Professional Ethics & Standards Flashcards
7 cards from real ACA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Professional Ethics & Standards flashcards as text
A client asks their navigator to use a slightly different income figure to qualify for a higher subsidy. What must the navigator do?
Answer: Refuse, explain that only accurate income must be reported, and use the correct figure
Providing false income information to obtain premium tax credits is fraud, and assisters are ethically and legally obligated to use accurate data only.
Which element is most critical when documenting an ACA enrollment assistance session for compliance purposes?
Answer: A record of services offered, client decisions made, and any referrals provided
Complete documentation of services rendered, decisions made, and referrals given protects both the client and the assister and demonstrates program compliance.
An assister's personal religious beliefs conflict with advising a client about a plan that covers services the assister objects to. What is the ethical standard?
Answer: The assister must provide complete, objective information or refer the client to another assister
Personal beliefs cannot limit the information provided to clients; if an assister cannot remain objective, they must refer the client to someone who can.
Under HIPAA and ACA program standards, how long must a navigator typically retain client records?
Answer: At least 5 years, or as required by grant terms
HHS grant requirements and best practices generally mandate retaining client assistance records for a minimum of five years.
A client with limited English proficiency arrives without an interpreter. What is the ethically required response?
Answer: Provide language assistance services or schedule a session with a qualified interpreter
Federal civil rights requirements mandate that assisters provide meaningful access to services for individuals with limited English proficiency through qualified language assistance.
When a client's Special Enrollment Period (SEP) eligibility is questionable, what is the ethical approach?
Answer: Explain the qualifying events, let the client self-attest accurately, and document the basis for the SEP claim
Assisters must explain SEP rules accurately, ensure the client attests truthfully, and document the qualifying event rather than gaming the system.
Which behavior by an assister would most directly violate the ACA's program integrity standards?
Answer: Steering clients toward a plan because the assister's family member is a provider in that network
Using personal relationships to steer clients toward specific plans is a conflict of interest that violates ACA program integrity and ethical standards.