Practice Test Geeks(CACs) Certified Application Counselor Practice Test
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Affordable Care Act Basics Flashcards

7 cards from real CACS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Affordable Care Act Basics flashcards as text

  1. A consumer who is a lawfully present immigrant with income at 100% FPL in a non-Medicaid expansion state is likely eligible for:

    Answer: APTC for a Marketplace plan, since they fall in the coverage gap exception

    Lawfully present immigrants below 100% FPL in non-expansion states may qualify for APTC because they cannot access Medicaid and fall in a recognized coverage gap exception.

  2. What is the role of a Certified Application Counselor (CAC) under the ACA?

    Answer: To provide free, unbiased help with Marketplace applications without selling plans

    CACs are trained to provide free, impartial assistance helping consumers understand and enroll in Marketplace coverage, but they do not sell insurance or receive commissions.

  3. Which ACA provision requires plans to cover preventive services with no cost-sharing?

    Answer: The preventive services mandate for non-grandfathered plans

    The ACA requires non-grandfathered plans to cover USPSTF-recommended preventive services, ACIP vaccinations, and other preventive care at no cost-sharing.

  4. Under the ACA, what does 'community rating' prohibit insurers from doing?

    Answer: Setting premiums based on health status or pre-existing conditions

    ACA community rating rules prohibit insurers from varying premiums based on health status, gender, or pre-existing conditions; only age, tobacco use, and geography are allowed.

  5. What is the income range (as % FPL) for eligibility for Advanced Premium Tax Credits (APTC) in states that have NOT expanded Medicaid?

    Answer: 100-400% FPL (with possible expansion to higher incomes)

    In non-expansion states, APTC eligibility starts at 100% FPL (since Medicaid doesn't cover 0-138%), and under the American Rescue Plan there is no upper income cap for 2021-2025.

  6. A consumer estimates their income incorrectly when applying for APTC and ends up receiving more subsidy than they were entitled to. What happens?

    Answer: They must repay the excess APTC when filing their federal tax return

    Excess APTC must be reconciled on the consumer's federal tax return (Form 8962), and the difference is either owed or refunded based on actual income.

  7. Which ACA requirement ensures that a health plan covers a broad range of services including hospitalization, maternity care, and mental health?

    Answer: Essential Health Benefits (EHB) requirement

    The ACA's Essential Health Benefits requirement mandates that individual and small group plans cover ten categories of services, including hospitalization, maternity, mental health, and more.