NABIP CERTIFICATION FINAL EXAM
2026/2027 | Verified Questions | Answers |
Detailed Rationales
1. Under the Affordable Care Act (ACA), what is the maximum permissible waiting
period for an employer-sponsored group health plan to enroll a new, eligible
employee?
A) 30 days
B) 60 days
C) 90 days
D) 120 days
Answer: C) 90 days
Detailed Rationale: The ACA prohibits group health plans and health insurance
issuers from applying a waiting period that exceeds 90 days after an employee is
otherwise eligible for coverage. Being "otherwise eligible" means the employee
has met the plan's substantive eligibility conditions (e.g., being in an eligible job
classification, achieving a certain number of hours, etc.).
2. Which of the following is a required element of a Section 125 Cafeteria Plan?
A) All employees must receive the same employer contribution regardless of
coverage tier.
B) The plan must offer at least one taxable benefit and one qualified benefit.
C) Employees must make their benefit elections before the plan year begins and
cannot change them.
D) The plan must be funded entirely by employee salary reductions.
Answer: B) The plan must offer at least one taxable benefit and one qualified
benefit.
,Detailed Rationale: A Section 125 Cafeteria Plan must allow employees to choose
between at least one taxable benefit (such as cash) and one qualified benefit
(such as health insurance). This allows employees to pay for qualified benefits
with pre-tax dollars, thereby reducing their taxable income.
3. Under HIPAA, a "Special Enrollment" right allows an employee to add a
dependent to a group health plan outside of the open enrollment period. Which
of the following events triggers a special enrollment right?
A) The employee receives a substantial raise in salary.
B) The employee adopts a child or has a baby.
C) The employee divorces and loses their spouse's coverage.
D) Both B and C.
Answer: D) Both B and C.
Detailed Rationale: HIPAA special enrollment rights are triggered by specific life
events, including the acquisition of a new dependent through marriage, birth, or
adoption. It is also triggered by the loss of other coverage (such as a spouse
divorcing and losing their employer-sponsored coverage).
4. What is the primary purpose of the Employee Retirement Income Security Act
(ERISA) of 1974?
A) To provide health insurance to retirees
B) To protect the assets of employees who participate in employer-sponsored
benefit plans
C) To mandate employer contributions to pension plans
D) To regulate the licensing of health insurance agents
Answer: B) To protect the assets of employees who participate in employer-
sponsored benefit plans
,Detailed Rationale: ERISA was enacted to establish minimum standards for
pension and health plans in private industry to protect individuals enrolled in
these plans. It sets standards for plan administration, fiduciary responsibilities,
and provides appeal rights for participants.
5. Under the ACA's Employer Shared Responsibility provisions (Employer
Mandate), an Applicable Large Employer (ALE) is generally defined as an employer
with:
A) 25 or more full-time equivalent employees
B) 50 or more full-time equivalent employees
C) 100 or more full-time equivalent employees
D) 500 or more full-time equivalent employees
Answer: B) 50 or more full-time equivalent employees
Detailed Rationale: An Applicable Large Employer (ALE) is defined under the ACA
as an employer that employed an average of at least 50 full-time (or full-time
equivalent) employees on business days during the preceding calendar year. ALEs
are subject to the Employer Shared Responsibility provisions (Pay or Play rules).
6. Under COBRA, what is the maximum continuation coverage period for a
qualifying event such as termination of employment (for reasons other than gross
misconduct)?
A) 12 months
B) 18 months
C) 24 months
D) 36 months
Answer: B) 18 months
Detailed Rationale: For a qualifying event that is a termination of employment
(not for gross misconduct) or a reduction in hours, the maximum COBRA
, continuation period is 18 months. Other qualifying events, such as death of the
employee or divorce, extend the period to 36 months.
7. Which of the following is NOT considered a qualifying event under COBRA for a
covered employee?
A) Termination of employment for gross misconduct
B) Death of the covered employee
C) Divorce or legal separation of the covered employee from their spouse
D) The covered employee becoming entitled to Medicare benefits
Answer: A) Termination of employment for gross misconduct
Detailed Rationale: Termination of employment for reasons other than gross
misconduct is a qualifying event. However, if the employee is terminated for gross
misconduct, COBRA continuation coverage is not offered. Death, divorce, and
Medicare entitlement are all qualifying events for the employee's covered
dependents.
8. Which statement best describes a Health Savings Account (HSA) "catch-up"
contribution?
A) It allows an accountholder to contribute extra funds if they have a high medical
bill that year.
B) It allows accountholders who are 55 or older to contribute an additional
amount over the standard annual limit.
C) It allows employers to match employee HSA contributions up to a specific IRS
limit.
D) It allows an employee to roll over unused FSA funds into their HSA.
Answer: B) It allows accountholders who are 55 or older to contribute an
additional amount over the standard annual limit.
2026/2027 | Verified Questions | Answers |
Detailed Rationales
1. Under the Affordable Care Act (ACA), what is the maximum permissible waiting
period for an employer-sponsored group health plan to enroll a new, eligible
employee?
A) 30 days
B) 60 days
C) 90 days
D) 120 days
Answer: C) 90 days
Detailed Rationale: The ACA prohibits group health plans and health insurance
issuers from applying a waiting period that exceeds 90 days after an employee is
otherwise eligible for coverage. Being "otherwise eligible" means the employee
has met the plan's substantive eligibility conditions (e.g., being in an eligible job
classification, achieving a certain number of hours, etc.).
2. Which of the following is a required element of a Section 125 Cafeteria Plan?
A) All employees must receive the same employer contribution regardless of
coverage tier.
B) The plan must offer at least one taxable benefit and one qualified benefit.
C) Employees must make their benefit elections before the plan year begins and
cannot change them.
D) The plan must be funded entirely by employee salary reductions.
Answer: B) The plan must offer at least one taxable benefit and one qualified
benefit.
,Detailed Rationale: A Section 125 Cafeteria Plan must allow employees to choose
between at least one taxable benefit (such as cash) and one qualified benefit
(such as health insurance). This allows employees to pay for qualified benefits
with pre-tax dollars, thereby reducing their taxable income.
3. Under HIPAA, a "Special Enrollment" right allows an employee to add a
dependent to a group health plan outside of the open enrollment period. Which
of the following events triggers a special enrollment right?
A) The employee receives a substantial raise in salary.
B) The employee adopts a child or has a baby.
C) The employee divorces and loses their spouse's coverage.
D) Both B and C.
Answer: D) Both B and C.
Detailed Rationale: HIPAA special enrollment rights are triggered by specific life
events, including the acquisition of a new dependent through marriage, birth, or
adoption. It is also triggered by the loss of other coverage (such as a spouse
divorcing and losing their employer-sponsored coverage).
4. What is the primary purpose of the Employee Retirement Income Security Act
(ERISA) of 1974?
A) To provide health insurance to retirees
B) To protect the assets of employees who participate in employer-sponsored
benefit plans
C) To mandate employer contributions to pension plans
D) To regulate the licensing of health insurance agents
Answer: B) To protect the assets of employees who participate in employer-
sponsored benefit plans
,Detailed Rationale: ERISA was enacted to establish minimum standards for
pension and health plans in private industry to protect individuals enrolled in
these plans. It sets standards for plan administration, fiduciary responsibilities,
and provides appeal rights for participants.
5. Under the ACA's Employer Shared Responsibility provisions (Employer
Mandate), an Applicable Large Employer (ALE) is generally defined as an employer
with:
A) 25 or more full-time equivalent employees
B) 50 or more full-time equivalent employees
C) 100 or more full-time equivalent employees
D) 500 or more full-time equivalent employees
Answer: B) 50 or more full-time equivalent employees
Detailed Rationale: An Applicable Large Employer (ALE) is defined under the ACA
as an employer that employed an average of at least 50 full-time (or full-time
equivalent) employees on business days during the preceding calendar year. ALEs
are subject to the Employer Shared Responsibility provisions (Pay or Play rules).
6. Under COBRA, what is the maximum continuation coverage period for a
qualifying event such as termination of employment (for reasons other than gross
misconduct)?
A) 12 months
B) 18 months
C) 24 months
D) 36 months
Answer: B) 18 months
Detailed Rationale: For a qualifying event that is a termination of employment
(not for gross misconduct) or a reduction in hours, the maximum COBRA
, continuation period is 18 months. Other qualifying events, such as death of the
employee or divorce, extend the period to 36 months.
7. Which of the following is NOT considered a qualifying event under COBRA for a
covered employee?
A) Termination of employment for gross misconduct
B) Death of the covered employee
C) Divorce or legal separation of the covered employee from their spouse
D) The covered employee becoming entitled to Medicare benefits
Answer: A) Termination of employment for gross misconduct
Detailed Rationale: Termination of employment for reasons other than gross
misconduct is a qualifying event. However, if the employee is terminated for gross
misconduct, COBRA continuation coverage is not offered. Death, divorce, and
Medicare entitlement are all qualifying events for the employee's covered
dependents.
8. Which statement best describes a Health Savings Account (HSA) "catch-up"
contribution?
A) It allows an accountholder to contribute extra funds if they have a high medical
bill that year.
B) It allows accountholders who are 55 or older to contribute an additional
amount over the standard annual limit.
C) It allows employers to match employee HSA contributions up to a specific IRS
limit.
D) It allows an employee to roll over unused FSA funds into their HSA.
Answer: B) It allows accountholders who are 55 or older to contribute an
additional amount over the standard annual limit.
