Affordable Care Act (ACA) practice test questions and answers 2024.
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Course
Affordable Care Act
Institution
Affordable Care Act
Advance Premium Tax Credit (APTC)
designed to help individuals lower their monthly health insurance premiums right away. Individuals must meet certain eligibility requirements and the __________ only apply to health insurance purchased through a marketplace. Each qualified individual chooses how m...
Affordable Care Act (ACA) practice test
questions and answers 2024
Advance Premium Tax Credit (APTC) - answer designed to help individuals lower their monthly health
insurance premiums right away. Individuals must meet certain eligibility requirements and the
__________ only apply to health insurance purchased through a marketplace. Each qualified individual
chooses how much of the ______________ to apply to the monthly insurance premium, up to a
maximum amount.
T/F: If an individual does not file a federal income tax return in a year for which a tax credit was paid on
his or her behalf, the marketplace will terminate the individual's eligibility for financial assistance to help
pay for coverage. - answer True
Affordable - answer A factor of an individual's eligibility for APTCs. Employer-sponsored health insurance
is considered affordable if the employee's share of the premium for employee-only coverage is no more
than a specific percentage of the employee's annual household income. (This figure is indexed and
published annually by HSS and the IRS.)
T/F: An employee who is offered employer-sponsored coverage that is both affordable and provides
"minimum value" is not eligible for an APTC. - answer True
Agent or Broker - answer a person or business entity that helps individuals, families, and small
businesses apply for, and enroll in, qualified health plans inside or outside the marketplace. ________
are permitted to make specific recommendations because they are licensed by the state insurance
department and are usually compensated by health carriers in the form of commissions for enrolling
applicants into health plans.
Actuarial Value - answer The _________ of a health plan equals the percentage of the total average costs
of covered benefits for which the plan will pay. Each insured person may be responsible for a slightly
higher percentage of the total costs of covered services based on his or her individual health care needs
and policy terms. For instance, if a health plan had an average __________ of 80%, insured individuals
would be responsible for paying an average of 20% of the costs of covered benefits.
Benefit Year - answer The term of coverage under an individual health insurance plan. _________ for all
health plans—whether sold in a marketplace or by private insurers outside a marketplace—begin on
, January 1 and end December 31 (i.e., the calendar year). If an individual's health insurance begins after
January 1, the __________ still ends on December 31.
Essential Health Benefits (EHBs) - answer The ACA requires all health plans offered in the individual and
small group markets to offer a comprehensive package of health care benefits and services referred to as
__________. Every plan offered in a marketplace must provide _________ to include 10 categories of
care and services, although each state determines the specific health care benefits included in each
category
10 Categories for Essential Health Benefits - answer Ambulatory
Emergency
Hospitalization
Maternity and newborn care
Mental health and substance use disorders
Prescription drugs
Rehabilitative and habilitative
Laboratory
Preventive wellness, and chronic disease management
Pediatric (including dental and vision)
T/F: In states that expanded Medicaid, the Medicaid program must also offer EHBs to individuals who are
newly eligible for coverage. - answer True
Exchange - answer synonymous term for "marketplace"
Federal Poverty Level (FPL) - answer A standard measurement of income used to determine individual
eligibility for certain state and federal programs and benefits. The ______ is determined and published
by HHS on an annual basis (usually in the month of February) and varies according to family size.
For each plan year, the marketplace uses the _____ guidelines in place for the previous year until the
new guidelines are released by HHS.
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