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Eligibility and Enrollment Process 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 Eligibility and Enrollment Process flashcards as text

  1. A consumer loses job-based health coverage on March 15. How many days does she have to enroll in a Marketplace plan through a Special Enrollment Period?

    Answer: 60 days from the loss of coverage

    Consumers who lose qualifying health coverage have a 60-day Special Enrollment Period to enroll in a Marketplace plan.

  2. Which of the following is NOT a qualifying life event that triggers a Special Enrollment Period?

    Answer: Voluntarily dropping existing coverage

    Voluntarily dropping existing coverage is not a qualifying life event; SEPs are triggered by involuntary loss or specific life changes.

  3. A couple gets divorced on June 1. The spouse who was covered under the other's plan loses coverage. When does the SEP window close?

    Answer: July 31

    Loss of coverage due to divorce triggers a 60-day SEP, so coverage starting from June 1 gives until July 31 to enroll.

  4. Which Native American or Alaska Native enrollment rule differs from standard Marketplace rules?

    Answer: They may enroll or change plans once per month outside of Open Enrollment

    Members of federally recognized tribes and Alaska Natives can enroll in or change Marketplace plans once per month throughout the year.

  5. A consumer's Medicaid application is denied. How does this affect their Marketplace enrollment options?

    Answer: They receive a SEP to enroll in a Marketplace plan

    A denial of Medicaid or CHIP eligibility triggers a Special Enrollment Period for Marketplace coverage.

  6. What is the standard Open Enrollment Period for Marketplace health plans for the 2025 plan year?

    Answer: November 1 – January 15

    The federal Marketplace Open Enrollment Period for 2025 coverage runs from November 1 through January 15.

  7. A consumer moves from one state to another mid-year. Which statement best describes their enrollment options?

    Answer: They qualify for a SEP because moving to a new coverage area is a qualifying life event

    Moving to a new area where different Marketplace plans are available is a qualifying life event that triggers a Special Enrollment Period.