CERTIFIED ENROLLER COVERED CALIFORNIA
EXAM NEWEST ACTUAL 2025/2026 WITH
COMPLETE QUESTIONS AND ANSWERS
VERIFIED/GRADED A+
Save
Terms in this set (167)
The ACA requires employers with 50 or more FTE employees
FTE (Full-Time Equivalent)
employees to offer coverage with a
minimum of ____________?
Which state became the first state in California
the nation to enact legislation to
establish a health insurance
marketplace after the passage of the
ACA?
Can individuals still be penalized You will not be penalized by the federal
when they file their federal tax government, BUT can be through the state of
returns for failing to have MEC California.
(Minimum Essential Coverage)?
,What is the eligibility criteria for - Be a citizen or national of US or a non-citizen who
consumers in a QHP (Qualified is lawfully present in the US
Health Plan) through Covered CA - Be a resident (or intend to be a resident) of CA
include: and
- Not incarcerated (other than incarceration
pending the disposition or judgement of charges)
Do agents have to have a license Yes, additionally they must also become certified
with the California Department of with Covered California
Insurance before they begin selling
insurance?
Certified Insurance Agents (CIA) - Individual and Family Plans: commissions are paid
earn and are paid commissions for by Covered CA Qualified Health and Dental Plans
effectuated enrollments with: - Covered CA for Small business (CCSB):
commissions are paid by CCSB
Certified Application Counselor These enrollment partners ARE NOT compensated
(CAC) provide in-person consumer by Covered CA.
enrollment assistance and are largely
represented by CBOs (Community
Based Organizations).
Navigator Grant Program- CEC Provides outreach, education, enrollment
(Certified Enrollment Counselor) assistance, and post-enrollment services to
consumers on behalf of Covered CA
What is considered SEP (Special Qualifying life events such as birth or adoptions,
Enrollment Period)? marriage, moving to or within California, or loss of
MEC (Minimum Essential Coverage)
, To ensure that consumer assistance -Provide enrollment resources, websites, and tools
is accessible to people with that are accessible to individuals with disabilities
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 Until they reach age 26
their parent's health insurance plan?
What are not subject to copayments, - Preventative care, vaccinations, and medical
coinsurance, or deductibles? screenings
- Mammograms and colonoscopies
- Wellness visits
- Gestational diabetes screening
- Additional preventative care and screenings are
available to women
- Approved contraceptive methods
What is the difference between - Platinum-level plans cover 90 percent of health
metal tiers? care costs, and you pay 10 percent
- Gold plans cover 80 percent, while you pay 20
percent
- Silver plans cover 70 percent, while you pay 30
percent
- Bronze plans cover 60 percent, while you pay 40
percent.
What is a premium? The amount a consumer must pay their health or
dental plan, usually paid on a monthly basis.
EXAM NEWEST ACTUAL 2025/2026 WITH
COMPLETE QUESTIONS AND ANSWERS
VERIFIED/GRADED A+
Save
Terms in this set (167)
The ACA requires employers with 50 or more FTE employees
FTE (Full-Time Equivalent)
employees to offer coverage with a
minimum of ____________?
Which state became the first state in California
the nation to enact legislation to
establish a health insurance
marketplace after the passage of the
ACA?
Can individuals still be penalized You will not be penalized by the federal
when they file their federal tax government, BUT can be through the state of
returns for failing to have MEC California.
(Minimum Essential Coverage)?
,What is the eligibility criteria for - Be a citizen or national of US or a non-citizen who
consumers in a QHP (Qualified is lawfully present in the US
Health Plan) through Covered CA - Be a resident (or intend to be a resident) of CA
include: and
- Not incarcerated (other than incarceration
pending the disposition or judgement of charges)
Do agents have to have a license Yes, additionally they must also become certified
with the California Department of with Covered California
Insurance before they begin selling
insurance?
Certified Insurance Agents (CIA) - Individual and Family Plans: commissions are paid
earn and are paid commissions for by Covered CA Qualified Health and Dental Plans
effectuated enrollments with: - Covered CA for Small business (CCSB):
commissions are paid by CCSB
Certified Application Counselor These enrollment partners ARE NOT compensated
(CAC) provide in-person consumer by Covered CA.
enrollment assistance and are largely
represented by CBOs (Community
Based Organizations).
Navigator Grant Program- CEC Provides outreach, education, enrollment
(Certified Enrollment Counselor) assistance, and post-enrollment services to
consumers on behalf of Covered CA
What is considered SEP (Special Qualifying life events such as birth or adoptions,
Enrollment Period)? marriage, moving to or within California, or loss of
MEC (Minimum Essential Coverage)
, To ensure that consumer assistance -Provide enrollment resources, websites, and tools
is accessible to people with that are accessible to individuals with disabilities
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 Until they reach age 26
their parent's health insurance plan?
What are not subject to copayments, - Preventative care, vaccinations, and medical
coinsurance, or deductibles? screenings
- Mammograms and colonoscopies
- Wellness visits
- Gestational diabetes screening
- Additional preventative care and screenings are
available to women
- Approved contraceptive methods
What is the difference between - Platinum-level plans cover 90 percent of health
metal tiers? care costs, and you pay 10 percent
- Gold plans cover 80 percent, while you pay 20
percent
- Silver plans cover 70 percent, while you pay 30
percent
- Bronze plans cover 60 percent, while you pay 40
percent.
What is a premium? The amount a consumer must pay their health or
dental plan, usually paid on a monthly basis.
