CAW Certification Exam Questions
and Answers12
Maryland Health Connection - ANSWERS -The Name of Maryland's health insurance
marketplace website is
Maryland Health Connection offers a - ANSWERS -"single step" application. This which means
that when a consumer fills out an application form, they can also apply for financial assistance
programs at the same time, with the same information. They do it all at once, rather than filling
out an insurance application and then having to fill out separate forms for each program they'd
like to apply
Monthly - ANSWERS -The system is checked for households with deceased primary applications.
Families who fall under this category are disenrolled and contacted for the household to re-
enroll with a new primary applicant.
10 essential benefits plans must cover - ANSWERS -preventive care, maternity & newborn care,
emergency care, pediatric care, hospitalization, mental health care, prescription drugs,
substance use disorder treatment, doctor visits, laboratory test
The Affordable Care Act (ACA) - ANSWERS -allows states to expand healthcare coverage through
the creation of health insurance marketplaces and the expansion of Medicaid. It does this by
allowing states to create health insurance marketplaces and expand who they can offer
Medicaid to.
Main components of the Affordable Care Act - ANSWERS -The ACA requires states to establish
and operate a Health Insurance Exchange for those who do not have health insurance.
Exchanges provide coverage options for those who do not have health coverage or lose health
coverage during the year. In Maryland, this exchange is called the Maryland Health Benefit
Exchange (MHBE).
, Small Business Health Options Program (SHOP) - ANSWERS -This program includes incentives for
small employers (up to 50 employees) to offer employer-based coverage. To qualify for SHOP, a
small business must have at least 1 full-time equivalent (FTE) employee other than owners,
spouses, and family members.
Pre-Existing Conditions - ANSWERS -Under ACA, insurance plans are required to cover people
with pre-existing health conditions - Pre-existing conditions are health problems (e.g., diabetes
or cancer) that started before an individual's health insurance went into effect. The Affordable
Care Act guarantees that consumers with pre-existing conditions can apply for and purchase
health insurance if they are otherwise eligible
Coverage for young adults - ANSWERS -The ACA allows children to stay on their parent's health
insurance plan until age 26. Previously, insurance companies could limit the age.
Employer mandate - ANSWERS -Under the employer shared responsibility provision of the ACA,
large employers must offer health insurance that is affordable and provides minimum value to
their full-time employees, or be subject to penalties. Large employers are generally defined as
those with 50 or more full-time employees/ full-timeequivalents.
Minimum Essential Coverage (MEC) - ANSWERS -The ACA requires consumers to have health
coverage that is considered Minimum Essential Coverage (MEC), which generally means the
plan has an "Actuarial Value" of 60% or more and covers the 10 Essential Health Benefits
(EHBs).
Plans that qualify as minimum essential coverage - ANSWERS -include employer-sponsored
plans, individual major medical plans (including Qualified Health Plans (QHPs), TRICARE,
Medicare, most Medicaid plans, and CHIP, among others.
Affordable coverage - ANSWERS -Under ACA regulations, a job-based health plan covering only
the employee that costs 9.56% (9.78%?) or less of the employee's household income is
considered affordable
and Answers12
Maryland Health Connection - ANSWERS -The Name of Maryland's health insurance
marketplace website is
Maryland Health Connection offers a - ANSWERS -"single step" application. This which means
that when a consumer fills out an application form, they can also apply for financial assistance
programs at the same time, with the same information. They do it all at once, rather than filling
out an insurance application and then having to fill out separate forms for each program they'd
like to apply
Monthly - ANSWERS -The system is checked for households with deceased primary applications.
Families who fall under this category are disenrolled and contacted for the household to re-
enroll with a new primary applicant.
10 essential benefits plans must cover - ANSWERS -preventive care, maternity & newborn care,
emergency care, pediatric care, hospitalization, mental health care, prescription drugs,
substance use disorder treatment, doctor visits, laboratory test
The Affordable Care Act (ACA) - ANSWERS -allows states to expand healthcare coverage through
the creation of health insurance marketplaces and the expansion of Medicaid. It does this by
allowing states to create health insurance marketplaces and expand who they can offer
Medicaid to.
Main components of the Affordable Care Act - ANSWERS -The ACA requires states to establish
and operate a Health Insurance Exchange for those who do not have health insurance.
Exchanges provide coverage options for those who do not have health coverage or lose health
coverage during the year. In Maryland, this exchange is called the Maryland Health Benefit
Exchange (MHBE).
, Small Business Health Options Program (SHOP) - ANSWERS -This program includes incentives for
small employers (up to 50 employees) to offer employer-based coverage. To qualify for SHOP, a
small business must have at least 1 full-time equivalent (FTE) employee other than owners,
spouses, and family members.
Pre-Existing Conditions - ANSWERS -Under ACA, insurance plans are required to cover people
with pre-existing health conditions - Pre-existing conditions are health problems (e.g., diabetes
or cancer) that started before an individual's health insurance went into effect. The Affordable
Care Act guarantees that consumers with pre-existing conditions can apply for and purchase
health insurance if they are otherwise eligible
Coverage for young adults - ANSWERS -The ACA allows children to stay on their parent's health
insurance plan until age 26. Previously, insurance companies could limit the age.
Employer mandate - ANSWERS -Under the employer shared responsibility provision of the ACA,
large employers must offer health insurance that is affordable and provides minimum value to
their full-time employees, or be subject to penalties. Large employers are generally defined as
those with 50 or more full-time employees/ full-timeequivalents.
Minimum Essential Coverage (MEC) - ANSWERS -The ACA requires consumers to have health
coverage that is considered Minimum Essential Coverage (MEC), which generally means the
plan has an "Actuarial Value" of 60% or more and covers the 10 Essential Health Benefits
(EHBs).
Plans that qualify as minimum essential coverage - ANSWERS -include employer-sponsored
plans, individual major medical plans (including Qualified Health Plans (QHPs), TRICARE,
Medicare, most Medicaid plans, and CHIP, among others.
Affordable coverage - ANSWERS -Under ACA regulations, a job-based health plan covering only
the employee that costs 9.56% (9.78%?) or less of the employee's household income is
considered affordable
