NYSOH ASSISTORS LATEST
EXAM
What is the FPL for consumers to get CSR? - 200->250% FPL
Can federal subsidies be applied to Catastrophic plans? - No
Who can enroll in the Catastrophic plans? - Anyone under the age of 30
What are the features of the catastrophic plan? - covers 3 primary care
visits before reaching the deductible, preventative visits are free, the
other EHB are not covered until the deductible is met
What are AI/AN eligible for whose income does not exceed 300% FPL?
- they are eligible for 0 cost sharing- no out of pocket costs
What are AI/AN eligible for whose income is above 300% FPL? - They
are eligible for limited cost sharing- no out of pocket costs for services
from an Indian Health Care provider formerly known as Contract Health
Services
What is the Essential Plan? - offers qualified individuals and families a
choice of plans from high-quality private health insurers
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PAGE
1
, NYSOH ASSISTORS LATEST
EXAM
What does the Essential Plan cover? - All EP's cover the EHB with no
annual deductible- low out of pocket costs- free preventative care
What are the Essential Plan eligibility requirements? - ages 19-64, must
be lawfully present, must be NYS resident
Who isn't eligible for the Essential Plan? - if you are eligible for
Medicaid, CHP or APTC, if you are eligible for MEC
What is the income FPL for Essential Pan 3? - 100% <138%
What is the income FPL for Essential Plan 4? - below 100%
What is the income FPL for Essential Plan 1? - >150%<200%
What is the income FPL for Essential Plan 2? - >138<150%
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PAGE
2
, NYSOH ASSISTORS LATEST
EXAM
What are the Essential Plan benefits? - each carrier will cover the same
benefits, all cover EHB, no annual deductible, low out of pocket costs,
free preventative care, 0$ cost sharing for AI/AN
When is Essential Plans enrollment periods? - has continuous open
enrollment, can enroll all year long, can change their plan at anytime
throughout the year
What is the effective coverage date for Essential Plan 1 and 2? - follows
the 15th of the month rule
What is the effective coverage date for Essential Plan 3and 4? -
enrollment 1st->end of month coverage begins 1st of that month
Does Essential Plan 1 and 2 come with vision and dental? - No,
consumer has the option to purchase adult vision+ adult dental benefits
at additional cost
Does Essential Plan 3 and 4 come with Vision and dental? - Yes,
consumers get to enroll in plan with additional benefits including dental
and vision
END OF
PAGE
3
EXAM
What is the FPL for consumers to get CSR? - 200->250% FPL
Can federal subsidies be applied to Catastrophic plans? - No
Who can enroll in the Catastrophic plans? - Anyone under the age of 30
What are the features of the catastrophic plan? - covers 3 primary care
visits before reaching the deductible, preventative visits are free, the
other EHB are not covered until the deductible is met
What are AI/AN eligible for whose income does not exceed 300% FPL?
- they are eligible for 0 cost sharing- no out of pocket costs
What are AI/AN eligible for whose income is above 300% FPL? - They
are eligible for limited cost sharing- no out of pocket costs for services
from an Indian Health Care provider formerly known as Contract Health
Services
What is the Essential Plan? - offers qualified individuals and families a
choice of plans from high-quality private health insurers
END OF
PAGE
1
, NYSOH ASSISTORS LATEST
EXAM
What does the Essential Plan cover? - All EP's cover the EHB with no
annual deductible- low out of pocket costs- free preventative care
What are the Essential Plan eligibility requirements? - ages 19-64, must
be lawfully present, must be NYS resident
Who isn't eligible for the Essential Plan? - if you are eligible for
Medicaid, CHP or APTC, if you are eligible for MEC
What is the income FPL for Essential Pan 3? - 100% <138%
What is the income FPL for Essential Plan 4? - below 100%
What is the income FPL for Essential Plan 1? - >150%<200%
What is the income FPL for Essential Plan 2? - >138<150%
END OF
PAGE
2
, NYSOH ASSISTORS LATEST
EXAM
What are the Essential Plan benefits? - each carrier will cover the same
benefits, all cover EHB, no annual deductible, low out of pocket costs,
free preventative care, 0$ cost sharing for AI/AN
When is Essential Plans enrollment periods? - has continuous open
enrollment, can enroll all year long, can change their plan at anytime
throughout the year
What is the effective coverage date for Essential Plan 1 and 2? - follows
the 15th of the month rule
What is the effective coverage date for Essential Plan 3and 4? -
enrollment 1st->end of month coverage begins 1st of that month
Does Essential Plan 1 and 2 come with vision and dental? - No,
consumer has the option to purchase adult vision+ adult dental benefits
at additional cost
Does Essential Plan 3 and 4 come with Vision and dental? - Yes,
consumers get to enroll in plan with additional benefits including dental
and vision
END OF
PAGE
3
