Certified Application Counselor Exam
Questions And Answers.
How long is my certification good for? - Answer 12 months
How often must my certification be review? - Answer 12 months
What are 6 responsibilities of agents and brokers? - Answer Sell, solicit, or negotiate
insurance. Facilitate enrollment and assist customers with applying for QHPs and insurance
affordability programs.
What are 4 forms of additional customer support? - Answer FFM Call center, FFM website,
State Consumer Assistance Programs, Agents and Brokers
As a CAC am I allowed to accept payment in exchange for providing a referral or
recommendations? - Answer No
What 2 entities are available to help consumers find coverage through FFM? - Answer
Navigators and CAC
What are the websites to sign up folks for health insurance? - Answer HealthCare.gov,
CMS.gov, and Marketplace.cms.gov
What is a premium? - Answer A premium is the amount that must be paid to a health
insurance company for a health insurance plan. Consumers and/or their employers usually pay
it every month.
What is copayment? - Answer A copayment is a fixed amount (e.g., $15) consumers pay to
health care providers for a covered health care service, usually at the time of service.
Deductible - Answer A deductible is the amount consumers owe for health care services
before their health insurance plans begin to pay.
What is coinsurance? - Answer Coinsurance is a consumer's share of the cost of a covered
, What is a claim? - Answer A claim is a request for payment that consumers or health care
providers submit to a health insurance company for items or services they think are covered.
What is allowed amount? - Answer An allowed amount is the maximum amount allowed to be
paid for a covered health service by a health insurance company.
This may also be called an "eligible expense," "payment allowance," or "negotiated rate."
What is balance billing? - Answer Balance billing happens when providers bill consumers for
the difference between the provider's charge and the amount allowed by the health plans.
Which drug tier is the cheapest? - Answer First tier with generic costs
Health insurers and group health plans must provide SBC under what 3 conditions? - Answer
When consumers enroll in coverage for the first time
At the beginning of each new plan year
Within seven business days after a consumer requests a copy
If any changes are made to an SBC plan when must the consumer receive their notice? - Answer
60 days
What is an allowed amount? - Answer Maximum amount on which payment is based for
covered health care services. This may be called "eligible expense," "payment allowance," or
"negotiated rate."
What is an appeal? - Answer A request for your health insurer or plan to review a decision or a
grievance again.
What is balance billing? - Answer When a provider bills you for the difference between the
provider's charge and the allowed amount.
If you have a chronic health condition which plan should you not get? - Answer HDHP
Which HSA or FSA carry on to the next year's plan if the money is not used? - Answer HSA
Questions And Answers.
How long is my certification good for? - Answer 12 months
How often must my certification be review? - Answer 12 months
What are 6 responsibilities of agents and brokers? - Answer Sell, solicit, or negotiate
insurance. Facilitate enrollment and assist customers with applying for QHPs and insurance
affordability programs.
What are 4 forms of additional customer support? - Answer FFM Call center, FFM website,
State Consumer Assistance Programs, Agents and Brokers
As a CAC am I allowed to accept payment in exchange for providing a referral or
recommendations? - Answer No
What 2 entities are available to help consumers find coverage through FFM? - Answer
Navigators and CAC
What are the websites to sign up folks for health insurance? - Answer HealthCare.gov,
CMS.gov, and Marketplace.cms.gov
What is a premium? - Answer A premium is the amount that must be paid to a health
insurance company for a health insurance plan. Consumers and/or their employers usually pay
it every month.
What is copayment? - Answer A copayment is a fixed amount (e.g., $15) consumers pay to
health care providers for a covered health care service, usually at the time of service.
Deductible - Answer A deductible is the amount consumers owe for health care services
before their health insurance plans begin to pay.
What is coinsurance? - Answer Coinsurance is a consumer's share of the cost of a covered
, What is a claim? - Answer A claim is a request for payment that consumers or health care
providers submit to a health insurance company for items or services they think are covered.
What is allowed amount? - Answer An allowed amount is the maximum amount allowed to be
paid for a covered health service by a health insurance company.
This may also be called an "eligible expense," "payment allowance," or "negotiated rate."
What is balance billing? - Answer Balance billing happens when providers bill consumers for
the difference between the provider's charge and the amount allowed by the health plans.
Which drug tier is the cheapest? - Answer First tier with generic costs
Health insurers and group health plans must provide SBC under what 3 conditions? - Answer
When consumers enroll in coverage for the first time
At the beginning of each new plan year
Within seven business days after a consumer requests a copy
If any changes are made to an SBC plan when must the consumer receive their notice? - Answer
60 days
What is an allowed amount? - Answer Maximum amount on which payment is based for
covered health care services. This may be called "eligible expense," "payment allowance," or
"negotiated rate."
What is an appeal? - Answer A request for your health insurer or plan to review a decision or a
grievance again.
What is balance billing? - Answer When a provider bills you for the difference between the
provider's charge and the allowed amount.
If you have a chronic health condition which plan should you not get? - Answer HDHP
Which HSA or FSA carry on to the next year's plan if the money is not used? - Answer HSA
