SEP's
Name 2 life events that could qualify someone to make a plan change.
Losing qualifying health coverage, marriage, divorce, having a baby/adopting, moving, leaving incarceration, gaining citizenship, etc.
The Marketplace Open Enrollment period is from _______ to ________.
The _________ requires individual plans to cover a range of essential health benefits.
ACA
For a Marketplace quote, household _______ and household ________ are gathered.
When you fill out a health insurance application and use some tools on this website, you’ll need to estimate your household’s ___________.
expected income for the year you want coverage
Most Marketplace SEP’s have a timeframe of ___ days.
60
Someone with Medicaid __________ enroll in a Marketplace plan.
Can not / is not allowed to
How many different Marketplace plan categories are there?
4 – Bronze, Silver, Gold, and Platinum
A roommate __________ included in the household size.
Prospects who are unemployed can apply for ________ or _________ at any time.
Medicaid / CHIP
You can submit a ______ if you are wrongfully denied an SEP.
appeal
When someone turns __ they can remain on their parent’s plan until the end of the calendar year.
26
Individual health insurance policies were created to mimic ____________. These include Marketplace and off-exchange policies.
Employer/job-based coverage
________, __________, & _________ are included in the household.
Name 3 things that could affect a household’s expected income.
Raises, new jobs/employment changes, changes in investments, changes in Social Security benefits, gaining/losing dependents
You can qualify for an SEP if your employer offers tax-free reimbursement for qualified medical expenses up to a certain dollar amount each year. This is called a ___________.
Health Reimbursement Arrangement (HRA)
If someone doesn’t qualify for a Marketplace plan due to their income being too high, they can enroll in ________ plans.
Off-marketplace / Off-Exchange
If a person qualifies for Cost-Sharing Reductions, they can use these on a _______ plan.
Silver
Children under 26 are included in the household ________.
Only if they are going to be covered in the parent’s Marketplace plan.
Gifts, Worker’s compensation, and child support are three examples of incomes that _____________.
Should not be counted toward your estimated household income.
You may qualify for an SEP if you lose premium-free ________.
Medicare Part A
Marketplace is for individuals/families whose income is at or below __% FPL.
150%
Spouses are not required to be included in your household if ___________.
You’re a victim of domestic abuse/violence or spousal abandonment.
If a household has an income that is hard to estimate, they can refer to a calculator on healthcare.gov and use the __________ for the coverage year to get a quote.
Net expected income