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CERTIFIED ENROLLER EXAM - COVERED
CALIFORNIA NEWEST 2025/2026 COMPLETE 150
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
What can the consumer do if the prescription drug needed is not covered by the health insurance plan? - ANSWER-They can call the health insurance company's customer service number and request approval from the plan.
True or False: To replace a member ID card, members should contact
their health insurance company. - ANSWER-True
What is a CAE? - ANSWER-Certified Application Entities
What does an CAE do? - ANSWER-They provide enrollment assistance to consumers who are eligible for Covered CA QHP, dental plans, or Medi-Cal
Are CAEs compensated by Covered CA? - ANSWER-No, they are not.
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What are some requirements CECs do? - ANSWER-- Are responsible for referring consumers to the applicable state agency when they have a grievance, complaint, or question about how a benefit decision was made.
What are the 7 steps to becoming a successful certified counselor? - ANSWER-1. Identifying the uninsured and potentially eligible
- Sensitivity and confidentiality
- The appointment
- Walk through the enrollment process
- Engaging consumers in culturally and linguistically appropriate ways
- Develop a plan with your entity
- Assisting consumer with Annual Renewals
What must an agent complete prior to obtaining the consumer's PII? - ANSWER-Make sure the consumer completes an Authorization for Enrollment Assistance Form.
When providing phone assistance, what must you obtain from the consumer in order to access their PII? - ANSWER-First you must obtain oral consent from the consumer and must also complete a written attestation confirming that you obtained the required consent. Thirdly, your entity must maintain these forms and attestations for future auditing purposes. 2 / 4
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How long approximately does the appointment need to take? - ANSWER-About an hour
How long are Covered CA Enrollment Entities requires to keep the authorization forms? - ANSWER-10 years
True or False: According to the CA Code of Regulations requires that
Certified Counselors be re-certified annually. - ANSWER-True
Passive Renewal means that consumers will be automatically: -
ANSWER-Enrolled in their current plan
What are some motivators and barriers that impact consumers feelings toward purchasing health insurance? - ANSWER-- Financial
- Social
- Safety and security
What constitutes an employer-sponsored affordable plan? - ANSWER-A plan is considered affordable if the cost of the coverage for the employee is more than 9.12% of their household income.
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What is the minimum value of an employer-sponsored plan? - ANSWER- A plan provides minimum value when it pays at least 60% of the total costs of medical services for a standard population and includes substantial coverage of physician and inpatient hospital services.
Are Certified Counselors allowed to possess an insurance license from the CA Department of Insurance? - ANSWER-No, they are not allowed.
What are topics that you are allowed to talk about with Media outlets?
- ANSWER-Discuss with media outlets your role in outreach and
education efforts with Covered CA which may include:
- Educational events
- Volunteer recruitment
- Outreach strategies to target audiences
- How you conduct your day-to-day operations
Are Certified Counselors required to complete annual recertification training and pass an exam? - ANSWER-Yes, they are. They are also required to review program updates as they become available throughout the year.
LMS (Learning Management System) - ANSWER-Is a database of training and reference materials.
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