CAC Roles and Responsibilities 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 CAC Roles and Responsibilities flashcards as text
A CAC's certification has lapsed. What happens to their authority to provide consumer assistance?
Answer: Their authority to assist consumers is suspended until recertification is complete
CACs must maintain current certification to provide assistance; a lapsed certification suspends their authority to assist consumers.
Which entity is ultimately responsible for monitoring CAC compliance with federal rules?
Answer: The CAC's sponsoring organization and CMS
Both the CAC's sponsoring organization and CMS share oversight responsibility for ensuring CAC compliance with federal requirements.
A consumer visits a CAC seeking help enrolling in Medicaid. The CAC determines the consumer appears eligible. What should the CAC do?
Answer: Assist the consumer in applying for Medicaid through the appropriate state or Marketplace pathway
CACs are authorized to assist consumers with Medicaid applications and must help facilitate access to all available coverage options.
A CAC notices that a client's application may qualify them for CHIP for their children but a QHP for the adults. What should the CAC do?
Answer: Explain the options and help the family apply for both programs as appropriate
CACs must inform consumers of all coverage options for which they appear eligible and assist them in applying accordingly.
What is the significance of a CAC keeping their training certificates and documentation organized?
Answer: It demonstrates compliance and supports oversight by CMS and the sponsoring organization
Maintaining organized training records demonstrates compliance and is necessary for audits and oversight by CMS and sponsoring organizations.
When is a CAC allowed to share a consumer's personally identifiable information (PII) with a third party?
Answer: Only with the consumer's written consent or as required by law
CACs may only share consumer PII with explicit written consent from the consumer or when legally required, consistent with federal privacy standards.
A consumer wants to enroll in a Marketplace plan but also wants the CAC to help them dispute a prior insurer claim denial. What should the CAC do?
Answer: Assist with Marketplace enrollment but refer the consumer to appropriate resources for the claim dispute
CACs assist with Marketplace enrollment; claim disputes with insurers are outside their scope and should be referred to appropriate advocates or state resources.