Premium Tax Credits and Cost-Sharing Reductions Flashcards
6 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 6 Premium Tax Credits and Cost-Sharing Reductions flashcards as text
What is a Cost-Sharing Reduction (CSR)?
Answer: A subsidy that lowers out-of-pocket costs like deductibles and copays for eligible consumers
Cost-Sharing Reductions lower a consumer's out-of-pocket costs — such as deductibles, copays, and coinsurance — when they use health services.
To receive Cost-Sharing Reductions, which type of Marketplace plan must a consumer enroll in?
Answer: A Silver plan only
CSRs are only available on Silver-tier Marketplace plans; consumers must choose a Silver plan to access this benefit.
What household income level generally qualifies a consumer for Cost-Sharing Reductions?
Answer: Up to 250% of the Federal Poverty Level
CSRs are available to consumers with household income at or below 250% of the Federal Poverty Level who enroll in a Silver plan.
How do CSRs affect the actuarial value of a Silver plan for eligible consumers?
Answer: They increase it, potentially making it equivalent to Gold or Platinum coverage
CSRs effectively increase the actuarial value of a Silver plan, meaning the plan pays a higher share of covered costs for eligible enrollees.
A consumer is eligible for both APTC and CSR. What should a CAC advise regarding plan selection?
Answer: Enroll in a Silver plan to receive both premium savings and reduced cost-sharing
Enrolling in a Silver plan allows the consumer to receive both the premium reduction from APTC and the out-of-pocket savings from CSRs.
Which of the following consumers would NOT qualify for Cost-Sharing Reductions?
Answer: An individual at 300% FPL enrolled in a Silver plan
A consumer with income at 300% FPL exceeds the 250% FPL threshold for CSR eligibility, so they would not qualify for Cost-Sharing Reductions.