Embedded deductibles are typical because they protect
families when one member has high costs.
◉ Why did enhanced subsidies expire in 2026
Answer: They were temporary pandemic-era subsidy expansions
that ended under current law after 2025.
◉ What are cost-sharing reductions (CSRs)
Answer: Extra savings that lower deductibles, copays, coinsurance,
and out-of-pocket maximums.
◉ CSRs Qualifiers/Criteria
Answer: Generally up to ~250% FPL if enrolled in an on-exchange
Silver plan.
◉ Why are CSR Silver plans so rich
COST CONTROL PRACTICE TEST 2026
◉ What is actuarial value (AV)
Answer: The average percentage of EHB costs a plan pays for a
standard population.
◉ Why do metal levels exist
Answer: To standardize plan generosity, improve consumer
comparison, and prevent under-insurance.
◉ What does cost-sharing mean
Answer: The portion the member pays when using care—
deductible, copays, and coinsurance.
◉ What are cost-sharing levers
Answer: Deductibles, copays, coinsurance, out-of-pocket maximums,
and pre/post-deductible coverage rules used to shape AV.
◉ Why are cost-sharing tradeoffs required
Answer: If you make one benefit richer, you usually must make
another leaner to stay AV-compliant.
, ◉ Aggregate deductible
Answer: The entire family deductible must be met before coverage
begins for anyone.
◉ Which deductible type is typical in ACA plans
Answer: Embedded deductibles are typical because they protect
families when one member has high costs.
◉ Why did enhanced subsidies expire in 2026
Answer: They were temporary pandemic-era subsidy expansions
that ended under current law after 2025.
◉ What are cost-sharing reductions (CSRs)
Answer: Extra savings that lower deductibles, copays, coinsurance,
and out-of-pocket maximums.
◉ CSRs Qualifiers/Criteria
Answer: Generally up to ~250% FPL if enrolled in an on-exchange
Silver plan.
◉ Why are CSR Silver plans so rich
