CERTIFIED ENROLLER EXAM – COVEREDCALIFORNIA
2025 ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) {170 Q
& A} ALL ANSWERED
What choices will pop up if the answer is No, the user is asked "why
does the household member not have a SSN?" - ✔✔✔ Correct Answer >-
religious exemption
- individual taxpayer identification number (ITIN)
- adoption taxpayer identification number (ATIN)
- does not qualify for an SSN
- I do not have an SSN, but have applied for one
What must an agent complete prior to obtaining the consumer's PII? -
✔✔✔ Correct Answer >Make sure the consumer completes an Authorization for
Enrollment Assistance Form.
What is Medicare? -✔✔✔ Correct Answer >The federal health insurance
program for people who are 65 or older, certain younger eligible people
with disabilities, and people with End-Stage Renal Disease (ESRD)
,When providing phone assistance, what must you obtain from the
consumer in order to access their PII? -✔✔✔ Correct Answer >First you must
obtain oral consent from the consumer and must also complete a
written attestation confirming that you obtained the required consent.
Thirdly, your entity must maintain these forms and attestations for
future auditing purposes.
The ACA requires employers with FTE (Full-Time Equivalent) employees
to offer coverage with a minimum of ? - ✔✔✔ Correct Answer
>50 or more FTE employees
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)
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.
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
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)
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
- Approved contraceptive methods
2025 ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) {170 Q
& A} ALL ANSWERED
What choices will pop up if the answer is No, the user is asked "why
does the household member not have a SSN?" - ✔✔✔ Correct Answer >-
religious exemption
- individual taxpayer identification number (ITIN)
- adoption taxpayer identification number (ATIN)
- does not qualify for an SSN
- I do not have an SSN, but have applied for one
What must an agent complete prior to obtaining the consumer's PII? -
✔✔✔ Correct Answer >Make sure the consumer completes an Authorization for
Enrollment Assistance Form.
What is Medicare? -✔✔✔ Correct Answer >The federal health insurance
program for people who are 65 or older, certain younger eligible people
with disabilities, and people with End-Stage Renal Disease (ESRD)
,When providing phone assistance, what must you obtain from the
consumer in order to access their PII? -✔✔✔ Correct Answer >First you must
obtain oral consent from the consumer and must also complete a
written attestation confirming that you obtained the required consent.
Thirdly, your entity must maintain these forms and attestations for
future auditing purposes.
The ACA requires employers with FTE (Full-Time Equivalent) employees
to offer coverage with a minimum of ? - ✔✔✔ Correct Answer
>50 or more FTE employees
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)
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.
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
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)
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
- Approved contraceptive methods
