NYSOH ASSISTORS COMPLETE COLLECTION OF THE
MOST RECENTLY UPDATED EXAM QUESTIONS AND
VERIFIED ANSWERS FOR CURRENT TESTS
What is the age limit for Child Health Plus? - ANSWER under 19
Are there co-pays and coinsurance or deductibles for CHP? - ANSWER No
What is the income guidelines for CHP? - ANSWER no income limit, premium
contribution varies on household size and FPL
What makes you ineligible for CHP? - ANSWER can't be eligible for
Medicaid, can't have other insurance, don't have access to or aren't enrolled in
NYSHIP
What is the FPL of CHP for no premium? - ANSWER <160%
What is the QHP open enrollment period? - ANSWER November 1- January
31st
When QHP Enroll is completed, when does coverage begin?
Nov. 1-Dec. 15
Dec. 16- Jan 15
Jan 16-Jan 31 - ANSWER Jan. 1
Feb 1
March 1
When are payments due for full pay QHP? - ANSWER consumers have a 10
day grace period for the first month and then 30 days every month after
When are payments due for a subsidized QHP? - ANSWER consumers have a
10 day grace period for the first month and then 90 days after that
What must quality rating include? - ANSWER effectiveness, access and
availability of care, cost of care, use of frequency of services, satisfaction
What features does a QHP has to have? - ANSWER Adequate networks,
quality ratings
, What does the Platinum, Gold, Silver and Bronze pay? - ANSWER Platinum
90-10
Gold 80-20
Silver 70-30
Bronze 60-40
What are the QHP deductibles for the metal levels? - ANSWER Platinum 0
Gold $600
Silver $2000
Bronze $4000
What must all insurance offer across all metal levels? - ANSWER same
benefits, same cost sharing
How can Standard QHP's vary? - ANSWER premiums, provider networks,
formularies and quality ratings
What are the Eligibility for PTC and CSR Tax Filing requirements? -
ANSWER consumers must attest that they will file taxes
if married, must file jointly unless they have a special exception
What are premium tax credits? - ANSWER Lower the cost of premiums,
making health insurance more affordable
What is the FPL for PTCs? - ANSWER more than 200% and at or below 400%
FPL
How can you help consumers choose a plan? - ANSWER help consumers
identify priorities
help consumers use marketplace tools to narrow down plan options
help consumers enroll in a plan
What is Cost Sharing Reduction? - ANSWER helps reduce out of pocket costs
including co-pays, co-insurance, deductibles, MOOP
What is Non Standard QHPs? - ANSWER has different networks, variations on
cost sharing, additional benefits not included in EHBs, limited substitutions in 2
benefit categories.
What is APTC reconciliation? - ANSWER consumers who receive APTC must
report all life events, such as change in household size, income, or job related
insurance
MOST RECENTLY UPDATED EXAM QUESTIONS AND
VERIFIED ANSWERS FOR CURRENT TESTS
What is the age limit for Child Health Plus? - ANSWER under 19
Are there co-pays and coinsurance or deductibles for CHP? - ANSWER No
What is the income guidelines for CHP? - ANSWER no income limit, premium
contribution varies on household size and FPL
What makes you ineligible for CHP? - ANSWER can't be eligible for
Medicaid, can't have other insurance, don't have access to or aren't enrolled in
NYSHIP
What is the FPL of CHP for no premium? - ANSWER <160%
What is the QHP open enrollment period? - ANSWER November 1- January
31st
When QHP Enroll is completed, when does coverage begin?
Nov. 1-Dec. 15
Dec. 16- Jan 15
Jan 16-Jan 31 - ANSWER Jan. 1
Feb 1
March 1
When are payments due for full pay QHP? - ANSWER consumers have a 10
day grace period for the first month and then 30 days every month after
When are payments due for a subsidized QHP? - ANSWER consumers have a
10 day grace period for the first month and then 90 days after that
What must quality rating include? - ANSWER effectiveness, access and
availability of care, cost of care, use of frequency of services, satisfaction
What features does a QHP has to have? - ANSWER Adequate networks,
quality ratings
, What does the Platinum, Gold, Silver and Bronze pay? - ANSWER Platinum
90-10
Gold 80-20
Silver 70-30
Bronze 60-40
What are the QHP deductibles for the metal levels? - ANSWER Platinum 0
Gold $600
Silver $2000
Bronze $4000
What must all insurance offer across all metal levels? - ANSWER same
benefits, same cost sharing
How can Standard QHP's vary? - ANSWER premiums, provider networks,
formularies and quality ratings
What are the Eligibility for PTC and CSR Tax Filing requirements? -
ANSWER consumers must attest that they will file taxes
if married, must file jointly unless they have a special exception
What are premium tax credits? - ANSWER Lower the cost of premiums,
making health insurance more affordable
What is the FPL for PTCs? - ANSWER more than 200% and at or below 400%
FPL
How can you help consumers choose a plan? - ANSWER help consumers
identify priorities
help consumers use marketplace tools to narrow down plan options
help consumers enroll in a plan
What is Cost Sharing Reduction? - ANSWER helps reduce out of pocket costs
including co-pays, co-insurance, deductibles, MOOP
What is Non Standard QHPs? - ANSWER has different networks, variations on
cost sharing, additional benefits not included in EHBs, limited substitutions in 2
benefit categories.
What is APTC reconciliation? - ANSWER consumers who receive APTC must
report all life events, such as change in household size, income, or job related
insurance
