MHA 705 Module 7 Exam – Health Law and
Bioethics Examination 2026/2027 | University
of Phoenix.
Instructions: This examination consists of 40 questions exactly. Select the best answer for each
multiple-choice question, all applicable answers for select-all-that-apply (SATA) questions, and
True or False for T/F questions. Each correct answer is followed by a detailed rationale citing
specific U.S. Code sections, CMS regulations, or HHS OCR guidance.
DOMAIN 1: THE ACA, ERISA & FEDERAL HEALTHCARE POLICY (10 Questions)
Question 1 (Multiple-Choice)
The Tax Cuts and Jobs Act of 2017 effectively eliminated the ACA's individual shared
responsibility penalty beginning with which tax year?
A. 2017
B. 2018
C. 2019
D. 2020
[CORRECT] C
Rationale: The Tax Cuts and Jobs Act, signed December 22, 2017, reduced the ACA's individual
mandate penalty to zero, effective beginning with the 2019 tax year
. While individuals remained subject to the mandate for 2018, penalties no longer applied for
2019 and beyond. The mandate itself was not repealed—only the penalty was zeroed out,
leaving the statutory requirement intact but unenforced through taxation.
Question 2 (Multiple-Choice)
Under the ACA's employer shared responsibility provisions, an applicable large employer (ALE)
is defined as an employer with at least how many full-time equivalent employees?
A. 25
B. 50
,C. 75
D. 100
[CORRECT] B
Rationale: The ACA defines an applicable large employer as one that employed an average of at
least 50 full-time employees (including full-time equivalents) during the preceding calendar
year, per Internal Revenue Code § 4980H. This triggers the "pay or play" employer mandate
requirements, which remain fully enforceable despite the elimination of the individual mandate
penalty.
Question 3 (SATA)
Which of the following ACA provisions remained fully enforceable after the 2017 tax reform bill
eliminated the individual mandate penalty? (Select all that apply.)
A. The employer shared responsibility ("pay or play") rules
B. The Cadillac tax on high-cost employer-sponsored coverage
C. PCORI fees on insured and self-funded plans
D. Section 6055 and Section 6056 reporting requirements
E. The preventive care mandate without cost-sharing
[CORRECT] A, C, D, E
Rationale: The Tax Cuts and Jobs Act specifically targeted only the individual shared
responsibility penalty; all other ACA provisions remained intact
. The employer shared responsibility rules (A), PCORI fees (C), employer reporting under
Sections 6055/6056 (D), and the preventive care mandate (E) continue in full force. Note: The
Cadillac tax (B) was subsequently repealed by separate legislation (the CARES Act of 2019) and is
no longer in effect.
Question 4 (Multiple-Choice)
ERISA's preemption clause provides what specific advantage to a self-funded employer health
plan operating in multiple states?
A. Exemption from federal minimum essential coverage requirements
B. Exemption from state insurance mandates and state premium taxes
C. Automatic qualification for Medicare Advantage contracts
D. Immunity from HIPAA privacy and security regulations
, [CORRECT] B
Rationale: ERISA's broad preemption clause (29 U.S.C. § 1144) exempts self-funded employer
health plans from state insurance mandates, state premium taxes (typically 2–3%), and
conflicting state coverage requirements
. This creates a uniform federal standard for multi-state employers. However, self-funded plans
remain subject to federal requirements including HIPAA, ACA preventive care mandates, mental
health parity under MHPAEA, COBRA, and the No Surprises Act.
Question 5 (SATA)
A self-funded employer health plan governed by ERISA remains subject to which of the
following federal requirements? (Select all that apply.)
A. HIPAA privacy and portability rules
B. ACA preventive care mandates without cost-sharing
C. Mental health parity requirements under MHPAEA
D. State-mandated coverage for autism spectrum disorder
E. COBRA continuation coverage requirements
[CORRECT] A, B, C, E
Rationale: ERISA preemption exempts self-funded plans from state-level mandated benefits
such as autism coverage mandates (D)
. However, these plans must comply with all applicable federal law: HIPAA privacy/portability
(A), ACA preventive care (B), MHPAEA mental health parity (C), and COBRA continuation
coverage (E). Level-funded plans also qualify for ERISA preemption because the law treats them
as self-insured arrangements.
Question 6 (Multiple-Choice)
Under ERISA § 514(a), a state law that "relates to" an employee benefit plan is preempted.
Which judicial test determines whether a state law has sufficient connection to trigger ERISA
preemption?
A. The "active labor" test
B. The "reference to" or "connection with" test
C. The "substantial nexus" standard
D. The "minimum necessary" exception
Bioethics Examination 2026/2027 | University
of Phoenix.
Instructions: This examination consists of 40 questions exactly. Select the best answer for each
multiple-choice question, all applicable answers for select-all-that-apply (SATA) questions, and
True or False for T/F questions. Each correct answer is followed by a detailed rationale citing
specific U.S. Code sections, CMS regulations, or HHS OCR guidance.
DOMAIN 1: THE ACA, ERISA & FEDERAL HEALTHCARE POLICY (10 Questions)
Question 1 (Multiple-Choice)
The Tax Cuts and Jobs Act of 2017 effectively eliminated the ACA's individual shared
responsibility penalty beginning with which tax year?
A. 2017
B. 2018
C. 2019
D. 2020
[CORRECT] C
Rationale: The Tax Cuts and Jobs Act, signed December 22, 2017, reduced the ACA's individual
mandate penalty to zero, effective beginning with the 2019 tax year
. While individuals remained subject to the mandate for 2018, penalties no longer applied for
2019 and beyond. The mandate itself was not repealed—only the penalty was zeroed out,
leaving the statutory requirement intact but unenforced through taxation.
Question 2 (Multiple-Choice)
Under the ACA's employer shared responsibility provisions, an applicable large employer (ALE)
is defined as an employer with at least how many full-time equivalent employees?
A. 25
B. 50
,C. 75
D. 100
[CORRECT] B
Rationale: The ACA defines an applicable large employer as one that employed an average of at
least 50 full-time employees (including full-time equivalents) during the preceding calendar
year, per Internal Revenue Code § 4980H. This triggers the "pay or play" employer mandate
requirements, which remain fully enforceable despite the elimination of the individual mandate
penalty.
Question 3 (SATA)
Which of the following ACA provisions remained fully enforceable after the 2017 tax reform bill
eliminated the individual mandate penalty? (Select all that apply.)
A. The employer shared responsibility ("pay or play") rules
B. The Cadillac tax on high-cost employer-sponsored coverage
C. PCORI fees on insured and self-funded plans
D. Section 6055 and Section 6056 reporting requirements
E. The preventive care mandate without cost-sharing
[CORRECT] A, C, D, E
Rationale: The Tax Cuts and Jobs Act specifically targeted only the individual shared
responsibility penalty; all other ACA provisions remained intact
. The employer shared responsibility rules (A), PCORI fees (C), employer reporting under
Sections 6055/6056 (D), and the preventive care mandate (E) continue in full force. Note: The
Cadillac tax (B) was subsequently repealed by separate legislation (the CARES Act of 2019) and is
no longer in effect.
Question 4 (Multiple-Choice)
ERISA's preemption clause provides what specific advantage to a self-funded employer health
plan operating in multiple states?
A. Exemption from federal minimum essential coverage requirements
B. Exemption from state insurance mandates and state premium taxes
C. Automatic qualification for Medicare Advantage contracts
D. Immunity from HIPAA privacy and security regulations
, [CORRECT] B
Rationale: ERISA's broad preemption clause (29 U.S.C. § 1144) exempts self-funded employer
health plans from state insurance mandates, state premium taxes (typically 2–3%), and
conflicting state coverage requirements
. This creates a uniform federal standard for multi-state employers. However, self-funded plans
remain subject to federal requirements including HIPAA, ACA preventive care mandates, mental
health parity under MHPAEA, COBRA, and the No Surprises Act.
Question 5 (SATA)
A self-funded employer health plan governed by ERISA remains subject to which of the
following federal requirements? (Select all that apply.)
A. HIPAA privacy and portability rules
B. ACA preventive care mandates without cost-sharing
C. Mental health parity requirements under MHPAEA
D. State-mandated coverage for autism spectrum disorder
E. COBRA continuation coverage requirements
[CORRECT] A, B, C, E
Rationale: ERISA preemption exempts self-funded plans from state-level mandated benefits
such as autism coverage mandates (D)
. However, these plans must comply with all applicable federal law: HIPAA privacy/portability
(A), ACA preventive care (B), MHPAEA mental health parity (C), and COBRA continuation
coverage (E). Level-funded plans also qualify for ERISA preemption because the law treats them
as self-insured arrangements.
Question 6 (Multiple-Choice)
Under ERISA § 514(a), a state law that "relates to" an employee benefit plan is preempted.
Which judicial test determines whether a state law has sufficient connection to trigger ERISA
preemption?
A. The "active labor" test
B. The "reference to" or "connection with" test
C. The "substantial nexus" standard
D. The "minimum necessary" exception
