PY 2024 Individual Marketplace Training for New Agents and Brokers Exam Questions and Answers What is the primary goal of the ACA - Correct Answers ✅Provides a premium tax credit (PTC) to help subsidize coverage.Gives consumers tools to make informed choices about their healthcare coverage.Puts in place strong consumer protections The ACA makes care more accessible by - Correct Answers ✅1 - Creating the Health Insurance Marketplace
- - Provided qualified Individuals with Financial Assistance
- Medicaid expansion to cover household income up to or
below 133% of the federal poverty level (FPL) ACA Health Insurance Requirements - Correct Answers ✅Extension of dependent child to age 26 Expansion of guaranteed Issue - regardless of health status Prohibits limitations for preventative Prohibits exclusion for existing condition Medical Loss Ratio (MLR) ensures at least 80% of premium paid are spent on healthcare services Covers EHB (Essential Health Benefits) Prohibits annual and lifetime limits on EHB 1 / 3
PY 2024 Individual Marketplace Training for New Agents and Brokers Exam Questions and Answers Rating variations can only vary based on age, number of covered family members, location and tobacco use Prohibits rating on health status What is Guaranteed issue? - Correct Answers ✅Carrier must offer all plans (not grandfathered) to all individuals What is a A health insurance issuer, or issuer - Correct Answers ✅an insurance company, insurance service, or insurance organization (including a health maintenance organization) that is required to be licensed to engage in the business of insurance in a state and that is subject to state law that regulates insurance (within the meaning of Section 514(b)(2) of the Employee Retirement Income Security Act of 1974 [ERISA]). This term does not include a group health plan.What is a Grandfathered plan - Correct Answers ✅a group health plan that was created, or an individual health insurance policy that was purchased on or before March 23, 2010, has not changed in certain ways, and for which the issuer disclosed to enrollees that the plan is grandfathered.Grandfathered plans are exempted from many requirements of the ACA. Plans or policies may lose their grandfathered status if they make certain significant changes that reduce benefits or increase costs to consumers. 2 / 3
PY 2024 Individual Marketplace Training for New Agents and Brokers Exam Questions and Answers Existing Health Condition mandatory coverage went into effect - Correct Answers ✅January 1, 2014 What is a existing health condition - Correct Answers ✅any health condition or illness that was present before the coverage effective date, regardless of whether medical advice or treatment was actually received or recommended.Under the ACA, health plans that allow coverage of children as dependents must make dependent coverage available to children up to age 26.* These young adults can join or remain
on a parent's plan even if they: - Correct Answers ✅Are
married (coverage requirement does not extend to a married child's spouse) Are not living with a parent Are not attending school Are not financially dependent on a parent Are eligible to enroll in their own employer's plan Have or adopt a child
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