PY 2026/2027 PENNIE INDIVIDUAL
MARKETPLACE TRAINING FOR NEW
AGENTS AND BROKERS EXAM STUDY
GUIDE - COMPLETE QUESTIONS WITH
VERIFIED CORRECT ANSWERS ||
100% GUARANTEED PASS
<NEWEST VERSION>
1. What is the primary goal of the ACA - ANSWER ✔ Provides a premium tax
credit (PTC) to help subsidize coverage.
Gives consumers tools to make informed choices about their healthcare
coverage.
Puts in place strong consumer protections
2. The ACA makes care more accessible by - ANSWER ✔ 1 - Creating the
Health Insurance Marketplace
2 - Provided qualified Individuals with Financial Assistance
3. Medicaid expansion to cover household income up to or below 133% of
the federal poverty level (FPL)
3. ACA Health Insurance Requirements - ANSWER ✔ Extension of dependent
child to age 26
Expansion of guaranteed Issue - regardless of health status
, Prohibits limitations for preventative
Prohibits exclusion for existing condition
Medical Loss Ratio (MLR) ensures at least 80% of premium paid are spent
on healthcare services
Covers EHB (Essential Health Benefits)
Prohibits annual and lifetime limits on EHB
Rating variations can only vary based on age, number of covered family
members, location and tobacco use
Prohibits rating on health status
4. What is Guaranteed issue? - ANSWER ✔ Carrier must offer all plans (not
grandfathered) to all individuals
5. What is a A health insurance issuer, or issuer - ANSWER ✔ an insurance
company, insurance service, or insurance organization (including a health
maintenance organization) that is required to be licensed to engage in the
business of insurance in a state and that is subject to state law that regulates
insurance (within the meaning of Section 514(b)(2) of the Employee
Retirement Income Security Act of 1974 [ERISA]). This term does not
include a group health plan.
6. What is a Grandfathered plan - ANSWER ✔ a group health plan that was
created, or an individual health insurance policy that was purchased on or
before March 23, 2010, has not changed in certain ways, and for which the
issuer disclosed to enrollees that the plan is grandfathered. Grandfathered
plans are exempted from many requirements of the ACA. Plans or policies
may lose their grandfathered status if they make certain significant changes
that reduce benefits or increase costs to consumers.
7. Review ? - Are the following individuals eligible to obtain coverage through
the Marketplace?
U.S. citizen or national
Lawfully present non-citizen
, Incarcerated individual pending the disposition of charges
Residents of the state in which they are applying for coverage
Individuals under 18 with a non-applicant parent
Individuals recently experiencing hardships such as homelessness, natural
disasters, or domestic violence - ANSWER ✔ Eligible
8. Review ? - re the following individuals eligible to obtain coverage through
the Marketplace?
Non-citizen who is not lawfully present
Incarcerated individual (not pending disposition of charges)
A household with no residents of the state in which they are applying for
coverage
Individuals under 18 without an adult filing the application - ANSWER ✔
Ineligible
9. A customer calls the Pennie contact center on the 22nd of the month to
notify us that she will be moving out of state in a couple of days, and request
to terminate her policy. The end of the date of her policy will be: a) her last
day before she moves b) the first of the following month c) the first of the
current month d) the last day of the current month - ANSWER ✔ d) the last
day of the current month
10.An aptc eligible customer enrolls and coverage for the first of the year.
When making February's premium payment, he accidentally enters the
wrong amount and pays less than the total due. He pays the correct, full
amount each month until july, when he gets a new credit card and forgets to
update his auto pay with the insure, missing two months of payments. His
coverage will be terminated back to: a) January 1st b) February 28th c) July
31st - ANSWER ✔ b) February 28th
, 11.Customers who are enrolled through Pennie and receive aptc must file a
federal tax return, including IRS form 8962. The information needed to
complete the form will be found on form 1095-a provided by: a) Pennie b)
their broker or assister c) the insurer - ANSWER ✔ a) Pennie
12.A customer believes they called Pennie to terminate their policy at the end of
last november. After filing their tax return, they realize their policy was not
terminated and continued through the end of the year. The customer calls
Pennie and is advised there is no record of them calling to terminate the
coverage. They decide to pursue an appeal. Excluding extenuating
circumstances, the appeal will be: a) granted and the policy termination date
backdated to November 30th b) granted and the policy termination date
backdated to December 31st c) dismissed as a retro termination request -
ANSWER ✔ c) dismissed as a retro termination request
13.A customer wants to see a specialist they've never gone to before. He calls
his insurers customer service number and is advised by the representative
that the provider would be covered as in network. A month after the
appointment, the customer receives a bill for $500 from the provider, build
is out of network. He wants to peel this invoice his appeal should be filed
with: a) Pennie b) their broker or assister c) the insurer - ANSWER ✔ c) the
insurer
14.While there is significant overlap in the populations, undeserved
communities have limited access to healthcare services, while historically
marginalized communities may be underserved, but also experience
additional systemic barriers to getting care. a) true b) false - ANSWER ✔ a)
true
15.Historically marginalized and underserved populations may have a higher
risk of multiple health problems and/or pre-existing conditions. In part, these
can be partially attributed to which of the following? Aa) in general, less
access to income and generational wealth b) less access to transportation for
MARKETPLACE TRAINING FOR NEW
AGENTS AND BROKERS EXAM STUDY
GUIDE - COMPLETE QUESTIONS WITH
VERIFIED CORRECT ANSWERS ||
100% GUARANTEED PASS
<NEWEST VERSION>
1. What is the primary goal of the ACA - ANSWER ✔ Provides a premium tax
credit (PTC) to help subsidize coverage.
Gives consumers tools to make informed choices about their healthcare
coverage.
Puts in place strong consumer protections
2. The ACA makes care more accessible by - ANSWER ✔ 1 - Creating the
Health Insurance Marketplace
2 - Provided qualified Individuals with Financial Assistance
3. Medicaid expansion to cover household income up to or below 133% of
the federal poverty level (FPL)
3. ACA Health Insurance Requirements - ANSWER ✔ Extension of dependent
child to age 26
Expansion of guaranteed Issue - regardless of health status
, Prohibits limitations for preventative
Prohibits exclusion for existing condition
Medical Loss Ratio (MLR) ensures at least 80% of premium paid are spent
on healthcare services
Covers EHB (Essential Health Benefits)
Prohibits annual and lifetime limits on EHB
Rating variations can only vary based on age, number of covered family
members, location and tobacco use
Prohibits rating on health status
4. What is Guaranteed issue? - ANSWER ✔ Carrier must offer all plans (not
grandfathered) to all individuals
5. What is a A health insurance issuer, or issuer - ANSWER ✔ an insurance
company, insurance service, or insurance organization (including a health
maintenance organization) that is required to be licensed to engage in the
business of insurance in a state and that is subject to state law that regulates
insurance (within the meaning of Section 514(b)(2) of the Employee
Retirement Income Security Act of 1974 [ERISA]). This term does not
include a group health plan.
6. What is a Grandfathered plan - ANSWER ✔ a group health plan that was
created, or an individual health insurance policy that was purchased on or
before March 23, 2010, has not changed in certain ways, and for which the
issuer disclosed to enrollees that the plan is grandfathered. Grandfathered
plans are exempted from many requirements of the ACA. Plans or policies
may lose their grandfathered status if they make certain significant changes
that reduce benefits or increase costs to consumers.
7. Review ? - Are the following individuals eligible to obtain coverage through
the Marketplace?
U.S. citizen or national
Lawfully present non-citizen
, Incarcerated individual pending the disposition of charges
Residents of the state in which they are applying for coverage
Individuals under 18 with a non-applicant parent
Individuals recently experiencing hardships such as homelessness, natural
disasters, or domestic violence - ANSWER ✔ Eligible
8. Review ? - re the following individuals eligible to obtain coverage through
the Marketplace?
Non-citizen who is not lawfully present
Incarcerated individual (not pending disposition of charges)
A household with no residents of the state in which they are applying for
coverage
Individuals under 18 without an adult filing the application - ANSWER ✔
Ineligible
9. A customer calls the Pennie contact center on the 22nd of the month to
notify us that she will be moving out of state in a couple of days, and request
to terminate her policy. The end of the date of her policy will be: a) her last
day before she moves b) the first of the following month c) the first of the
current month d) the last day of the current month - ANSWER ✔ d) the last
day of the current month
10.An aptc eligible customer enrolls and coverage for the first of the year.
When making February's premium payment, he accidentally enters the
wrong amount and pays less than the total due. He pays the correct, full
amount each month until july, when he gets a new credit card and forgets to
update his auto pay with the insure, missing two months of payments. His
coverage will be terminated back to: a) January 1st b) February 28th c) July
31st - ANSWER ✔ b) February 28th
, 11.Customers who are enrolled through Pennie and receive aptc must file a
federal tax return, including IRS form 8962. The information needed to
complete the form will be found on form 1095-a provided by: a) Pennie b)
their broker or assister c) the insurer - ANSWER ✔ a) Pennie
12.A customer believes they called Pennie to terminate their policy at the end of
last november. After filing their tax return, they realize their policy was not
terminated and continued through the end of the year. The customer calls
Pennie and is advised there is no record of them calling to terminate the
coverage. They decide to pursue an appeal. Excluding extenuating
circumstances, the appeal will be: a) granted and the policy termination date
backdated to November 30th b) granted and the policy termination date
backdated to December 31st c) dismissed as a retro termination request -
ANSWER ✔ c) dismissed as a retro termination request
13.A customer wants to see a specialist they've never gone to before. He calls
his insurers customer service number and is advised by the representative
that the provider would be covered as in network. A month after the
appointment, the customer receives a bill for $500 from the provider, build
is out of network. He wants to peel this invoice his appeal should be filed
with: a) Pennie b) their broker or assister c) the insurer - ANSWER ✔ c) the
insurer
14.While there is significant overlap in the populations, undeserved
communities have limited access to healthcare services, while historically
marginalized communities may be underserved, but also experience
additional systemic barriers to getting care. a) true b) false - ANSWER ✔ a)
true
15.Historically marginalized and underserved populations may have a higher
risk of multiple health problems and/or pre-existing conditions. In part, these
can be partially attributed to which of the following? Aa) in general, less
access to income and generational wealth b) less access to transportation for
