Exchange Plan Types
Who would it be the average percentage of costs typically covered by the Platinum plan?
90% Percent
Consumers who have a life change may qualify for a special enrollment period outside of open enrollment an Example would be
off exchange plans are purchased through the government-created marketplaces? True or False
False
When was signed The Affordable Care Act
March 23, 2010
Mention the Ancillary Business Partners
Plan Sponsor, Brokers, Navigator, Exchange Partners
Which are the two types of subsidies which are determined by the exchange that may be available for members
Who is eligible to purchase an individual plan through the marketplace
If individuals continue to receive subsidies through the marketplaces after becoming __________ eligible, they may be required to repay the subsidies when they file their next federal tax return.
Medicare
What are the components of ACA
Guaranteed issue, Subsidies, Medicaid expansion, Public exchange
_____________ are state regulated in that they are required in some states to be licensed to sell plans in that state. There are limited exceptions to this.
Brokers
If an individual is enrolled in a health plan through the Health Insurance Marketplace, they will get _________ Health Insurance Marketplace Statement. It'll come from the Marketplace, not the IRS.
Form 1095-A
To ensure there’s no coverage gap, they have to select their new plan by _______________ for their new plan to take effect on _______________
December 15, 2021 and January 1, 2022
What is the state based market place for Nevada residents
Nevada Health Link
____________________ has historically been the primary driver for individuals shopping for coverage on the individual ACA marketplaces
Having a competitive price point - price
What is the key difference between on- and off-exchange plans
If you're eligible for and want to use government tax credits to offset premium costs, you must apply through a government-run marketplace
An individual is eligible for an ____________ if coverage on the lowest-cost bronze plan, or self-only coverage on their job-based coverage, costs more than 8.16% of that person’s household income.
affordability exemption
What is the main purpose of Federally Qualified Health Center
Enhance the provision of primary care services in underserved communities.
If by the end of the grace period, the non-subsidized member has not paid, they’ll be terminated with a reason code of __________ he member won't be allowed to enroll in an Exchange plan until the next open enrollment period.
Lack of Payment
________ of consumers purchased Silver Plans Followed by ______ purchasing Bronze Plans
59% and 33%
In the HealthCare Glossary what is the meaning of QSEHRA
Qualified Small Employer Health Reimbursement Arrangement
In contrast, Advanced Premium Tax Credits (APTCs) can be used to reduce a member’s premium cost for
any bronze, silver, gold, or platinum plan.
Any partial payments made after termination date will be refunded to the member? True or False
True
In which cities applies Innovation Health Joint Venture?
Richmond, Roanoke, Northern Virginia
which are the differentiated offering options to members with the Aetna Public Exchanges Strategy
In the Off Exchange (Private Exchange) link using the Zip Code 23237 which is the plan that have a Maximum Out of Pocket of $6.400
Aetna Medicare Select Plan (HMO-POS) H3931-098