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Marketplace Basics
Federal Marketplace Application
Insurance Basics
Insurance Law Terminology
Misc.
100
Eligibility requirments for the Marketplace?
What is must be a citizen or legal resident of the US, reside in Indiana, and not presently be incarcerated
100
The 3 ways consumers can apply through the federal marektplace.
What is paper, online, phone
100
MEC
What is Minimum Essential Coverage
100
Terms that refer to the insurance company that issues health insurance plans or policies.
What is Health Insurer, Health Insurance Issuer, Health Insurance Carrier
100
How can you file a Medicaid Appllication?
What is paper, online, or phone.
200
What are the Metal Levels?
What is Bronze, Silver, Gold, Platinum
200
What are the factors of eligibility?
What is US Citizen or lawfully present, Resident, and not presently incarcerated.
200
What is the individual mandate?
What is a tax penalty for an individual that does not have sufficient health coverage (aka SRP)
200
A health insurance plan that has passed a federal certification process to be offered on a Marketplace.
What is A Qualified Health Plan
200
How often is eligibility reassesed for Medicaid.
What is every 12 Months
300
What is the income level for individuals to recieve PTCs?
What is 138% - 400% FPL
300
Length of time to recieve an eligibility notice when applying online.
What is immediately
300
What is the affordability exemption?
What is cost of coverage is more than 8% of household income
300
Plans that were in existence prior to the Affordable Care Act (ACA) and have not had substantial changes. These plans do not have to comply with many ACA requirements.
What is Grandfathered Plans
300
What criteria must be met to be eligible for Medicaid?
What is Uninsured adults, Age 19-64, Up to 100%* FPL
400
What are the insurance affordability programs
What is Cost Sharing Reductions and Premium Tax Credits
400
True or False: To renew into a QHP the consumer must reapply through the marketplace annually?
What is False. If the consumer does not reapply during open enrollment, they will be autoenrolled into the plan they selected the previous year.
400
What is the age a dependant can be on their parents plan?
What is up to age 26.
400
The type of coverage an individual must have to meet the Individual Mandate (shared-responsibility) requirement under the Affordable Care Act (ACA).
What is Minimum Essential Coverage
400
What are the AV's for the metal levels
What is Bronze 60% Silver 70% Gold 80% Platinum 90%
500
Due to loss of minimum essential coverage (MEC), change in family size, change in location, etc.
What is Special Enrollment Period (SEP)
500
What are the 10 Essential Health Benefits?
What is Ambulatory, Emergency, Hospitalization, Maternity and Newborn Care, Mental Health/ Behavioral Health, Rx, Rehabilitative/habilitative, Laboratory Services, Preventative, Pediatric Services including dental and vision.
500
True or False: Plans provided outside of the marketplace are eligible for PTC's and CSR's.
What is False
500
An health insurance policy that is not compliant with ACA rules but that the federal government allowed to be extended on a limited basis until 2016.
What is Grandmother Plans
500
Employers with more than ______ full-time equivalent employees (FTEs) will be subject to penalties if at least one FTE receives a Premium Tax Credit (PTC)*
What is 50 (2015) 100 (2016)