FFM QUESTIONS & ANSWERS
When are the first month's premium due? - Answers -issuers set the deadlines for
payment of the first month's premium
QHP Issuer provides an enrollment information packet before or after the first months
premium is paid - Answers -After
You are assisting clients with enrollment during the Open Enrollment Period (OEP). You
want to send each of them an email to remind them to make their binder payments on
the earliest possible deadline. What is the earliest possible payment deadline date to
include in your client reminder emails?
December 15
December 31
January 1
January 31 - Answers -January 1
Consumers are required to report any changes to their application information within
30,60,90 days of the change in order to receive an updated eligibility determination. -
Answers -30
When a consumer who you previously assisted uses any of these methods to update
their application during the year, your National Producer Number (NPN) will be removed
from the application. True or False - Answers -False
True or false: If a consumer makes a QHP change to a different QHP issuer before the
coverage effective date (and before the December 15 deadline), but after making their
initial binder payment, the initial QHP issuer is responsible for refunding the premium for
January.
True or False - Answers -True
Policy effective dates of SEP for Past loss of qualifying health coverage is - Answers -
Up to 60 days in the past
Policy effective dates of SEP for future loss of qualifying health coverage is - Answers -
Up to 60 days in the future
Scenario: A consumer moved to a new state last week. Select the correct coverage
effective date.
Retroactive to when the child was born
First day of the next month following the last day of coverage
, First day of the next month - Answers -First day of the next month
Scenario: A consumer had a child last month. Select the correct coverage effective
date.
Retroactive to when the child was born
First day of the next month following the last day of coverage
First day of the next month - Answers -Retroactive to when the child was born
Scenario: A consumer will be losing minimum essential coverage (MEC) next month.
Select the correct coverage effective date.
Retroactive to when the child was born
First day of the next month following the last day of coverage
First day of the next month - Answers -First day of the next month following the last day
of coverage
Consumers can file an appeal of a Marketplace eligibility determination online, by:
mail
fax
both - Answers -Both
Appeal requests must be submitted within ___ days of the contested eligibility
determination, unless the consumer demonstrates that their failure to submit the appeal
on a timely basis was due to exceptional circumstances and should not preclude the
appeal. - Answers -90 days
In order to complete an appeal for a consumer you will need to complete an
authorization form "Appoint authorized Representative".
True or False - Answers -True
You help your client, Maria, apply for Marketplace coverage, but she disagrees with the
eligibility determination she received from the Marketplace. She asks you to assist her
with filing an appeal online through HealthCare.gov and appoints you as an authorized
representative so you can file the appeal on her behalf. If the Marketplace Appeals
Center finds that her determination was incorrect, what could happen next? Select all
that apply.
1. The Marketplace plan may owe Maria a refund if she paid premiums to the plan
before the appeal was decided
2. Maria may need to pay the Marketplace for the cost of filing the appeal
3. Maria may be eligible for a larger PTC
When are the first month's premium due? - Answers -issuers set the deadlines for
payment of the first month's premium
QHP Issuer provides an enrollment information packet before or after the first months
premium is paid - Answers -After
You are assisting clients with enrollment during the Open Enrollment Period (OEP). You
want to send each of them an email to remind them to make their binder payments on
the earliest possible deadline. What is the earliest possible payment deadline date to
include in your client reminder emails?
December 15
December 31
January 1
January 31 - Answers -January 1
Consumers are required to report any changes to their application information within
30,60,90 days of the change in order to receive an updated eligibility determination. -
Answers -30
When a consumer who you previously assisted uses any of these methods to update
their application during the year, your National Producer Number (NPN) will be removed
from the application. True or False - Answers -False
True or false: If a consumer makes a QHP change to a different QHP issuer before the
coverage effective date (and before the December 15 deadline), but after making their
initial binder payment, the initial QHP issuer is responsible for refunding the premium for
January.
True or False - Answers -True
Policy effective dates of SEP for Past loss of qualifying health coverage is - Answers -
Up to 60 days in the past
Policy effective dates of SEP for future loss of qualifying health coverage is - Answers -
Up to 60 days in the future
Scenario: A consumer moved to a new state last week. Select the correct coverage
effective date.
Retroactive to when the child was born
First day of the next month following the last day of coverage
, First day of the next month - Answers -First day of the next month
Scenario: A consumer had a child last month. Select the correct coverage effective
date.
Retroactive to when the child was born
First day of the next month following the last day of coverage
First day of the next month - Answers -Retroactive to when the child was born
Scenario: A consumer will be losing minimum essential coverage (MEC) next month.
Select the correct coverage effective date.
Retroactive to when the child was born
First day of the next month following the last day of coverage
First day of the next month - Answers -First day of the next month following the last day
of coverage
Consumers can file an appeal of a Marketplace eligibility determination online, by:
fax
both - Answers -Both
Appeal requests must be submitted within ___ days of the contested eligibility
determination, unless the consumer demonstrates that their failure to submit the appeal
on a timely basis was due to exceptional circumstances and should not preclude the
appeal. - Answers -90 days
In order to complete an appeal for a consumer you will need to complete an
authorization form "Appoint authorized Representative".
True or False - Answers -True
You help your client, Maria, apply for Marketplace coverage, but she disagrees with the
eligibility determination she received from the Marketplace. She asks you to assist her
with filing an appeal online through HealthCare.gov and appoints you as an authorized
representative so you can file the appeal on her behalf. If the Marketplace Appeals
Center finds that her determination was incorrect, what could happen next? Select all
that apply.
1. The Marketplace plan may owe Maria a refund if she paid premiums to the plan
before the appeal was decided
2. Maria may need to pay the Marketplace for the cost of filing the appeal
3. Maria may be eligible for a larger PTC
