1
CERTIFIED ENROLLER EXAM -
COVERED CALIFORNIA QUESTIONS
WITH SOLUTIONS
The ACA requires employers with FTE (Full-Time Equivalent) employees to offer
coverage with a minimum of ____________? - correct-answer - 50 or more FTE
employees
Which state became the first state in the nation to enact legislation to establish a
health insurance marketplace after the passage of the ACA? - correct-answer -
California
Can individuals still be penalized when they file their federal tax returns for failing
to have MEC (Minimum Essential Coverage)? - correct-answer - You will not be
penalized by the federal government, BUT can be through the state of California.
, 2
What is the eligibility criteria for consumers in a QHP (Qualified Health Plan)
through Covered CA include: - correct-answer - - Be a citizen or national of US or a
non-citizen who is lawfully present in the US
- Be a resident (or intend to be a resident) of CA and
- Not incarcerated (other than incarceration pending the disposition or judgement
of charges)
Do agents have to have a license with the California Department of Insurance
before they begin selling insurance? - correct-answer - Yes, additionally they must
also become certified with Covered California
Certified Insurance Agents (CIA) earn and are paid commissions for effectuated
enrollments with: - correct-answer - - Individual and Family Plans: commissions
are paid by Covered CA Qualified Health and Dental Plans
- Covered CA for Small business (CCSB): commissions are paid by CCSB
, 3
Certified Application Counselor (CAC) provide in-person consumer enrollment
assistance and are largely represented by CBOs (Community Based
Organizations). - correct-answer - These enrollment partners ARE NOT
compensated by Covered CA.
Navigator Grant Program- CEC (Certified Enrollment Counselor) - correct-answer -
Provides outreach, education, enrollment assistance, and post-enrollment
services to consumers on behalf of Covered CA
What is considered SEP (Special Enrollment Period)? - correct-answer - Qualifying
life events such as birth or adoptions, marriage, moving to or within California, or
loss of MEC (Minimum Essential Coverage)
, 4
To ensure that consumer assistance is accessible to people with disabilities: -
correct-answer - -Provide enrollment resources, websites, and tools that are
accessible to individuals with disabilities
- Provide assistance in a location and manner that is physically and otherwise
accessible
- Maintain knowledge to refer people with disabilities to long-term services and
support programs when appropriate
What age can children remain on their parent's health insurance plan? - correct-
answer - Until they reach age 26
What are not subject to copayments, coinsurance, or deductibles? - correct-
answer - - Preventative care, vaccinations, and medical screenings
- Mammograms and colonoscopies
- Wellness visits
- Gestational diabetes screening
- Additional preventative care and screenings are available to women
CERTIFIED ENROLLER EXAM -
COVERED CALIFORNIA QUESTIONS
WITH SOLUTIONS
The ACA requires employers with FTE (Full-Time Equivalent) employees to offer
coverage with a minimum of ____________? - correct-answer - 50 or more FTE
employees
Which state became the first state in the nation to enact legislation to establish a
health insurance marketplace after the passage of the ACA? - correct-answer -
California
Can individuals still be penalized when they file their federal tax returns for failing
to have MEC (Minimum Essential Coverage)? - correct-answer - You will not be
penalized by the federal government, BUT can be through the state of California.
, 2
What is the eligibility criteria for consumers in a QHP (Qualified Health Plan)
through Covered CA include: - correct-answer - - Be a citizen or national of US or a
non-citizen who is lawfully present in the US
- Be a resident (or intend to be a resident) of CA and
- Not incarcerated (other than incarceration pending the disposition or judgement
of charges)
Do agents have to have a license with the California Department of Insurance
before they begin selling insurance? - correct-answer - Yes, additionally they must
also become certified with Covered California
Certified Insurance Agents (CIA) earn and are paid commissions for effectuated
enrollments with: - correct-answer - - Individual and Family Plans: commissions
are paid by Covered CA Qualified Health and Dental Plans
- Covered CA for Small business (CCSB): commissions are paid by CCSB
, 3
Certified Application Counselor (CAC) provide in-person consumer enrollment
assistance and are largely represented by CBOs (Community Based
Organizations). - correct-answer - These enrollment partners ARE NOT
compensated by Covered CA.
Navigator Grant Program- CEC (Certified Enrollment Counselor) - correct-answer -
Provides outreach, education, enrollment assistance, and post-enrollment
services to consumers on behalf of Covered CA
What is considered SEP (Special Enrollment Period)? - correct-answer - Qualifying
life events such as birth or adoptions, marriage, moving to or within California, or
loss of MEC (Minimum Essential Coverage)
, 4
To ensure that consumer assistance is accessible to people with disabilities: -
correct-answer - -Provide enrollment resources, websites, and tools that are
accessible to individuals with disabilities
- Provide assistance in a location and manner that is physically and otherwise
accessible
- Maintain knowledge to refer people with disabilities to long-term services and
support programs when appropriate
What age can children remain on their parent's health insurance plan? - correct-
answer - Until they reach age 26
What are not subject to copayments, coinsurance, or deductibles? - correct-
answer - - Preventative care, vaccinations, and medical screenings
- Mammograms and colonoscopies
- Wellness visits
- Gestational diabetes screening
- Additional preventative care and screenings are available to women
